Generality
Acute bronchitis is the inflammation of abrupt and sudden appearance bronchi, which associates an intense symptomatology with a duration not exceeding 10 days.
Acute bronchitis recognizes several causes, including: viral or bacterial infections affecting the respiratory tract, prolonged inhalation of irritating substances for the respiratory system, the presence of some chronic lung disease (eg, asthma) and special conditions like gastroesophageal reflux disease.
Acute bronchitis is typically responsible for symptoms and signs, such as: cough with phlegm, chest pain, runny nose, sore throat, sneezing, wheezing, fever and widespread muscle pain.
For the diagnosis of acute bronchitis, only the physical examination and the anamnesis are sufficient; the use of more specific diagnostic tests takes place in doubtful situations.
As a rule, the treatment of acute bronchitis is based on a therapy aimed at countering the triggering causes, combined with symptomatic therapy (that is, against symptoms).
Short review of the Bronchial Tree
Following the trachea and preceding the pulmonary alveoli, the bronchial tree is the complex section of the lower airways (or lower respiratory tract ), which includes, in order, the primary bronchi, secondary bronchi, tertiary bronchi, bronchioles, the terminal bronchioles and respiratory bronchioles .
According to the most common anatomical vision relating to the bronchial tree, the latter can be divided into two sections: the extrapulmonary tract (ie, external to the lungs), to which only the primary bronchi belong, and the intrapulmonary tract (ie, inside the lungs) which include the secondary bronchi, the tertiary bronchi, the bronchioles, the terminal bronchioles and the respiratory bronchioles.
What is acute bronchitis?
Acute bronchitis is the inflammation of the bronchi with an abrupt and sudden onset, intense in terms of symptoms and lasting no more than 10 days .
Acute Bronchitis and Chronic Bronchitis: the differences
Acute bronchitis contrasts with chronic bronchitis . With the expression "chronic bronchitis", the doctors mean the inflammation of the bronchi with a gradual appearance, mild in terms of symptoms, lasting several weeks and the protagonist of recurrent relapses.
In pathology, chronic bronchitis is a condition of considerable interest, due to its association with morbid conditions such as chronic obstructive pulmonary disease, pulmonary emphysema and asthma .
Causes
The causes of acute bronchitis include viruses, bacteria, bronchial tree irritants, chronic lung diseases and other conditions .
Acute bronchitis of viral origin
Viruses are the main cause of acute bronchitis in adult humans; according to statistics, in fact, it would have a viral origin between 85 and 95% of acute bronchitis cases in adult subjects.
The viruses responsible for acute bronchitis are the same as those that cause colds and flu, so:
- Rhinovirus;
- Influenza virus;
- Parainfluenza virus;
- Respiratory syncytial virus;
- Adenovirus;
- Coronavirus;
- Metapneumovirus.
Did you know that ...
The transmission to a healthy individual of the typical viruses that cause acute bronchitis generally occurs through contact with contaminated objects or inhalation of droplets of infected saliva, emitted by a patient, during sneezing, coughing or when speaking .
Acute bronchitis of bacterial origin
Acute bronchitis episodes resulting from a bacterial infection are relatively uncommon; therefore, the recorded cases of acute bronchitis with bacterial origin are numerically contained.
Bacteria capable of causing acute bronchitis include: Mycoplasma pneumoniae, Chlamydia pneumoniae and Bordetella pertussis .
Irritants that cause Acute Bronchitis
The irritating substances capable of causing acute bronchitis are: cigarette smoke and the like (in other words, tobacco smoke), so-called environmental pollution, some chemical fumes and some toxic dusts .
In addition to the bronchial tree, these irritating substances could also ignite the trachea, resulting in a condition known as tracheitis.
Chronic Lung Diseases Associated with Acute Bronchitis
Among the chronic lung diseases associated with episodes of acute bronchitis, a condition known as asthma and chronic bronchitis stand out; in this second case, the resulting acute bronchitis is a sort of sudden worsening of the already present chronic inflammation in the bronchi.
Other Causes of Acute Bronchitis
Among the so-called other causes of acute bronchitis, gastroesophageal reflux disease deserves special mention.
Gastroesophageal reflux disease is the medical condition characterized by the continuous repetition of the abnormal rising phenomenon towards the esophagus of gastric contents, whose acidic nature makes it irritating to any other organ other than the stomach.
Gastroesophageal reflux disease can be the cause of acute bronchitis in the most severe cases, ie when the gastric contents rise beyond the esophagus, reaching the larynx and penetrating the airways.
Who is more at Risk of Acute Bronchitis
The subjects most prone to develop acute bronchitis are:
- Those who have contracted a viral or bacterial infection, which affects the respiratory tract;
- Smokers. As previously stated, tobacco smoking (smoking) is one of the causes of acute bronchitis;
- Those who live in particularly polluted cities or who, for work reasons, are exposed daily to environmental pollution typical of urban centers;
- Practitioners work that exposes daily to irritating substances to the bronchial tree;
- Carriers of asthma or chronic bronchitis.
Is acute bronchitis contagious?
Acute bronchitis is a contagious condition when it is viral or bacterial; therefore, if it is due to causes other than viruses and bacteria, it is not a communicable disease.
Symptoms and Complications
The typical symptoms and signs of acute bronchitis are:
- Cough with phlegm production of color, first white and then yellow or green.
Cough is the most characteristic manifestation of acute bronchitis; in fact, it is the first to appear and the last to resolve.
- Sneezing;
- Sore throat;
- Runny nose (rhinorrhea);
- Dyspnoea;
- Sense of malaise in the chest, in less serious cases, or real pain in the chest, in the most severe cases;
- Fever, chills and muscle aches, especially in the back. It should be pointed out that these symptoms are present only when acute bronchitis has an infectious origin (ie it is due to a virus or a bacterium); this also explains why the article brings them all together.
Cough in Acute Bronchitis: how long can it last?
Acute bronchitis is typically responsible for a cough that persists even after the exhaustion of the inflammatory state for one / two weeks (NB: remember that acute bronchitis is such when it lasts up to 10 days).
The persistence of the cough despite the resolution of the inflammation is the result of the characteristic slowness with which it heals the bronchial tree, following damage or "offenses" against it.
When should I go to the doctor?
Among the reasons that should induce an individual with acute bronchitis (or someone who takes care of such an individual) to contact their doctor immediately or go to the nearest hospital center as soon as possible are:
- The addition to the classical symptomatology of a sudden drop in body weight;
- A worsening of the cough, which becomes barking ( barking cough );
- The appearance of severe respiratory problems;
- The consolidation of chest pain, which becomes severe;
- A feverish state that exceeds 38 ° C;
- The prolonged stay of the cough (the persistence of the cough even after the exhaustion of the inflammation is to be considered normal, as long as it is not in terms of months).
Diagnosis
In general, doctors reach the diagnosis of acute bronchitis after a thorough physical examination and a scrupulous medical history .
The physical examination is the set of maneuvers and tests, which the diagnostic doctor performs in order to ascertain the symptoms and signs of a pathology which he suspects is present.
During the physical examination to a person with a presumed acute bronchitis, the evaluation of the breath (which, in the case of a positive test, will present wheezing or wheezing) and cough (which, in the case of a positive examination, will be catarrhose).
The anamnesis is the particular study of the symptomatology with a view to identifying its triggering / favoring factors; the anamnesis, in fact, consists of an examination of the symptoms, combined with an investigation regarding elements such as the age of the patient, his clinical history, his work activity, his habits, his family history etc.
In a context of presumed acute bronchitis, the anamnesis allows to establish the causal factors of the current condition (eg cigarette smoke, in a smoking patient; viral infection, in a patient with a recent cold; exposure to irritants, in a patient with a job at risk, etc.).
What happens if there is a doubtful diagnosis?
In case of doubtful diagnosis, the physician may follow the physical examination and medical history:
- A chest radiograph (or RX-thorax ). This radiological test is particularly useful, when there is a suspicion that the ongoing symptoms are due to pneumonia;
- A sputum culture test . This laboratory test allows the identification of possible bacterial infections in progress, for which a specific treatment is needed;
- A blood test . This analysis serves to clarify the precise connotations of the present inflammation.
Why is it important to investigate the causes?
The diagnosis of the causes of acute bronchitis is important, because it is based on the triggers that any therapeutic choice is based.
Therapy
It is customary for the treatment of acute bronchitis to include a therapy aimed at treating the causes / factors favoring the condition ( causal therapy ) and a therapy aimed at alleviating the symptomatology and preventing its worsening ( symptomatic therapy ).
Causal therapy
The causal therapy varies according to what the doctor has identified as the trigger for acute bronchitis; this means, for example, that an acute bronchitis of viral origin will require a causal therapy different from an acute bronchitis of bacterial origin.
In the following, the article reports an easy-to-consult scheme, which describes how to treat different types of acute bronchitis in causes.
- Acute bronchitis of viral origin: the causal therapy for this condition is based on the respect of a rest period generally a week and on the constant intake of liquids (in order to avoid dehydration resulting from the presence of fever).
No special pharmacological therapies are therefore necessary.
- Acute bronchitis with bacterial origin: in these situations, the therapy of causes involves a pharmacological treatment based on antibiotics, combined with rest and constant intake of liquids.
The use of antibiotics is essential to eliminate the bacteria that have established the inflammatory status of the bronchi from the body.
- Acute bronchitis due to inhalation of irritating substances: the causal therapy for this situation consists in avoiding exposure to the triggering factor; in practical terms, this means, for example, smoking cessation, if tobacco smoking is the cause.
- Acute bronchitis associated with chronic lung disease or other conditions: for such a circumstance, the treatment of the causes consists in the control of the underlying chronic lung disease (eg, the treatment of asthma, if the cause is the latter) or any another condition responsible for inflammation of the bronchi (eg, the treatment of gastroesophageal reflux disease, if the trigger is the ascent to the esophagus and airways of the acid gastric contents).
Symptomatic therapy
Symptomatic therapy is essential to reduce the patient's suffering, in the period in which the patient is undergoing causal therapy.
To appease the symptoms of acute bronchitis, it may be useful:
- Intake of a non-steroidal anti-inflammatory drug (or NSAID ). NSAIDs calm the fever, if present, and any pain the patient may suffer (eg: chest pain, muscle pain, throat pain, etc.).
An example of a non-steroidal anti-inflammatory very used in the case of acute bronchitis is ibuprofen.
- Taking cough medications . These medicines are contraindicated in the case of patients under 6 years of age.
- Humidify the air of the domestic environment, where most of the time is spent. This ploy improves the picture of respiratory symptoms.
Prognosis
Acute bronchitis is usually due to a viral infection and episodes of acute viral bronchitis are usually easy to resolve.
Consequently, the prognosis for acute bronchitis is, in most situations, benevolent.
Prevention
Avoid close contact with people suffering from colds, flu and other respiratory tract infections, do not smoke, minimize exposure to air pollution and toxic dusts / fumes, and finally, better manage any chronic lung disease. the main medical indications, when the topic of discussion is the prevention of acute bronchitis.
