What Are the Different Types of Bronchitis?
Bronchitis can be either acute or chronic, and both types have different causes, treatments, and outcomes. Acute Bronchitis The defining symptom of acute bronchitis is a cough that typically develops after a cold or the flu and lasts for about 10 to 14 days (though it may linger for as long as three or more weeks). (3,4) Chronic Bronchitis The other type, chronic bronchitis, is a far more serious, incurable lung disease involving periods of persistent coughing and inflammation. The condition causes structural changes to the bronchial tubes; symptoms may flare up and get better and worse over time, but they’ll never completely go away. (5) (The rest of this article and the related articles focus on acute bronchitis, often just referred to as bronchitis.) Bronchitis results from the infection moving from your nose and throat into the lungs, resulting in the swelling and inflammation in your bronchial tubes that causes coughing, which can be dry, but often produces mucus (sputum) that’s yellowish-gray or green in color. Other common symptoms of bronchitis include (6,7,8):
FatigueCoughingRunny or stuffy noseLow-grade feverChillsBody achesHeadachesProduction of sputumChest tightness or discomfort
See your doctor if you experience any of these symptoms: (8,9,10)
WheezingShortness of breathPersistent fever that lasts more than three days or any fever over 100 degrees F (which could be a sign of pneumonia)Cough that prevents you from sleepingSymptoms that last longer than three weeksBlood in your mucusMucus that has a bad smell
If you have a chronic illness, such as heart or lung disease, and suspect you may have bronchitis, it’s also a good idea to see your doctor, as you may be at higher risk for complications from bronchitis. (See more about complications linked to bronchitis below.) (9) Learn More About Bronchitis Symptoms If the viral infections that cause colds and the flu can sometimes cause bronchitis, you may be asking: “Can I stop the flu or a cold from turning into bronchitis?” Not necessarily, according to Carlos Picone, MD, a pulmonologist in private practice at Chevy Chase Pulmonary Associates in Chevy Chase, Maryland, and former chair of pulmonary medicine at Johns Hopkins Medicine’s Sibley Memorial Hospital in Washington, DC. It’s common for a cold or the flu to be caused by an infection in the upper nasal respiratory epithelium, and there’s nothing you can do to prevent that infection from spreading into the lower airways (resulting in bronchitis) because those airways are so close to one each other, Dr. Picone explains. “The two areas are very connected,” he says. Learn More About What Causes Bronchitis and That Annoying Cough That Comes With It
Is Bronchitis Contagious?
Since acute bronchitis is usually caused by a viral or bacterial respiratory infection, it is typically contagious, though it’s the infection rather than the bronchitis itself that actually spreads. So if you have a bout of acute bronchitis you can give someone the infection that caused it, but it doesn’t necessarily mean that person’s infection will turn into acute bronchitis, too. (Chronic bronchitis, on the other hand, is not contagious.) (3,4,13) The virus that causes bronchitis may be transmitted from person to person in the typical way — through droplets that are released when someone who has acute bronchitis coughs, sneezes, or talks. Viruses can also spread through touch when someone who is not sick comes into contact with a surface or object such as a doorknob or light switch that has the virus on it (say, because it’s been coughed on, sneezed on, or handled by the person who has the infection), and they then touch their own eyes, mouth, or nose, allowing the virus to enter their body. (3,4,13) How long you are contagious after developing bronchitis depends on the type of infection that causes it, how active your symptoms are, and your overall health status prior to getting sick. Generally, you’re contagious for the first few days after cold or flu symptoms develop, possibly continuing up to a week for the flu. (14) If the infection is bacterial (which is uncommon) and your doctor prescribes an antibiotic, you should no longer be contagious after 24 hours of starting the medication. (15) Learn More About How to Not Spread (or Catch) Bronchitis Your doctor may also order the following tests if she or he suspects you may have another condition, such as pneumonia or asthma: (1,3,16)
A chest X-ray to examine your bronchial tubes and lungs for abnormalities and rule out pneumonia (18)Blood test to look for signs of infectionSputum analysis to help identify what type of infection you havePulmonary function test — for which you blow into a device to measure how much air your lungs can hold and how fast you can move air in and out of your lungs — to check for asthma or emphysema
Chronic bronchitis — the type that is not caused by infection and is not contagious — is a lifelong condition. Because the illness usually resolves on its own, Picone advocates taking a minimalist approach when you first notice symptoms. Keep hydrated (particularly when you have a fever) and avoid medication unless you have an underlying complication, such as asthma. That said, you should monitor your symptoms for changes in cough frequency or mucous consistency or color. “Change from clear to yellow or green is often suggestive of infection,” says Albert Rizzo, MD, chief medical officer at the American Lung Association. If your cough has worsened or your sputum has thickened and turned yellow or green, you should call your doctor. Here’s what you should know about when over-the-counter medications, antibiotics, home remedies, and alternative and complementary therapies might be helpful:
Over-the-Counter Medications for Bronchitis
Acute bronchitis typically doesn’t need to be treated with medication but your doctor may recommend pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil) for fever or pain relief. Picone notes that over-the-counter medications such as cough expectorants and decongestants have not been proven to be effective for acute bronchitis. (4) He particularly recommends avoiding medications with codeine. While codeine may help suppress a cough, it is also a powerful narcotic, and it won’t necessarily treat the cause of the symptoms or quicken your recovery. (22) As for cough suppressants, there’s also not enough scientific evidence showing that they are effective. More importantly, coughing up mucus is the body’s way of carrying out the virus-causing infections and other undesirable materials from your body. If your doctor recommends you try this medication, it should only be used for a short period of time for dry coughs that interfere with you getting a good night’s sleep. (21) “The science behind using expectorants and cough suppressants is weak, but I see many patients who feel that they benefit from using them,” says Dr. Rizzo. “I often tell them: ‘Give it a try — if you think it’s making a difference, no harm in using it until your symptoms are better. If you don’t notice any benefits, then stop.’” The point, says Rizzo, is that each individual is different and they respond to these medications differently, and what works for someone may not work for someone else.
Antibiotics for Bronchitis: When They Work and When They Don’t
When bronchitis is caused by a virus, which is the case for most bouts of acute bronchitis, antibiotics won’t clear up the infection since these medications only help fight bacterial infections. If your doctor determines through your personal history, physical exam, laboratory tests, and other diagnostic tools that you have a bacterial infection, such as pneumonia, they may prescribe antibiotics. But generally antibiotics are not prescribed for acute bronchitis unless a patient has a chronic lung condition, because they have been shown to have very little benefit for acute bronchitis and to likely lead to negative effects such as nausea, vomiting, and allergic reactions. (19) It’s also worth noting that a 2015 study showed that many doctors continue to prescribe antibiotics for acute bronchitis despite public health campaigns to stop the practice. (The overprescription of antibiotics can contribute to making certain forms of pneumonia, tuberculosis, and other diseases harder to treat globally.) (23) According to Picone: “Doctors face a lot of pressure from patients to prescribe antibiotics, but usually [for bronchitis] the drugs are unnecessary because they won’t combat viruses.”
Home Remedies and Alternative and Complementary Therapies for Bronchitis
Yes, there are things you can do at home to help make bronchitis symptoms more manageable as you recover. They include:
Take hot, steamy showers. Inhaling steam can help loosen the mucus secretions in the lungs. (1,24) You can do this in the shower or by bending over a bowl of piping hot water, covering your head with a towel, and breathing in the steam.Consider adding essential oils to steam therapy. If using a bowl to steam, you can also add a few drops of eucalyptus oil (which also acts as an antibacterial) to the water, which may help open the airways further. (25,26) Other options that may be helpful in alleviating symptoms of respiratory illnesses (such as bronchitis, colds, and flu) are tea tree oil, thyme oil, and peppermint oil (containing menthol, which is a decongestant), though it should not be used in younger children due to a risk of bronchial spasms. (26) Some important safety tips to keep in mind when using essential oils: Most essential oils must be diluted before use (such as direct application to skin), and you should only use 1 or 2 drops of oil to steam since using more than that can be overpowering. (27)Use a humidifier. You may also want to try a humidifier in your bedroom to help keep the air moist, which may help loosen sputum and ease coughing and breathing, says Rizzo. “It may not work for everyone, but you can give it a try,” says Rizzo. If you use a humidifier, be sure to clean it regularly and thoroughly so that it doesn’t accumulate mold or bacteria.Stay hydrated. Keep hydrated by drinking plenty of water, at least eight glasses a day, which may help loosen congestion. Rizzo notes that while there isn’t good science-based evidence that shows hydration can change the viscosity of your mucus, drinking enough water is good for your overall health. “In some people, it may make a difference,” says Rizzo. (3)Use a nasal spray or neti pot. Rinse out your nose and sinuses twice a day with a saline nasal spray (or use a neti pot and 6 ounces of warm distilled water mixed with ½ teaspoon of salt) to help loosen thick mucus and open clogged nasal passages to ease breathing. (28)Avoid antihistamines. They can dry out your secretions and make your cough worse. (29)Limit (or avoid) caffeine and alcohol. They can act as diuretics and lead to dehydration, which is the last thing your body needs as it tries to clear out mucus. (30)Skip dairy. Consider switching to nondairy milk and reduce dairy intake. While research indicates that dairy products may not stimulate production of mucus, they may make it thicker and more irritating. (31) “The science behind this is also unclear, but some people have reported that avoiding milk products can make a difference,” says Rizzo.Keep moving. Picone is a strong proponent of exercise unless you have a fever (in which case you should rest). “Exercise helps limit the progression of the illness and boosts your immunity. It also enhances respiratory clearance. When you get the system in motion, this helps to eliminate secretions,” he says. Do, however, opt for a mild- or moderate-intensity workout until symptoms clear up.
Additionally, some supplements and herbs have been shown to be helpful in easing the symptoms of bronchitis and building immunity. But it’s worth noting that the evidence for these remedies is not yet robust enough to be conclusive. And it’s always important to first check with your doctor before trying herbs and natural remedies, as some can interfere with other medications you may be taking. Here are a few that may help:
Echinacea Studies have shown that this flower may help stimulate the immune system to better fight off infections such as the common cold, though there is no evidence it will make an infection clear up quicker, notes the National Center for Complementary and Integrative Health (NCCIH). (32)Astragalus This herb, which has been used for centuries in Chinese medicine, has been touted as being beneficial for many conditions, including respiratory infections and used to help support a healthy immune system. According to the NCCIH however, there are not yet enough quality studies to definitely back up these assertions. (33)Mullein This plant, which grows as a weed in the United States, is a traditional remedy for respiratory and throat ailments. Drinking tea made from mullein’s yellow flowers may help loosen phlegm and aid in expelling it from the nasal passages, throat, and lungs. (34)Vitamin C Some studies have shown that taking vitamin C may help protect against respiratory infections or shorten the length of time that symptoms persist, though others have shown no benefit. (28)Zinc Some studies have shown that taking a zinc supplement every two to three hours in the early days of a cold may shorten the duration of the illness. (28)Garlic, Ginseng, and Andrographis There is some evidence that all of these plants may help reduce the likelihood of colds and the flu. (28)
Learn More About How to Treat Acute Bronchitis
What to Do When Your Child Gets Bronchitis
Children get bronchitis for the same reason adults do: infection. And most of the time the infection is viral, as it is in adults, though bacterial infections can cause acute bronchitis in children, too. (35) Though anyone can get acute bronchitis, it’s worth noting that children who have chronic sinusitis, allergies, asthma, enlarged tonsils, or frequent exposure to secondhand smoke are at an increased risk. Symptoms of acute bronchitis in children are nearly identical to those in adults: (36)
Runny noseCoughComplaints of discomfort or not feeling wellChillsSlight feverBody achesChest congestion and discomfortWheezingSore throat
Most cases of acute bronchitis in children go away on their own and do not require medications. But if you see the following, call your child’s doctor right away: (10,35)
Your child’s symptoms seem to get worseYour child develops new symptomsYour child experiences trouble breathingYour child has a fever above 100 degrees F
Babies and toddlers can become infected with the same germs that cause colds and the flu in adults and older children, though they usually develop bronchiolitis (an infection of the smaller breathing tubes in the lungs) rather than bronchitis. Babies are often more vulnerable to germs because they are more likely to touch toys and other objects they can get their hands on, and then touch their mouth, nose, or eyes. (37) Learn More About What to Do When Your Child Has Bronchitis
Prevention of Bronchitis
The best way to avoid getting bronchitis is to reduce your risk of catching a cold or a flu in the first place. Here are some good habits you can follow to stay healthy and prevent getting an infection: (2,3,8)
Wash your hands regularly.Avoid being in close contact with too many people.Cover your cough (so you don’t infect others).Wear a face mask or cloth covering your nose and mouth.Get a flu shot every year.Don’t smoke (and avoid exposure to secondhand smoke).Steer clear of things that can irritate your nose, throat, and lungs, such as dust, mold, pet dander, and fumes from chemicals (such as cleaning products, paint, or varnish); if you must use these products, wear a mask that covers your nose and mouth.Eat a healthy diet and get plenty of sleep to help keep your immune system stay strong.
Children and the elderly are often more vulnerable to bronchitis-related complications. Others who may be at increased risk of complications include people with lung cancer, chronic obstructive pulmonary disorder (COPD), diabetes, asthma, or cardiovascular disease, as well as those who didn’t receive immunization for the flu, pneumonia, or whooping cough (pertussis). (39) Here are some complications to be aware of: Pneumonia If your bronchitis symptoms (such as coughing and fatigue) aren’t getting better after a few weeks and you’re experiencing shortness of breath, fever, or chest or shoulder pain, your doctor may evaluate you for pneumonia. Pneumonia occurs when the infection spreads beyond the bronchi and into the lung tissue. This results in the tiny air sacs in the lungs filling up with fluid or pus. (40) Bronchitis can progress to pneumonia in anyone, but those with underlying conditions and weakened immune systems are particularly at risk of more serious complications. “In people who have heart disease, if the illness stays confined as bronchitis, they tend not to have too many symptoms like worsening oxygen levels or shortness of breath,” says Rizzo. “But if the infection either causes some airway spasms or develops into a pneumonia, then the work of breathing increases and the oxygen levels could be affected as well, which can potentially make the heart condition worse.” Learn More About Bronchitis, Pneumonia, and the Differences Between the Two Asthma Flares If you have asthma or another chronic lung condition, acute bronchitis may set off a flare. “People who have asthma or a chronic lung disease like COPD already have some degree of bronchial inflammation,” explains Rizzo. Bronchitis results in more inflammation, which can lead to an asthma attack or flare-up. Depending on the severity of the asthma attack, your doctor may recommend medication to quell the airway inflammation and provide relief, says Picone. “You may need medication, often both a bronchodilator for relief of acute symptoms and an inhaled steroid to control the inflammation that’s flared up as a result of the acute bronchitis,” says Rizzo. Learn More About Complications That Can Arise When People With Asthma Get Bronchitis
Influenza A and B (flu)Rhinovirus (common cold)Enterovirus (similar to the common cold)Respiratory syncytial virus (RSV, RSV infection)SARS-CoV-2 (the novel coronavirus that causes COVID-19) and other coronaviruses (41)
While viruses account for the majority of acute bronchitis infections, some bacterial infections can also be a cause. Some bacterial illnesses related to bronchitis are: (4,19)
Bordetella pertussis (whooping cough)Chlamydophila pneumoniae (pneumonia or similar lung infections)Mycoplasma pneumoniae (“walking” pneumonia, a mild form of the illness)
In some cases, your illness may not be bronchitis but something else. If your cough persists for longer than three weeks, your doctor may need to evaluate you to rule out these possible conditions: (4)
Asthma (as many as one-third of patients who have asthma are misdiagnosed as having acute bronchitis)Acute or chronic sinusitisBronchiolitisCOPDSore throat caused by a virusHeart failure (Though not common, in some people, the cause of persistent coughing can actually be heart failure, not a respiratory problem.)Pulmonary embolismPneumonia
This informative overview of bronchitis from AAFP offers a comprehensive summary of the basic aspects of this condition, from symptoms of acute bronchitis to prevention and treatment. American Lung Association (ALA) When it comes to lung health, ALA is one of the leading experts. From basic facts about bronchitis to questions to ask your doctor, this important resource has the info you need. Cedars-Sinai What is bronchitis and what can you expect if you have this lung condition? This guide to bronchitis from Cedars-Sinai delves into details about aspects of the illness such as what may trigger symptoms and which medications and at-home treatments are commonly used to relieve and improve symptoms. Centers for Disease Control and Prevention This information page on bronchitis offers insights about bronchitis, such as when to seek medical help and home remedies that may ease symptoms. CHEST Foundation This detailed resource from the American College of Chest Physicians breaks down important info you need about bronchitis such as how it affects the body, how doctors diagnose and treat the condition, and what resources are available for those seeking more information and support. Cleveland Clinic This guide to bronchitis (which includes informative illustrations and videos) offers easy-to-understand information about the condition, as well as answers to questions someone might have after a diagnosis, such as, “How long are you contagious if you have acute bronchitis?” and “How is it spread?” Mayo Clinic As it does with other health topics, the Mayo Clinic breaks down the aspects of bronchitis we need to know, such as symptoms, prevention, diagnosis, and treatment. UPMC Pinnacle UPMC Pinnacle, which is part of the University of Pittsburgh Medical Center, offers an overview of bronchitis and links to related topics such as “Using Antibiotics Wisely” and “Tests for Lung Infections.” KidsHealth How does bronchitis affect children and teens? This site offers a look at the basics of bronchitis (such as symptoms, causes, and prevention) in terms of how it might affect kids and adolescents. With additional reporting by Katherine Lee.
