Overview
Bronchitis is inflammation of the bronchial tubes, the airways that carry air to the lungs. Acute bronchitis is short-lived and usually follows a chest infection. Chronic bronchitis is a long-term condition, usually caused by smoking, where the airways are persistently inflamed and produce excess mucus.
How common is it?
Acute bronchitis is extremely common, affecting millions of people each winter. Chronic bronchitis affects around 3 million people in the UK, mostly smokers over 40.
Causes and risk factors
Acute bronchitis is almost always caused by viruses (the same that cause colds and flu). Chronic bronchitis is caused by long-term irritation of the airways, most often from cigarette smoke.
Common risk factors
- Viral respiratory infection
- Cigarette smoking (primary cause of chronic bronchitis)
- Secondhand smoke exposure
- Air pollution or chemical fumes
- Gastro-oesophageal reflux (stomach acid irritating airways)
- Repeated chest infections in childhood
- Weakened immune system
Symptoms
- Persistent cough lasting 1 to 3 weeks
- Coughing up mucus (yellow, green, or clear)
- Wheezing
- Chest tightness or discomfort
- Breathlessness on exertion
- Mild fever and fatigue
- Sore throat
When to see a doctor
See a doctor if you have a cough lasting more than 3 weeks, cough up blood, have a fever above 38C, are very breathless at rest, or feel seriously unwell. See a doctor promptly if you have heart or lung disease.
Diagnosis
Acute bronchitis is usually diagnosed clinically. Chest X-ray is done if pneumonia is suspected. Sputum culture identifies bacterial infection if present. Spirometry assesses lung function in chronic bronchitis.
Treatments
Rest and supportive care
For acute viral bronchitis: fluids, rest, paracetamol or ibuprofen for discomfort. Antibiotics are not effective for viral infections and are not routinely recommended.
Bronchodilator inhalers
Help open airways and relieve wheeze in both acute and chronic bronchitis, particularly when asthma is also present.
Pulmonary rehabilitation
For chronic bronchitis/COPD: a structured exercise and education programme that significantly improves breathlessness and quality of life.
Self-care and lifestyle
- Stopping smoking is the single most effective intervention for chronic bronchitis
- Use a humidifier to moisten the air and make coughing more productive
- Stay well hydrated to thin mucus
- Annual flu vaccination and pneumococcal vaccine reduce serious respiratory infections
Prevention
Not smoking prevents the vast majority of chronic bronchitis cases. Flu vaccination annually, good hand hygiene, and avoiding people with respiratory infections reduce acute bronchitis episodes.