Bronchitis

Bronchitis occurs when the airways in your lungs become inflamed and fill with mucus, causing you to cough persistently. While most cases clear up on their own within a few weeks, understanding the difference between acute and chronic forms can help you manage symptoms and know when to seek medical care.

Table of contents

• What Is Bronchitis?
• Types of Bronchitis
• What Causes Bronchitis?
• Symptoms of Bronchitis
• Who Is at Risk?
• How Is Bronchitis Diagnosed?
• Treatment Options
• How to Feel Better at Home
• Preventing Bronchitis
• When to See a Doctor

What Is Bronchitis?

Bronchitis is an inflammation of the lining of your bronchial tubes, which are the airways that carry air to and from your lungs.^[1] When these tubes become irritated and swollen, they produce mucus, which makes you cough.^[11]

The tubes that carry air to your lungs swell and produce mucus when you have bronchitis. This mucus and the swelling of the airways make it harder for your lungs to move oxygen in and carbon dioxide out of your body.^[5] Your body tries to clear this mucus by coughing, which is why a persistent cough is the main symptom of bronchitis.^[11]

• Bronchial tubes
• Lungs
• Airways

Types of Bronchitis

There are two main types of bronchitis: acute and chronic. Understanding the difference between them is important for proper treatment.^[1]

Acute Bronchitis

Acute bronchitis, often called a chest cold, is a short-term condition that usually comes on quickly and improves within a week to 10 days without lasting effects, although the cough may linger for weeks.^[1] This is the most common type of bronchitis, affecting millions of people each year.^[3]

Acute bronchitis is usually caused by a viral infection, such as the viruses that cause colds or the flu.^[1] It often develops a few days after having an upper respiratory tract infection.^[8] Most healthy people who get acute bronchitis recover without any problems, but it can be more serious in older adults, children, and people with other health problems such as asthma or chronic obstructive pulmonary disease.^[8]

Chronic Bronchitis

Chronic bronchitis is a more serious, long-term condition. You have chronic bronchitis if you have a cough with mucus most days of the month for three months out of the year, and this goes on for at least two years.^[11] It is a constant irritation or inflammation of the lining of the bronchial tubes, often due to smoking.^[1]

Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD), a group of lung diseases that make it hard to breathe and get worse over time.^[1] Nearly three out of four people with COPD have chronic bronchitis, and between 3% and 7% of all adults are believed to have the condition.^[3] There is no cure for chronic bronchitis, but ongoing treatment can help you manage symptoms and slow the disease.^[3]

chest cold, acute bronchitis

What Causes Bronchitis?

The causes of bronchitis differ depending on whether you have the acute or chronic form of the condition.

Causes of Acute Bronchitis

Acute bronchitis is usually caused by airway inflammation from viral infections.^[2] The same viruses that cause colds and influenza (flu) are the most common causes. Other viruses that can cause acute bronchitis include respiratory syncytial virus (RSV), adenovirus, rhinovirus, and coronavirus.^[11] About 95% of acute bronchitis cases happen when a cold or flu virus infects the airways in the lung.^[14]

When a virus finds its way into your respiratory system, it can settle in the main airways connecting the windpipe to the lungs, causing airway inflammation.^[3] Occasionally, a bacterial infection can cause acute bronchitis.^[2] Only about 6% of cases of acute bronchitis are found to be bacterial rather than viral.^[3]

Acute bronchitis can also be caused by breathing in things that irritate the bronchial tubes, such as tobacco smoke (including secondhand smoke), dust, fumes, vapors, or air pollution.^[8]

Causes of Chronic Bronchitis

The cause of chronic bronchitis is usually long-term exposure to irritants that damage your lungs and airways.^[5] In the United States, cigarette smoke is the main cause. Pipe, cigar, and other types of tobacco smoke can also cause chronic bronchitis, especially if you inhale them.^[5]

Chronic bronchitis typically develops after decades of lung damage due to smoking, daily exposure to harmful chemicals, and other factors.^[3] Exposure to other inhaled irritants can contribute to chronic bronchitis, including secondhand smoke, air pollution, and chemical fumes or dusts from the environment or workplace.^[5]

Rarely, a genetic condition called alpha-1 antitrypsin deficiency can play a role in causing chronic bronchitis.^[5]

Symptoms of Bronchitis

A persistent cough that lasts one to three weeks is the main symptom of bronchitis.^[11] You usually bring up mucus when you cough with bronchitis, but you might get a dry cough instead.^[11]

Symptoms of Acute Bronchitis

If you have acute bronchitis, you may have cold symptoms along with your cough, such as:^[1]

• Production of mucus (also called sputum), which can be clear, white, yellowish-gray, or green in color—rarely, it may be streaked with blood
• Sore throat
• Mild headache and body aches
• Slight fever and chills
• Fatigue (feeling tired)
• Chest discomfort
• Shortness of breath and wheezing (a whistling or squeaky sound when you breathe)

The most common symptom of acute bronchitis is coughing with or without mucus.^[6] While these symptoms usually improve in about a week, you may have a nagging cough that lingers for several weeks after the infection is gone.^[1] Someone with acute bronchitis will have a cough that may last for 2 to 3 weeks.^[4]

Symptoms of Chronic Bronchitis

For chronic bronchitis, signs and symptoms may include:^[1]

• Cough
• Production of mucus
• Fatigue
• Chest discomfort
• Shortness of breath

Some people with chronic bronchitis get frequent respiratory infections such as colds and the flu.^[5] In severe cases, chronic bronchitis can cause weight loss, weakness in your lower muscles, and swelling in your ankles, feet, or legs.^[5]

Who Is at Risk?

Bronchitis is a very common condition, with millions of cases occurring every year.^[9] Anyone can get bronchitis, but certain factors increase your risk.^[11]

Risk Factors for Acute Bronchitis

People at higher risk of acute bronchitis include:^[4]

• Elderly people, infants, and young children
• People who smoke or are around someone who smokes
• People with a lung condition, such as asthma
• People with poor immunity
• People who haven’t been vaccinated against influenza, pneumococcal disease, or whooping cough
• People breathing in irritating chemicals

Risk Factors for Chronic Bronchitis

The risk factors for chronic bronchitis include:^[5]

• Smoking—this is the main risk factor. Up to 75% of people who have chronic bronchitis smoke or used to smoke
• Long-term exposure to other lung irritants, such as secondhand smoke, air pollution, and chemical fumes and dusts from the environment or workplace
• Age—most people who have chronic bronchitis are at least 40 years old when their symptoms begin
• Genetics—this includes alpha-1 antitrypsin deficiency, which is a genetic condition. Also, smokers who get chronic bronchitis are more likely to get it if they have a family history of COPD
• A history of respiratory diseases such as asthma, cystic fibrosis, or bronchiectasis
• Gastroesophageal reflux disease (GERD)

People of all ages can develop chronic bronchitis, but it occurs more often in people who are older than 45.^[9] Women are more than twice as likely as men to be diagnosed with chronic bronchitis.^[9]

How Is Bronchitis Diagnosed?

During the first few days of illness, it can be difficult to distinguish the signs and symptoms of acute bronchitis from those of a common cold.^[10] Your doctor will ask about your symptoms and perform a physical examination. They will use a stethoscope to listen closely to your lungs as you breathe.^[10]

Your doctor will ask detailed questions about your symptoms, including:^[16]

• How long have you had your cough?
• Are you coughing up mucus?
• Is there blood in your sputum?
• Did you ever have a fever or other symptoms, such as chest tightness?
• Did you have a cold before the cough?
• Are you wheezing?
• Do you have trouble catching your breath?
• Have you been around other people who have the same kinds of symptoms?

You may not need any tests for acute bronchitis.^[16] This may be enough for them to make an acute bronchitis diagnosis.^[16] However, tests are usually not necessary unless your doctor is concerned you might have a different infection.^[4]

Tests for Bronchitis

In some cases, your doctor may suggest the following tests:^[10]

• Chest X-ray—A chest X-ray can help determine if you have pneumonia or another condition that may explain your cough. This is especially important if you smoke or have ever smoked
• Sputum tests—Sputum is the mucus that you cough up from your lungs. It can be tested to see if you have illnesses that could be helped by antibiotics. Sputum can also be tested for signs of allergies
• Pulmonary function test—During a pulmonary function test, you blow into a device called a spirometer, which measures how much air your lungs can hold and how quickly you can get air out of your lungs. This test checks for signs of asthma, chronic bronchitis, or emphysema

For chronic bronchitis diagnosis, your doctor may use lung function tests, a chest X-ray or CT scan, and blood tests.^[5]

Treatment Options

Most cases of acute bronchitis get better without treatment, usually within a couple of weeks.^[10] Acute bronchitis usually gets better on its own—without antibiotics.^[6]

When Antibiotics Are Not Needed

A virus usually causes acute bronchitis, so antibiotics will not help you get better.^[6] When antibiotics aren’t needed, they won’t help you, and their side effects could still cause harm.^[6] Side effects can range from mild reactions, like a rash, to more serious health problems. These problems can include severe allergic reactions, antimicrobial-resistant infections, and C. diff infection, which causes diarrhea that can lead to severe colon damage and death.^[6]

Because most cases of acute bronchitis are caused by viruses, antibiotics most often do not help.^[21]

Medications

In some circumstances, your doctor may recommend medications, including:^[10]

• Cough medicine—If your cough keeps you from sleeping, you might try cough suppressants at bedtime. Central cough suppressants such as codeine and dextromethorphan are recommended for short-term symptomatic relief of coughing.^[15]
• Bronchodilators—If you have allergies, asthma, or chronic obstructive pulmonary disease (COPD), your doctor may recommend an inhaler and other medications to reduce inflammation and open narrowed passages in your lungs.^[10] Treatment with beta2-agonist bronchodilators may be useful in patients who have associated wheezing with cough and underlying lung disease.^[15]

Treatment for Chronic Bronchitis

There is no cure for chronic bronchitis. However, treatments can help with symptoms, slow the progress of the disease, and improve your ability to stay active.^[5] There are also treatments to prevent or treat complications of the disease. Treatments include:^[5]

• Lifestyle changes, such as quitting smoking if you are a smoker—this is the most important step you can take to treat chronic bronchitis
• Avoiding secondhand smoke and places where you might breathe in other lung irritants
• Following an eating plan that will meet your nutritional needs
• Physical activity to strengthen the muscles that help you breathe and improve your overall wellness
• Medicines, such as bronchodilators, which relax the muscles around your airways and help open your airways to make breathing easier. Most bronchodilators are taken through an inhaler

How to Feel Better at Home

There are several ways you can care for yourself at home to manage bronchitis symptoms:^[6]

• Get plenty of rest
• Drink plenty of fluids—try 8 to 12 glasses a day to help thin out that mucus and make coughing easier^[8]
• Use a clean humidifier or cool mist vaporizer
• Use saline nasal spray or drops to relieve a stuffy nose
• Breathe in steam from a bowl of hot water or shower
• Use throat lozenges or cough drops (do not give lozenges to children younger than 4 years of age)
• Use honey to relieve cough for adults and children at least 1 year of age or older

You can take an over-the-counter pain medicine, such as acetaminophen, ibuprofen, or naproxen, to reduce fever and relieve body aches.^[21] Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen. Too much acetaminophen can be harmful.^[21]

Do not smoke. Smoking can make bronchitis worse.^[21] The most effective means for controlling cough and sputum production in patients with chronic bronchitis is the avoidance of environmental irritants, especially cigarette smoke.^[15]

Preventing Bronchitis

Taking steps to prevent bronchitis or lower your chances of getting it again is important:^[2]

• Quit smoking if you smoke
• Avoid fumes, air pollution, or secondhand smoke (cigarette smoke from someone else)
• Get the flu shot every year
• Get the pneumonia vaccine when appropriate, based on your age or risk factors
• Get the COVID-19 vaccine and booster shots at the recommended times
• Clean your hands frequently
• Cover your mouth and nose when coughing or sneezing

Important ways you can improve your lung health if you have chronic bronchitis include quitting smoking, avoiding things that can irritate your lungs (such as secondhand smoke, air pollution, and dust), and washing your hands a lot to lower the odds of infection.^[16]

When to See a Doctor

Most people with acute bronchitis will feel better with time and rest.^[4] However, you should see your doctor in certain situations.

Call 911 anytime you think you may need emergency care. For example, call if you have severe trouble breathing.^[21]

Call your doctor or seek immediate medical care if:^[21]

• You have new or worse trouble breathing
• You cough up dark brown or bloody mucus
• You have a new or higher fever
• You have a temperature of 100.4°F or higher^[6]
• You have a cough with bloody mucus
• Symptoms last more than 3 weeks^[6]
• You have repeated episodes of bronchitis

If you are very unwell or not getting better, or if you get worse, see your doctor.^[4] See your doctor if your cough lasts longer than 2 to 3 weeks, to check for complications.^[4]

If your child is under 3 months old with a fever of 100.4°F (38°C) or higher, talk to a healthcare provider right away.^[6]

Watch closely for changes in your health, and be sure to contact your doctor if you cough more deeply or more often, especially if you notice more mucus or a change in the color of your mucus, or if you are not getting better as expected.^[21]