Acute Bronchitis: symptoms, treatment, dangers

Acute Bronchitis: symptoms, treatment, dangers

Acute bronchitis is an inflammation of the mucous membrane in the bronchi. It is usually triggered by viruses and heals by itself within a few days. Bronchitis can also cause complications. Read it now: What symptoms does bronchitis cause? What to do about the complaints? What helps with bronchitis with complications? How long does bronchitis last?

Acute Bronchitis: Short overview

  • What exactly is bronchitis? Inflammation of the mucous membrane in the bronchi (air-conducting “channels” from the trachea to the alveoli).
  • Symptoms: Cough (dry at first, later with sputum), possibly also fever, headache, sore throat and limbs, cold, hoarseness
  • Treatment: Take it easy, drink enough, inhale, possibly cough loosener, in case of severe irritable cough (without sputum) possibly cough suppressant (only in the evening); in certain cases antibiotics and/or cortisone
  • Causes: in 90 percent of cases viruses, in almost 10 percent of cases bacteria; rare causes of bronchitis are fungi, inhaled irritants (such as ammonia, stomach acid) and radiation in cancer therapy
  • Complications: additional bacterial infection in viral bronchitis, pneumonia, spastic bronchitis
  • Prognosis: Acute bronchitis usually heals without medical treatment. In case of complications and longer duration of bronchitis, a visit to a doctor is advisable.

Acute bronchitis: symptoms and course

Acute bronchitis is usually triggered by cold viruses. Therefore, it often occurs together with or after a cold. One of the most important bronchitis symptoms is coughing: most patients initially have a dry irritable cough. It is often accompanied by a cold.

In about half of the cases, the viruses spread throughout the body. Then bronchitis develops into fever. Frequently, cold symptoms such as sore throat, headaches and aching limbs, hoarseness and a burning sensation behind the breastbone also appear. Those affected feel sick and unwell.

In acute bronchitis, the mucous membrane in the bronchi is inflamed. The disease is usually caused by viruses, more rarely bacteria.

By the way: A bronchitis without cough is very rare. However, the fever may be absent. It only occurs when the whole body is affected by the virus infection.

In the further course of the disease the symptoms change: Bronchitis patients develop a “productive cough” after a few days, i.e. mucus is released in the lower respiratory tract (bronchial tubes) and is coughed up. The dry irritable cough turns into a cough with sputum.

The coughing up mucus is normally viscous and clear to whitish. This is typical for acute viral infections of the bronchial mucosa. In some patients the sputum discolours yellowish or greenish. Then additional bacteria have settled on the inflamed mucous membranes. Doctors call this a bacterial superinfection or bacterial secondary infection: a bacterial infection has “superimposed” itself on the viral infection.

Bronchitis: signs of complications

In severe cases bronchitis patients cough up mucus with blood admixture. The blood usually comes from small injuries of the mucous membrane. This is generally not dangerous. Bloody sputum can also have a serious cause. He should therefore always be examined by a doctor.

When the mucosa produces more mucus, swells and narrows, a complicated bronchitis has developed. It is also called obstructive or spastic bronchitis (see below). Audible breathing noises (rattling, wheezing) occur. Some patients also have difficulty breathing (shortness of breath).

Sometimes an acute bronchitis develops into pneumonia (inflammation of the lungs).

If bronchitis causes the following symptoms, you should definitely see your doctor:

  • The cough lasts longer than eight weeks.
  • The patient has very high fever, or the fever rises again after a fever-free phase.
  • The patient feels very ill, has chills and night sweats.
  • The expectorated mucus contains blood.
  • There is increased respiratory distress. In addition, conspicuous whistling breath sounds are audible.

People with a weakened immune system should see a doctor even with mild bronchitis symptoms. The same applies to people with chronic heart or lung diseases (such as heart failure, COPD, asthma).

Bronchitis & Pregnancy

Pregnant women should consult a doctor if they experience bronchitis-like symptoms. It can exclude more serious causes for the symptoms (such as whooping cough). It is also advisable to have the course of bronchitis in pregnancy monitored by a doctor – especially if complications arise. The doctor can also advise the pregnant woman on the choice of suitable medication for the symptoms of bronchitis.

Bronchitis: treatment

“What to do for bronchitis.” With this question, especially in the cold season, many people turn to the doctor, pharmacist or to a health site on the Internet. The correct answer: There are no special bronchitis medications. In most cases, such would not be necessary either. A simple bronchitis is unpleasant but not dangerous. Simple measures such as protection, sufficient drinking and inhalation are sufficient. This can alleviate the symptoms and support the healing process.

Coughing is important to keep the airways clear. However, especially with severe bronchitis, it can be very painful, damage the mucous membranes and hinder sleep. In the short term, a cough blocker, e.g. codeine, can help. If the cough becomes productive, i.e. with mucus formation, the symptoms usually improve on their own. You can support this with agents that liquefy the mucus or improve its transport in the airways.

Bronchitis usually heals itself: In the case of uncomplicated bronchitis, this usually takes one to two, at most four, weeks. If, on the other hand, a bacterial infection is involved, it can also take much longer. Timely and adequate antibiotic therapy is a decisive factor in determining the duration of the illness. By the way: A dry, irritable cough can persist for a long time even after a survived bronchitis.

You should take it easy for a few more days, even if the last symptoms have subsided. This is important in order to safely avoid possible secondary diseases, such as myocarditis. Also, do not overdo it at first, but it makes sense to keep a moderate heart rate that should not exceed 70 percent of the maximum load. You should wait about two weeks until you are fully loaded.

Dissolving mucus is particularly important

The fact that the lower respiratory tract produces more mucus in bronchitis is an important defence mechanism: together with the secretion, pathogens and dead cells are to be coughed up and thus removed from the body. Treating acute bronchitis therefore means above all drinking enough. This makes the mucus more easily dissolved and can be coughed up more easily. In this way you support the defence against infection.

Inhalation also helps to liquefy and dissolve the mucus. The same can be achieved by carefully tapping the chest. To do this, use your hollow hand or the edge of your little finger.

Many patients rely on expectorant medication (“cough expectorant“). They contain N-acetylcysteine or ambroxol as the active substance. So far, however, there is no clear scientific evidence that such preparations are actually helpful in acute bronchitis therapy.

Cough removers only work if you drink a lot of liquid (tea, clear soup etc.).

Do not suppress expectoration!

Many patients do not sleep well when coughing painfully and unproductively (without sputum). In addition, the constant, hard cough additionally irritates the affected mucous membrane. Many patients then take medication that suppresses the irritation of the cough (antitussives such as codeine). Colloquially they are called “cough suppressants” or “cough blockers“. Some are available only on prescription and are more effective. Other cough suppressants are available without a prescription (such as those containing clobutinol). However, their effectiveness has not been scientifically proven.

If you want to use cough suppressants, you should only do so if severe, dry cough attacks disturb your night’s sleep. The purpose of coughing is to remove the germs from the respiratory tract. This defence mechanism should therefore only be suppressed for a short time if you cannot sleep calmly otherwise.

Prescription cough suppressants in particular should only be used for a short time. They contain opiates like codeine. These have a certain potential for dependence and addiction. They can also make you very tired, limit your reactions and cause constipation.

If you have a productive cough (cough with sputum), you should not take cough suppressants. The mucus in the bronchi must be coughed up. Furthermore, you must not combine cough suppressants with cough medicine: Otherwise the much liquefied mucus can accumulate in the bronchial tubes.

Bronchitis: antibiotics only for bacterial infection

Many patients with bronchitis want to take antibiotics in order to get well quickly. However, this is rarely useful. Because bronchitis is a viral infection. Antibiotics will not help. These are only effective against bacteria.

For this reason, the doctor prescribes an antibiotic for bronchitis only if additional bacteria have spread to the affected mucous membrane (bacterial superinfection). This can be recognized, for example, by the fact that the coughing up mucus is discolored yellowish or greenish by pus.

Cortisone for bronchitis

The effect of antibiotics in bronchitis with bacterial superinfection can be enhanced if cortisone tablets are also taken for a short time. They have an anti-inflammatory effect. They are also particularly useful in cases of obstructive (spastic) bronchitis. Cortisone causes the mucous membrane in the airways to swell. The bronchial mucus, which is rich in germs and waste products, can be better removed. Inhalations with cortisone are often recommended for obstructive (spastic) bronchitis.

Further tips

If the bronchitis is accompanied by a cold or flu, fever, sore throat, headache and aching limbs may occur. On the other hand, if necessary, you can take painkillers such as ibuprofen or paracetamol. They lower the fever and ease the pain. Ibuprofen also has an anti-inflammatory effect.

Physicians recommend physical protection in case of bronchitis. Sport is therefore not advisable during the acute illness, especially not in the case of fever. Then you’d better keep to bed rest.

The rooms in which bronchitis patients are staying should not be overheated. It is also important that the air is not too dry. You can, for example, hang damp cloths over the heating system or “bumper ventilate” regularly. A certain amount of humidity is good for the mucous membranes.

Bronchitis: home remedy

Many people use medicinal plants for bronchitis. For example, ribwort plantain and Icelandic moss have a calming effect on irritated mucous membranes. The medicinal plants are drunk as tea, for example, or used in the form of ointments, liquid extracts or lozenges. A full bath with suitable medicinal herbs can also be very beneficial for acute respiratory diseases such as acute bronchitis.

A popular household remedy is also compresses and chest compresses. They are prepared with curd cheese, onions or boiled and mashed potatoes, for example.

You can read more about the best home remedies for treating bronchitis in the article Bronchitis – Home remedies.

Acute bronchitis: causes and risk factors

Acute bronchitis is usually caused by viruses. These are often cold viruses: the common cold is an infection and inflammation of the upper respiratory tract. It can spread down into the bronchi. Then an acute bronchitis develops.

There are also other viruses that can cause acute bronchitis. These include rhino, flu, herpes, corona and parainfluenza viruses. Viral bronchitis in children is often caused by the RS virus (Respiratory Syncytial Virus).

More rarely, bronchitis is caused by bacteria, especially mycoplasma or chlamydia. Other bacteria are also possible. These include streptococci, staphylococci, pneumococci and Haemophilus influenzae. These are mainly responsible for acute bronchitis in immunocompromised people, lung patients and hospital patients.

More frequent than a purely bacterial bronchitis is a so-called bacterial superinfection in viral bronchitis: the mucous membrane attacked by the viruses is then additionally colonized by bacteria.

Very rarely fungi cause acute bronchitis. This happens especially with people whose immune system is weakened.

Other rare causes of bronchitis are ammonia, hydrochloric acid, sulphur dioxide and nitrous gases. When inhaled, they damage the mucous membrane of the bronchial tubes and can cause inflammation. Irradiation (radiotherapy) as part of cancer treatment can also be the cause of acute bronchitis.

For allergy sufferers, contact with the allergy trigger can cause acute allergic bronchitis.

Bronchitis: incubation period

The period between infection with a pathogen (viruses, bacteria, fungi, etc.) and the appearance of the first symptoms is called the incubation period. Bronchitis caused by such germs can break out at different rates. Viruses are particularly fast: For example, in the case of viral bronchitis, the incubation period is only one day. The additional colonization of bacteria on the mucous membranes in viral bronchitis can take up to ten days.

Is bronchitis contagious?

An acute bronchitis is contagious if it is caused by pathogens (viruses, bacteria, fungi). If, for example, the patient coughs, it distributes tiny droplets of liquid with the germs in the ambient air. If a healthy person breathes these in, he can also fall ill.

However, not every infection leads to the outbreak of the disease: bronchitis pathogens often only make people ill when the infected person is weakened (for example, by a cold). Smog, smoking, cold and tobacco smoke are also considered risk factors that favour acute bronchitis.

Acute bronchitis: examinations and diagnosis

Acute bronchitis can usually be treated at home without medical help. If you have severe bronchitis, however, you should at least have your family doctor examine you once. He can assess potential dangers and risks well. Specialists for diseases of the respiratory tract are pneumologists and ENT physicians. However, in the case of acute bronchitis, they only need to be consulted very rarely.

In any case, a visit to a doctor is advisable in the following cases:

  • Difficulty breathing, shortness of breath and chest pain
  • Coughing of blood
  • high fever
  • yellowish or greenish sputum
  • Complaints lasting longer than seven days
  • Pre-existing conditions such as COPD, bronchial asthma or cardiac insufficiency
  • Immunodeficiency in HIV infection, cancer or cortisone therapy
  • acute bronchitis in elderly people or children

Physician-patient conversation and physical examination

The doctor will first ask you about your symptoms – what they are, the colour of the sputum, the severity of the symptoms and when they started. Also inform him about any pre-existing or underlying illnesses (cold, flu, asthma, etc.). Through this conversation the doctor can take your medical history (anamnesis). It provides him with important clues as to the cause of her complaints and possible complications.

Then the doctor will examine you. Above all, he will use the stethoscope to listen to the heart and lungs. With bronchitis, in addition to the normal breathing sounds, a rattling, whistling or humming is noticeable. These noises are caused by the mucus in the bronchial tubes that vibrates when the air passes by. In children, a so-called tube breathing can be noticed.

The doctor will also palpate the chest to assess the tapping sound. This provides indications of possible secretion congestion or effusions in the lungs. The doctor also palpates the lymph nodes in the neck and takes a look in the mouth, throat and ears. It often also measures body temperature, pulse and blood pressure.

A blood test is usually not necessary. It is carried out when the doctor suspects pneumonia: the direct connection between the bronchial tubes and the lungs can cause bronchitis to turn into pneumonia.

In addition, a blood analysis can sometimes help to clarify the suspicion of a bacterial infection in bronchitis: If the blood sedimentation rate and the number of white blood cells are greatly increased, bacteria have probably settled on the mucous membranes of the respiratory tract. Then treatment with antibiotics can be useful.

However, there are also bronchitis patients with bacterial infection in whom all blood values are normal. Then the doctor can have the sputum or a nose or throat swab examined in the laboratory. In this way the exact pathogen causing the bronchitis can be determined. If necessary, the doctor will then initiate a targeted antibiotic therapy.

An X-ray of the chest (chest x-ray) is necessary if pneumonia is suspected. It also helps to rule out more serious causes of symptoms, such as lung cancer with bloody sputum and worsening symptoms. In such a case further examinations may be indicated, for example a bronchoscopy.

In case of complicated bronchitis, a lung function test (spirometry) is performed. In this way, the doctor can determine whether the airways are narrowed (for example, in spastic bronchitis).

Acute Bronchitis: Prognosis

The prognosis for acute bronchitis is very good. In most patients it heals without medical treatment without any problems. The duration of bronchitis varies: In uncomplicated cases it usually subsides after a few days to a maximum of four weeks. A dry, irritable cough may persist for a long time (up to eight weeks). However, if you are ill for a longer period of time, consult a doctor. Bronchitis may then not be the correct diagnosis or the acute bronchitis may have developed into chronic bronchitis.

Bronchitis: complications

Caution should be exercised in elderly or immunocompromised patients and those with existing lung diseases. Acute bronchitis can more easily lead to complications such as pneumonia. This is especially true if the bronchitis is protracted or not cured properly. As a result, bronchitis can also become chronic.

In COPD patients, acute bronchitis can trigger a flare-up of the disease: The COPD symptoms then worsen acutely.

Pneumonia and a bacterial superinfection are among the most common complications of acute bronchitis. More rarely a so-called “bronchiolitis obliterans” develops. This causes the smallest bronchial branches (bronchioles) to become inflamed and subsequently scarred. They then remain permanently closed, i.e. this part of the airways is narrowed. Especially small children tend to bronchiolitis obliterans.

Spastic bronchitis

Acute obstructive or spastic bronchitis occurs mainly in infants and toddlers. It occurs as a complication of acute viral bronchitis. In spastic bronchitis, the mucous membrane of the bronchial tubes forms a lot of mucus and at the same time is swollen, i.e. constricted. It makes it hard to breathe. The shortness of breath can even become threatening. In addition, a wheezing, whistling and/or humming can be heard when breathing out.

The young patients receive special medication for respiratory distress, so-called sympathomimetics. These active ingredients are often used as sprays or inhalations. They dilate the airways. This makes it easier for patients to breathe again. In certain cases this particular acute bronchitis is also treated with other medications.

You can read more about this special form of acute bronchitis in the article Spastic bronchitis.

Sandra Eades

Hello I am Sandra Eades, physician, researcher and author from Australia. I am working currently as researcher for a private institution. I have studied in Britain and Australia, where I currently reside. I write about research topics in the organization of the public health government agencies. For the iMS I write about general medical conditions. I also research scholar sources to provide information to writers of other articles. I also check the citations of scholar papers. Finally, I read other articles before they are published. I am also a mother of three children!

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