Acute bronchitis

Reviewed by Dr Dan Rutherford, GP

What is acute bronchitis?

Acute (ie recent onset) bronchitis is an inflammation of the lower respiratory passages (bronchi).

What causes acute bronchitis?

The usual cause is an infection due to a virus. The viruses responsible for acute bronchitis include those that might otherwise only cause a cold, but in bronchitis they spread further down the respiratory tree. The bronchial lining, already damaged by this infection, is then open to secondary attack by bacteria.

People who have underlying lung problems, such as chronic (ie long-standing) bronchitis, are more likely to get acute bronchitis as their lung defence mechanism against infection is lower than normal. Smoking is the commonest reason for this to happen.

Although much less common, exposure to irritant fumes and dust can be a cause of acute bronchitis.

How does acute bronchitis affect the bronchi?

Viruses or bacteria cause inflammation in the respiratory passages, which results in:

irritation of the respiratory passages, causing a cough.

an increased production of mucus (phlegm).

the swelling of the mucous membrane (lining) of the bronchi, along with the increased production of mucus makes the airways narrower, leading to a wheeze.

The inflammation can lead to fever, fatigue, coloured spit and a general feeling of ill-health.

What makes acute bronchitis worse?

Cigarette smoke.

Cold, close, damp weather.

Air pollution.

What can I do to help myself?

Drink plenty of water.

Cough naturally to remove the phlegm.

Paracetamol (eg Panadol, Calpol) or aspirin (eg Disprin, Aspro clear) will relieve any fever. Aspirin should not be given to children under 16 years of age, unless on the advice of a doctor.

When should the doctor be consulted?

If it gets difficult to breathe.

If the skin or lips, change to a bluish or whitish colour.

If the symptoms seems to be getting worse or if they last more than 10 days.

Asthmatic people may find that their asthma becomes worse during a bronchitis infection, and should discuss with their doctor what steps to take with their treatment if this happens.

Do I need any medicine?

As the majority of infections are caused by a virus it is not usually possible to treat acute bronchitis with antibiotics unless your doctor suspects that secondary bacterial infection has occurred.

When a wheeze is present, or if there is a persistent cough there can be some value in using beta-2 agonists, which are also used to treat asthma. These may be especially useful for children.

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