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Not to be confused with bronchiolitis. Bronchitis_sentence_0


PronunciationBronchitis_header_cell_0_1_0 Bronchitis_cell_0_1_1
SpecialtyBronchitis_header_cell_0_2_0 Infectious disease, pulmonologyBronchitis_cell_0_2_1
SymptomsBronchitis_header_cell_0_3_0 Coughing up mucus, wheezing, shortness of breath, chest discomfortBronchitis_cell_0_3_1
TypesBronchitis_header_cell_0_4_0 Acute, chronicBronchitis_cell_0_4_1
FrequencyBronchitis_header_cell_0_5_0 Acute: ~5% of people a year

Chronic: ~5% of peopleBronchitis_cell_0_5_1

Bronchitis is inflammation of the bronchi (large and medium-sized airways) in the lungs that causes coughing. Bronchitis_sentence_1

Symptoms include coughing up sputum, wheezing, shortness of breath, and chest pain. Bronchitis_sentence_2

Bronchitis can be acute or chronic. Bronchitis_sentence_3

Acute bronchitis usually has a cough that lasts around three weeks, and is also known as a chest cold. Bronchitis_sentence_4

In more than 90% of cases the cause is a viral infection. Bronchitis_sentence_5

These viruses may be spread through the air when people cough or by direct contact. Bronchitis_sentence_6

A small number of cases are caused by a bacterial infection such as Mycoplasma pneumoniae or Bordetella pertussis. Bronchitis_sentence_7

Risk factors include exposure to tobacco smoke, dust, and other air pollution. Bronchitis_sentence_8

Treatment of acute bronchitis typically involves rest, paracetamol (acetaminophen), and nonsteroidal anti-inflammatory drugs (NSAIDs) to help with the fever. Bronchitis_sentence_9

Chronic bronchitis is defined as a productive cough – one that produces sputum – that lasts for three months or more per year for at least two years. Bronchitis_sentence_10

Many people with chronic bronchitis have chronic obstructive pulmonary disease (COPD). Bronchitis_sentence_11

Tobacco smoking is the most common cause, with a number of other factors such as air pollution and genetics playing a smaller role. Bronchitis_sentence_12

Treatments include quitting smoking, vaccinations, rehabilitation, and often inhaled bronchodilators and steroids. Bronchitis_sentence_13

Some people may benefit from long-term oxygen therapy. Bronchitis_sentence_14

Acute bronchitis is one of the most common diseases. Bronchitis_sentence_15

About 5% of adults are affected and about 6% of children have at least one episode a year. Bronchitis_sentence_16

Acute bronchitis is the most common type of bronchitis. Bronchitis_sentence_17

In the United States, in 2018, 9.3 million people were diagnosed with chronic bronchitis. Bronchitis_sentence_18

Acute bronchitis Bronchitis_section_0

Main article: Acute bronchitis Bronchitis_sentence_19

Acute bronchitis, also known as a chest cold, is short term inflammation of the bronchi of the lungs. Bronchitis_sentence_20

The most common symptom is a cough, that may or may not produce sputum. Bronchitis_sentence_21

Other symptoms may include coughing up mucus, wheezing, shortness of breath, fever, and chest discomfort. Bronchitis_sentence_22

Fever when present is mild. Bronchitis_sentence_23

The infection may last from a few to ten days. Bronchitis_sentence_24

The cough may persist for several weeks afterwards, with the total duration of symptoms usually around three weeks. Bronchitis_sentence_25

Symptoms may last for up to six weeks. Bronchitis_sentence_26

Cause Bronchitis_section_1

In more than 90% of cases, the cause is a viral infection. Bronchitis_sentence_27

These viruses may spread through the air when people cough or by direct contact. Bronchitis_sentence_28

Risk factors include exposure to tobacco smoke, dust, and other air pollutants. Bronchitis_sentence_29

A small number of cases are due to bacteria such as Mycoplasma pneumoniae or Bordetella pertussis. Bronchitis_sentence_30

Diagnosis Bronchitis_section_2

Diagnosis is typically based on a person's signs and symptoms. Bronchitis_sentence_31

The color of the sputum does not indicate if the infection is viral or bacterial. Bronchitis_sentence_32

Determining the underlying organism is usually not required. Bronchitis_sentence_33

Other causes of similar symptoms include asthma, pneumonia, bronchiolitis, bronchiectasis, and COPD. Bronchitis_sentence_34

A chest X-ray may be useful to detect pneumonia. Bronchitis_sentence_35

Another common sign of bronchitis is a cough which lasts ten days to three weeks. Bronchitis_sentence_36

If the cough lasts for longer than a month, it may become chronic bronchitis. Bronchitis_sentence_37

In addition, a fever may be present. Bronchitis_sentence_38

Acute bronchitis is normally caused by a viral infection. Bronchitis_sentence_39

Typically, these infections are rhinovirus, parainfluenza, or influenza. Bronchitis_sentence_40

No specific testing is normally needed in order to diagnose acute bronchitis. Bronchitis_sentence_41

Treatment Bronchitis_section_3

One form of prevention is to avoid smoking and other lung irritants. Bronchitis_sentence_42

Frequent hand washing may also be protective. Bronchitis_sentence_43

Treatment for acute bronchitis usually involves rest, paracetamol (acetaminophen), and NSAIDs to help with the fever. Bronchitis_sentence_44

Cough medicine has little support for its use, and is not recommended in children under the age of six. Bronchitis_sentence_45

There is tentative evidence that salbutamol may be useful in treating wheezing; however, it may result in nervousness and tremors. Bronchitis_sentence_46

Antibiotics should generally not be used. Bronchitis_sentence_47

An exception is when acute bronchitis is due to pertussis. Bronchitis_sentence_48

Tentative evidence supports honey and pelargonium to help with symptoms. Bronchitis_sentence_49

Getting plenty of rest and drinking enough fluids are often recommended as well. Bronchitis_sentence_50

Chinese medicinal herbs are of unclear effect. Bronchitis_sentence_51

Epidemiology Bronchitis_section_4

Acute bronchitis is one of the most common diseases. Bronchitis_sentence_52

About 5% of adults are affected, and about 6% of children have at least one episode a year. Bronchitis_sentence_53

It occurs more often in the winter. Bronchitis_sentence_54

More than 10 million people in the US visit a doctor each year for this condition, with about 70% receiving antibiotics which are mostly not needed. Bronchitis_sentence_55

There are efforts to decrease the use of antibiotics in acute bronchitis. Bronchitis_sentence_56

Acute bronchitis is the most common type of bronchitis. Bronchitis_sentence_57

Chronic bronchitis Bronchitis_section_5

See also: Chronic obstructive pulmonary disease Bronchitis_sentence_58

Chronic bronchitis is defined as a productive cough that lasts for three months or more per year for at least two years. Bronchitis_sentence_59

When this occurs together with decreased airflow it is known as chronic obstructive pulmonary disease (COPD). Bronchitis_sentence_60

Many people with chronic bronchitis have COPD however, most people with COPD do not have chronic bronchitis. Bronchitis_sentence_61

Estimates of the number of people with COPD who have chronic bronchitis are 7 to 40%. Bronchitis_sentence_62

Estimates of the number of people who smoke and have chronic bronchitis who also have COPD is 60%. Bronchitis_sentence_63

The term "chronic bronchitis" was used in previous definitions of COPD but is no longer included in the definition. Bronchitis_sentence_64

The term is still used clinically. Bronchitis_sentence_65

While both chronic bronchitis and emphysema are often associated with COPD, neither is needed to make the diagnosis. Bronchitis_sentence_66

A Chinese consensus commented on symptomatic types of COPD that include chronic bronchitis and with frequent exacerbations. Bronchitis_sentence_67

Chronic bronchitis is a respiratory disease marked by overproduction of mucus and mucins. Bronchitis_sentence_68

The excess mucus is produced by goblet cells and enlarged submucosal glands in response to long-term irritation. Bronchitis_sentence_69

The mucous glands in the submucosa secrete more than the goblet cells. Bronchitis_sentence_70

Mucins thicken mucus, and their concentration has been found to be high in cases of chronic bronchitis, and also to correlate with the severity of the disease. Bronchitis_sentence_71

Excess mucus can narrow the airways, thereby limiting airflow and accelerating the decline in lung function, and result in COPD. Bronchitis_sentence_72

Excess mucus shows itself as a chronic productive cough and its severity and volume of sputum can fluctuate in periods of acute exacerbations. Bronchitis_sentence_73

In COPD, those with the chronic bronchitic phenotype with associated chronic excess mucus, experience a worse quality of life than those without. Bronchitis_sentence_74

The increased secretions are initially cleared by coughing. Bronchitis_sentence_75

The cough is often worse soon after awakening, and the sputum produced may have a yellow or green color and may be streaked with specks of blood. Bronchitis_sentence_76

In the early stages, a cough can maintain mucus clearance. Bronchitis_sentence_77

However, with continued excessive secretion, mucus clearance is impaired and when the airways become obstructed a cough becomes ineffective. Bronchitis_sentence_78

Effective mucociliary clearance depends on airway hydration, ciliary beating, and the rates of mucin secretion. Bronchitis_sentence_79

Each of these factors is impaired in chronic bronchitis. Bronchitis_sentence_80

Chronic bronchitis can lead to a higher number of exacerbations and a faster decline in lung function. Bronchitis_sentence_81

The ICD-11 lists chronic bronchitis with emphysema (emphysematous bronchitis) as a "certain specified COPD". Bronchitis_sentence_82

Cause Bronchitis_section_6

Most cases of chronic bronchitis are caused by tobacco smoking. Bronchitis_sentence_83

Chronic bronchitis in young adults who smoke is associated with a greater chance of developing COPD. Bronchitis_sentence_84

There is an association between smoking cannabis and chronic bronchitis. Bronchitis_sentence_85

In addition, chronic inhalation of air pollution, or irritating fumes or dust from hazardous exposures in occupations such as coal mining, grain handling, textile manufacturing, livestock farming, and metal moulding may also be a risk factor for the development of chronic bronchitis. Bronchitis_sentence_86

Bronchitis caused in this way is often referred to as industrial bronchitis, or occupational bronchitis. Bronchitis_sentence_87

Rarely genetic factors also play a role. Bronchitis_sentence_88

Air quality can also affect the respiratory system with higher levels of nitrogen dioxide and sulfur dioxide contributing to bronchial symptoms. Bronchitis_sentence_89

Sulfur dioxide can cause inflammation which can aggravate chronic bronchitis and make infections more likely. Bronchitis_sentence_90

Air pollution in the workplace is the cause of several non-communicable diseases (NCDs) including chronic bronchitis. Bronchitis_sentence_91

Treatment Bronchitis_section_7

Decline in lung function in chronic bronchitis may be slowed by stopping smoking. Bronchitis_sentence_92

Chronic bronchitis may be treated with a number of medications and occasionally oxygen therapy. Bronchitis_sentence_93

Pulmonary rehabilitation may also be used. Bronchitis_sentence_94

A distinction has been made between exacerbations (sudden worsenings) of chronic bronchitis, and otherwise stable chronic bronchitis. Bronchitis_sentence_95

Stable chronic bronchitis can be defined as the normal definition of chronic bronchitis, plus the absence of an acute exacerbation in the previous four weeks. Bronchitis_sentence_96

A Cochrane review found that mucolytics in chronic bronchitis may slightly decrease the chance of developing an exacerbation. Bronchitis_sentence_97

The mucolytic guaifenesin is a safe and effective treatment for stable chronic bronchitis. Bronchitis_sentence_98

This has an advantage in that it is available as an extended use tablet which lasts for twelve hours. Bronchitis_sentence_99

Another mucolytic fudosteine may also be used. Bronchitis_sentence_100

In those with chronic bronchitis and severe COPD, the phosphodiesterase-4 inhibitor roflumilast may decrease significant exacerbations. Bronchitis_sentence_101

Epidemiology Bronchitis_section_8

Chronic bronchitis affects about 3.4% to 22% of the general population. Bronchitis_sentence_102

Individuals over 45 years of age, smokers, those that live or work in areas with high air pollution, and anybody with asthma all have a higher risk of developing chronic bronchitis. Bronchitis_sentence_103

This wide range is due to the different definitions of chronic bronchitis that can be diagnosed based on signs and symptoms or the clinical diagnosis of the disorder. Bronchitis_sentence_104

Chronic bronchitis tends to affect men more often than women. Bronchitis_sentence_105

While the primary risk factor for chronic bronchitis is smoking, there is still a 4%-22% chance that never smokers can get chronic bronchitis. Bronchitis_sentence_106

This might suggest other risk factors such as the inhalation of fuels, dusts, fumes and genetic factor. Bronchitis_sentence_107

In the United States, in 2016, 8.6 million people were diagnosed with chronic bronchitis, and there were 518 reported deaths. Bronchitis_sentence_108

Per 100,000 of population the death rate of chronic bronchitis was 0.2. Bronchitis_sentence_109

History Bronchitis_section_9

The condition of bronchitis has been recognised for many centuries, in several different cultures including the Ancient Greek, Chinese, and Indian, with the presence of excess phlegm and cough noted in recognition of the same condition. Bronchitis_sentence_110

In Britain in 1808, a physician Charles Badham was the first person to describe the condition and name the acute form as acute bronchitis. Bronchitis_sentence_111

This was written of in a book entitled Inflammatory conditions of the bronchia. Bronchitis_sentence_112

In this book Badham distinguished three forms of bronchitis including acute and chronic. Bronchitis_sentence_113

A second edition of this book was renamed An Essay on Bronchitis and published in 1814. Bronchitis_sentence_114

Bradham used the term catarrh to refer to the cardinal symptoms of chronic cough and mucus hypersecretion of chronic bronchitis, and described chronic bronchitis as a disabling disorder. Bronchitis_sentence_115

In 1901 an article was published on the treatment of chronic bronchitis in the elderly. Bronchitis_sentence_116

The symptoms described have remained unchanged. Bronchitis_sentence_117

The cause was thought to be brought on by dampness, cold weather, and foggy conditions, and treatments were aimed towards various cough mixtures, respiratory stimulants, and tonics. Bronchitis_sentence_118

It was noted that something other than the weather was thought to be at play. Bronchitis_sentence_119

Exacerbations of the condition were also described at this time. Bronchitis_sentence_120

Another physician Harry Campbell was referred to who had written in the British Medical Journal a week before. Bronchitis_sentence_121

Campbell had suggested that the cause of chronic bronchitis was due to toxic substances, and recommended pure air, simple food, and exercise to remove them from the body. Bronchitis_sentence_122

A joint research programme was undertaken in Chicago and London from 1951 to 1953 in which the clinical features of one thousand cases of chronic bronchitis were detailed. Bronchitis_sentence_123

The findings were published in the Lancet in 1953. Bronchitis_sentence_124

It was stated that since its introduction by Badham, chronic bronchitis had become an increasingly popular diagnosis. Bronchitis_sentence_125

The study had looked at various associations such as the weather, conditions at home, and at work, age of onset, childhood illnesses, smoking habits, and breathlessness. Bronchitis_sentence_126

It was concluded that chronic bronchitis invariably led to emphysema, particularly when the bronchitis had persisted for a long time. Bronchitis_sentence_127

In 1957 it was noted that at the time there were many investigations being carried out into chronic bronchitis and emphysema in general, and among industrial workers exposed to dust. Bronchitis_sentence_128

Excerpts were published dating from 1864 in which Charles Parsons had noted the occurring consequence of the development of emphysema from bronchitis. Bronchitis_sentence_129

This was seen to be not always applicable. Bronchitis_sentence_130

His findings were in association with his studies on chronic bronchitis among pottery workers. Bronchitis_sentence_131

A CIBA (now Novartis) meeting in 1959, and a meeting of the American Thoracic Society in 1962, defined chronic bronchitis as a component of COPD, in the terms that have not changed. Bronchitis_sentence_132

Eosinophilic bronchitis Bronchitis_section_10

Main article: Eosinophilic bronchitis Bronchitis_sentence_133

Eosinophilic bronchitis is a chronic dry cough, defined by the presence of an increased number of a type of white blood cell known as eosinophils. Bronchitis_sentence_134

It has a normal finding on X-ray and has no airflow limitation. Bronchitis_sentence_135

Protracted bacterial bronchitis Bronchitis_section_11

Protracted bacterial bronchitis in children, is defined as a chronic productive cough with a positive bronchoalveolar lavage that resolves with antibiotics. Bronchitis_sentence_136

Protracted bacterial bronchitis is usually caused by Streptococcus pneumoniae, non-typable Haemophilus influenzae, or Moraxella catarrhalis. Bronchitis_sentence_137

Protracted bacterial bronchitis (lasting more than 4 weeks) in children may be helped by antibiotics. Bronchitis_sentence_138

Plastic bronchitis Bronchitis_section_12

Plastic bronchitis is a rarely found condition in which thickened secretions plug the bronchi. Bronchitis_sentence_139

The plugs are rubbery or plastic-feeling (thus the name). Bronchitis_sentence_140

The light-colored plugs take the branching shape of the bronchi that they fill, and are known as bronchial casts. Bronchitis_sentence_141

When these casts are coughed up, they are firmer in texture from typical phlegm or the short, softer mucus plugs seen in some people with asthma. Bronchitis_sentence_142

However, some people with asthma have larger, firmer, more complex plugs. Bronchitis_sentence_143

These differ from the casts seen in people whose plastic bronchitis is associated with congenital heart disease or lymphatic vessel abnormalities mainly because eosinophils and Charcot–Leyden crystals are present in the asthma-associated casts but not in the others. Bronchitis_sentence_144

Casts obstruct the airflow, and can result in the overinflation of the opposite lung. Bronchitis_sentence_145

Plastic bronchitis usually occurs in children. Bronchitis_sentence_146

Some cases may result from abnormalities in the lymphatic vessels. Bronchitis_sentence_147

Advanced cases may show imaging similarities to bronchiectasis. Bronchitis_sentence_148

Aspergillus bronchitis Bronchitis_section_13

Aspergillus bronchitis is one of the Aspergillosis spectrum of diseases, in which the bronchi are specifically subject to a fungal infection. Bronchitis_sentence_149

This differs from the other pulmonary aspergillosis conditions, in that it need not affect just the immunocompromised. Bronchitis_sentence_150

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