The Call-On-Doc Guide to Acute Bronchitis

Defined by the inflammation of the bronchial tubes, acute bronchitis causes tend to be viral infections targeting the respiratory system, more specifically, those that can affect or irritate the bronchial tubes in some way. (2) In addition to being caused by them, acute bronchitis can also be caused by: 

• Influenza
• The common cold
• Respiratory syncytial virus (RSV) 
• Covid-19 
• Adenovirus

In addition to viral infections, acute bronchitis can be the result of or cause sinus infections and upper respiratory infections. (3)(4) The cause in either regard tends to be because the upper respiratory system is either compromised from a viral infection or in response to environmental irritants. Airborne irritants can also be the source of acute bronchitis in many patients, with the most common causes including: 

• Tobacco smoke: Active smoking or exposure to secondhand smoke can irritate the bronchial tubes.
• Air pollution: Breathing in polluted air with high levels of particulate matter can irritate the respiratory system.
• Chemical fumes: Exposure to noxious chemicals and fumes in the workplace or environment can lead to bronchitis symptoms.

Seasonal allergies, also known as allergic rhinitis or hay fever, can also trigger acute bronchitis due to the postnasal drip that occurs in reaction to the pollen, mold spores, dust mites, and pet dander that floats in the air inside and outside. While in many, this will not be a direct cause, seasonal allergies often do cause the condition in many due to the conditions created inside the body, with mucus flowing in the bronchial tubes and the respiratory system generally being irritated in response. 

With it developing from the bronchial tubes and, as a result, only affecting the respiratory system, acute bronchitis symptoms can be confused with conditions like the common cold, flu, and other respiratory illnesses. Most often, the condition develops because of these viruses and other infections, with the most common symptoms including: 

• Cough: The most common symptom of acute bronchitis is a persistent cough. This cough is usually dry or starts as a dry cough and may later become productive, meaning it produces mucus or phlegm. The mucus can vary in color from clear or white to yellow or green. The cough is the body's natural mechanism for clearing irritants and excess mucus from the bronchial tubes.
• Chest Discomfort: Many individuals with acute bronchitis experience discomfort or a sensation of tightness in the chest. This can range from mild to more pronounced discomfort, often due to the inflammation and irritation of the bronchial tubes.
• Fatigue: The body's immune response to the infection and the effort expended in coughing can lead to fatigue. People with acute bronchitis may feel tired and generally unwell.
• Sore Throat: The inflammation and irritation associated with bronchitis can extend to the throat, leading to a sore throat. This symptom is not as common as the cough or chest discomfort.
• Runny or Stuffy Nose: While not a primary symptom of bronchitis, some individuals may experience a runny or stuffy nose. This can be due to the shared connection between the upper and lower respiratory tracts, where irritation in the bronchial tubes can affect the nasal passages.
• Low-Grade Fever: Acute bronchitis can sometimes lead to a mild fever, usually below 100.4°F (38°C). However, high fevers are less common in acute bronchitis, and most cases are associated with low-grade or no fever at all.

Acute bronchitis typically lasts for up to two to three weeks, with symptoms gradually improving over that time. Most people experience relief from the worst symptoms within about 7-10 days, but the cough may persist for several weeks. However, it's important to note that the duration can vary from person to person, and in some cases, it may last longer or resolve more quickly. (5)

Differentiating between acute bronchitis and pneumonia can be challenging because both conditions can share some similar symptoms like a cough and fever. However, there are key signs that can help distinguish between the two:

Acute Bronchitis:

• Cough: A persistent cough is a common symptom of both bronchitis and pneumonia. In acute bronchitis, the cough is typically dry at first and may later become productive (producing mucus).
• Mucus: If mucus is produced, it is often clear, white, or yellowish, but not typically blood-tinged.
• Fever: If present, fever is usually low-grade (below 100.4°F or 38°C).
• Chest Discomfort: Chest discomfort is common but tends to be mild to moderate in intensity.

Pneumonia:

• Cough: The cough in pneumonia is often productive and may produce yellow, green, or even bloody mucus.
• Fever: Pneumonia is more likely to cause a high fever, typically over 100.4°F (38°C).
• Breathing Difficulty: Individuals with pneumonia may experience more severe breathing difficulties, including rapid and labored breathing.
• Chest Pain: Chest pain associated with pneumonia is usually more severe than that of bronchitis and may be felt as a sharp or stabbing pain.
• Systemic Symptoms: Pneumonia often presents with more pronounced systemic symptoms like chills, shaking, and a feeling of severe illness.
• Symptom Progression: Pneumonia symptoms tend to worsen more quickly and significantly than those of bronchitis.

To diagnose acute bronchitis, a doctor typically begins with a thorough medical history and examination of the present symptoms. When in person,  the doctor will listen to the patient's chest with a stethoscope to assess lung sounds and check for any abnormal respiratory sounds. While there are no specific laboratory tests that definitively diagnose acute bronchitis, the doctor may order tests to rule out other conditions with similar symptoms, such as pneumonia. Depending on your condition, these tests can include chest X-rays, blood tests, and sputum cultures.

In most cases, the diagnosis of acute bronchitis is based on the clinical presentation of symptoms that closely align with the condition.  

When it comes to differentiating between chronic and acute bronchitis, the primary factor is how long each lasts. Here's how you can differentiate between the two:

Acute Bronchitis:

• Duration: Acute bronchitis is typically short-lived and often lasts for a few weeks, with symptoms gradually improving over time. Most people experience relief from the worst symptoms within about 7-10 days, but the cough may persist for several weeks.
• Occurrence: Acute bronchitis is usually a one-time occurrence or linked to a recent respiratory infection, such as a cold or flu.
• Chronicity: It does not persist or recur frequently. If you experience bronchitis symptoms repeatedly or for extended periods, it may indicate a more chronic condition.

Chronic Bronchitis:

• Duration: Chronic bronchitis is defined by its persistence, as it lasts for at least three months a year for two consecutive years.
• Occurrence: It is characterized by recurrent bouts of productive cough and mucus production.
• Chronicity: Unlike acute bronchitis, chronic bronchitis is a long-term condition often associated with smoking, exposure to lung irritants, or underlying respiratory diseases like chronic obstructive pulmonary disease (COPD).

Alongside treating the main cause, acute bronchitis treatment typically involves managing the symptoms and allowing the body to heal on its own. Rest and staying well-hydrated are essential, as they help the immune system fight the infection. Most often, the condition cannot necessarily be treated through medications, with prescriptions most often being prescribed to manage the symptoms and prevent a worse condition from arising. In the same way, over-the-counter cough suppressants or expectorants can provide relief from coughing and mucus production, while pain relievers like ibuprofen or acetaminophen can help alleviate discomfort and reduce fever. 

Antibiotics are generally not effective against acute bronchitis, as it is usually caused by viral infections. Antibiotics are reserved for bacterial infections, which make up a small minority of cases of acute bronchitis. In the event that symptoms are severe and do not get better, antibiotics will be considered alongside further examination. 

Acute bronchitis is a condition centered in the human respiratory system, which means that habits that relax or irritate parts of the upper respiratory system might also benefit or worsen your condition: 

Do's:

• Breath in Steam: Inhaling steam for acute bronchitis can help soothe irritated airways, loosen mucus, and provide relief from congestion and breathing difficulties.
• Rest: Get plenty of rest to allow your body to recover.
• Stay Hydrated: Drink fluids to help thin mucus and soothe your throat.
• Use a Humidifier: A humidifier can add moisture to the air, which may ease breathing and reduce throat irritation.
• Cough Drops or Lozenges: These can help relieve a sore throat and ease coughing.
• Drink Herbal Teas with Honey and Lemon: Herbal teas like ginger, peppermint, and thyme with honey and freshly squeezed lemon can help soothe symptoms of acute bronchitis. 
• Gargle Salt Water: Gargling salt water for acute bronchitis can help alleviate a sore throat and reduce throat irritation caused by postnasal drip or persistent coughing.
• Over-The-Counter Medications: Consider over-the-counter cough suppressants or expectorants, and pain relievers like acetaminophen or ibuprofen for symptom relief. Follow dosing instructions carefully.

Don’ts:

• Immediately Use Antibiotics: Unless a bacterial infection is confirmed or strongly suspected, antibiotics are not typically needed for acute bronchitis, which is usually viral in origin.
• Smoke: If you smoke, avoid smoking or exposure to secondhand smoke, as this can worsen bronchitis symptoms and delay recovery.
• Exacerbate Symptoms: Avoid exposure to environmental irritants such as air pollution, chemical fumes, and allergens that can make symptoms worse.

The steps for healing from acute bronchitis will be something you can repeat for other conditions that target the respiratory system and can especially be used during allergy seasons. Try: 

• Getting Plenty of Rest: Adequate rest is crucial for recovery. It allows your body to conserve energy and focus on fighting the infection. Rest can also help reduce fatigue, which is common with acute bronchitis.
• Staying Hydrated: Hydration is essential. Drinking water, herbal teas, or warm broths helps keep mucus thin and easier to expel. Proper hydration, typically around one gallon a day, does the trick. 
• Soothing Respiratory Techniques: Inhaling warm, moist air can be particularly helpful for soothing the inflamed airways and reducing congestion. You can use a humidifier to add moisture to the air in your room or take steamy showers. A bowl of hot water with a towel draped over your head is an easy DIY steam inhalation method.
• Getting Active: Regular exercise when you're not sick can help improve lung function and respiratory efficiency. Aerobic activities like walking, swimming, and cycling can strengthen your respiratory muscles.
• Maintaining a Healthy Diet: A balanced diet rich in fruits, vegetables, and whole grains provides essential nutrients that support respiratory health. Certain foods, like those rich in antioxidants and omega-3 fatty acids, can have anti-inflammatory effects.
• Managing Allergies: If you have allergies, managing them effectively can reduce symptoms and minimize irritation to the respiratory system.
• Staying Ontop of Vaccinations: Vaccinations, such as the flu vaccine and vaccines for other preventable respiratory infections, can help protect your respiratory health.

While upper respiratory infections and conditions such as acute bronchitis are difficult to prevent during cold and flu season, there are several things you and your loved ones can do to avoid getting sick. If you or a family member do happen to feel unwell, Call-On-Doc is an easy, same-day solution to get you back on track and feeling better with prescription strength treatment.

1. Singh, Anumeha, et al. “Acute Bronchitis - StatPearls.” NCBI, 13 July 2023, https://www.ncbi.nlm.nih.gov/books/NBK448067/.
2. “Learn About Bronchitis (Acute).” American Lung Association, https://www.lung.org/lung-health-diseases/lung-disease-lookup/bronchitis/learn-about-bronchitis.
3. “Bronchitis - Bronchitis.” NHLBI, 2 December 2022, https://www.nhlbi.nih.gov/health/bronchitis.
4. Mainous AG III, Hueston WJ. Upper Respiratory Infections and Acute Bronchitis. Management of Antimicrobials in Infectious Diseases. 2009 Sep 10, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7123462/. 
5. “Acute Bronchitis.” Johns Hopkins Medicine, https://www.hopkinsmedicine.org/health/conditions-and-diseases/acute-bronchitis.