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Bronchitis: Inflammation of the tracheal branches

Bronchitis is the medical term for “inflammation of the tracheal branches”. The lungs themselves are not affected by the infection . However, this does cause swelling, which narrows the airways. Breathing problems and coughing are some typical features of bronchitis. Bronchitis exists in an acute and chronic form. The symptoms usually disappear after a few days, although smokers in particular suffer from persistent attacks of coughing up phlegm. Some self-care tips can help with bronchitis, and the doctor is also able to prescribe medicines.

  • Epidemiology inflammation of tracheal branches
  • Causes and types of bronchitis
  • Risk factors
  • Symptoms of narrowing of the airways: Fever and coughing
  • Diagnosis and examinations
  • Treatment of acute and chronic bronchitis
  • Complications
  • Prognosis is usually good


Epidemiology inflammation of tracheal branches

Approximately 4% of the population worldwide suffers from bronchitis every year. This figure may be (much) higher, but many patients do not visit the doctor with these symptoms. Consequently, it is difficult to determine the exact frequency of bronchitis. People are especially affected in autumn and winter. The infectious disease has no racial predilection. Bronchitis is more common in populations with low socioeconomic status and in patients living in urban and highly industrialized areas. Men are also affected more often than women. Acute bronchitis is most common in children under the age of five, while chronic bronchitis (persistent inflammation of the tracheal tubes) usually occurs in patients over the age of fifty.

Causes and types of bronchitis

Acute bronchitis

Acute bronchitis almost always occurs after a cold (mild infection with symptoms in the nose and throat) or another illness with flu-like symptoms. The bronchitis infection is caused by infection with a virus. This first affects the nose, sinuses and throat, and then moves into the airways, which lead to the lungs. Occasionally bacteria also attack the respiratory tract; this is then known as a secondary infection.

Chronical bronchitis

Chronic bronchitis is a long-term form of chronic obstructive pulmonary disease (COPD) that only affects smokers. The diagnosis is made when the patient coughs up phlegm on most days for at least three months. The smoking patient must cough up mucus every day in attacks due to cigarette smoke. In medical terms, these attacks are known as acute exacerbations of COPD. These potentially serious exacerbations are sometimes even fatal.

Risk factors

Anyone can develop the disease, but smokers (with or without smoker’s cough) are particularly affected more often. Infectious agents penetrate the delicate lining of the airways more easily in this target group, and in addition, the cilia (small hairs on the wall of the airways) do not work properly. They are not able to remove mucus well, which is a factor for organisms to multiply more quickly. Smokers are more likely to develop the chronic form of bronchitis.Chest pain occurs with bronchitis / Source: Pexels, Pixabay

Symptoms of narrowing of the airways: Fever and coughing

The main symptoms of acute bronchitis are:

  • a runny or stuffy nose
  • wheezing inhalation (stridor) and/or wheezing (wheezing sound during exhalation) in patients with asthma
  • coughing, more specifically a dry cough, sometimes also nocturnal coughing
  • headache
  • a sore throat
  • fever (usually mild)
  • shortness of breath (dyspnea) that worsens with exertion (this usually indicates an extension to the lungs = pneumonia)
  • nausea, vomiting and diarrhea (rare)
  • chest pain (in severe cases)
  • mucus production: The purulent, green-yellow mucus in dry cough production may indicate the presence of neutrophils (type of white blood cells). These immune cells fight the pathogens.
  • muscle strain
  • fatigue


Diagnosis and examinations

Physical examination

The doctor listens to the breathing sounds of the lungs using his stethoscope. The breathing sounds sound abnormal or rather rough (rattles). In addition to the existing symptoms, the doctor notices redness in the throat and swollen lymph nodes (lymphadenopathy). Normally, shortness of breath and cyanosis (blue discoloration of the skin and mucous membranes) do not occur unless the patient has an underlying lung condition or a disease that damages the lungs.

Diagnostic research

The doctor takes an X-ray of the chest (chest X-ray) when the doctor suspects that the patient has pneumonia. Pulse oximetry is also useful. This painless test determines the amount of oxygen in the blood using a small device that the doctor places on the end of the finger. If a cough persists, the doctor will perform an analysis of the mucus (sputum analysis). A blood test is necessary when the doctor suspects that the patient is suffering from a bacterial superinfection. The doctor tests the lung function with spirometry. Finally, a laryngoscopy (examination of the throat, larynx and vocal cords) is occasionally necessary to rule out epigottitis (life-threatening inflammation of the epiglottis).

Differential diagnosis

It is sometimes difficult for the doctor to know the difference between pneumonia and bronchitis. The patient usually has a higher fever with chills, is more short of breath and feels sicker with pneumonia. Other differential diagnoses include:

  • acute sinusitis
  • alpha1-antitrypsin deficiency: liver and lung disease
  • asthma
  • bacterial tracheitis
  • occupational exposure
  • heartburn
  • bronchiectasis (dilated and irritated airways)
  • bronchiolitis (respiratory tract infection with breathing problems)
  • chronic sinusitis (chronic inflammation of the paranasal sinus)
  • COPD
  • tonsillitis (tonsillitis)
  • a hyper-reactive airway disease
  • pharyngitis (inflammation of the throat)
  • group A streptococcal infections
  • swallowing a foreign object
  • cough
  • influenza (flu)
  • cystic fibrosis (cystic fibrosis with blockage of organs)


Treatment of acute and chronic bronchitis

Acute bronchitis

Good hand hygiene is necessary / Source: Gentle07, PixabaySelf-care Bed rest and plenty of fluids (three to four liters per day) are necessary. In case of fever, the patient may use paracetamol or aspirin (note: do not give aspirin to children!). In principle, paracetamol works against fever, but fever is a natural response to an infection that makes the immune system work better. It is therefore better to maintain the natural course. A humidifier or steam in the bathroom also reduces symptoms. Patients with asthma also use their medications correctly. It is furthermore not recommended to smoke passively and/or actively. The patient also avoids exposure to air pollution. A well-maintained humidifier is also recommended; this increases the moisture content in a room. It has been proven that low humidity and low temperatures are associated with the development of respiratory infections. Breathing warm air is also helpful for some patients because it loosens mucus. Finally, it is important to maintain good hand hygiene so that the viruses and other germs do not spread quickly.Professional medical help The patient seeks medical advice when symptoms do not go away on their own or when he or she has an underlying heart or lung condition (such as COPD). The doctor will then prescribe antibiotics (usually penicillin) or possibly corticosteroids to cure the infection. In addition, an inhaler is useful to widen the airways. Furthermore, the patient preferably receives the flu vaccine annually between October and December.Quitting smoking is necessary for bronchitis / Source: Geralt, PixabayChronic bronchitis Quitting smoking is the most effective treatment for chronic bronchitis. Patients also stay away from other irritants that sometimes lead to bronchitis (dust, chemicals in household products and air pollution). Furthermore, a healthy diet consisting of fruits, vegetables and whole grains, as well as lean meat, poultry, fish, beans, eggs and nuts, is recommended. This diet also contains fat-free or low-fat dairy products and a limited number of saturated fats and trans fats, cholesterol, salt and added sugars.


Complications occur in approximately 10% of patients with acute bronchitis and include:

  • hemoptysis
  • the progression to chronic bronchitis with repeated attacks of acute bronchitis
  • a bacterial superinfection
  • Pneumonia develops in approximately 5% of patients with bronchitis
  • reactive respiratory diseases due to acute bronchitis


Prognosis is usually good

Patients with acute bronchitis have a good prognosis. Symptoms usually resolve within seven to 10 days if the patient does not have pneumonia associated with the bronchitis, or if he has no other underlying illness. However, the dry, nagging cough may persist for one to four weeks even after the infection clears.

read more

  • Stridor: Whooping, wheezing
  • Chronic bronchitis (inflammation of tracheal branches)
  • Pneumonia: Inflammation of the lower respiratory tract
  • Breathing sounds: Sounds from airways and lungs
  • Sputum culture (examination) in lung-related disorders

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