ACUTE AND CHRONIC BRONCHITIS
WHAT YOU SHOULD KNOW
Chest infections are a common occurrence in winter (colds and flu season). They are largely as a result of a low immune system and the spread of viruses and bacteria associated with the cold weather1. Although the majority of infections are mild and can be treated with over the counter medications alone, certain conditions such as bronchitis may need further assistance.
So, what is bronchitis?
In essence, bronchitis is inflammation of the lining of the bronchial tubes2 which carry air to and from the lungs3. During bronchitis, the airways become irritated, swollen and inflamed, resulting in less air reaching the lungs. This causes mucus to build up in the lungs, developing into a chest infection3.
There are two main types of bronchitis, namely acute and chronic bronchitis3,4.
Acute bronchitis, also known as a chest cold, develops as a result of a cold or another respiratory infection such as sinusitis, tonsillitis or a sore throat2,5. It typically develops quickly, with symptoms easing within two or three weeks, without lasting effects2,4.
Acute bronchitis can affect anyone, but more commonly affects children under the age of five. In fact, acute bronchitis is one of the top five reasons for visits to the general practitioner. As expected, acute bronchitis is more common in winter and develops as a result of a cold or flu6.
The main symptom of acute bronchitis is a cough with yellow-grey mucus or phlegm, accompanied by a sore throat and wheezing6. Other symptoms can include fatigue, shortness of breath, slight fever and chills and chest discomfort2.
Chronic bronchitis is more serious and is most often the result of constant irritation or inflammation of the lining of the bronchial tubes caused by smoking2, inhaling irritating fumes or dust, or viruses such as flu or bacteria4. Chronic bronchitis is defined as a phlegmy cough (mucus) that persists for most days of the month, for at least three months and at least two years in a row4.
People who smoke, those with existing chronic obstructive pulmonary disease (COPD), as well as individuals who are repeatedly exposed to lung irritants, have an increased risk of developing bronchitis4. For more information, speak to your healthcare professional who can advise on the management of chronic bronchitis.
Acute Bronchitis is usually caused by viruses, which means that antibiotics are not recommended2,3. If a doctor suspects that the cause is bacterial, then an antibiotic should be considered2. Drinking plenty of fluids, getting adequate rest and avoiding smoke and other airway irritants is the standard method of treatment while the virus runs its course3.
Cough medication may also be recommended. An expectorant may be recommended as it encourages coughing which helps rid the airways of mucus3. Mucolytics are also useful as they alter the mucus viscosity, making it less thick and easier to cough up7. A bronchodilator may also be of assistance as it opens up the airway to assist with easier breathing3, 9.
Cessation of smoking is the single most important aspect of treatment for chronic bronchitis, but other treatments include oral steroids to reduce inflammation, supplemental oxygen to increase blood oxygen levels, a pneumonia vaccine, or antibiotics if a bacterial infection is suspected3.
A cough, whether acute or a chronic cough can be a major area of concern, especially parents with young children as it may result in parents having to take time off work to look after their child. A single episode of bronchitis is not usually serious or a cause for concern, but in some patients, bronchitis can lead to pneumonia2.
If you are concerned about yourself or a family member, make an appointment with your general practitioner, especially if a cough is severe and lasts more than three weeks. Other symptoms that warrant a trip to the doctor includes if there is a constant fever of 38° C for three or more days, if you cough up mucus streaked with blood or if you have an underlying heart or lung condition such as asthma or heart failure6.
Know the facts this winter so that bronchitis can be managed effectively!
DISCLAIMER: This editorial has been commissioned and brought to you by iNova Pharmaceuticals. Content in this editorial is for general information only and is not intended to provide medical or other professional advice. This editorial has content that includes independent comments and opinions from independent healthcare providers and are the opinions and experiences of that particular healthcare provider which are not necessarily that of iNova Pharmaceuticals.
Name and business address of applicant: iNova Pharmaceuticals (Pty) Limited. Co. Reg. No.1952/001640/07, 15E Riley Road, Bedfordview. Tel. No. 011 087 000. www.inovapharma.co.za. For full prescribing information, refer to the individual package inserts as approved by the SAHPRA (South African Health Products Regulatory Authority). by the Medicines Control Council (MCC). Further information is available on request from iNova Pharmaceuticals. IN2820/18
- Chest Infections – Patient Info. April 2016 (https://patient.info/health/chest-infection) Website accessed on 8 July 2018.
- Mayo Clinic – Bronchitis (https://www.mayoclinic.org/diseases-conditions/bronchitis/diagnosis-treatment/drc-20355572) Website accessed on 8 July 2018.
- Inogen – Acute vs Chronic Bronchitis: Understanding the differences (https://www.inogen.com/blog/acute-vs-chronic-bronchitis-understanding-differences/) Website accessed on 8 July 2018.
- eMedicinehealth – Facts and Definition of Chronic Bronchitis (https://www.emedicinehealth.com/bronchitis/article_em.htm#facts_and_definition_of_chronic_bronchitis) Website accessed on 8 July 2018
- Acute Bronchitis – Patient Info. September 2016 (https://patient.info/health/chest-infection/acute-bronchitis) Website accessed on 8 July 2018.
- NHS inform – Bronchitis (https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/bronchitis#symptoms) Website accessed on 8 July 2018.
- Van Schoor J. An approach to recommending cough mixtures in pharmacy. S Afr Pharm J 2012;79(6):30-33.
- Truter I. Cough. Evidence Based Pharmacy Practice. SA Pharm J 2007;74(4):20-27.
- Cough treatment. Specialist Forum 2017;17(6): 28-30