Introduction- Bronchitis is when the tubes that carry air to your lungs, called the bronchial tubes, get inflamed and swollen. You end up with a nagging cough and mucus.
There are two types:
1. Acute bronchitis:-This is more common. Symptoms last a few weeks, but it doesn’t usually cause problems past that time.
2. Chronic bronchitis:- This one is more serious. It keeps coming back or doesn’t go away.
Symptoms of both acute and chronic bronchitis include breathing problems, such as:
– Chest congestion, when your chest feels full or clogged
– A cough that may bring up mucus that’s clear, white, yellow, or green
– Shortness of breath
– Wheezing or a whistling sound when you breathe
Symptoms of acute bronchitis also may include:
– Body aches and chills
– Feeling “wiped out”
– Low fever
– Runny, stuffy nose
– Sore throat
Even after the other symptoms of acute bronchitis are gone, the cough can last a few weeks while your bronchial tubes heal and the swelling goes down. If it goes on much longer than that, the problem might be something else.
Most often, the same viruses that give you a cold or the flu cause acute bronchitis. But sometimes, bacteria bring it on. In both cases, as your body fights the germs, your bronchial tubes swell and make more mucus. That means you have smaller openings for air to flow through, which can make it harder to breathe.
Chronic bronchitis causes include:
1. Breathing in air pollution and other things that bother your lungs, like chemical fumes or dust, over time.
2. Smoking or breathing in secondhand smoke for a long time.
Bronchitis Risk Factors:-
You have a higher chance of getting either kind of bronchitis if:
1. You smoke.
2. You have asthma and allergies.
You have a weaker immune system. This is sometimes the case for older adults and people with ongoing diseases, as well as for babies and young children. Even a cold can make it more likely, since your body’s already busy fighting those germs.
Your risk of getting chronic bronchitis is higher if:
1. You’re a female smoker. You may be more at risk than a male smoker.
2. You have a family history of lung disease.
When Should I Call My Doctor?
Call your doctor if your cough:
1. Brings up blood or mucus that thickens or darkens
2. Keeps you awake at night
3. Lasts more than 3 weeks
4. Causes chest pain
5. Has a barking sound and makes it hard to speak
6. Comes along with unexplained weight loss
Check the oxygen levels in your blood. This is done with a sensor that goes on your toe or finger.
Do alung function test. You’ll breathe into a device called a spirometer to test for emphysema (a type of COPD in which air sacs in your lungs are destroyed) and asthma.
Give you a chest X-ray. This is to check for pneumonia or another illness that could cause your cough.
Sputum Culture This allows the doctor to check for signs of inflammation or a bacterial infection.
Order blood tests. These can identify signs of infection or measure the amount of carbon dioxide and oxygen in your blood.
Test your mucus to rule out diseases caused by bacteria. One of these is whooping cough, also called pertussis. It causes violent coughing that makes it hard to breathe. If your doctor thinks you have this or the flu, they’ll also take a nasal swab.
Most of the time, acute bronchitis goes away on its own within a couple of weeks. If yours is caused by bacteria (which is rare), your doctor may give you antibiotics. If you have asthma or allergies, or you’re wheezing, they might suggest an inhaler. This helps open your airways and makes it easier to breathe.
To ease your acute bronchitis symptoms, you can:
Drink a lot of water. Eight to 12 glasses a day helps thin out your mucus and makes it easier to cough it up. Get plenty of rest.
Take over-the-counter pain relievers. Aspirin, ibuprofen, or naproxen treat pain. But avoid giving aspirin to children. You can use acetaminophen to treat both pain and fever.
Use a humidifier or steam. A hot shower can be great for loosening mucus.
Take over-the-counter cough medicines. You might take a medicine like guaifenesin during the day to loosen your mucus so it’s easier to cough up. Your doctor will call this an expectorant.
Chronic bronchitis treatments target your symptoms and include:
1. Medications like antibiotics, anti-inflammatories, and bronchodilators to open your airways.
2. A mucus-clearing device to help you cough up fluid more easily.
3. Oxygen therapy so you can breathe better.
4. Pulmonary rehab, an exercise program that can help you breathe more easily and exercise more.
Physiotherapy Management :-
The main aim of Physiotherapy is to keep the airways open and functioning properly. Physiotherapists are able to do this using different techniques such as: ( see Respiratory Physiotherapy)
Postural Drainage:- This can be exercised at an angle of 45º in prone and in side lying. This must first be cleared with the institution as necessary, as well as considering possible contra-indications such as a head injury.
Manual Techniques Percussion, shaking and vibrations can be used to mobilize secretions and aid expectoration. Once again, precautions and contra-indications are to be observed.
Breathing Exercises Active Cycle of Breathing Technique(ACBT) could be used in order to mobilize secretions. Teaching relaxed breathing techniques as well as diaphragmatic breathing to aid oxygenation and prevent respiratory distress. Full thoracic expansion must be emphasized which will aid oxygenation. The patient should be encouraged to aid the mobilization of secretions through coughing and deep breathing during the day. The patient, and family, should be advised that the patient needs to rest and avoid bronchial irritants where possible. This, however, does not exempt the patient from partaking in physiotherapeutic activities.
Education Teaching the importance of nose blowing into a tissue and not swallowing the secretions as well as discarding the tissue safely after blowing their nose is important, as this will prevent the spread of infection. The patient and family/caregiver should be advised that a dry cough may persist a free bronchitis has resolved due to irritation of the respiratory passages. A humidifier at the bedside may be useful in combating the negative after-effects as it will saturate the air that is breathed in.
Treatment Schedule and Home Advice Treatment should be carried out 3 to 4 times a day depending on the severity of the condition. If an upper respiratory tract infection is contracted again, treatment should be started as soon as possible to prevent it from developing into bronchitis or further severe complications. The patient and/or family should be able to recognize early signs and symptoms of acute bronchitis and report them immediately.
Dr. Gaurav Shrivastava (PT), Assistant Professor, Department of Physiotherapy, Career Point University, Kota