Tuesday, December 16, 2008

Bronchitis

Bronchitis
Definition
Bronchitis is inflammation of the air passages (bronchi) of the lungs. It can make breathing difficult and sometimes painful.
Acute Bronchitis—sudden onset of symptoms. This lasts only a short time and there is full recovery of lung function.
Chronic Bronchitis—long-term inflammation, obstruction, and degeneration of the bronchi. This is often the result of many years of cigarette smoking. This is a serious medical condition, also called chronic obstructive pulmonary disease .
Asthmatic Bronchitis—intermittent inflammation of the airways in people with underlying asthma . This is most commonly associated with allergies or environmental irritants.
Irritative Bronchitis—(also called industrial or environmental bronchitis); due to chronic exposure to substances such as acids, ammonia, chlorine, minerals, or vegetable dusts
Chronic Bronchitis

Causes
The inflammation may be caused by:
• Bacterial and viral infections
• Smoking (cigarettes or marijuana)
• Inhalation of certain respiratory irritants (ie, chemical pollutants, dust), particularly in an occupational setting
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include:
• Smoking
• Exposure to second-hand smoke
• Contact with a person infected with bronchitis
• Viral upper respiratory tract infection ( cold or flu )
• Asthma
• Chronic sinusitis
• Occupational exposures to respiratory inhalants
• Smog, in susceptible individuals
• Enlarged tonsils and/or adenoids
• Malnutrition
Symptoms
Symptoms depend on the type of bronchitis.
Acute Bronchitis
• Runny nose
• Malaise
• Slight fever
• Back and muscle pain
• Sore throat
• Cough, initially dry, then produces mucus that may be thick, yellow, green, blood-streaked
• Wheezing
Chronic Bronchitis
• Cough that brings up yellow-green mucus, often worse in the morning
• Difficulty breathing
• Bluish tint to lips and skin (in severe cases)
• Swelling of the feet (in end-stage cases)
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam.
Acute Bronchitis
Tests for acute bronchitis are not usually needed. However, for severe or questionable cases, the following may be recommended:
• Blood Test
• Chest X-rays to rule out pneumonia , a complication of bronchitis
• Pulse Oximetry –measures the amount of oxygen in the blood
• Bronchoscopy with culture of the obtained sputum
Chronic Bronchitis
Tests for chronic bronchitis may include:
• Blood test
• Chest x-rays
• Pulmonary function tests or spirometry to evaluate lung function
• Sputum culture
• Arterial blood gas (for levels of oxygen, carbon dioxide, and acid in the blood)
• Pulse oximetry
• Bronchoscopy with culture of obtained sputum
Treatment
Acute Bronchitis
Treatment is aimed at relieving the symptoms. It includes:
• Aspirin or acetaminophen to treat pain and fever
• Expectorants or cough suppressants
• Increased fluid intake
• Cool mist humidification
In most cases, antibiotics are not necessary because the infection is viral, not bacterial. Antihistamines are usually not recommended, because they tend to dry up secretions, which can make the cough worse.
Chronic Bronchitis
Treatment is based on:
• Age
• Overall health
• Extent of the disease
• Past response to treatments
Treatment may include:
• Oral antibiotics and bronchodilators, particularly clarithromycin
• Bronchodilators
• Oral or intravenous corticosteroid medications
• Inhaled bronchodilators or corticosteroids
• Expectorants to loosen secretions
• Mucolytics
• Supplemental oxygen
• Cool mist humidification
• Lung reduction surgery –removal of the most damaged part of the lungs (in severe cases)
• Lung transplant (in end-stage cases)
Prevention
To reduce your chance of getting bronchitis:
• Stop smoking or never start.
• Avoid passive smoke.
• Avoid exposure to respiratory irritants.
• Avoid contact with people who have bronchitis.