Bronchitis (acute)

Symptoms of bronchitis 

Most cases of bronchitis develop when an infection irritates and inflames the bronchi. This causes them to produce more mucus than usual. Your body tries to shift this extra mucus by coughing.

Key things about acute bronchitis include:

• inflammation of the airways for a short time
• causes a cough and mucus production, lasting up to three weeks
• can affect people of all ages but is most common in children under the age of five
• it's more common in winter and often develops following a common cold, sore throat or flu

The main symptom of acute bronchitis is a hacking cough. The cough may bring up clear, yellow-grey or greenish mucus (phlegm). Other symptoms are similar to those of the common cold or sinusitis, and may include:

• sore throat
• headache
• runny or blocked nose
• aches and pains
• tiredness

If you have acute bronchitis, your cough may last for several weeks after other symptoms have gone. You may also find the continual coughing makes your chest and stomach muscles sore.

When to see your GP 

Most cases of acute bronchitis can be easily treated at home with rest, adequate fluid intake, and the use of paracetamol or ibuprofen for symptomatic relief.

You only need to see your GP if your symptoms are severe or unusual – for example, if:

• your cough is severe or lasts longer than three weeks
• you have a constant fever of 38C (100.4F) or above, for more than three days – this may be a sign of flu or a more serious condition, such as pneumonia
• you cough up mucus streaked with blood
• you have an underlying heart or lung condition, such as asthma, heart failure or COPD
• you are breathing rapidly (more than 30 breaths a minute) or develop chest pains
• you become drowsy or confused
• you've had repeated episodes of bronchitis

Your GP may need to rule out other lung infections, such as pneumonia, which has symptoms similar to those of bronchitis.

Chronic obstructive pulmonary disease (COPD)  

Bronchitis was commonly described as being either acute bronchitis or chronic bronchitis. Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause difficulty breathing. Chronic bronchitis is now included in this group of conditions.

Another condition that affects the lungs is bronchiectasis. Bronchiectasis is a long-term condition.

The condition leads to a permanent widening and thickening of the airways linked to:

• chronic cough
• sputum production
• recurring bacterial infection

• Read more about COPD and bronchiectasis

Treating bronchitis 

In most cases, acute bronchitis will clear up by itself within a few weeks without the need for treatment. In the meantime, you should drink lots of fluid and get plenty of rest (see managing symptoms at home below).

In some cases, the symptoms of bronchitis can last much longer, indicating you might have COPD or bronchiectasis.

Managing symptoms at home 

If you have acute bronchitis:

• get plenty of rest
• drink lots of fluid – this helps prevent dehydration and thins the mucus in your lungs, making it easier to cough up
• treat headaches, fever, and aches and pains with paracetamol or ibuprofen – although ibuprofen isn't recommended if you have asthma

There's little evidence that cough medicines work. The Medicines and Healthcare Products Regulatory Agency (MHRA) has recommended that over-the-counter cough medicines shouldn't be given to children under the age of six. Children aged 6 to 12 should only use them on the advice of a doctor or pharmacist.

Antibiotics 

Antibiotics aren't routinely prescribed for bronchitis because it's normally caused by a virus. Antibiotics have no effect on viruses, and prescribing them when they're unnecessary can, over time, make bacteria more resistant to antibiotic treatment.

 Complications of bronchitis 

Pneumonia is the most common complication of bronchitis. It occurs when the infection spreads further into the lungs, causing the tiny air sacs inside the lungs to fill up with fluid. People at an increased risk of developing pneumonia include:

• older people
• people who smoke
• people with other health conditions, such as heart, liver or kidney disease
• people with a weakened immune system

Mild pneumonia can usually be treated with antibiotics at home. More severe cases may require admission to hospital.

Causes of bronchitis 

Bronchitis can be caused by either a virus or bacteria.

In most cases, bronchitis is caused by the same viruses that cause the common cold or flu. The virus is contained in the millions of tiny droplets that come out of the nose and mouth when someone coughs or sneezes.

 These droplets can eventually land on surfaces. Anyone who touches these surfaces can spread the virus further by touching something else.

Stopping smoking 

It's important that you stop smoking if you smoke and you have any lung disease. Better to avoid smoking altogether to avoid developing lung disease.

Cigarette smoke and the chemicals in cigarettes make bronchitis worse and increase your risk of developing COPD.

Your GP can help you to stop smoking. There is also free specialist advice available to help you quit smoking. Stop smoking support services, through GP practices and community pharmacies, are available across Northern Ireland.

More useful links

• How to use your health services
• The importance of hand hygiene
• Air pollution and health
• Air quality in Northern Ireland
• Support for chest conditions