Bronchitis

Overview

What is bronchitis?

Bronchitis occurs when the bronchioles (air-carrying tubes in the lungs) are inflamed and make too much mucus. There are two basic types of bronchitis:

  • Chronic bronchitis is defined as cough productive of sputum that persists for three months out of the year for at least two consecutive years. The cough and inflammation may be caused by initial respiratory infection or illness, exposure to tobacco smoke or other irritating substances in the air. Chronic bronchitis can cause airflow obstruction and then is grouped under the term chronic obstructive pulmonary disease (COPD).
  • Acute or short-term bronchitis is more common and usually is caused by a viral infection. Episodes of acute bronchitis can be related to and made worse by smoking. Acute bronchitis could last for 10 to 14 days, possibly causing symptoms for three weeks.

Mucus in the bronchial tubes when you have bronchitis

Excess mucus in the bronchial tubes

What is the difference between bronchitis and pneumonia?

In terms of symptoms, these two diseases may seem very similar. Both cause cough, fever, fatigue, and a heavy feeling in your chest. Bronchitis can sometimes progress to pneumonia.

Despite similarities, the conditions are different. First, bronchitis involves the bronchial tubes, while pneumonia affects the alveoli, or the air sacs in the lungs. Second, pneumonia symptoms are usually much worse. In addition, pneumonia can be life-threatening, especially in older people and other vulnerable groups.

If your symptoms do not get better in a week or so, it is best to contact your doctor.

Symptoms and Causes

What causes bronchitis?

Usually, acute bronchitis is brought on by a viral infection, though it may also be caused by a bacterial infection. The flu and colds are examples of viral infections.

Chronic bronchitis is usually, but not always, caused by smoking tobacco. It can also be caused by exposure to secondhand cigarette smoke, air pollution, dust, or toxic gases. Your risk can be increased by family history of bronchitis, having asthma and allergies, and having gastroesophageal reflux disease (GERD).

What are the symptoms of bronchitis?

Symptoms of bronchitis include:

  • A cough that is frequent and produces mucus.
  • A lack of energy.
  • A wheezing sound when breathing (may or may not be present).
  • A fever (may or may not be present).
  • Shortness of breath.

Is bronchitis contagious?

Acute bronchitis can be contagious because it is usually caused by infection with a virus or bacteria. Chronic bronchitis is not likely to be contagious because it is a condition usually caused by long-term irritation of airways.

How long are you contagious if you have acute bronchitis?

If you have begun taking antibiotics for bronchitis, you usually stop being contagious 24 hours after starting the medication. If you have a viral form of bronchitis, antibiotics will not work. You will be contagious for at least a few days and possibly for as long as a week.

How is acute bronchitis spread?

If bronchitis is caused by a viral or bacterial infection, it is spread the same ways that colds are spread—by germs traveling through the air when someone coughs or sneezes. You can breathe the germs in if you are close enough. You could also touch something that has germs on it, like a door, and then transfer the germs by touching your nose, mouth or eyes. That is why good hand washing practices are important for adults and children.

Diagnosis and Tests

How is bronchitis diagnosed?

Your healthcare provider will do a physical examination and take a medical history. They may ask if you have had a cold recently, how long your cough has lasted, and if you produce mucus when you cough. In addition, they may order a chest X-ray, tests for viruses in your upper respiratory secretions or blood tests.

Management and Treatment

How is bronchitis treated?

The treatment for bronchitis depends on what type you have. If you have acute bronchitis, you might not need any treatment. Or you might use over-the-counter drugs that break up mucus or that treat fever or pain. If you have a bacterial infection, your doctor might prescribe antibiotics.

If you have chronic bronchitis, treatment will be different. Chronic bronchitis, considered to be chronic obstructive pulmonary disease (COPD), is not curable. Symptoms can be treated using a variety of methods, including drugs, oxygen therapy, pulmonary rehabilitation, surgery, or a combination of these. Your doctor might prescribe a mucus clearing device, also called an airway clearance device, to help you bring up mucus easily.

What medications are used to treat chronic bronchitis/COPD?

Drug classes that may be used to treat chronic bronchitis/COPD include:

  • Antibiotics to treat worsening coughs, breathlessness, and mucus production caused by infections.
  • Anti-inflammatory drugs, such as corticosteroids (also called steroids), to reduce swelling and mucus output. Steroids can have many different types of side effects, including swelling in feet and hands, mood changes, increased appetite and weight gain, trouble sleeping, and more serious ones such as diabetes, higher risk of infections, osteoporosis, and cataracts.
  • Bronchodilators to keep muscles around the airways relaxed so that airways stay open. There are long-acting and short-acting bronchodilators. Short-acting products are often called rescue drugs because they act quickly, but wear off in a couple of hours.
  • Combination drugs that contain a mix of steroids and long- or short-acting bronchodilators

How can I take care of myself?

If you have bronchitis, you might consider these home remedies:

  • Drink fluids every one to two hours, unless your doctor has restricted your fluid intake.
  • Rest.
  • Don't smoke. Stay away from all kinds of smoke.
  • Relieve body aches by taking aspirin or acetaminophen.
  • Follow your doctor's instructions on ways to help you clear your mucus.
  • If you have a cough that is severe or keeps you from sleeping, your doctor may prescribe a cough medicine to suppress (or quiet) your cough. If you have a dry cough or difficulty coughing out the mucus, your doctor may also prescribe an expectorant to help loosen and cough out the mucus.
  • If you have a moist, productive cough (with mucus), note how often you cough, as well as the color and amount of the sputum (mucus). Report this to your doctor.
  • Use a humidifier.
  • Try herbal teas or lemon water with 1-2 tablespoons of honey to provide comfort.

Prevention

What can I do to reduce my risk of getting bronchitis?

  • Don't smoke.
  • Insist that others do not smoke in your home.
  • Stay away from or try to reduce your time around things that irritate your airway (nose, throat, and lungs). Irritants can include dust, mold, pet dander, air pollution, smoke, and cleaners.
  • If you catch a cold, get plenty of rest.
  • Take your medicine exactly the way your doctor tells you.
  • Eat a healthy diet.
  • Wash your hands often. Use soap and water. If you are not able to use soap and water, use a hand sanitizer that contains alcohol.
  • Make sure you are up-to-date on the flu and pneumonia vaccines.

Outlook / Prognosis

What is the outlook for people with bronchitis?

People who have acute bronchitis generally have very few problems with their recovery as long as they get the treatment they need. You can expect to stay home from work or school for a few days while you are recovering.

Although chronic bronchitis/COPD cannot be cured, its symptoms can be treated and your quality of life can be improved. Your prognosis, or outlook, for the future will depend on how well your lungs are functioning and your symptoms. It will also depend on how well you respond to and follow your treatment plan.

Living With

When should I see my healthcare provider?

It is often difficult to know whether you have a cold, bronchitis, or pneumonia because symptoms are similar. See your healthcare provider if you have:

  • A cold that lasts more than two to three weeks.
  • A fever greater than 102° F.
  • A fever that lasts more than five days.
  • A cough that produces blood.
  • Any shortness of breath or wheezing.
  • A change in the color of mucus.

If you have chronic bronchitis/COPD, choose lifestyle and activity changes that promote mental and physical health. Tips include:

  • Working as long as you are able to do so.
  • Managing your emotional health. Talk to a counselor if you need to do so. Make positive changes, like going outside, staying involved with friends and hobbies, getting a good night’s sleep and following suggestions of your healthcare provider.
  • Being a partner in your healthcare plan.
  • Asking for support from family and friends.
  • Managing stress by exercising and practicing relaxation methods.
  • Eating well.

Last reviewed by a Cleveland Clinic medical professional on 08/12/2019.

References

  • National Heart, Lung and Blood Institute. . Accessed 8/13/2019.Bronchitis (https://www.nhlbi.nih.gov/health-topics/bronchitis)
  • American Lung Association. . Accessed 8/13/2019.Chronic Bronchitis (https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/chronic-bronchitis/)
  • American Lung Association. . Accessed 4/15/2020.Acute Bronchitis (https://www.lung.org/lung-health-diseases/lung-disease-lookup/bronchitis)
  • Centers for Disease Control & Prevention. Accessed 8/13/2019.Bronchitis. (https://www.cdc.gov/antibiotic-use/community/for-patients/common-illnesses/bronchitis.html)
  • Lefebvre CW. Lefebvre C.W. Lefebvre, Cedric W.Acute Bronchitis and Upper Respiratory Tract Infections. In: Tintinalli JE, Stapczynski J, Ma O, Yealy DM, Meckler GD, Cline DM. Tintinalli J.E., Stapczynski J, Ma O, Yealy D.M., Meckler G.D., Cline D.M. Eds. Judith E. Tintinalli, et al.eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e New York, NY: McGraw-Hill; 2016

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