What is acute bronchitis?
Acute bronchitis is an acute inflammation of the mucous membranes of the bronchi. It is usually associated with inflammation of the upper airways ( nose and throat ) and is widespread, especially in the winter months. Bronchitis is one of the most common diseases of all. Approximately 80 patients per week live on about 100 patients. This number doubled in the winter months. Women and men are equally affected. In general, bronchitis is more common in children and adolescents than in adults.
Causes & Risk Factors
An acute bronchitis is caused in 90 percent of cases by viruses. In adults, the disease is usually caused by myxoviruses such as influenza or parainfluenza viruses. Often the pathogens are not known at all. Increased travel nowadays exposes us to more viral types than before, which is why acute bronchitis has become more common.
Only in five to ten percent of cases does viral infection result in secondary infection with bacteria. This is due to the virus-induced mucous membrane of the bronchial mucosa. A primary bacterial bronchitis, on the other hand, is rare and occurs mainly in the context of basic diseases. The most common bacterial agents of acute bronchitis are: streptococci, Haemophilus and chlamydia
Fungi and chemicals
In rare cases, infection with fungi may be the cause of acute bronchitis in patients with immune deficiency. Other causes include damage to the mucous membranes by ammonia, hydrochloric acid, sulphur dioxide, nitrous gases and radiation in the context of cancer.
Illness & course
At the beginning, acute bronchitis usually manifests itself with a dry cough, which is often accompanied by coryza. If the virus spread over the entire body (which happens in about half of the cases), fever and other common cold symptoms such as a headache, headache, limb pain, burning sensation behind the sternum, general feeling of sickness and night sweats are often added,
Bronchitis with a productive cough
Only after a few days, a productive cough develops with viscous, clear to whitish expectoration. This can also turn yellowish or greenish when an additional infection is caused by bacteria (see also “Bacterial Superinfection”). In severe cases, it may also come in the ejection to slight admixtures of blood. These can be caused by small injuries to the mucous membranes and usually have no disease significance. Nevertheless, blood in the ejection, in any case, should be clarified by the doctor.
Bronchitis with an unproductive cough
It can also stay without coughing when coughing. Then the acute bronchitis is usually already over after 8 to 10 days. In 5-10% of patients, however, there is an additional bacterial infection (bacterial superinfection: see below).
Main complaints of uncomplicated bronchitis
The main symptom is the often tormenting cough, which can increasingly cause a feeling of soreness in the chest. Frequently, the throat is red and the lymph nodes in the area of the head are swollen. Uncomplicated bronchitis usually heals within about one to two weeks (maximum four weeks) without further consequences. If not, the doctor must be consulted.
The investigation of acute bronchitis is based on the patient’s individual complaints and also serves to rule out other diseases with similar symptoms, such as atypical pulmonary inflammation. This inflammation of the lungs, caused mainly by mycoplasma and chlamydia, usually begins, very similar to acute bronchitis, with flu-like symptoms, with slight temperature elevation and dry cough.
Questioning and general examination
A questionnaire of the patient (anamnesis) and a physical examination with tapping and listening to the thoracic cavity by stethoscope are usually sufficient. In the case of bacterial superinfection, the physician can often find so-called rattle sounds in the lungs and bronchi. These can also be missing. They are caused by loose and retractable mucus in the respiratory tract. Also examined are usually also ears, mouth, throat and the lymph nodes in the neck area.
In a bacterial superinfection physician may investigate the number of white blood cells and perform laboratory tests, such as a blood reduction or more commonly used determination of inflammatory markers (CRP) to determine whether the use of antibiotics (acting only against bacteria, but not against viruses) are) makes sense. A slight increase in CRP inflammation markers (BSG) and a reduction in the number of white blood cells indicates a viral, a strong rate of blood-lowering, and an increase in the number of white blood cells for a bacterial infection. However, there are cases where all these laboratory values may be normal, even though a bacterial infection (sometimes even a very severe one) is present.
An X-ray image of the chest is always necessary in case of suspected lung inflammation, or to the exclusion of a lung tumour, especially if the symptoms do not subsist and the course of the disease worsens or if the expectoration is bloody.
Lung function test
A lung function measurement should be performed at the latest in patients with complicated bronchitis. In this way, an existing airway constriction (obstruction) can be detected as early as possible and then treated accordingly. A developing non- allergic asthma can thus possibly be prevented. In the complicated form of bronchitis, limitations of the pulmonary function pulmonary function and thus the stress capacity of the affected patients can be quite pronounced. Whether a previously unrecognized chronic obstructive bronchitis which has worsened due to infection and must be treated accordingly, the doctor can also determine this examination method.
Uncomplicated bronchitis heals mostly without treatment. However, it is important to abstain from tobacco smoke and in case of fever the observance of bed rest. Otherwise, the treatment will be depending on which complaints are present.
Chest wraps or Einreibungen alleviate the complaints quite well. Why is not exactly known. The increase in body heat that these agents cause will likely accelerate the production of antibodies, thereby boosting the immune system. For this reason, in otherwise healthy people existing fever should not be lowered. Because, if they go through the fever phase, the bronchitis is in all experience, much faster survived.
Recommended are steam baths or steam saunas since the inhaled water vapour is quite large amounts of heat to the mucous membrane of the airways brings. Especially at the beginning of a disease, some viruses can be killed with it. An addition of chamomile should, however, be used with caution: this may indeed flatter the nose and has a low degree of germicidal activity, but can also trigger allergies in rare cases.
Coughing has the purpose of purifying our airways. Sometimes it can become too violent and then damages the mucous membrane even more by frequent attacks. Therefore, cough-suppressing agents are very helpful in severe acute bronchitis, for example, when a cough is taken over and is any way unproductive (dry, without ejection.
Cough blockers can also be used in a torturous cough at night, in order to allow the patient a restful night’s sleep. These so-called antitussives, such as codeine, attenuate the cough centre in the brain and thus suppress the coughing irritation. They should not be used for more than a week, and in any case only as long as a cough is still dry and tormenting. As soon as mucus has formed in the bronchi, and can be coughed, the cough also loses its agonizing character.
In case of bronchitis with productive (purulent or non-purulent) a cough, cough-killers are often prescribed. Even though their effectiveness has been scientifically proven only in a few studies, cough removers in individual cases can undoubtedly be helpful in speeding up the cleaning of the respiratory tract. In practice, you often have to try out different substances to find out which one helps.
The so-called mucolytics (such as N-acetylcysteine or ambroxol) liquefy the mucus so that it can be easily coughed off. So-called secretomotor oils (for example, essential oils of thyme, menthol or ivy and sufficient fluid intake through copious drinking) can also promote the removal of mucus. In principle, cough-dissolving (chemical and herbal) preparations should only be taken in tablet form. On the other hand, inhaling these medications may irritate the mucous membranes and cause asthma attacks in patients with bronchial hypersensitivity.
The inhalation of neutral inhalation solutions is not absolutely necessary for acute bronchitis, but can significantly relieve discomfort due to the mucolytic effect. It is recommended to use a physiological saline solution or Emser salt, the latter also has the advantage of accelerating the removal of mucus via the bronchial clearance.