Bronchitis

What is bronchitis?

Bronchitis is inflammation of the bronchi, the main airways that carry air into the lungs. When these airways become inflamed, often after an infection, they produce more mucus than usual and become irritated, leading to the cough that is the main symptom of bronchitis. It is a common condition, particularly in the colder months when respiratory infections circulate.

There are two main types. Acute bronchitis is short-term, usually following a cold or other viral infection, and clears up within a few weeks as the airways recover — this is the common type most people mean by bronchitis. Chronic bronchitis is a long-term condition, part of a group of conditions called COPD, usually related to long-term damage such as from smoking, and is different from the short-lived acute form. This guide focuses mainly on acute bronchitis, while noting the distinction.

Symptoms

The main symptom of acute bronchitis is a cough, which can persist for some time even after other symptoms settle. Symptoms often follow on from a cold or similar infection and include:

• •A cough, which may be dry at first then bring up clear, white, yellow or green mucus
• •A cough that can linger for several weeks
• •Soreness or tightness in the chest
• •Breathlessness or wheezing in some cases
• •Tiredness
• •Symptoms of the original infection, such as a sore throat, blocked nose or mild fever

Causes

Acute bronchitis is most often caused by a viral infection — frequently the same viruses that cause colds and flu — which spreads from the upper airways down to the bronchi. This is why bronchitis often develops a few days after a cold starts. Several factors are involved:

• •Viral infections (the most common cause), often following a cold or flu
• •Less commonly, bacterial infections
• •Breathing in irritants such as smoke, dust or fumes
• •Smoking, which irritates the airways and is the main cause of chronic bronchitis
• •Having a weakened immune system, which can increase susceptibility

Treatment and recovery

Because acute bronchitis is usually viral, it typically clears up on its own within a few weeks without specific treatment, as the airways recover. Antibiotics are usually not needed or helpful, since they do not work against viruses, and are reserved for the less common situations where a bacterial infection is involved or there is a particular risk, as a doctor judges. The focus is on supporting recovery and easing symptoms.

Helpful self-care includes resting, drinking plenty of fluids to stay hydrated and help loosen mucus, and using paracetamol or ibuprofen for any fever, aches or chest soreness. Warm drinks and honey (for those over one year) can soothe a cough. Avoiding smoke and other irritants helps the airways recover. The cough from bronchitis can be persistent and may linger for several weeks even as you otherwise recover, which is normal, though a cough that does not eventually settle should be checked.

When bronchitis needs medical attention

While acute bronchitis usually resolves on its own, certain features mean it should be checked by a doctor. These include a cough that lasts more than about three to four weeks, symptoms that are severe or getting worse rather than better, coughing up blood, a high fever that does not settle, or significant breathlessness or chest pain. These can indicate a more significant infection like pneumonia, or another condition needing attention.

Some people are at higher risk of complications from a chest infection and should be more cautious, seeking advice sooner. These include older adults, young children, pregnant women, and people with existing heart or lung conditions such as asthma or COPD, or a weakened immune system. For these groups, bronchitis warrants a lower threshold for seeking medical advice, as it can occasionally lead to more serious infections.

It is also worth distinguishing the lingering cough of recovering acute bronchitis — which is common and improves over weeks — from a persistent cough that does not settle at all, which should always be assessed. A cough lasting more than a few weeks, recurrent bronchitis, or any concerning symptoms deserve a doctor's review, both to ensure recovery and to check for any underlying condition, particularly in smokers.