Acute bronchitis

What is acute bronchitis?

Acute bronchitis is the sudden onset of inflammation in the major airways (bronchial tubes) of the lungs. It usually starts with an infection in the nose or throat, which travels to the bronchial tubes. These tubes swell when the body tries to fight the infection, which triggers you to cough. Acute bronchitis is temporary and usually does not cause any permanent difficulty with breathing. 

Acute bronchitis can affect both males and females of all ages and ethnic backgrounds. It is more common during winter, especially during flu outbreaks. Individuals that are more at risk include: 

• The elderly
• Young children
• Those with a weakened immune system
• Those not immunised for the flu, pneumonia and whooping cough
• Association with other diseases (such as chronic bronchitis or asthma).

Causes and symptoms

The most common cause of acute bronchitis is a viral infection, which means it can be contagious. Less commonly, it can be caused by: 

• Environmental factors such as smoke, chemical fumes and air pollution
• Bacterial infection
• Association with other diseases such as chronic bronchitis or asthma. 

The first symptoms of acute bronchitis are similar to having a cold or flu, followed by a cough. Although the infection usually lasts for 3 – 10 days, the cough may continue for several weeks. Other symptoms include: 

• A runny or stuffy nose which starts a few days before the chest congestion
• Coughing up phlegm or mucus that is yellow or green
• Feeling tired or fatigued 
• Sore chest from long periods of coughing
• Wheezing or whistling sound while breathing
• Not being able to be as active as normal

Diagnosis

While there are no specific tests to diagnose acute bronchitis apart from physical examination, if your doctor is concerned that pneumonia might be present, they may organise a chest X-ray. Other tests are rarely done unless your doctor thinks you might have an additional infection. 

In most cases, acute bronchitis clears up in several days. However, for some people, symptoms such as a cough can last longer. In some cases, people experience more severe symptoms over a longer period of time. This can sometimes lead to complications such as pneumonia. 

Treatment

In most cases, there is no treatment for acute bronchitis, and it will go away on its own. Drinking plenty of liquids, resting and/or taking pain relievers may help to ease symptoms. Occasionally other treatment options will include: 

• Antibiotics: while your doctor will not usually prescribe antibiotics for acute bronchitis caused by a virus, they might be prescribed if your doctor is concerned you are at high risk of developing pneumonia. 
• Bronchodilators: this medicine is used to open up the airways and are not usually helpful in reducing a cough in people with acute bronchitis. However, it may reduce wheezing or chest tightness in some patients. 
• Cough suppressants: while cough suppressants often make little difference to people who have acute bronchitis, some people use them when their cough is troubling, especially when it disturbs sleep. 

There are various self-management options you can try, including quitting smoking and avoiding irritants. 

Quitting smoking or avoiding second-hand smoke can help to relieve symptoms. Having acute bronchitis is a good opportunity to review your smoking habits and to discuss strategies with your doctor to support you to quit. 

Avoiding irritants such as dust, chemical fumes or air pollution can not only help protect your lungs if you have acute bronchitis, but also help prevent infection. Wearing a mask over your mouth and nose can also help reduce the risk in these situations.

Preventative options

To further reduce the risk of recurrent acute bronchitis, we recommend staying active and healthy and ensuring your vaccinations are up-to-date. Being physically active, eating well, getting plenty of rest, and washing your hands often are all things you can do to limit your risk of infection. Ensuring your vaccinations are up-to-date includes discussing a seasonal flu vaccination and the pneumonia vaccination with your doctor to help support your immune system.