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Physician Chronicles


By Alan S. Peterson, MD
Walter L. Aument Family Health Center

Bronchitis is an inflammation and irritation of the airways that lead to the lungs. Viruses are the usual cause of bronchitis, but it can also be caused by bacteria in some cases, or by exposure to cigarette smoke or air pollution.


The inflammation caused by acute bronchitis is not usually permanent. It goes away when the infection or irritation goes away. Obviously if the bronchitis becomes chronic, for example, with cigarette smoking, there can be permanent damage done.

Symptoms of bronchitis usually begin several days after symptoms of a cold onset. Symptoms of that bronchitis include a dry cough that may become productive (produce sputum), mild fever, fatigue, discomfort or tightness in the chest, and possibly wheezing.

Having bronchitis and other lung disease, such as asthma, may increase your chance of pneumonia. Frequent lung infections, especially in a person who smokes, may lead to the development of chronic bronchitis. Tobacco smokers are also at high risk for developing emphysema. Chronic bronchitis, emphysema, and other chronic lung conditions, such as asthma, are known as chronic obstructive pulmonary disease (COPD).


Bronchitis cannot usually be prevented, but you can improve your body’s ability to fight infection.

  • Give proper home care to minor respiratory problems such as colds and flu.
  • Stop smoking. People who smoke or who are around other smokers have more frequent bouts of bronchitis and other infections.
  • Avoid polluted air and don’t exercise outdoors when the ozone concentration is high. Your local weather forecaster can tell you when that is about to happen.

Home treatment

Most cases of bronchitis can be managed with home treatment. Here is what you can do at home to prevent complications and feel better.

  • Drink lots of liquid. As long as you don’t have lots of swelling or edema in your legs or a past history of kidney failure or congestive heart failure, it’s suggested that you try to get a minimum of 8 glasses of liquid a day. Liquids help to thin the mucus in the lungs so that it can be coughed out more easily.
  • Get some extra rest. Let your energy go to healing. Your lungs work better when they are upright, so try to sleep in a recliner if you have a lot of symptoms. Otherwise, you can prop yourself up on 4 or 5 pillows.
  • Take acetaminophen (Tylenol) to relieve fever and body aches. Do not give aspirin to anyone younger than 20 years old for fear of causing a syndrome called Reye’s syndrome. Obviously aspirin or ibuprofen in adults should only be taken if your doctor agrees that it’s safe for you.
  • Use a non-prescription cough suppressant that contains dextromethorphan to help quiet a dry, hacking cough so that you can sleep. Dextromethorphan can interact with other medications. (It can be abused if taken in high doses.) If you are on other drugs, ask your doctor if it is OK to take this. Try to avoid cough medicines that contain more than one active ingredient. For example, if Sudafed (pseudoephredrine) is one of the ingredients, older men with large prostates may have difficulty urinating. Also if one has a heart or a vascular problem, such as hypertension, Sudafed can cause complications.
  • Breathe moist air from a humidifier, hot shower, or a sink filled with hot water. The heat and moisture will thin the mucus so that it can be coughed out. Saline or salt nasal spray or drops can be used every hour, if needed, to help a congested nose. If you are using a room humidifier make sure that you completely clean all of the inner mechanisms of the humidifier at least every three days to decrease the multiplication of molds, yeasts, and other detrimental growth in the humidifier. This is the reason why many pediatricians and allergists do not like humidifier use in the bedroom.
  • If you have classic flu symptoms, try home treatment and reassess your symptoms in 48 hours. There are anti-viral medications that can be used if started within the first two to three days of true influenza that are purchased by prescription. A flu shot should be received on a yearly basis in the fall of the year.

When to call a health professional

Call if you develop any of the following symptoms. It may mean that your lung infection is getting worse or that you are developing a bacterial lung infection.

  • A cough with wheezing or difficulty breathing that is new or different.
  • A cough that:
    • Brings up bloody sputum
    • Frequently produces yellow or green sputum from the lungs (not post- nasal drainage), lasts longer than two days and occurs with a fever of 101 degrees or higher.
    • Lingers for more than 7-10 days after other symptoms have cleared, especially if it is productive (brings up sputum). A dry, hacking cough may last several weeks after a viral bronchitis such as a cold.
  • A fever of 104° or higher that does not go down after two hours of home treatment.
  • A fever higher than 101° with shaking chills and a productive cough.
  • A fever that persists despite home treatment. Many viral illnesses cause fevers of 100° or higher for short periods of time (up to 12-24 hours). Call a doctor if the fever stays high.
  • Labored, shallow, or rapid breathing with shortness of breath.
    • If you have significant chest-wall pain (pain in the muscles of the chest) when you cough or breathe. Sometimes this can just be muscle strain due to the coughing, but your doctor should probably verify that.
    • If you are unable to drink enough fluids to avoid becoming dehydrated or if you are unable to eat.
    • If the sick person is an infant, an older adult, or someone who is chronically ill, especially with lung problems. In those with chronic lung problems, antibiotics may be used if the doctor cannot determine whether he feels you have a bacterial or viral cause.
    • If any cough last longer than four weeks.

Dr. Peterson is a doctor of Family and Community Medicine at the Walter L. Aument Family Health Center, 317 S. Chestnut St., Quarryville.


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