Bronchitis is inflammation of the airways that connect the windpipe (trachea) to the lungs, resulting in persistent cough with quantities of phlegm or sputum. Attacks usually occur in the winter among smokers, babies, the elderly, and those with lung disease, although anyone can get bronchitis.

Bronchitis presents in one of two forms: acute (of sudden onset and short duration) and chronic (persistent over a long period, and recurring for several years).

Cause - Acute bronchitis is usually a complication of a viral infection (such as a cold or the flu), although it can also be caused by air pollution. A bacterial infection also may lead to acute bronchitis. Attacks occur most often in winter. Cigarette smoking is the primary cause of chronic bronchitis, because it stimulates the production of mucus in the lining of the bronchi and thickens the bronchi's muscular walls and those of smaller airways in the lungs, narrowing those passages. The passages then become more susceptible to infection, which cause further damage. Air pollution can have the same effect. The disease is most prevalent in industrial cities and in smokers, and more common in manual and unskilled workers.

Symptoms - The symptoms of both chronic and acute bronchitis are the same. As the bronchial tubes swell and become congested, symptoms appear: wheezing, breathlessness, and a persistent cough that produces yellow or green phlegm. There also may be pain behind the breastbone. Acute bronchitis is also characterized by fever. In chronic bronchitis, symptoms don't quickly clear up, and there is usually no fever. The persistence of symptoms also differentiates this disease from chronic asthma, in which wheezing and breathlessness vary in severity from day to day. As the disease progresses, emphysema may develop. The lungs become more resistant to the flow of blood, leading to pulmonary hypertension. Those with chronic bronchitis usually have two or more episodes of acute viral or bacterial infection of the lungs every winter. Occasionally, blood may be coughed up.

Treatment - Humidifying the lungs either with a humidifier or by inhaling steam will ease symptoms. Drinking plenty of fluids also helps bring up phlegm. Most acute bronchitis clears up on its own without further treatment. If there is a suspicion of an underlying bacterial infection, antibiotics will be prescribed. In chronic bronchitis, an inhaler containing a bronchodilator may relieve breathlessness. In specific cases, the patient may improve by inhaling oxygen from a cylinder. Antibiotics may treat or prevent any bacterial lung infection. Bronchitis is generally treated with inhalers as in the case of Asthma. A rescue puffer, Salbutomal, Ventolin, or Novo-Salmol, is commonly used in cases of respiratory emergency (dyspnea). There are a number of other inhalers which can be prescribed for daily therapy use.

Complications - Pleurisy or pneumonia may rarely occur in cases of acute bronchitis. A physician should be consulted if any of the following symptoms appear: severe breathlessness; audible wheezing; no improvement after three days; blood is coughed up; fever over 101 degrees F, and if patient has underlying lung disease. Chronic bronchitis often leads inexorably to increased shortness of breath; eventually, the patient may become housebound.