Bronchitis means inflammation of the air passages to the lungs. Bronchitis can be acute or chronic. Acute bronchitis is usually due to a viral infection that begins in your nose or sinuses and spreads to the airways. To be considered chronic, you must have a cough productive of sputum at least three months out of the year. Chronic bronchitis occurs most often in smokers and, together with emphysema, is known as chronic obstructive pulmonary disease (COPD).

Acute bronchitis:

• Cough that produces mucus
• Burning sensation in the chest
• Wheezing
• Sore throat
• Fever
• Fatigue

Chronic bronchitis:

• Chronic cough that produces excessive amounts of mucus
• Wheezing, shortness of breath
• Blue-tinged lips
• Ankle, feet, and leg swelling

Acute bronchitis is usually caused by a virus, but can also be caused by bacteria. Generally, acute bronchitis is passed from person to person.

The main causes of chronic bronchitis are cigarette smoking and prolonged exposure to air pollution or other irritants such as dust and grain.

Your provider will listen to your chest and back, look at your throat, and may draw blood and take a culture of the secretions from your lungs. If your doctor is concerned about possible pneumonia or COPD, a chest xray might be ordered.

The best way to avoid chronic bronchitis is to not smoke and to stay away from air pollutants. To avoid infection that may lead to either acute bronchitis or exacerbation of chronic bronchitis, get an annual flu vaccine and pneumococcal vaccine once in your lifetime.

Acute bronchitis from a virus generally clears on its own within 7 to 10 days. Using a humidifier, taking a cough medicine that contains an expectorant (something that helps you "bring up" secretions), and drinking plenty of fluids can help relieve symptoms. If a bacterial infection is suspected or confirmed (by, for example, sputum cultures), your health care provider may prescribe antibiotics to help treat your bronchitis.

• DO NOT smoke.
• Use a humidifier or steam in the bathroom.
• Drink plenty of fluids.
• Rest while you have an active infection.
• If you have low oxygen levels from chronic bronchitis, home oxygen therapy will be prescribed.

• Bronchodilators (such as albuterol) - this is an inhaler that can help open up your airways
• Corticosteroids -- inhaled or oral to reduce mucus and inflammation
• Cough suppressant or expectorant
• Antibiotics for bacterial infection

If you have chronic bronchitis, you might want to experiment with different food choices to see if changes to your diet make any difference in your symptoms. As you do this, keep a careful record of how you are feeling (that is, any changes in your symptoms). For example, try reducing your intake of dairy which may increase mucus production. Also, try eliminating eggs, milk, nuts, food coloring, preservatives, and additives. Try adding onions and garlic.

N-Acetyl-Cysteine (NAC)

A review of scientific studies found that NAC may help dissolve mucus and improve symptoms associated with chronic bronchitis.

Zinc

Zinc supplementation enhances immune system activity and protects against a range of infections including colds and upper respiratory infections (such as bronchitis).

Other supplements to consider may help prevent you from catching an infection or may help relieve symptoms from bronchitis:

• Bromelain
• Lactobacillus
• Quercetin
• Vitamin C

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain active substances that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care and only under the supervision of a practitioner knowledgeable in the field of herbal medicine.

Barberry (Berberis vulgaris)

This herb contains substances that help fight infection and improve immune function. For this reason, herbalists commonly include barberry in the treatment of respiratory infections like bronchitis.

Eucalyptus (Eucalyptus globules)

Eucalyptus is commonly used in remedies to treat coughs and the common cold. Eucalyptus oil helps loosen phlegm, so many herbal practitioners recommend inhaling eucalyptus vapors to help treat bronchitis, coughs, and the flu.

Peppermint (Mentha x piperita)

Peppermint and its main active agent, menthol, are effective decongestants. Because menthol thins mucus, it is also a good expectorant, meaning that it helps loosen and breaks up coughs with phlegm. It is soothing and calming for sore throats (pharyngitis) and dry coughs as well.

Slippery elm (Ulmus fulva)

Slippery elm has received recognition from the U.S. Food and Drug Administration (FDA) as a safe and effective option for sore throat (pharyngitis) and respiratory symptoms including cough.

Stinging nettle (Urtica dioica)

Active compounds in stinging nettle may act as an expectorant (meaning that it can loosen and break up a cough) and may have anti-viral properties.

Other

Additional remedies that an herbalist might consider as part of the treatment for bronchitis or its symptoms include:

• Astragalus (Astragalus membranaceus)
• Echinacea (Echinacea angustifolia/Echinacea pallida/Echinacea purpurea)
• Garlic (Allium sativum)
• Ginger (Zingiber officinale)
• Ivy leaves (Hedera helix L.)
• Jamaica dogwood (Piscidia erythrina/Piscidia piscipula) - Note: there has been little to no scientific research on Jamaica dogwood, so the safety and effectiveness of this herb is relatively unknown. Jamaica dogwood is a potent herb and should be used only under the guidance of a qualified healthcare professional.
• Licorice (Glycyrrhiza glabra) - Note: this herb should NOT be used if you have high blood pressure
• Linden (Tilia cordata and Tilia platypus)
• Lobelia (Lobelia inflata), also known as Indian tobacco - Note: this herb, which is potentially toxic, should NOT be used without specific instruction from a trained and qualified herbal specialist.
• Marshmallow (Althea officinalis)
• Red clover (Trifolium pratense)
• Saw palmetto (Serenoa repens/Sabal serrulata)

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of bronchitis in addition to standard medical care. Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

• Aconitum -- for early stages of bronchitis or other respiratory disorders; this remedy is most appropriate for people with a hoarse, dry cough who complain of dry mouth, thirst, restlessness, and being awakened by their own coughing; symptoms tend to worsen in cold air or when when lying on one's side
• Antimonium tartaricum -- for wet, rattling cough (although the cough is usually too weak to bring up mucus material from the lungs) that is accompanied by extreme fatigue and difficulty breathing; symptoms usually worsen when lying on one's back; this remedy is particularly good for children and the elderly and is generally used during the later stages of bronchitis
• Bryonia -- for dry, painful cough that tends to worsen with movement and deep inhalation; this remedy is most appropriate for individuals who are generally thirsty, chilly, and irritable
• Hepar sulphuricum -- for later stages of bronchitis, accompanied by wheezing, scant mucus production, and coughing that occurs when any part of the body gets cold
• Ipecacuanha -- for the earliest stages of bronchitis accompanied by a deep, wet cough, nausea and vomiting; this remedy is commonly prescribed for infants
• Phosphorus -- for several different types of cough but usually a dry, harsh cough accompanied by a persistent tickle in the chest and significant chest pain; this remedy is most appropriate for individuals who are often worn out and exhausted, tend to be anxious and fear death, and require a lot of reassurance

Aromatherapy

Running a humidifier with an essential oil such as cedarwoord, bergamot, eucalyptus, myrrh, sweet fennel, jasmine, lavender, tea tree, or marjoram at night may help thin mucus and ease cough. Consult an experienced aromatherapist to learn which oil, alone or in combination, is best for you.

Acupuncture can help relieve symptoms of acute bronchitis and, possibly, help improve quality of life for those with chronic bronchitis.

Acupuncturists treat people with bronchitis based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. Needling treatment for bronchitis tends to focus on the lung and spleen meridians. Acupuncturists usually perform other treatments as well to clear the blockage of qi in the chest area. These treatments may include specialized massage, moxibustion (a technique in which the herb mugwort is burned over specific acupuncture points), breathing exercises, lifestyle counseling, and herbal remedies.

Prognosis and Complications

For acute bronchtitis, symptoms usually resolve within 7 to 10 days if you do not have an underlying lung disorder. However, a dry, hacking cough can linger for a number of months.

The chance for recovery is poor for advanced chronic bronchitis. Early recognition and treatment, combined with smoking cessation, significantly improve the chance of a good outcome.

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