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).
Signs and Symptoms
Cough that produces mucus
Burning sensation in the chest
Chronic cough that produces excessive amounts of mucus
Wheezing, shortness of breath
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
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
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
Cough suppressant or expectorant
Antibiotics for bacterial infection
Nutrition and Dietary Supplements
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.
A review of scientific studies found that NAC may help dissolve mucus and
improve symptoms associated with chronic bronchitis.
Zinc supplementation enhances immune system activity and protects against a
range of infections including colds and upper respiratory infections (such as
Other supplements to consider may help prevent you from catching an infection
or may help relieve symptoms from bronchitis:
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.
Additional remedies that an herbalist might consider as part of the treatment
for bronchitis or its symptoms include:
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
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
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
Massage and Physical Therapy
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
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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Review Date: April 2004
Reviewed By: Participants in the review process include: Constance Grauds, RPh, President,
Association of Natural Medicine Pharmacists, San Rafael, CA; Jacqueline A. Hart,
M.D., Department of Internal Medicine, Newton-Wellesley Hospital, Boston, Ma.,
and Senior Medical Editor, A.D.A.M., Inc; Sherif H. Osman, MD, President,
Medical Staff Harford Memorial Hospital, Falston General Hospital, Bel Air, MD;
Marcellus Walker, MD, LAc, (Acupuncture section October 2001) St. Vincent's
Catholic Medical Center, New York, NY; Tom Wolfe, P.AHG, Smile Herb Shop,
College Park, MD; Ira Zunin, MD, MPH, MBA, (Acupuncture section October 2001)
President and Chairman, Hawaii State Consortium for Integrative Medicine,
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