Bronchitis

Diagnosis

Diagnosing bronchitis typically involves a comprehensive evaluation that includes a thorough medical history inquiry, assessment of presenting signs and symptoms, and a physical examination. Differentiating between the symptoms of bronchitis and those of a common cold can be challenging, particularly in the early stages of illness.

To confirm the diagnosis of bronchitis, additional tests may be necessary. These tests can include:

• Physical examination: During the physical examination, the healthcare provider will examine the lungs for symptoms of congestion and to ensure that one is breathing properly. They will attentively listen to the breathing using a stethoscope to assess the lungs.
• Chest X-ray: In cases where the cough persists, a healthcare provider may recommend a chest X-ray to rule out more serious conditions. A chest X-ray can provide detailed images of the heart and lungs, aiding in the detection of pneumonia or other underlying ailments that may be causing the cough. This is particularly important for individuals with a history of smoking or who are currently smokers.
• Sputum tests: Patients may be asked to cough and expel mucus into a tube. Sputum is the mucus that comes up from the lungs during a cough. The sample will undergo testing to identify any indications of a viral or bacterial presence. Sputum can also be checked for allergy symptoms. It is evaluated to discover whether one has any illnesses that might benefit from antibiotics.
• Pulmonary function test (PFT): This is often recommended if the healthcare provider suspects chronic bronchitis. This test looks for symptoms of asthma or emphysema. PFT assesses how effectively the lungs’ function.

In a pulmonary function test, one exhales into a device known as a spirometer. This device measures how much air the lungs can hold, and how quickly the air is released from one’s lungs.

• Nasal swab: The healthcare provider may put a soft-tipped stick, known as swab, in the nose to test for viruses such as COVID-19 or the flu.
• Blood tests: This test may be necessary to check for the patient’s overall health or existing infections.

Treatment

In general, acute bronchitis often resolves on its own without requiring medical intervention. Since viral infections are the primary cause of this condition, and most viruses do not have specific medications, the body’s natural defenses work to combat the infection. During the recovery period, managing the symptoms of acute bronchitis can be done at home while waiting for the inflammation to subside.

If bronchitis is caused by factors other than viruses, it may require treatment to manage the condition. In the case of chronic bronchitis, complete recovery is less likely, but appropriate treatment can lead to improvement of the condition.

• Medications: Medication is rarely used to treat acute bronchitis. In some instances, one can take drugs to alleviate symptoms or address the underlying problem, such as:
  • Cough medicine: A lingering cough may benefit from over the counter or prescription cough suppressants, such as dextromethorphan and benzonatate.
  • Bronchodilators: If one is having problems breathing, a bronchodilator may be prescribed.
  • Antiviral drugs: If the bronchitis is caused by the flu, the healthcare provider may prescribe an antiviral drug. The sooner it is taken, the sooner one may feel better.
  • Other medications: To minimize inflammation, corticosteroids and other drugs may be prescribed.
    Individuals with allergies, asthma, or chronic obstructive pulmonary disease (COPD) might receive a doctor’s recommendation for using an inhaler and other prescribed medications. These treatments aim to minimize inflammation and widen constricted air passages within the lungs.

In approximately 95% of cases, bronchitis is attributed to viral infections. However, if the diagnosis suggests that bacterial infection is responsible for bronchitis, antibiotics may be prescribed. Once an individual begins taking antibiotics, they generally cease to be contagious within 24 hours.

• Therapies: Individuals with chronic bronchitis may find pulmonary rehabilitation advantageous. This program involves a series of breathing exercises facilitated by a respiratory therapist, who guides in learning techniques to enhance ease of breathing and improve exercise tolerance.