Acute or chronic bronchitis: how is it treated?

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Acute bronchitis is most often viral infections that do not require treatment other than symptomatic. Chronic bronchitis is mainly related to smoking.

Acute or chronic bronchitis

In winter 2020, viruses circulated little due to the curfew and drastic barrier gestures. Since this fall, when 75% of French people have been vaccinated against Covid , it has to be said that the hygiene measures complementary to vaccination (hand washing, wearing a mask indoors, social distance, ventilation of closed places ) are less respected. Result, the pathologies of winter are back: bronchiolitis , colds , gastro and already some flu .

The bronchitis is also back. What are the symptoms ? How to tell the difference between bronchitis and Covid? The answers of the pulmonologist.


What is bronchitis?

Acute bronchitis is an episode of inflammation of the bronchial tubes. It almost always has a viral origin but can become superinfected. We speak of chronic bronchitis in the presence of cough and expectoration for at least 3 months per year, for at least two consecutive years. “Chronic bronchitis is the first stage of chronic obstructive pulmonary disease (COPD)”, specifies Professor Christos Chouaid, pulmonologist at the CHI of Créteil. COPD is a chronic respiratory disease defined by a permanent and progressive obstruction of the airways and the presence of an obstructive ventilatory disorder.

Asthmatic bronchitis is a form of bronchitis that combines symptoms of acute bronchitis with symptoms of asthma . “It concerns people who have asthma and who have a viral infection, which leads to a picture of bronchitis”, explains Professor Christos Chouaid.

What is the cause of bronchitis?

Acute bronchitis is most often viral and is generally preceded by rhinitis or nasopharyngitis. Viruses frequently involved? Influenza virus (flu), respiratory syncitial virus (bronchiolitis in infants), adenovirus, metapneumovirus.

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Bacterial superinfections are rare . There are risk factors for bacterial complication of viral bronchitis. Thus, people with chronic bronchitis (COPD), asthma, heart failure, chronic kidney disease, cancer, immunosuppression or cirrhosis of the liver are more at risk of developing bacterial bronchitis following a viral infection.

“Chronic bronchitis is mainly due to tobacco”, informs the pulmonologist.

What are the symptoms of bronchitis?

Acute bronchitis is indicated by a cough, dry or oily , sometimes accompanied by sputum , chest pain especially when coughing. The other symptoms are fever generally below 38.5°c, body aches and headaches.

Chronic bronchitis is characterized by the presence of cough and expectoration for at least 3 months per year , for at least two consecutive years. “The difference between asthmatic bronchitis and chronic bronchitis is the presence of wheezing in the event of asthmatic bronchitis”, specifies Professor Chouaid.

Bronchitis and Covid: how to tell the difference?

Bronchitis or Covid? Cough being the main symptom of bronchitis but also of Covid-19 infection, it is recommended to consult a doctor if you cough. “In the slightest doubt, a Covid test must be carried out”, recommends Professor Chouaid.

How is she diagnosed?

The diagnosis of acute bronchitis is clinical (based on symptoms), as is that of chronic bronchitis. The characteristic wheezes of asthmatic bronchitis are heard on auscultation.

How to cure bronchitis?

Acute viral bronchitis heals on its own in about ten days . The cough can persist for up to 3 weeks. The treatment is symptomatic : paracetamol to relieve headaches, body aches and reduce fever. A cough that is accompanied by sputum should not be treated with an antitussive syrup because the cough clears the bronchi.

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In case of chronic bronchitis , in order to avoid the passage to the stage of COPD, it is advisable to stop smoking . “It is also important to have regular physical activity, to get vaccinated against the flu and to have it checked that there is no dental or sinus infection ,” says Professor Chouaid.

How to treat bronchitis naturally?

If you have viral bronchitis and are not at risk of complications, you can use homeopathy to relieve symptoms, although there is no evidence of its effectiveness. You can try Hepar Sulpuris Calcareum three pellets three times a day, and add a remedy according to your symptoms: Mercurius Solubilis 9 CH, three pellets three times a day in case of bronchitis with large yellow sputum, Bryona Alba 9CH three pellets three times per day in case of small dry cough (1).

On the phytotherapy side, infusions of pectoral flowers (white broth, poppy, mallow, marshmallow root, etc.) relieve coughs: to make an infusion, put a teaspoon of pectoral flowers in 25cl of boiling water, leave to infuse for 10 minutes, filter and drink hot (3 cups a day). (2)

How long does bronchitis last? Is she tired?

Viral bronchitis can last about ten days and the cough can persist longer. Like any infection, this one tires the body, especially since coughing can prevent quality sleep.

Is it contagious?

Viral bronchitis is contagious like all viral infections. If you have bronchitis, protect others by coughing into your elbow and wearing a mask in the presence of fragile people.

How do you know if bronchitis is getting worse?

If you have had bronchitis for a few days and you present certain of the following signs: headache, vomiting, sweating, reddening of blood, difficulty breathing, wheezing, pain in the chest, fever above 38.5°C, you should consult your doctor again. “Progressive shortness of breath on exertion is a sign of aggravation of acute or chronic bronchitis”, indicates Professor Chouaid.

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