Bronchitis is an inflammatory disease caused in the bronchi or airways of the lungs. It is one of the most commonly diagnosed inflammatory diseases of the lung. The exact description of bronchitis is the consistent onset of productive cough throughout the year at regular intervals. Exceptions for the occurrence of bronchitis include children and infants. In most cases, the diagnosis of bronchitis becomes a challenge as many other pulmonary diseases mimic the symptoms associated with bronchitis. The obstruction of large airways is the specific cause for bronchitis.
The etiologies associated with bronchitis are categorized as bacterial and viral origins. In many cases, the disease is caused by respiratory syncytial viruses, influenza viruses and adeno viruses. Bacterial agents such as Bordatella pertussis and Mycoplasma are causative agents for bronchitis. In these cases, the occurrence of purulent cough is not a significant diagnostic factor of Pneumonia.
Symptoms of bronchitis
The most frequent incidences of bronchitis are during the onset of winter season. This is because of the high volume of viral particles in the atmosphere which attack the host for their mode of survival during unfavorable conditions. Bronchitis can cause much discomfort as it weakens the infected person. Some of the common symptoms of bronchitis include dry cough leading to productive cough which contains greenish yellow phlegm, chest pain, breathlessness, Myalgia, fatigue and headache.
Diagnosis and Treatment of bronchitis
Bronchitis in many cases is self-limiting in origin. Most physicians recommend fluid intake and rest. The key to effective treatment for bronchitis lies in differentiating it from other diseases such as tuberculosis, carcinoma, mycotic infections of the lungs and asthma. Chest x- rays and blood tests are recommended to analyze the toxicity and the inflammation caused. Antibiotics are usually not recommended. However, in case of increased white blood cell count, patient is given intravenous fluids along with antibiotics.
Wheezing is a characteristic high pitched whistling sound made while breathing, a primary symptom of a chronic respiratory disease - Asthma. It is not uncommon in those with respiratory allergies, especially during the hay fever season. Sometimes, other respiratory infections could be accompanied by mild wheezing, especially when acute Bronchitis is experienced. It is also noticed in those with heart failure and Chronic Obstructive Pulmonary Disease COPD. While most commonly wheezing occurs during breathing out, it can sometimes also be related to breathing in.
Causes of Wheezing
Narrowing of airways results in breathing difficulty and wheezing. There could be several causes for narrowing of airways including inflammation from asthma, infection, allergic reaction or a physical obstruction such as tumor or foreign body inhalation. Among the possible causes of wheezing include allergies, insect bite or medication or pollen, pet dander, dust, foods, Bronchiolitis, bronchitis, childhood asthma, epiglottitis, GERD, heart failure, lung cancer, pneumonia, sleep apnea, smoking and vocal cord dysfunction.
Respiratory Syncytial Virus (RSV) Infection is also known as Bronchiolitis - inflammation of the bronchioles which in turn refer to the the narrow airways which branch from bronchi to the air sacs called as alveoli. This RSV infection largely affects infants and children.
To determine the cause of wheezing, your doctor will ask questions about any symptoms that triggers it. If you have no history of lung disease and develop wheezing after eating a certain food or in a certain season, respiratory allergy is suspected. The doctor checks the lungs with a stethoscope to find out where the wheezing is and how bad it is. During a first time evaluation, the doctor performs a spirometry - breathing test, and also a chest X ray.
Sometimes other blood tests and procedures become necessary depending upon the health condition. In case it is allergic wheezing, then a variety of tests to determine the allergies including dermatological examinations are done.
Wheezing is accompanied by difficult breathing, rapid breathing and briefly bluish skin color. Emergency care must be sought if wheezing begins suddenly after being stung by a bee, while taking medication, or eating an allergy-causing food or after choking on a small object or food.
Wheezing in infants
In case of a baby, wheezing could be due to cold or problematic asthma. But it is not always clear if the infant has asthma. It is essential to get a firm diagnosis and make sure that the child gets treated for any breathing problems. In some infants, Bronchiolitis could occur due to a viral infection. The airways swell making breathing difficult. As the airway of an infant is small, infants are easily affected. Wheezing could result due to Bronchiolitis, which may develop into asthma in later life. Otherwise a child could be born with a tendency to wheeze and therefore could be prone to bronchiolitis and asthma. Less common reasons for wheezing in infants include inhalation of a foreign object or piece of food into the lungs, premature birth, insufficiently developed airways and cystic fibrosis.
A variety of treatments are available to help alleviate wheezing. However, regular monitoring by a doctor is a must, especially if the patient has asthma, chronic allergies, severe bronchitis, emphysema or chronic obstructive pulmonary disease. In some, wheezing can be relieved by certain medications or by using an inhaler. Some might need insertion of a breathing tube into the throat. The doctor may recommend some or all of the following to reduce inflammation and open up the airways obstructing breathing to stop wheezing:
- A bronchodilator inhaler, which can act fast to dilate constricted airways.
- An inhaled Corticosteroid
- A long-acting bronchodilator and Corticosteroid combination
- A controller pill for asthma to reduce airway inflammation
- A non-sedating antihistamine pill or a prescription nasal spray for nasal allergies, which are available over the counter.
Self-care measures to ease wheezing
Moisturize the air by either using a humidifier or a steamy shower or just sit in the bathroom with the door closed while running a hot shower. This is simply because moist air can help relieve mild wheezing in some cases.
Drinking fluids can relax the airway and loosen up sticky mucus in the throat.
Active or passive smoking can worsen a cough and hence it is best to avoid tobacco.
Normally, mild wheezing that accompanies bronchitis disappears when the infection subsides. But in case of breathing difficulty, she needs to rush to the doctor who can administer the following:
- A shot of epinephrine to open up the clogged respiratory passages.
- Frequent nebulizer to ease breathing
- A mechanical ventilator to help you breathe
It is for the doctor to determine the cause of wheezing and then treat the patient for the specific cause.
Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease (COPD)encompasses a group of lung disorders that include chronic bronchitis, emphysema, chronic obstructive airways disease and chronic asthma. COPD affects millions of people worldwide and this disease is mostly attributed to smoking. Air pollution, working in an environment with harmful effluents and passive smoking are also likely causes for Chronic Obstructive Pulmonary Disease. Sometimes a patient may suffer an inherited form of emphysema due to a deficiency of alpha-1-antitrypsin. With chronic bronchitis, the air passages and mucus glands are enlarged thereby leading to severe cough. Over time, the enlargement can lead to reduced oxygen supply to the lungs. Elevated blood pressure is noticed. This condition is more predominant in those who smoke or have a history of respiratory illness. While some patients develop wheezing and shortness of breath, others notice mucus while coughing. Chronic bronchitis is noticed with symptoms such as continuous cough, rapid breathing and cyanosis (bluish tint to the lips and nails). Morning headaches may be noticed on account of inability to remove carbon dioxide from the blood. Patients with severe case of COPD may face hemoptysis (alternatively haemoptysis) (blood while coughing). Emphysema occurs when the tiny alveoli in the lungs are destroyed thereby hampering efficiency of the lungs. It leads to labored breathing and the patient often feels out of breath. Other symptoms are loss of weight, disturbed sleep and tight constriction in the chest.
Diagnostic tests for COPD include blood tests and pulmonary function test. The pulmonary function test is an indicator of the extent of blockage of the lungs. Chest x-rays help in identifying damaged areas of the lungs and areas of fluid collection as well as any masses in the lungs. Sputum culture can identify any respiratory infection. A spirometry test measures the amount of air a person can blow in a second. Arterial blood gas analysis indicates how efficiently the lungs bring oxygen into the blood and remove carbon dioxide.
Antibiotics can help in tackling the bacterial infections in the lungs. Bronchodilators open up the air passages in the lungs thereby alleviating some of the symptoms of Chronic Obstructive Pulmonary Disease. Inhaled corticosteroids will reduce airway inflammation. In severe cases, oxygen is administered. In addition, some lifestyle changes must be followed:
- Avoid smoking
- Avoid exposure to secondhand tobacco smoke
- Adopt physical fitness regime to maintain good lung health
- As far as possible, avoid environmental irritants, hazardous inhaled substances such as paints, chemicals and cleaning agents
- Balanced diet
- Plenty of water and fluids
- Steam inhalation