Bronchitis

• Also Listed As
• Signs and Symptoms
• What Causes It?
• Risk Factors
• What to Expect at Your Provider's Office
• Treatment Options
• Treatment Plan
• Drug Therapies
• Complementary and Alternative Therapies
• Following Up
• Supporting Research

Bronchitis is a respiratory tract infection (viral or bacterial) that causes inflammation of the mucous lining of the bronchial tubes. Acute bronchitis generally is reversible. Chronic bronchitis, often referred to as smoker's cough, is not usually reversible.


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Also Listed As
Respiratory Infection, Bronchitis

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Signs and Symptoms

Acute bronchitis:

• Cough that produces mucus or pus
• Burning sensation in the chest
• Sore throat and fever (with some types)
• Fatigue
• Blue-tinted lips
• Wheezing
• Weight gain

Chronic bronchitis:

• Chronic cough that produces excessive amounts of mucus or pus
• Wheezing, shortness of breath
• Present for three consecutive months, two years in a row


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What Causes It?

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.

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Risk Factors
• Cigarette smoking
• Severe pneumonia early in life
• Being a man over age 50


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What to Expect at Your Provider's Office

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.

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Treatment Options


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Treatment Plan

Chronic bronchitis may be irreversible but it is preventable. The best way to avoid bronchial infections is to not smoke and to stay away from air pollutants. Your health care provider may prescribe antibiotics to help treat your bronchitis if it is caused by bacteria. He or she may also suggest using a humidifier, taking a cough medicine that contains an expectorant (something that helps you "bring up" secretions), and drinking plenty of fluids.


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Drug Therapies
• Bronchodilators (such as albuterol)
• Corticosteroids (20 to 40 mg per day of prednisone or 100 to 200 mcg, 2 to 4 puffs per day of inhaled beclomethasone) to reduce mucus and inflammation
• Cough suppressants
• Expectorant medication (10 to 12 drops 3 times daily of potassium iodide) or tracheal suction
• Antibiotics for bacterial infection (250 to 500 mg of penicillin or tetracycline every 6 hours for 10 days)
• Oxygen for hypoxia (a lower-than-normal concentration of oxygen in the blood): more than 12 hours per day required to be effective


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Complementary and Alternative Therapies

Alternative therapies can be useful in treating chronic bronchitis.

Nutrition • Eliminate known allergenic foods (for example, eggs, milk, nuts, peanuts, soy), food coloring, preservatives, and additives. Reduce intake of mucus-producing foods such as dairy, citrus, wheat, and bananas. Onions and garlic help to thin mucus.
• Vitamin C (250 to 500 mg two times per day), zinc (30 mg per day), and beta-carotene (50,000 to 100,000 IU per day) support the immune system. Some studies suggest that smokers do not use beta-carotene. N-acetylcysteine (200 mg twice a day between meals) protects lung tissue from damage and helps break up mucus.

Herbs
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Herbs can be used in combination. Tincture combinations should be taken at 30 drops three to four times per day. Make infusions with 1 heaping tsp. of herbal combination, steep covered for 10 minutes, and drink 3 to 4 cups per day. Substitute grindelia (Grindelia robusta) for licorice root if you have high blood pressure.
• Acute bronchitis: Thyme leaf (Thymus vulgaris), licorice root (Glycyrrhiza glabra), coneflower (Echinacea purpurea), ginger (Zingiber officinale), and linden flowers (Tilia cordata). Smokers should substitute Indian tobacco (Lobelia inflata) for the linden flowers. White horehound (Marrubium vulgare) is a gentle stimulating expectorant (helps you cough up mucus) that relaxes spasms of the bronchi (passages in the lungs). Sundew (Drosera rotundifolia) helps you cough up mucus and relaxes spasms.
• Chronic bronchitis: Pleurisy root (Asclepias tuberosa), Indian tobacco (Lobelia inflata), elecampane (Inula helenium), licorice root, lungwort (Sticta pulmonaria), and lomatium (Lomatium dissectum). Boneset (Eupatorium perfoliatum), is an herb that helps to sweat out impurities and relax spasms. Pill bearing spurge (Euphorbia hirta) is an herb that breaks up mucus and relaxes spasms.
• Garlic (Allium sativum) and ginger tea can be used long-term (2 cloves of garlic and 2 to 3 slices of ginger root). Simmer in 1 cup of water for 15 minutes. Drink 3 to 4 cups per day. Add honey or lemon to flavor.

Homeopathy
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 respiratory disorders such as bronchitis; this remedy is most appropriate for people with a hoarse, dry cough who complain of dry mouth, thirst, restlessness, and being awakened by 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 the person is lying on his or her 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

Physical Medicine • Castor oil pack. Apply oil directly to skin, cover with a clean soft cloth and plastic wrap. Place a heat source (hot water bottle or heating pad) over the pack and let sit for 30 to 60 minutes.
• Chest rubs with 3 to 6 drops of essential oil in 1 tbsp. of food-grade oil. Thyme, eucalyptus, and pine oils can ease bronchial spasm and thin mucus.
• Running a humidifier with essential oils such as eucalyptus, tea tree, or marjoram at night may help thin mucus and ease cough.
• Postural drainage can be of great help in relieving congestion.

Acupuncture
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.

Massage
Therapeutic massage can increase circulation and loosen mucus.


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Following Up

It can take from one to eight weeks to recover completely. To help prevent getting bronchitis again, do not smoke and try to avoid pollutants in the air. Getting an annual flu shot can also help.

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Supporting Research

Allan H, Goroll MD, et al., eds. Primary Care Medicine. 3rd ed. Philadelphia, Pa: Lippincott-Raven Publishers; 1995:252-260, 285-294.

Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers; 1995:72-73.

Bone RC, ed. Pulmonary and Critical Care Medicine. St. Louis, Mo: Mosby-Year Book, Inc; 1998:G3 1-6.

Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999;69(6):1086-1107.

Cecil RL, Plum F, Bennett JC, eds. Cecil Textbook of Medicine. 20th ed. Philadelphia, Pa: WB Saunders Co; 1996:382-389.

Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines. 3rd ed. New York, NY: Penguin Putnam; 1997: 68.

JAMA Patient Page. How much vitamin C do you need? JAMA. 1999;281(15):1460.

Johnston CS. Recommendations for vitamin C intake. JAMA. 1999;282(22):2118-2119.

Jonas WB, Jacobs J. Healing with Homeopathy: The Doctors' Guide. New York, NY: Warner Books; 1996: 210.

Kruzel T. The Homeopathic Emergency Guide. Berkeley, Calif: North Atlantic Books; 1992:40-43.

Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.

Rakel RE, ed. Conn's Current Therapy. 50th ed. Philadelphia, Pa: WB Saunders Co; 1998:211-212.

Ullman D. Homeopathic Medicine for Children and Infants. New York, NY: Penguin Putnam; 1992: 70-72.

Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Penguin Putnam; 1995: 227-228.