Acute bronchitis (inflammation of the airways) is a common condition that causes a cough along with other symptoms and tends to affect people more often during the winter. An acute episode typically lasts 10 to 14 days and resolves on its own or with medications. Chronic bronchitis is a less common condition, and is defined as a cough that persists for more than three months.
Every year, approximately 9.1 million Americans – usually those over 45 years old – are diagnosed with chronic bronchitis. Females are more than twice as likely as men to have the condition.
By its very nature, chronic bronchitis doesn't strike suddenly. For example, a person who continues to cough for weeks after having gotten over a cold might not think that the cough is a problem. But the chronic coughing could be a sign that the lungs are becoming seriously injured.
What Causes the Coughing?
Acute bronchitis is usually caused by an infection. Chronic bronchitis, however, has a variety of causes – the most common of which are smoking and an underlying chronic lung disease known as chronic obstructive pulmonary disease (COPD). COPD causes irreversible obstruction of air flow into the lungs, and is a disease that worsens over time. In addition to having a chronic cough, a person with COPD can feel short of breath at rest or with activity and eventually might require treatment with oxygen.
Other causes of a chronic cough include:
- Allergies that lead to post-nasal drip which then triggers a cough
- Asthma – a chronic inflammatory condition that causes narrowing of the airways and a reversible obstruction of air flow
- Gastroesophageal reflux – also known as acid reflux, caused by food contents backing up from the stomach into the esophagus causing inflammation
- Medications such as ACE (angiotensin converting enzyme) inhibitors, which are often used to treat high blood pressure
- Persistent exposure to irritants, such as dust or smoke in a home or work setting
- A foreign body in the lungs or airways
More serious causes of a chronic cough include tuberculosis, cancer, cystic fibrosis, and others. It is important for a person who is suffering from a persistent cough to see a doctor who can take a detailed medical history, do a thorough examination, determine the cause of the cough, and prescribe proper management and treatment.
Tests that a doctor might order to help diagnose the cause of bronchitis include:
- A chest x-ray, which can reveal evidence of pneumonia, congestive heart failure, a mass, inflammation, and other patterns of disease
- A sample of mucous (if it is a wet cough rather than a dry cough) to look for evidence of infection, inflammation or a malignancy
- Blood work to see, for instance, if the white blood cell count is raised, which can suggest an infection
- Pulmonary function tests to see how well the lungs are functioning, and to check for signs of asthma
Less commonly, a pulmonoscopy – an exam where a doctor uses a scope to look inside the lungs – or even a lung biopsy might be required. These tests are more commonly done when there is a mass in the lungs or airways leading to the lungs, or if a chest x-ray is abnormal but the diagnosis is unclear.
Treatments for Chronic Coughing
If you have a chronic cough, do not simply treat yourself with over-the-counter medications without seeing a doctor. While over-the-counter medications might help ease some symptoms, the medication does not address the underlying problem. A persistent cough should be taken seriously and needs medical attention by a doctor.
Treatment for chronic bronchitis depends on the underlying diagnosis and include:
- antibiotics, antivirals, or antifungals if it’s a caused by an infection
- inhalers that open up the air passages and reduce inflammation for asthma sufferers
- acid blockers and lifestyle behavior changes for people with gastroesophageal reflux.
One absolute in preventing chronic bronchitis and subsequent COPD is to stop smoking! If you smoke, see your doctor to learn how to quit for good. This action can save your life – and your family’s lives – and prevent chronic, debilitating, and potentially life-threatening illness. |
