Common cold, dry cough then oily and productive, thick secretions… So many signs that can evoke a bronchitis. We count approximately10 million each year in France. What are the causes ? What treatments when the bronchi are congested? Should you take antibiotics ?How long it lasts ? East-contagious ? What are the other symptoms from bronchitis? Acute? Chronic?Explanation with Dr. Jacques Amselem, general practitioner in Seine-et-Marne.

Definition: what is bronchitis?

Bronchitis is inflammation of the bronchial mucosa, a tissue lining the bronchi and bronchioles. The bronchitis can be acute i.e. punctual. It is the bronchitis that falls on us in autumn-winter and is usually due to a virus. She can also be chronic i.e. repeating itself several times a year and is then often due to smoking. It’s hereCOPD.

What is acute bronchitis?

"Bronchitis can be a phenomenon punctualdue to an infectious, viral or bacterial agent", details Dr. Amselem, general practitioner in Seine-et-Marne. Before specifying that we are talking about acute bronchitis which is manifested by a fatty cough with sputum, sometimes difficulty breathing, slight fatigue, and fever. It usually heals by ten days.

What is chronic bronchitis?

Bronchitis can also be chronic: this is often the case in heavy smokers who are victims of chronic obstructive pulmonary disease or COPD. Occupational and prolonged exposure to certain toxins can also lead to COPD. Chronic bronchitis, caused in the vast majority of cases by smokingaffects approximately 1 in 5 men over the age of 40 and progresses in 10 to 20% of cases to aCOPD.

What is recurrent bronchitis?

When bronchitis is regular during the winter, or for several years, the possibility of an allergy must be considered. An allergological assessment can help determine the allergen in question. The COPD is frequently complicated by bronchial superinfections.

Causes: how do you get bronchitis?

• 90% of bronchitis is viral. Many viruses are responsible:influenza and parainfluenza virus, respiratory syncytial virus (RSV), adenovirus, rhinovirus…
• 10% of bronchitis is bacterial

Bronchitis is due to a decrease in the caliber of the bronchioles allowing the passage of ambient air to the lungs. Nasal secretions or mucus (in green in the diagram below) then flow through the back of the throat and then reach the bronchi.Nasopharyngitis (or cold) usually precedes acute bronchitis.

What are the symptoms of bronchitis?

• First and main symptom: cough.This can persist for several days, even 4 weeks in certain situations. Dry cough becomes oily over the days (productive cough). The person coughs fat and emits yellowish or greenish purulent sputum. This is not a sign that the disease is getting worse, on the contrary, it is normal! The acute phase of bronchitis, characterized by this cough, evolves over approximately 2 to 3 days.
• Rapid and labored breathing.
• A stuffy nose
• Thick secretions from the nose or throat
• Fever (mild, no higher than 38-38.5°C)
• Chest pain and a burning sensation in the sternum, especially on deep breaths
• Fatigue and aches.

How long does bronchitis last?

Usually bronchitis heals in about ten days.

Is bronchitis contagious?

Most often of viral origin, acute bronchitis is highly contagious. In order to limit the transmission of the virus, it is recommended to:

• cover your mouth and nose when coughing or sneezing
• use single-use tissues and throw it in a trash can with a lid,
• wash your hands frequently with liquid soap for 30 seconds to limit contamination,
• to limit contact with vulnerable people,
• avoid gathering places.

When should you consult?

"It is necessary to consult urgently in case of frequent and violent coughing episodesor if the person expectorates purulent sputum and/or sputum containing traces of blood, if he whistles and has difficulty breathing, if his lips are bluish, if the fever is higher than 39°C or even s he is shot", recommends Dr. Amselem. It is also recommended to consult as soon as possible when the cough affects a baby less than three months old. Also, a child with acute bronchitis who has been coughing for more than 8 days should see a doctor.

How is the diagnosis of bronchitis made?

Diagnosis of bronchitis is usually made through clinical examination and questioning the patient about their symptoms. To establish the diagnosis, the doctor can help himself an x-ray of the lungsbut this examination is not systematic.

What treatment to treat bronchitis?

In healthy adults, no treatment is needed for acute bronchitis. Bronchitis usually heals naturally within 10 days. When a treatment is necessary (defined by a doctor), it consists of taking antibioticsclassically based amoxicillin. Sometimes it will be necessary to add sessions ofrespiratory physiotherapy. Fever can also be lowered with paracetamol. The cortisone is not particularly indicated in case of bronchitis.For chronic bronchitis, one can only reduce the symptoms without eliminating it definitively.

What are the possible complications of bronchitis?

Generally, bronchitis evolves favorably in about ten days. But sometimes the cough may persist. It can evolve in pneumonia, an infection of the lung tissue, especially in fragile people (elderly people, people with a weakened immune system). Pneumonia is suspected if bronchitis is accompanied by high fever that persists for more than 2 days.

Prevention: how to avoid bronchitis?

Acute bronchitis can be avoided by respecting barrier gestures. Prevention of chronic bronchitis is based on smoking cessation. In case of COPD, vaccinations against influenza and pneumococcus are recommended. Some respiratory rehabilitation programs reduce the number of COPD superinfection episodes.

Thanks to Dr Jacques Amselem, general practitioner in Seine-et-Marne.

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