Acute bronchitis is one of the most common respiratory infections. Viruses are usually responsible for the cough, which is initially dry and later becomes mucous.
Acute bronchitis is a temporary inflammation of the bronchi. However, in addition to the bronchi, other parts of the upper respiratory tract are usually inflamed - most commonly the mucous membranes in the mouth, throat, nose or paranasal sinuses. Because acute bronchitis usually develops in the context of other diseases, mostly with a cold. So the definition is not very precise. When someone coughs, laypeople, but also some doctors, always like to talk about bronchitis, no matter where the cough comes from.
Acute bronchitis is mainly caused by cold viruses, rarely bacteria. Other triggers can be fungi, irritants (e.g. cigarette smoke and particulate matter), allergens, dry air and cold.
After four to six weeks at the latest, the cough should be over in acute bronchitis. There are also persistent forms such as chronic bronchitis and serious chronic obstructive pulmonary disease (COPD). There are some close connections between the diseases.
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Symptoms of acute bronchitis
Does a scratchy throat make you cough often?
Is your cough dry and does your chest hurt when you cough?
These are classic signs of early acute bronchitis, an inflammation of the bronchi. They are part of the pulmonary airways, the bronchial system. This starts at the larynx with the trachea, which splits into two smaller tubes in the chest, the right and left main bronchus. These bronchi branch out more and more and into smaller and smaller tubes. The smallest branches are called bronchioles. They can become inflamed as a complication of acute bronchitis (bronchiolitis).
In most cases, the typical cough associated with acute bronchitis is preceded by cold symptoms such as a sore throat and runny nose. After one or a few days, the dry cough becomes “wet”: the mucous membrane of the bronchi produces more secretion or mucus. This makes itself felt when coughing up as sputum. Expectoration and cough are the two hallmark symptoms of bronchitis. However, there are also completely dry courses.
Other symptoms may accompany the cough with sputum. In addition to cold symptoms, chest pain, limbs and joints, headache and sore throat, hoarseness, fever and a general feeling of illness are common. Sometimes breathing becomes audible when the bronchi secrete a lot of mucus.
People who are otherwise healthy usually recover from acute bronchitis in five to 10 days without special treatment. Only the cough often goes away more slowly. Healthy people with frequent respiratory infections, people with chronic lung diseases (e.g. asthma and COPD) and generally sick people with a weakened immune system carry an increased risk of complicated courses.
In infants and small children in particular, the bronchial muscles occasionally spasm and constrict the airways, or the finest branches of the bronchial tubes become inflamed (see "Course, complications, special features").
Treatment
In most cases, acute bronchitis is mild. Drug treatment is not mandatory. General measures such as those for a cold and home remedies are usually sufficient. However, medication can make the symptoms more bearable and support recovery. They are indispensable in the case of severe courses and complications. Of course, the cause also decides on the therapy. When coughing due to irritants (e.g. cigarette smoke), dry air, cold or allergens, the focus is on avoiding or eliminating these triggers (e.g. stopping smoking, humidifying the air). Otherwise, the treatment is almost always aimed only at the symptoms. Even when bacteria are involved, it is rarely necessary to use antibiotics.
General Measures
- In order to protect their body, those affected should sleep enough, rest a lot and avoid strain and stress.
- Those affected should drink enough to ensure that the mucous membranes can form enough secretions and that they do not become too viscous.
- In order not to additionally irritate the mucous membranes through dryness, the room air should be pleasantly humid (approx. 50 to 60% humidity).
- Smokers should give up cigarettes completely during the illness or at least reduce their consumption as much as possible.
Home remedies and self help
Inhaling warm steam helps secretions to become more fluid and loosen. Steam works best at a temperature of around 45 °C. Many sufferers add salt (1 teaspoon to 1 liter) or chamomile to the water. Essential oils such as eucalyptus or peppermint oil can also be used as additives. Whether they improve the effect has not been proven. Parents should avoid inhalations and essential oils for infants and young children because they can entail risks.
Tapping the chest can loosen and loosen cough phlegm. Those affected usually lie on their stomach, although the head can also lie a little lower. Parents, partners, or other confidants then lightly tap the back at the level of the lungs on either side of the spine. One can do this treatment several times a day if it seems useful.
Cough and cold teas and sweets keep the mucous membranes moist and are said to support healing if they contain herbal substances. Ready-made tea blends are available in pharmacies. You can also use regular fennel tea. Hot drinks and bouillons generally have a slight expectorant effect - similar to inhalations.
If you have a dry cough, breathing properly and coughing can help. Both relieve the bronchi. Breathing properly here means taking a slow, deep breath and exhaling evenly. If you cough into your fist, you create a kind of air cushion that reaches into the bronchi and reduces additional irritation there.
Breast wraps can relieve discomfort and often feel comfortable. If mucus is lodged, warm or hot compresses such as mashed potatoes, chopped onions, or water with lemon juice work best. Quark wraps are traditionally used for dry coughs. Cool chest wraps are said to lower the temperature when coughing with fever. Patients must be warm prior to treatment and their feet should remain warm throughout treatment. If they shiver, the treatment should be stopped.
In a study with children, buckwheat honey dampened their coughs very well and let the little ones sleep better. For use, one or two spoonfuls of honey can be slowly dissolved in the mouth. Alternatively, it is possible to take the honey with drinks (e.g. cough teas). They should not be warmer than 25 °C so that the heat does not destroy valuable active ingredients.
Expectorants, cough suppressants and Co.
Cough suppressants suppress or slow down the urge to cough. They should not be used with a wet, mucous cough, but only with a dry one, if it really bothers you, i.e. disturbs the recovery while sleeping. Some plants, such as marshmallow, buckhorn, hollyhock, coltsfoot and Icelandic moss, contain substances that relieve a dry cough. Among the synthetic drugs, the strongest are chemically related to opium (e.g. dextromethorphan and codeine). Others, such as pentoxyverine, are less likely to cause unwanted effects.
Cough or mucus removers (expectorants) are intended to liquefy the cough mucus so that it can be coughed up more easily. According to a review study, these drugs also reduce the risk of acute bronchitis becoming chronic. If you have a cold, it is best to take it in the morning and drink plenty of it during the day. In addition to well-tolerated cough relievers made from plants (e.g. ivy, thyme, aniseed, primula and liquorice), herbal active ingredients and combinations of active ingredients (e.g. myrtol and cineol), there are also synthetic active ingredients (e.g. acetylcysteine and ambroxol). They are not or only partially suitable for pregnant and breastfeeding women, children and people with certain diseases. Professional advice is also recommended because of possible side effects.
Many common medicines that reduce fever also reduce inflammation and relieve pain. Active ingredients such as acetylsalicylic acid (ASA), ibuprofen and diclofenac lead to gastrointestinal problems more often than the active ingredient paracetamol. Children should not take ASA because of special risks.
Antibiotics do not help against viruses, which usually cause acute bronchitis. Even simple bacterial bronchitis usually heals without these remedies. The active ingredients are only required if bacterial infections are severe and there is a risk of complications. Then symptoms such as fever and a general feeling of illness usually intensify again. In patients from risk groups (e.g. with chronic lung diseases or a weakened immune system), the use of antibiotics may be advisable earlier.
Doctors sometimes prescribe other medications such as anti-inflammatory or antispasmodic bronchospasmolytics if patients with a severe dry cough have previously had damaged bronchi, spasmodic coughing attacks occur or the airways are partially narrowed (obstruction).
Causes and risk factors
Causes of acute bronchitis are mostly viruses, rarely bacteria and even more rarely fungi. In addition to microorganisms, other possible triggers are vapours, gases, dust and other circumstances that irritate the bronchi. The most common include cigarette smoke, particulate matter, exhaust fumes, allergens, dry air and other climatic factors such as extreme heat and cold.
Risk factors
Weakened, irritated or damaged mucous membranes are less able to ward off pathogens and are also more susceptible to other disorders. If the mucous membranes of the bronchi are pre-stressed by diseases (e.g. asthma), hereditary disorders or irritants, the risk of acute bronchitis increases. The main factors that increase it include cigarette smoking and secondhand smoke. Children whose parents smoke in the home are twice as likely to develop acute bronchitis as children who do not smoke. Studies have shown that. People who are exposed to irritants at work, such as chemical fumes and dusts, are also more likely to become ill. City dwellers also suffer from acute bronchitis more often than people in the country, probably because of the higher fine dust pollution.
Similarly, dryness irritates the mucous membranes, and cold weakens them. This affects all mucous membranes in the upper respiratory tract, so that the risk of infections such as colds generally increases here and not just that of bronchitis. It is also increased by everything that impairs the immune system and the resistance of the mucous membranes - such as an unbalanced diet, lack of exercise, stress and lack of sleep.
Chronic sinusitis can lead to acute bronchitis, but is more likely to cause recurrent or chronic bronchitis.
Prevention
Targeted prevention in the case of acute bronchitis means sparing the mucous membranes of the bronchi. You should not expose them at all or to as few stimuli as possible - such as cigarette smoke - which are mentioned under "Risk factors". In addition, all measures that strengthen the immune system and thus reduce the general risk of infectious diseases are useful.
Strengthening of the immune system:
- Balanced and varied diet: fruit, vegetables, vitamins and minerals
- Sufficient and restful sleep, avoid stress and bad mood
- Regular exercise; Activities in the fresh air are advantageous
- Avoid hypothermia, dress appropriately for the outside temperature
- Refrain from smoking and lots of alcohol
- Harden off with a sauna, alternating showers and baths, Kneipp therapy - but only as long as there are no signs of a cold
- Drink enough
Prevent infections:
- Avoid close contact with people who have a cold or keep your distance as much as possible
- Wash hands frequently and thoroughly, avoid touching your face
- Change towels often, use handkerchiefs only once
- Air the rooms several times a day (five to ten minutes), avoid crowded rooms with dry air and draughts
- Keep room air moist with water bowls, vaporizers, damp cloths, etc
- Sucking on candy, preferably sugar-free, keeps the mucous membranes moist
- Daily nasal douches with isotonic saline solution reduce the risk of infection
- If necessary or if there is a high risk of complications, take protective measures (e.g. pull gloves and breathing mask or scarf over your mouth)