A season of wheezing and coughing

Feb. 12, 2013 @ 07:02 PM

While warmer weather is only weeks away, unfortunately, we’re still in the season for colds, flu and upper respiratory illnesses.

“There has been much focus on influenza this year — because it started early and affected many people — I also have treated many patients for upper respiratory conditions, such as bronchitis, this season,” said Katie Thompson, MD, with Waxhaw Family Physicians.

What is bronchitis?

Acute bronchitis is swelling and inflammation of the main air passages to the lungs. The swelling narrows the airways, making it harder to breathe and causing other symptoms, such as a cough. Acute means the symptoms have only been present for a short time.

Acute bronchitis is an infection caused by a virus in 90 percent of cases; only 10 percent are bacterial infections. At first, it affects your nose, sinuses, and throat. Then it spreads to the airways leading to your lungs. Chronic bronchitis is a long-term condition. To be diagnosed with chronic bronchitis, you must have a cough with mucus most days of the month for at least three months.

What are the symptoms of bronchitis?

Chest discomfort, cough that produces mucus (it may be clear or yellow-green), fatigue, fever (usually low-grade), shortness of breath that worsens with activity, wheezing (more often this is present in those with asthma. Even after acute bronchitis has cleared, a dry, nagging cough may linger for one to four weeks. The difference between pneumonia and bronchitis is that, with pneumonia, you are more likely to have a high fever and chills, feel sicker or feel short of breath.

To diagnose acute bronchitis, a healthcare provider listens to your lungs with a stethoscope. If a person has bronchitis, the physician will hear abnormal, coarse breathing that is even louder with coughing.

Tests to diagnose bronchitis

Chest x-ray. If the diagnosis is unclear or you are a high risk patient for complications, pulse oximetry to help determine the amount of oxygen in your blood by using a device placed on the end of your finger.

Treatment of bronchitis

Most people do not need antibiotics for acute bronchitis. The infection will almost always go away on its own within 3 weeks. The following steps will provide relief:

Drink plenty of fluids — this supports your immune system and keeps secretions thin. Rest — again to support your immune system. If you have wheezing, use your rescue inhaler (albuterol, a short acting bronchodilator), take NAIDS (ibuprofen or naproxen) or acetaminophen for pain and fever. Do not give aspirin to children. Use a humidifier or steam in the bathroom, as dry air is irritating to the airways. Keep air clean of smoke and other irritant pollution; do not smoke cigarettes. Over the counter cough medicines are typically not very helpful.  It is important to treat the underlying cause of the cough, such as clearing nasal congestion that causes post nasal drip down the back of your throat. Also, if the cough is productive, it is important to get the mucous out of your airways. People who are weak, such as the young, elderly and paralyzed, are high risk for complications such as pneumonia because they do not cough well.  Dark honey is soothing to the throat, but do not give it to children under one year old for the risk of botulism.

 If your symptoms do not improve and you are wheezing, your doctor may prescribe an inhaler to open your airways (even if you have never had wheezing previously).

If your doctor thinks you have a bacterial bronchitis or high risk for pneumonia, you may be prescribed antibiotics.

When to make a doctor’s appointment

Symptoms usually go away within three weeks if you do not have a lung disorder. However, a dry, hacking cough can linger for a number of months.

When to Contact a medical professional

Call your doctor if you: have a cough on most days or you have a cough that often returns, are coughing up blood, have a high fever or shaking chills, have a low-grade fever for three or more days, have thick, greenish mucus, especially if it has a bad smell, feel short of breath or have chest pain or have a chronic illness, like heart or lung disease.