Bronchitis refers to inflammation of the large airways in the lower respiratory system. The condition is characterized by a group of symptoms that includes cough, mucus production, shortness of breath, and chest tightness. It has many causes including viral or bacterial infections and environmental exposures such as smoking cigarettes or air pollution. In most cases, it goes away within a week or two.

There are two types of bronchitis. Doctors typically call the kind described above “acute bronchitis.” Chronic bronchitis, which is rare but serious, is another type and also refers to inflammation of the airways, but in response to long-term damage. It affects a person’s ability to breathe easily, and it has no cure. A person will be diagnosed with chronic bronchitis if they have a nagging cough for at least three months of the year for at least two years; often it is associated with chronic obstructive pulmonary disease, or COPD, although other respiratory conditions can also cause it.

Acute bronchitis is one of the most commonly diagnosed respiratory infections, prompting 100 million visits to doctor’s offices, urgent care centers, and emergency departments every year. Although it affects both children and adults, babies, children, and older adults may be at increased risk. Most cases of acute bronchitis are caused by a viral infection, including viruses that cause common colds and the flu. Thus, acute bronchitis is most prevalent during cold and flu season when these viruses circulate widely. Only about 6% of cases of acute bronchitis are found to be bacterial rather than viral.

In contrast, chronic bronchitis is usually the result of long-term lung damage. People who smoke, vape, or are exposed to air pollution are most likely to have this form of bronchitis. Nearly three out of four people with COPD have chronic bronchitis, and between 3% and 7% of all adults are believed to have the condition. It’s more common as people get older.

Acute bronchitis rarely requires treatment. Occasionally, acute bronchitis is caused by bacteria and is treated with antibiotics. People with acute bronchitis should expect to recover fully within one to three weeks.

For chronic bronchitis, treatments may alleviate symptoms or slow the course of the disease, but there is no cure for the condition. Many people with chronic bronchitis find relief with treatment.

The term “bronchitis” literally means “inflammation of the bronchial tubes.” Most commonly the term is used to refer to a condition known as acute bronchitis, a viral illness that causes coughing and chest pain, which gets better within a short time frame. Another lesser-known type, chronic bronchitis, is caused by long-term damage to the airways and has no cure. Both conditions cause inflammation of the airways.

• Acute bronchitis is frequently caused by exposure to cold or flu viruses. In addition, some symptoms of acute bronchitis overlap with cold and flu symptoms. When a virus finds its way into the respiratory system, it can settle in the main airways connecting the windpipe to the lungs, causing airway inflammation. This leads to coughing, wheezing, and shortness of breath. Some people also develop chest or abdominal pain due to the frequency and intensity of their coughs. In addition, mucus may build up in the inflamed airways, making it harder to breathe clearly, leading to what’s known as a “productive” cough (a cough that produces mucus). Acute bronchitis—like common colds, the flu, and other viral infections—typically gets better within a few weeks.
• Chronic bronchitis typically develops after decades of lung damage due to smoking, daily exposure to harmful chemicals, and/or other factors. Over time, lung damage leads to airway inflammation, causing excess mucus to be produced within the airways. Both inflammation and excess mucus make it more difficult to breathe.

Acute bronchitis is most frequently caused by viruses, including:

• Influenza (flu) viruses A and B
• Parainfluenza virus
• Certain coronaviruses
• Rhinoviruses
• RSV (respiratory syncytial virus)
• Human metapneumovirus

In some cases, acute bronchitis may be caused by bacteria, including:

• Bordetella pertussis
• Mycoplasma pneumoniae
• Chlamydia pneumoniae

Chronic bronchitis can be caused by:

• Smoking or vaping (i.e., smoking e-cigarettes)
• Secondhand smoke exposure
• Exposure to air pollution
• Exposure to forest fires, campfires, cooking fires, or other indoor or outdoor fires
• Exposure to chemical fumes
• Inhalation of dust
• A history of frequent lung infections
  

People who have acute bronchitis experience:

• A deep cough
• A productive cough (i.e., coughing up mucus)
• Nasal congestion
• Chest pain
• Wheezing
• Shortness of breath
• Fever
• Chills
• Headache
• Body aches

People with chronic bronchitis generally have the same symptoms as those with acute bronchitis. They may also experience:

• A cough that lasts at least three months, occurring for at least two consecutive years
• Abdominal pain

People who are at risk of acute bronchitis include:

• Babies, children, and older adults
• People who smoke or vape
• People with heart disease
• People with lung disease
• People with asthma or allergies

People who are at risk of chronic bronchitis include those who:

• Are current or former smokers/vapers
• Are regularly exposed to secondhand smoke
• Are exposed to air pollution, chemical fumes, dust, or fires at home or work
• Have a personal history of lung infections
• Have a family history of chronic bronchitis
  

You may be diagnosed with acute or chronic bronchitis after a doctor hears about your medical history, conducts a physical examination, and performs diagnostic tests, as needed.

For acute bronchitis:

• Tell your doctor about your symptoms and when you started to feel sick. If you were exposed to a friend or relative who had a cold, the flu, or another viral infection, let the doctor know the timing of your encounter. Also tell the doctor if you have asthma or allergies.
• During a physical exam, your doctor will listen to your lungs with a stethoscope to check your pulmonary function.
• You may receive a chest X-ray to confirm bronchitis or rule out other conditions. You may also need blood work to rule out other conditions.

For chronic bronchitis:

• Share details with your doctor about your symptoms, including when they began, how often and intensely you cough, and whether you cough up mucus. Also share information about yourself: Whether you smoke or vape, whether you inhale chemicals or dust at work, and whether you’re exposed to air pollution regularly.
• During a physical exam, your doctor will check your pulmonary function, listening to your lungs with a stethoscope. They may also check your blood oxygen levels with a pulse oximeter, which is briefly placed on your finger. (If you have shortness of breath, chronic bronchitis may limit the amount of oxygen circulating throughout your body.)
• You may undergo different diagnostic tests, including:
  • A chest X-ray to confirm chronic bronchitis or rule out pneumonia or other conditions
  • A computed tomography (CT) scan to see images of the chest
  • A sputum sample (coughed-up mucus), if doctors suspect a bacterial infection is present
  • Blood work to rule out other conditions

Because viruses cause most cases of acute bronchitis, treatment is not usually required. Your doctor may recommend that you care for yourself the same way that you would if you had a bad cold:

• Get rest
• Consume plenty of fluids, including hot beverages, to thin mucus
• Inhale steam from a hot shower or a humidifier or perform airway clearance techniques to help thin and remove mucus
• Use an inhaler, if prescribed, to manage wheezing

In some cases, you may be prescribed antiviral medication for acute bronchitis. If it is caused by bacteria, you will be prescribed a course of antibiotics.

For chronic bronchitis, different treatments may help to manage symptoms, including:

• Lifestyle modifications, such as quitting smoking or vaping
• Bronchodilators, which help to open the airways, making it easier to breathe
• Corticosteroids, which help to reduce swelling in the airways, making breathing easier
• Anticholinergic drugs, which help to open the airways
• Phosphodiesterase-4 inhibitors, which help open the airways and reduce inflammation
• Antibiotics, when symptoms worsen or testing reveals bacteria
• Oxygen therapy, if chronic bronchitis makes breathing difficult

Doctors may also recommend pulmonary rehabilitation for chronic bronchitis, a supervised activity that includes education about lung health, in addition to exercise. To make a difference, you will need to exercise regularly, make lung-healthy lifestyle changes, and take steps to avoid chronic bronchitis triggers, such as air pollution, harmful chemicals, and dust.

People with acute bronchitis should recover fully within several weeks; It’s possible to have a lingering cough for an additional few weeks.

There is no cure for chronic bronchitis; however, treatments are available to minimize symptoms.

“The Yale Winchester Center for Lung Disease has many programs that help manage both acute and chronic bronchitis,” says Ashley Losier, MD, a Yale Medicine pulmonologist and critical care specialist. “Within the Center, the Comprehensive Pulmonary, COPD, and Bronchiectasis and NTM (nontuberculous mycobacteria) programs all have expertise in managing acute and chronic bronchitis. Tailored approaches are taken to each patient’s care to help in understanding what is driving the chronic bronchitis so that a patient-specific treatment plan can be initiated.”