Acute vs. Chronic Bronchitis: Understanding the Differences

Bronchitis is a respiratory illness that causes inflammation of the tubes that carry air to the lungs (airways or bronchial tubes). When the airways become irritated, swollen and inflamed, less air is able to travel to and from the lungs and mucus begins to form in them. This generally causes an irritating cough that may be accompanied by shortness of breath, more mucus production and other bothersome symptoms.1

There are two types of bronchitis: acute and chronic. Let’s take a look at how they differ.

Acute vs. Chronic: What’s the Difference

Acute bronchitis is very common. Symptoms usually begin 3 to 4 days after an upper respiratory infection and disappear after two or three weeks. In contrast, chronic bronchitis, one of the two most common forms of COPD, is irreversible and is characterized by frequent reoccurrences.

Causes of Bronchitis

Acute bronchitis is generally caused by a virus, but the infection can also be bacterial in nature. Over time, recurring attacks of acute bronchitis may lead to chronic bronchitis. If you smoke during an attack of acute bronchitis, recovery will be much more difficult and will take a great deal longer than if you didn’t smoke. What’s more, continuing to smoke further damages the tiny hair-like structures in your lungs (cilia) that are responsible for ridding your lungs of debris, airway irritants, and excess mucus, thus increasing your risk for chronic bronchitis.1

The primary cause of chronic bronchitis is long-term cigarette smoking, but repeated exposure to dust, fumes, indoor and outdoor air pollution and other airway irritants also plays a key role in its development. Continuing to smoke when you have chronic bronchitis worsens symptoms and makes the disease progress at a much faster rate.1

Symptoms of Bronchitis

The symptoms2 of acute bronchitis include:

  • Dry, hacking cough
  • Increased mucus production
  • A sore chest
  • Absence of fever or low-grade fever

If however, your fever is greater than 100.4 degrees Fahrenheit and is accompanied by loss of appetite and generalized achiness, your symptoms may be caused by pneumonia, which means you will probably need antibiotics.

People with chronic bronchitis have a mucus-producing cough most days of the month for at least three months out of the year two years in a row.3 Other symptoms2 may include:

  • Shortness of breath
  • Wheezing
  • Fatigue

As the airways become increasingly irritated, mucus production worsens and an irritating cough develops. Over time, the lining of the airways become thickened, scar tissue forms and air flow to and from the lungs becomes impaired. As mucus production increases, it begins to pool in the airways creating a perfect breeding ground for infections.3

Diagnosis of Bronchitis

Acute bronchitis is generally easy for your doctor to detect through a physical examination and description of your symptoms. During your physical exam, your doctor will listen to your lung sounds with a stethoscope; a rattling sound in your chest is usually indicative of acute bronchitis.3

Diagnosis of chronic bronchitis may include a chest X-ray, lung function tests and measurement of the amount of oxygen in your blood. Tests such as these help your doctor determine how well your lungs are working and to what degree they are impaired.4

Treatment of Bronchitis

Because acute bronchitis is generally caused by a virus, taking antibiotics won’t provide a cure. Most of the time, drinking plenty of fluids, getting adequate rest and avoiding smoke and other airway irritants is the standard method of treatment while the virus runs its course. If your symptoms are severe, your doctor may order a bronchodilator inhaler to help relax your airways and/or a prescription cough suppressant. She may also advise you to take aspirin or Tylenol to reduce any physical discomfort.3

Smoking cessation is the single most important aspect of treatment for chronic bronchitis. In addition to quitting smoking, your doctor may prescribe any of the following:3

  • Oral steroids to reduce inflammation
  • Phosphodiesterase-4 inhibitors to suppress inflammation and prevent exacerbations
  • Bronchodilator inhalers to relax constricted airways
  • Supplemental oxygen to increase blood oxygen levels
  • Antibiotics (if a bacterial infection is present)
  • An annual flu shot
  • A pneumonia vaccine (depending upon your age, co-existing medical conditions and if you’ve had one in the past)
  • An expectorant (not a cough suppressant as coughing helps rid the airways of mucus)
  • Weight loss (reduces strain on the heart)

Prevention of Bronchitis

As mentioned previously, smoking cessation remains the single, most important and successful aspect of treatment and prevention of chronic bronchitis. It will also help you prevent or recover more quickly from acute bronchitis.3

If you’re like most people, you may find it difficult to quit on your own. Using a combination of stop smoking aids, support groups and counseling may increase the chances that you’ll quit – and remain abstinent – for good!

Preventing Exacerbations of Chronic Bronchitis

If you have chronic bronchitis, you may experience exacerbations, or periods of time when your symptoms worsen. Acute episodes such as these can be prevented, or reduced, by frequent hand washing, flu and pneumonia vaccines, avoiding people who are sick and a healthy diet and exercise program. Remember, when it comes to your health, an ounce of prevention is always worth a pound of cure!

Author: Deborah Leader RN, BSN, PHN

1 WebMD. Understanding Bronchitis – the Basics. Reviewed at May 7, 2013.
2 WebMD. Symptoms of Bronchitis. Reviewed May 7, 2013.
3 American Lung Association. Understanding Chronic Bronchitis. Accessed January 28, 2014.
4 WebMD. Understanding Bronchitis – Diagnosis and Treatment. Reviewed May 7, 2013.

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