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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 Between the Types of Bronchitis?

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 re-occurrences.

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.

14 thoughts on “Acute vs. Chronic Bronchitis: Understanding the Differences”

  1. Kathleen Doyle says:

    How do I prevent bronchitis if I am not a smoker? Your only suggestion to prevent bronchitis is to stop smoking, but I don't smoke. So is there nothing I can do to not get this again?

    1. Inogen Inogen says:

      Hi Kathleen, Although smoking cessation is the single most important and successful aspect of preventing bronchitis, avoiding repeated exposure to dust, fumes, indoor and outdoor air pollution and other airway irritants also plays a key role in preventing bronchitis development. Acute episodes can also be prevented, or reduced, by frequent hand washing, flu and pneumonia vaccines, avoiding people who are sick and a healthy diet and exercise program. For more information and facts on bronchitis, please visit: https://www.inogen.com/blog/bronchitis-faq/

  2. D says:

    Can exposure to mosquito coil smoke induce an episode of chronic bronchitis?

  3. D says:

    Sorry, I meant to ask:
    Can exposure to mosquito coil smoke induce an episode or ACUTE bronchitis?

    1. Inogen Inogen says:

      Hi D, Generally acute bronchitis is caused by a virus but smoke will make the recovery process much more difficult.

  4. teja says:

    Hi,
    My Kid is 4 years old. At present he is diagnosed with Bronchitis. I would like to understand if he is suffering from chronic or acute, as he is suffering from frequent URIs . He got Swine flu in 2016 and since then his cold and cough leads to high fever,body aches,vomiting. I would like to understand if this can be cured at all. Seeing him suffer like this is really paining.

    1. Inogen Inogen says:

      Hi Teja, Chronic bronchitis is re-occurring and it primarily caused by smoking. Acute bronchitis is a virus and usually resolves itself after 3 to 10 days. Since we are not your son's primary care doctor we can not give you medical advice, but if you would like more information on Bronchitis and Upper Respiratory Infections, please visit: https://www.inogen.com/blog/is-bronchitis-contagious/ and https://www.inogen.com/blog/upper-respiratory-infection/

  5. sri says:

    Good information and useful instructions they amazing. You did a great job on this topic, I have read your posts they amazing and very help us.Thanks for sharing this information

    1. Inogen Inogen says:

      Thank you Sri!

  6. heather says:

    can anyone please guide I was looking for help, and have stumbled here today
    I’ve been diagnosed with both asthma and chronic bronchitis at different times in the past. Recently (past 6 months) my normal OTC hasnt been preventing symptoms well. Most of the day every day I have coughing fits and constantly feel like I need to clear my throat. This has always been solved by taking a 24 hour allergy tab (allegra) and using my albuterol inhaler if the preventative allergy med fails me. This is not bringing any relief. Not serious enough symptoms to worry about an acute asthma attack with high risk but sick of constantly coughing and feeling like my throat needs clearing. Any recommendations on additional/alternative preventative measures or other diagnoses that may have been previously missed that would cause these symptoms are appreciated. Even if it’s a EverydayHealth level of far fetched possible cause, I would appreciate any thoughts that may steer me in the direction of relief. No other chronic conditions No drug/alcohol use No current tobacco use Former smoker/Last smoked 10 years ago.

  7. Matthew says:

    Hi heather, sorry to hear that you have to deal with bronchitis, I have had it a few times and it is nothing short of terrible….. so hopefully advice from my experience would help. If your over the counter allergy medicine no longer works then you could have a separate issue at hand, in fact bronchitis is not actually caused by allergies but it can lead to it. I have bad alergies and my doc told me this a few year ago when I was taking claritin but wasn't working and i didn't know why. Something else I learned , albuterol is a godsend but it only opens up the airways which is temporary and doesn't help the healing in the throat. One other thing if it feels like the mucus is moving to your chest that could be pneumonia and you definitely don't want that it's not fun either I would know. Well maybe that should help you…..my best advice is to visit your doc so you know if it's allergy or bronchitis or another thing then go from there.

  8. Dixie says:

    Hi. I have had symptoms of bronchitis (cough, excess mucus production, wheezing, shortness of breath and tight feeling in my chest) for about 10 years now (maybe longer—it’s been with me for so long I cannot remember for sure). My lungs haven’t really been the same since I had pneumonia in late 1993. Recently, I bought an air purifier, which helps the symptoms, although I still sometimes have periods when the cough, mucus production and some wheezing is present. Yet my doctor describes my condition in the records as “acute bronchitis”. Wouldn’t my condition be considered more of a chronic thing? I know my symptoms have improved since I have had the purifyer, but without it, the symptoms would come back full force.

    1. Inogen Inogen says:

      Hi Dixie, I am sorry to hear about your condition and happy to hear that you are finding some relief w/your purifier. I hope this continues to help you manage the bronchitis. The exact terminology is something a medical professional can confirm w/you, so perhaps you should seek a second opinion?

  9. Dixie says:

    Thanks very much for your reply. It’s odd that I grew up around smokers who don’t display any respiratory symptoms at all. I have never been a smoker, yet I’m the one who coughs, sputters and wheezes! Obviously, the secondhand smoke finally took its toll, or there must be something else, like dust or pollen or something that’s keeping this thing going. At least the distressing chest tightness is better since getting the purifier.

    At any rate, I think you’re right. Maybe I should get a second opinion.

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