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Bronchitis

Bronchitis is inflammation of the mucous membranes of the bronchi, the airways that carry airflow from the trachea into the lungs. Bronchitis can be divided into two categories, acute and chronic, each of which has distinct etiologies, pathologies, and therapies.

ACUTE BRONCHITIS
It is characterized by the development of a cough, with or without the production of sputum, mucus that is expectorated (coughed up) from the respiratory tract. Acute bronchitis often occurs during the course of an acute viral illness such as the common cold or influenza. Viruses cause about 90% of cases of acute bronchitis, whereas bacteria account for fewer than 10%.[1]

Causes
Acute bronchitis often develops during the course of an upper respiratory infection (URI) such as the common cold or influenza. About 90% of cases of acute bronchitis are caused by viruses, including rhinoviruses, adenoviruses, and influenza

Bacteria’s that cause bronchitis are Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Bordetella pertussis, account for about 10% of cases. Only about 5–10% of bronchitis cases are caused by a bacterial infection

Signs and symptoms
Bronchitis may be indicated by an expectorating cough, shortness of breath (dyspnea), and wheezing. On occasion, chest pains, fever, and fatigue or malaise may also occur. Bronchitis caused by Adenoviridae may cause systemic and gastrointestinal symptoms as well.

The coughs due to bronchitis can continue for up to three weeks or more even after all other symptoms have subsided.

Other common symptoms include sore throat, runny nose, nasal congestion (coryza), low-grade fever, pleurisy, malaise, and the production of sputum.[1]

Diagnosis
A physical examination will often reveal decreased intensity of breath sounds, wheezing, rhonchi, and prolonged expiration. Most doctors rely on the presence of a persistent dry or wet cough as evidence of bronchitis.

A variety of tests may be performed in patients presenting with cough and shortness of breath:

  • A chest X-ray that reveals hyperinflation; collapse and consolidation of lung areas would support a diagnosis of pneumonia. Some conditions that predispose to bronchitis may be indicated by chest radiography.
  • A sputum sample showing neutrophil granulocytes (inflammatory white blood cells) and culture showing that has pathogenic microorganisms such as Streptococcus species
  • A blood test would indicate inflammation (as indicated by a raised white blood cell count and elevated C-reactive protein).

Treatment

Most cases of bronchitis are caused by a viral infection and are "self-limited" and resolve themselves in a few weeks

Smoking cessation-To help the bronchial tree heal faster and not make bronchitis worse, smokers should quit smoking completely in order to allow their lungs to recover from the layer of tar that builds up over time.

In the management of acute attack of bronchitis the prescribed homeopathic medicines may have to be taken at shorter intervals may be after every few hours

CHRONIC BRONCHITIS
It is a type of chronic obstructive pulmonary disease, defined by a productive cough that lasts for 3 months or more per year for at least 2 years. Other symptoms may include wheezing and shortness of breath, especially upon exertion. The cough is often worse soon after awakening, and the sputum produced may have a yellow or green color and may be streaked with blood.

Causes
Tobacco smoking is the most common cause. Pneumoconiosis and long-term fume inhalation are other causes. Allergies can also cause mucus hyper secretion, thus leading to symptoms similar to asthma or bronchitis.

Diagnosis
A physical examination will often reveal diminished breath sounds, wheezing and prolonged exhalation. Most doctors rely on the presence of a persistent dry or wet cough as evidence of bronchitis.

A variety of tests may be performed in patients presenting with cough and shortness of breath:

  • Pulmonary Function Tests (PFT) (or Spirometry) must be performed in all patients presenting with chronic cough. An FEV1/FVC ratio below 0.7 that is not fully reversible after bronchodilator therapy indicates the presence of COPD, that requires more aggressive therapy and carries a more severe prognosis than simple chronic bronchitis.
  • A chest X-ray that reveals hyperinflation; collapse and consolidation of lung areas would support a diagnosis of pneumonia. Some conditions that predispose to bronchitis may be indicated by chest radiography.
  • A sputum sample showing neutrophil granulocytes (inflammatory white blood cells) and culture showing that has pathogenic microorganisms such as Streptococcus spp.
  • A blood test would indicate inflammation (as indicated by a raised white blood cell count and elevated C-reactive protein).
  • Neutrophils infiltrate the lung tissue, aided by damage to the airways caused by irritation.
  • Damage caused by irritation of the airways leads to inflammation and leads to neutrophils being present
  • Mucosal hyper secretion is promoted by a substance released by neutrophils
  • Further obstruction to the airways is caused by more goblet cells in the small airways. This is typical of chronic bronchitis
  • Although infection is not the reason or cause of chronic bronchitis it is seen to aid in sustaining the bronchitis.
  • High Resolution Computed Tomography (HRCT) - This is a special type of CT scan that provides your doctor with high-resolution images of your lungs. Having a HRCT is no different than having a regular CT scan; they both are performed on an open-air table and take only a few minutes.

Treatment

Smoking cessation is of benefit. Only about 5-10% of bronchitis cases are caused by a bacterial infection. Most cases of bronchitis are caused by a viral infection and are "self-limited" and resolve themselves in a few weeks. Avoiding long exposure to air pollution from heavy traffic may also help in prevent bronchitis.

Homeopathic management
In the management of bronchitis homeopathic medicine works very fast. In chronic bronchitis, constitutional treatment has to be taken along with acute medicines.


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