Bronchitis Health Article

Bronchitis

A lower respiratory inflammation affecting the windpipe (trachea) and bronchial tubes.

Bronchitis can be caused by viruses, bacteria, or allergies, and it occurs in both acute and chronic forms, the former usually caused by a virus and the latter by allergies. Acute bronchitis often accompanies upper respiratory tract infections associated with cold viruses that spread to the bronchial tubes, causing inflammation and producing excess secretions. More rarely, bronchitis may be associated with Bordetella pertussis (whooping cough) or mycoplasma (parasitic) infections. In some cases, the larynx, or voice box, is also affected, a condition known as laryngotracheobronchitis.

Acute bronchitis is a common childhood disease, especially before the age of four. It occurs more often in boys than girls and is most prevalent in wintertime. Generally, it is preceded by the upper respiratory symptoms of a cold, including a runny nose, sneezing, congestion, and a low fever. Bronchitis begins with a dry, hacking cough that usually lasts two or three days and then turns into a loose cough that produces thick mucous or sputum. Breathing through the congested airway often produces a wheezing sound and may also cause pain below the sternum, or breastbone. These symptoms may be accompanied by fatigue and appetite loss, but the latter only persist for two or three days, while the respiratory symptoms may last as long as a week or more. The cough usually gets worse at night, interfering with the child's sleep.

Treatment of bronchitis caused by a cold virus consists of controlling the symptoms, since there is no medication that is effective in treating the virus itself. A suppressant such as dextromethorphan may be used for a dry, hacking cough. However, a child with a loose cough needs to be able to expel mucous from clogged airways, and expectorants, such as guaifenesin, aid in this process by thinning the sputum. (However, expectorants are not recommended for children under two years of age.) Cough secretions can also be thinned by drinking plenty of fluids and using a humidifier. Although loose coughs should not be completely suppressed, some amount of cough suppression may be necessary to help a sick child sleep or prevent the excessive throat irritation caused by non-stop coughing. It is important for a child with bronchitis to get adequate rest in order to help the body fight the infection.

A physician should be contacted for any cough that persists longer than four or five days without improvement, or any cough associated with painful breathing. In addition to bronchitis, these may also be symptoms of two other, potentially more serious conditions: pneumonia and bronchiolitis, an inflammation of the bronchioles (small airways from the bronchial tubes to the air sacs of the lungs). If the cause of the bronchial inflammation can be identified as a bacterial infection, antibiotics such as erythromycin can be prescribed. Sometimes medicines called bronchodilators are prescribed to open congested airways and stop wheezing, but care should be taken when using them with children because they have a tendency to speed up the heart rate.

In chronic bronchitis, the symptoms of acute bronchitis persist over an extended period of time (more than three or four weeks) or recur frequently. Chronic bronchitis in children is generally caused by allergies (in adults it is often caused by smoking or by repeated attacks of acute bronchitis). Like acute bronchitis, chronic bronchitis is worse in winter, and it may be aggravated by viral and bacterial infections. While the cough can be controlled with suppressants, expectorants, and bronchodilators, the most effective treatment of chronic bronchitis in children is to identify any allergies that may be causing it and treat them by avoiding known allergens (things that trigger an allergic reaction—either foods or substances in the environment). Other treatments include antihistamines to control the body's reaction to allergens and, in the case of certain moderate to severe allergies, a program of desensitization, or allergy shots.

For children who are prone to bronchitis, there are measures that can help prevent recurrent attacks. The first is to eliminate smoking from the home. Infants in homes where there are smokers are four times as likely to get bronchitis as infants in non-smoking households. Frequent hand washing can help prevent the spread of germs that may cause acute bronchitis. Avoidance of any substances thought to produce allergic reactions can help prevent chronic allergic bronchitis.

Books

Bellet, Paul S. The Diagnostic Approach to Common Symptoms and Signs in Infants, Children, and Adolescents. New York: Lea and Febiger, 1989.

Feldman, B. Robert. The Complete Book of Children's Allergies: A Guide for Parents. New York: Times Books, 1986.

Garwood, John, and Amanda Bennett. Your Child's Symptoms. New York: Berkeley Books, 1995. Gershwin, M. Eric, and Edwin L. Klingelhofer. Conquering Your Child's Allergies. Reading, MA: Addison-Wesley, 1989.