What’s the difference between bronchiolitis and bronchitis
Bronchiolitis and bronchitis are both infections of the lungs. The names may sound similar, but they are two distinct conditions.
Bronchitis can affect people of all ages, though it’s most common in older children and adults. It causes inflammation and swelling in the trachea and upper bronchial tubes. Bronchitis can be both acute and chronic.
Bronchiolitis almost only affects younger children, many under the age of 2. It occurs when there is swelling in the smallest airways in the lungs, called bronchioles, obstructing them and making it more difficult to breathe.
Bronchiolitis in some toddlers and children is no more severe than a common cold. In some cases it can be dangerous and require hospitalization.
Bronchitis and bronchiolitis share common symptoms like coughing, wheezing, and slight fever. There are other symptoms unique to each.
Symptoms of bronchitis include:
- production of mucus
- shortness of breath
- slight fever
- chest discomfort or tightness
You should make an appointment to see your doctor if your cough lasts more than three weeks or prevents you from sleeping. You should also call your doctor if your cough is accompanied by:
- bright yellow or green mucus (this is a common symptom and indicates infection)
- blood-tinged sputum
Symptoms of bronchiolitis include:
- dry, raspy cough
- difficulty feeding, especially in infants
- slight fever
- runny or stuffy nose
If your infant, toddler, or young child displays any of the following symptoms, call your pediatrician for next steps:
- They are having difficulty breathing.
- They have a breathing rate of 50-60 breaths per minute.
- They have a temperature of 100.4˚F (38˚C) or higher.
- They are uncharacteristically tired or irritable.
- They haven’t needed a diaper change in 12 hours or more.
- They’ve eaten less than half their typical amount during the last several meals.
- They develop a bluish color to the face.
Both conditions can be caused by viruses.
Acute bronchitis is often caused by viruses, especially the flu and the common cold. The most common cause of chronic bronchitis is smoking cigarettes or being around lung irritants.
Bronchiolitis is typically caused by a viral infection. The respiratory syncytial virus causes more than half of all cases of bronchiolitis. The common cold or the flu can cause also the condition. Bronchitis can also be bacterial.
Being around cigarette smoke and other lung irritants is a risk factor for both conditions.
Risk factors specific to bronchitis include:
- gastric reflux, which can irritate your throat
- regular exposure to irritants
- low immune resistance, especially after a virus or primary infection
High risk factors for developing bronchiolitis include:
- babies born prematurely
- babies with heart, lung, or immune conditions
- children who spend time in day care
When your doctor suspects bronchitis, they will listen to your lungs with a stethoscope and ask about other symptoms.
If your doctor suspects pneumonia, they may order a chest X-ray. Chest X-rays can also rule out other conditions, like lung cancer.
Your doctor may also order sputum tests to send to the lab for a culture.
You may need to take a pulmonary function test. This test measures how well your lungs work and how well you can breathe.
If your doctor suspects that your child has bronchiolitis, they will listen to the lungs with a stethoscope. They’ll ask you about your child’s medical history and any other symptoms. They may also:
- collect a mucus sample from your child to check for viruses associated with bronchiolitis
- run a blood test to check your child’s white blood cell count — if elevated, they’ll know your child is likely fighting an infection
Chest X-rays are almost always used in diagnosing bronchiolitis unless a complication is suspected.
Treatments for bronchitis and bronchiolitis look very different.
Treatment for bronchitis can include:
- antibiotics to treat bacterial infections
- cough medicine, only for use at night to aid sleeping
- medications such as steroids that can reduce inflammation for other conditions like asthma
- medications by inhalation to help open up the airways
- pulmonary rehabilitation for chronic bronchitis, which includes a breathing exercise program
Treatment for bronchiolitis can include:
- helping your baby sleep with their head slightly raised by putting a pillow under their mattress
- encouraging your child to drink as much fluid as possible
- providing supplemental oxygen or IV fluids if your child is hospitalized
Bronchitis typically isn’t a cause for concern. But it can lead to complications like pneumonia. Never ignore bronchitis, especially if you have recurrent cases. This could indicate that you have some form of chronic obstructive pulmonary disease (COPD), which requires prompt treatment.
Many cases of bronchiolitis are minor and easily treatable. They can be no more severe than a common cold. But if severe bronchiolitis isn’t untreated, it can cause recurrent wheezing and a reduced quality of life. These complications can last into the teenage years. The condition can also be fatal if severe cases aren’t treated.
Most children recover at home within three to five days. If hospitalized, many children go home within five days, though some may stay for up to a week.
To prevent both conditions:
- Avoid cigarette smoke (including second-hand cigarette smoke) and any other environmental irritants.
- Practice good hygiene, which can help reduce the risk of infections.
- Wash your hands regularly and encourage both visitors and children to do the same.
- Wipe down your children’s toys regularly.
For bronchitis prevention, you can get vaccinated with the flu vaccine every year. A post-flu infection can cause many cases of bronchitis.