Bronchitis

By Dr. Loretta Lanphier, ND, CN, HHP, CH

As I am writing this, we are in the midst of my favorite season–autumn. The hot humid days of summer are gone, and the cool crisp fall weather has blessed us with its frosty wash of reds and oranges. The one downside to this time of year is that it has been labeled the beginning of the “cold and flu season.” Colds and respiratory infections are definitely more apt to interfere with our lives in the winter. Often, for healthy individuals, they are nothing more than a nuisance. However, sometimes they can turn into more serious conditions such as bronchitis. Infections such as bronchitis, if left untreated, can lead to very destructive and dangerous cardiovascular problems. How can we prevent this from happening? Let’s see what we can find out.

What is Bronchitis?

Bronchitis is a viral or bacterial infection of the upper respiratory system (the bronchi) that causes the bronchial passages or breathing airways to become irritated and enflamed. As the bronchial membranes grow and swell, more and more mucous accumulates, narrowing or completely closing off the airways.  Breathing becomes more difficult, and the patient is afflicted with thick phlegm and coughing spells. This only makes the irritation greater and worsens the condition. In many instances, bronchitis follows an upper respiratory infection such as a cold or the flu. The vast majority (90%) of bronchitis cases are viral in origin. The remainder (10%) are caused by bacterial infections. Sometimes bronchitis may be viral with a secondary bacterial infection tacked on.

While bronchitis and pneumonia are related, and bronchitis can actually increase the risk of developing pneumonia, they are two distinct conditions that can at times be difficult to distinguish between. Pneumonia is in the lungs rather than the bronchi, and sometimes a chest x-ray will help with diagnosis, showing an accumulation of fluid in the lungs. Pneumonia patients tend to have shallower breathing accompanied by wheezing and abnormal sounds.

Bronchitis is broken down into two main types: acute and chronic. Acute bronchitis usually is more common in winter, and often comes on after a cold or flu. Sometimes early symptoms will mirror that of a common cold, such as a runny nose, sneezing, and dry cough, accompanied by a fever of up to 102oF. As the condition develops, the cough may deepen and get painful. It may also produce greenish-yellow sputum of phlegm. Wheezing is also common. The fever and most other symptoms tend to last about three to five days, but the cough may persist for several weeks. If the outbreak is linked with an additional bacterial infection, the fever and general listlessness may last longer than normal.

Chronic bronchitis is a much more complex disease, requiring ongoing care. It is a major cause of death and disability in the United States.  Until recently, men have always had a greater incidence of chronic bronchitis than women. This change is mainly attributed to the fact that more women now smoke than in the past. In order to be diagnosed, symptoms of bronchitis must be observed for at least 3 months in a calendar year.  It may be brought on by recurring bouts of acute bronchitis, but the most common reason for the onset of chronic bronchitis is cigarette smoking or long-term exposure to industrial irritants. Chronic bronchitis is a result of damage, sometimes permanent, to the cilia of the respiratory system. Cilia are hair-like structures that are designed to rhythmically sweep the lungs and related organs clean of smoke, dust, mucous, and other irritants. An overload of pollutants may cause these cilia to become paralyzed or break off. A dry cough from the irritation can enflame the bronchi even more, contributing to the problem. Untreated chronic bronchitis can lead to more serious respiratory conditions such as COPD (chronic obstructive pulmonary disease), a family of respiratory diseases including chronic bronchitis and emphysema. Emphysema is a serious degenerative lung disease that is a common cause for death amongst smokers. Victims slowly suffocate to death. As a young boy I watched my grandfather die from it, and it left a horrible impression on me that I will never forget.

What Are the Causes of Bronchitis?

Acute bronchitis is usually the result of a viral infection. It is contagious and can be caught from germs spread through the coughing and sneezing of others who have the virus, much like the common cold. If the immune system is weakened, you are much more susceptible to infections of all kinds. A small percentage of acute cases are not viral, but caused by a bacterial infection. Sometimes a patient will have both simultaneously.

Chronic bronchitis is caused by several main factors. Often it is brought on by the weakening of the respiratory system due to repeated attacks of acute bronchitis. Heavy long-term cigarette smoking is by far the most common cause. Prolonged and constant irritation by the smoke damages the cilia and related organs, and the body can’t keep up with clearing the airways of mucous. The bronchia are narrowed so that there is chronically not enough oxygen delivered to the blood to be spread throughout the body. Second to smoking, industrial pollution–often work-related– is a major culprit in this disease. Certain occupations have a much higher risk of developing chronic bronchitis than others. Among these are:  coal miners, metal molders, and grain handlers, all of whom are exposed to higher than normal amounts of dust.

There are other risk factors for bronchitis as well. Being unconscious can cause your gag-reflex to malfunction, allowing you to aspirate fluids, increasing the chance of the onset of bronchitis or pneumonia. Any compromise of the immune system, such as cancer, increases risk. Even hospitalization can cause a greater risk, as you can be exposed to other infected individuals.

How Can I Prevent or Treat Bronchitis?

The main goal of treatment is to reduce blockage of the airways so the lungs can return to normal operation. However, bronchitis can be complex to treat. Specifics depend on how far it has developed and whether the patient has any other health complications. If it is a viral infection, as most of them are, it pretty much just has to run its course. Bacterial infections can be treated with antibiotics, but a word to the wise here. Antibiotics have been used so promiscuously and indiscriminately that they are often not very effective any more. (Bladder and urinary tract infections are good examples of this).  Worse than that, they may even make the condition worse by stimulating the growth of mucous, the very thing they are meant to help alleviate.

In viral infections, symptoms can be lessened as the illness lives out its cycle. A cool mist humidifier is often recommended to help loosen mucous and phlegm. Patients are also instructed to drink ample fluids and get sufficient rest. Cough syrups may be used, but another word of caution here:  make sure you are using the correct type. Cough suppressants may not be good because coughing is the main way to clear mucous from the lungs. Pooling of mucous can lead to further complications, such as pneumonia. A cough syrup with expectorant may be a good choice. These are designed to thin the mucous and make it easier to be coughed up and expelled from the lungs as sputum.

The best way to prevent bronchitis is to never smoke, or to quit smoking.  Studies show that smokers have a ten-fold greater chance of dying of COPD than non-smokers. The good news is that if you quit smoking, you can eliminate that risk factor relatively quickly–in five to ten years. Other ways to prevent bronchitis include avoiding polluted environments as much as possible, such as industrial or occupational exposure. If you live in a large city, find a green area and walk daily, taking deep breaths of the cleanest air you can find. Even twenty minutes a day will help. Get some sunshine while you’re at it too. We all need our vitamin D. Not only will the fresh air and sunshine help, but exercise is a great deterrent on its own merit. It strengthens the respiratory system and the immune system in a great one-two punch against disease.

Does Diet Play a Role in Prevention/Treatment?

Absolutely! Here are some tips to help you eat right and avoid respiratory problems:

  • Avoid certain foods, such as dairy, sugar, and eggs which can encourage the growth of mucous
  • The juice of a lemon mixed with water can help to alleviate mucous
  • Hot and spicy foods are your respiratory systems friends. Eat lots of hot peppers, curry, cayenne, horseradish, garlic, and onions. These will help to open the airways, fight germs, and build your immune system
  • Drink lots of pure high-quality water every day
  • Load up on chicken soup. It can soothe a sore throat
  • Sipping cool water can help alleviate coughing spells (not cold–this can cause spasms resulting in more coughing)
  • Choose a diet high in dark and/or leafy-green produce. The deeper-colored they are, the more antioxidants they contain to fight off free-radicals and boost the immune system.
  • Also consume fruits such as pineapples, kiwi, and papaya. These are high in the enzymes bromelain and papain, which are known to be mucous-fighters
  • Spinach is a good choice, and even better when cooked in olive oil. The fat in the oil makes the antioxidant lutcin in the spinach easier to absorb
  • Raw honey is rich in a wonderful phytonutrient called propolis which is an antimicrobial and also boosts water content in the bronchial tubes. 2-3 tablespoons of honey with plenty of water is recommended

What are some Natural Remedies for Bronchitis?

Herbs and natural treatments abound for bronchitis:

  • N-acetylcysteine (NAC) extract is derived from the naturally occurring amino acid cysteine. It has proved effective at thinning mucous and other fluids in the lungs and bronchial tubes.
  • Echinacea and astragalus are excellent immune system boosters
  • Licorice (glycyrrhiza glabra) has been tested and proven as an antiviral
  • Native Americans have used lomatium (lomatium dissectum) to help respiratory concerns. It is reported to lessen recovery time for the flu
  • Eucalyptus vapors are recommended for reducing cough and phlegm
  • Peppermint is a great decongestant, due to its main ingredient menthol. It also soothes coughing and sore throats

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