The difference between acute bronchitis and bronchitis

Written by Han Shun Li
Pulmonology
Updated on September 10, 2024
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What is the difference between acute bronchitis and bronchitis? Generally speaking, in terms of the duration of the disease, bronchitis can be classified into acute bronchitis and chronic bronchitis. Acute bronchitis is a type of bronchitis. It is often caused by infections, physical and chemical factors, allergies, etc. Patients may experience fever, cough, and expectoration, and the duration usually lasts 2 to 3 weeks. In the case of chronic bronchitis, the course of the disease is longer, with symptoms such as repeated coughing, expectoration, and wheezing, and the symptoms persist and do not improve.

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Written by Wang Xiang Yu
Pulmonology
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Can chronic bronchitis be treated?

Chronic bronchitis, commonly known as "chronic obstructive bronchitis," is treatable. The primary symptoms of chronic bronchitis are coughing and expectoration. If the disease occurs for more than three months each year, for two consecutive years, while excluding other organic diseases, chronic bronchitis can be diagnosed. Treatment for chronic bronchitis is divided into two parts. During acute exacerbations, which typically present with worsened coughing and expectoration, increased sputum volume, or the presence of purulent sputum and possibly accompanied by wheezing and fever, the main treatment is anti-infection. The primary medications for anti-infection are antimicrobial drugs, which include macrolides, quinolones, cephalosporins, etc. Additionally, treatment can be aimed at alleviating symptoms of coughing and expectoration and might include expectorants and cough suppressants, such as ambroxol. For wheezing, medications like aminophylline or nebulized treatments may be necessary. Most of the time, patients with chronic bronchitis are in a remission phase. The primary treatment here initially involves addressing known triggers, such as insisting smokers quit and minimizing exposure to dust or harmful gases at work. Chronic bronchitis patients are encouraged to exercise moderately, strengthen their physique, and prevent colds. For patients who experience repeated respiratory infections, vaccination or immune modulators, such as BCG, may be considered. Always follow a physician’s guidance regarding specific medication use.

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Written by Hu Bai Yu
Pulmonology
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Chronic Bronchitis Clinical Characteristics

Chronic bronchitis often presents with symptoms of coughing, which are long-term, recurrent, and progressively worsen. Coughing is a very prominent manifestation of this condition. For mild cases, symptoms typically flare up during the winter and spring seasons, especially noticeable upon waking in the morning, with less coughing during the day. In the summer and fall, the coughing may lessen or disappear. In severe cases, patients may experience coughing throughout the year. It's crucial to take note and, under a doctor's guidance, use corresponding anti-inflammatory and anti-infection medications, along with cough suppressants and expectorants to alleviate symptoms. Another characteristic is the presence of phlegm, typically white mucous sputum or serous foamy sputum. It's advised to use expectorants for treatment. During treatment, avoid smoking and alcohol, and maintain a light diet. Additionally, if there are symptoms of asthma or wheezing, it may be necessary to take medications to alleviate these symptoms. (Note: The answer is for reference only; medication should be administered under the guidance of a professional physician and should not be taken blindly.)

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Written by Wang Xiang Yu
Pulmonology
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Chronic bronchitis auscultation characteristics

Most patients with chronic bronchitis, for the most part, show no abnormalities upon lung auscultation. This means their breath sounds are relatively clear, without diminished or enhanced breath sounds, nor any dry or wet rales typically heard. This is the case for the majority of patients; however, a small number of patients during acute exacerbations might present with some dry or wet rales at the back or the base of the lungs. Moreover, these rales may disappear after the patient coughs, indicating that in chronic bronchitis, the sounds heard upon auscultation can change and are not constantly present. You might hear dry or wet rales one moment, and after the patient coughs or receives treatment, these sounds could potentially alleviate. Additionally, if a patient with chronic bronchitis starts to wheeze or develops asthma, they might exhibit sounds such as wheezing or prolonged expiration.

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Written by Wang Xiang Yu
Pulmonology
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How is chronic bronchitis diagnosed?

Chronic bronchitis: how is it diagnosed? First, we need to understand what chronic bronchitis is defined as. It refers to the chronic nonspecific inflammation of the trachea, bronchial mucosa, and surrounding tissues. We emphasize the chronic process, and currently, diagnosis is primarily based on clinical symptoms. This means the patient must exhibit symptoms such as coughing and expectoration, and these symptoms must persist for more than three months for at least two consecutive years. Additionally, it is crucial to exclude other diseases. Any organic disease that presents with symptoms of coughing, expectoration, and wheezing must be ruled out, such as tuberculosis, pneumoconiosis, lung abscess, lung cancer, heart disease, bronchiectasis, bronchial asthma, gastroesophageal reflux, and pulmonary interstitial fibrosis, among others.

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Written by Wang Xiang Yu
Pulmonology
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How to treat chronic bronchitis?

How to treat chronic bronchitis, first of all we need to know that chronic bronchitis can be divided into two phases, one is the remission phase, the other is the acute exacerbation phase. Since most patients are in the remission phase most of the time, that is, their symptoms of cough and expectoration are relatively stable, more or less the same every day, with no significant change in the amount and nature of the sputum, no purulent sputum, no significant increase in sputum, and no fever or other symptoms of infection. In such cases, the first step in treating chronic bronchitis patients is to target some possible causes of their condition, such as smokers must quit smoking. Most chronic bronchitis patients experience some relief in cough and expectoration after quitting smoking. Furthermore, some patients' chronic bronchitis may be due to exposure to dust or irritant gases. It is crucial to avoid contact with these harmful gases as much as possible. In addition, patients in a stable condition should engage in physical exercise, enhance their physical fitness, and prevent colds. Some chronic bronchitis patients who frequently suffer from respiratory infections can consider using immunomodulators or some traditional Chinese medicine to regulate immunity and enhance resistance. Additionally, since chronic bronchitis can acutely exacerbate, which means the patient’s condition has changed, their cough and expectoration frequency may increase, the amount of sputum may increase, or there may be some purulent sputum, or fever and other symptoms. In such cases, the primary treatment may still be infection control, commonly using antimicrobial drugs, often referred to as anti-inflammatory drugs. The types of anti-inflammatory drugs are numerous, the most common ones include penicillin, erythromycin, levofloxacin, amoxicillin, and some cephalosporins. In such cases, it is necessary to choose medication under the guidance of a doctor. Additionally, in these situations where the patient’s cough and expectoration are worsened, and sputum increases, medications for cough suppression and expectoration, commonly known as expectorants and cough relievers, are also needed. There are some proprietary Chinese medicines, such as licorice preparations, and Western medicines such as bromhexine and ambroxol as well. Moreover, a very small portion of patients may experience wheezing, meaning some patients might also have symptoms like chest tightness and shortness of breath. In such cases, it would be necessary to use bronchodilators under the guidance of a doctor, such as theophylline or doxophylline, and these medications must be used under medical supervision.