Bronchitis is caused due to irritation, inflammation and infection of the airways in the lungs called the bronchi. There are basically two major types of bronchitis:-

• Acute bronchitis – this lasts for 2 to 4 weeks and is usually responsive to therapy.
• Chronic bronchitis – this is a different entity and leads to long term damage to the inner walls of the airways in the lungs. This is part of a group of lung diseases called chronic obstructive pulmonary disease or COPD. This is a progressively worsening condition that cannot be cured

Persistent cough

The common symptom for both types of bronchitis is a cough that is usually persistent and accompanied by expectoration of a yellowish green mucus or phlegm.

The cough may last long after the acute bronchitis is resolved. The continued cough may cause pain and soreness in the chest and stomach muscles as well.

Symptoms of bronchitis

• Cough - the cough begins within two days of infection in 85 percent of patients. The cough in most people lasts for less than two weeks. In a quarter of patients however the cough may persist for six to eight weeks.

  The cough is worse and more noticeable in the morning because of pooling of secretions in the lying down position that get then mobilized with morning activities.

  Lying down at night may also result in cough because of the shifting or mobilization of the secretions.

• Bringing up phlegm that may be clear, white, yellow, green, or even tinged with blood. This color is due to presence of the peroxidise enzyme released by the white blood cells in the sputum and is not indicative of a bacterial infection.
• Tightness and pain in the chest
• Shortness of breath
• Soreness of throat
• Hoarseness of voice
• Runny or stuffy nose
• Fever with chills especially seen in acute bronchitis
• Wheezing and noisy breathing. On hearing with a stethoscope there are other sounds called rhonchi, and rales present along with breathing sounds. The breathing sounds raspy and harsh.
• Blocked sinuses
• Headaches
• Soreness and body aches
• Loss of appetite along with fatigue
• Repeated flare ups or exacerbation of symptoms especially in winter months seen in chronic bronchitis.
• In chronic bronchitis patients there may be a persistent lack of oxygen leading to features of cyanosis (blue lips and nails) and clubbing (enlargement of the tips of the fingers), swelling of the legs, or severe breathlessness.

Red flag symptoms

Some red flag symptoms that need medical attention immediately include:-

• Very severe cough that lasts over three weeks
• High fever for over three days
• Chest pains and rapid breathing rates of over 30 per minute
• Coughing up blood or sputum streaked with blood
• Drowsiness and confusion
• Recurrent bouts of bronchitis
• Presence of underlying heart or lung disorders like asthma, emphysema, heart failure or COPD.
• Very young (infants and babies) and very old patients with a lowered immunity