MEDICAL SURFARI: BRONCHITIS MAY HIT ANY AGE

Acute bronchitis, inflammation of the passageways for air moving to and from the lungs, may occur in people of any age. If you have ever experienced coughing fits or feel as if you need to breath shallow so as to prevent a nearly uncontrollable coughing spell, you may have had bronchitis. Sometimes this condition is difficult to distinguish between upper respiratory infections and colds, especially in children. It is usually associated with a runny nose, sore throat and muscle aches, dry cough, chills and either no fever or a very low-grade fever lasting three to five days. Bronchitis may be either acute or chronic, depending on how long it lasts and how serious the damage. Acute bronchitis caused by viruses or bacteria most often occurs in the winter months but acute bronchitis due to environmental pollutants that attack the mucus membranes within the respiratory tract may occur at any time during the year. Most cases of acute bronchitis last a week to ten days, although the cough may persist longer. Rarely, bronchitis due to measles may occur in some individuals who have not been immunized.

If you suspect that you may have acute bronchitis, seek prompt treatment to prevent serious complications as the inflammatory process may extend downward into the lungs and into the small air passages and air sacks, resulting in bronchopneumonia. Treatment generally includes avoiding fatigue by getting proper rest, medications that open up the bronchial passages, generous fluid intake to keep the lung surfaces well hydrated and mucus moist so that it may cleared from the lungs by coughing. So, it is generally best to avoid cough suppressants. Your doctor may also prescribe a course of antibiotics and an expectorant to help loosen the mucus.

Chronic bronchitis may result from repeated and/or prolonged irritation of the respiratory tract, leaving the lining red and inflamed. This may be caused by allergens and air pollution, although far and away the most common culprit is tobacco smoke. This may lead to a destructive process within the small air sacks of the lungs, resulting in emphysema along with chronic bronchitis. The combination of these destructive changes in the lungs may lead to permanent damage of the respiratory tract. Unlike acute bronchitis, this form of bronchitis is often associated with a deep rattling mucus-producing cough. Once the cough becomes constant, there is usually narrowing of the airways by a thickened, mucus-producing layer of the bronchial lining which causes breathing to become increasingly difficult. The tars and nicotine within tobacco smoke paralyze the cilia that sweep the air passages clean of foreign irritants; consequently these irritants may build up and block small air passages, making the individual more vulnerable to lung infection and spreading tissue damage.

If you suffer from chronic bronchitis, self-treatment is not recommended. The use of another's inhaler or use of over-the-counter cough medications may produce undesirable results. If tobacco smoking is the likely cause and you have had difficulty in stopping smoking, ask your doctor for guidance as there are a variety of stop smoking programs that have proven to be effective.

WORLD WIDE WEB RESOURCES

American Lung Association

www.lungusa.org/diseases/lungchronic.html

The American Lung Association's web site has a wealth of good information about lung problems, including chronic bronchitis.

American Institute of Preventive Medicine

www.healthy.net/library/Books/Healthyself/bronchitis.htm

Included in this web site are bronchitis self-care tips and information on when to seek emergency care and when to see your physician.

The Office Management of Obstructive Lung Disease

www-med.stanford.edu/school/DGIM/Teaching/Modules/copd.html

This is a teaching module on management of obstructive lung disease, including chronic bronchitis. Although designed for health care providers, it may also be of interest to consumers.

Dr. Scott Gibbs is a Cape Girardeau neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63701.