Acute vs. Chronic Bronchitis: Understanding the Differences

Bronchitis is a respiratory illness that causes inflammation of the tubes that carry air to the lungs—also known as the airways or bronchial tubes. When the airways become irritated, swollen and inflamed, less air is able to travel to and from the lungs and mucus begins to form in them. This generally causes an irritating cough that may be accompanied by shortness of breath, more mucus production and other bothersome symptoms.^[1]

There are two types of bronchitis: acute and chronic; the symptoms can be quite different for acute vs. chronic bronchitis. Read on to take a look at how these types of bronchitis differ.^[1]

Acute vs. Chronic: What Is the Difference between the Types of Bronchitis?

People who have bronchitis often have a persistent cough that brings up thick, discolored mucus. They may also experience wheezing, chest pain, and shortness of breath.^[2]

Bronchitis may be either acute or chronic:

• Acute bronchitis. Acute bronchitis develops from a cold or other respiratory infection. Symptoms last less than 3 weeks, often improving within a few days without lasting effects.^[2]
• Chronic bronchitis. Bronchitis is classified as chronic when symptoms — primarily productive cough – lasts more than 3 months within a span of 2 years. The constant inflammation in the lining of the bronchial tubes causes excessive amounts of sticky mucus to build up in the airways, restricting the amount of airflow into and out of the lungs.^[2]

This is the primary difference between acute and chronic bronchitis: Chronic bronchitis is a permanent and progressive disease, while acute bronchitis will improve and go away.^[1]

Causes of Bronchitis

Most often, the same viruses that give you a cold or the flu cause acute bronchitis. But sometimes, bacteria bring it on.^[1]

In both cases, as your body fights the germs, your bronchial tubes swell and make more mucus. That means you have smaller openings for air to flow through, which can make it harder to breathe.

Chronic bronchitis causes include:

• Breathing in air pollution and other things that bother your lungs, like chemical fumes or dust, over time
• Smoking or breathing in secondhand smoke for a long time.^[1]

Many people wonder, “Can acute bronchitis become chronic?” One instance of acute bronchitis does not put you at risk, but repeated recurring bronchitis can put you at a higher risk. Over time, acute recurring bronchitis may lead to chronic bronchitis. If you smoke during an attack of acute bronchitis, recovery will be much more difficult and will take a great deal longer than if you do not smoke. Moreover, continuing to smoke further damages the tiny hair-like structures in your lungs (cilia) that are responsible for ridding your lungs of debris, airway irritants and excess mucus, thus increasing your risk for chronic bronchitis.^[3] Continuing to smoke when you have chronic bronchitis worsens symptoms and makes the disease progress at a much faster rate.^[4] While smoking with both types of bronchitis guarantees a worsening condition, the primary difference between acute and chronic bronchitis is that it keeps coming back or doesn’t go away.^[1]

Symptoms of Acute Bronchitis vs. Chronic Bronchitis

Symptoms of both acute and chronic bronchitis include breathing problems, such as:^[1]

• Chest congestion, when your chest feels full or clogged
• A cough that may bring up mucus that’s clear, white, yellow, or green
• Shortness of breath
• Wheezing or a whistling sound when you breathe

Symptoms of acute bronchitis also may include:

• Body aches and chills
• Feeling “wiped out”
• Low fever
• Runny, stuffy nose
• Sore throat

Even after the other symptoms of acute bronchitis are gone, the cough can last a few weeks while your bronchial tubes heal and the swelling goes down. If it goes on much longer than that, the problem might be something else.

If you have a new cough, fever, or shortness of breath, call your doctor to talk about whether it might be COVID-19.

With chronic bronchitis, your cough lasts for at least 3 months and comes back at least 2 years in a row.^[1]

As the airways become increasingly irritated, mucus production worsens and an irritating cough develops. Over time, chronic bronchitis symptoms cause the lining of the airways to thicken, scar tissue forms and airflow to and from the lungs becomes impaired. As mucus production increases, it begins to pool in the airways creating a perfect breeding ground for infections, which is why recurring bronchitis is a significant concern.^[5]

Another difference between acute and chronic bronchitis is that chronic bronchitis can be dangerous, especially if it goes without proper treatment. These US-based facts illustrate the seriousness of this chronic disease.^[6] 

• In 2021, 4.6% of adults have been diagnosed with COPD, emphysema, or chronic bronchitis: 84% of the cases involved people over 50 years of age.
• In 2020 there were 457 bronchitis-related deaths in the United States
• Currently, women develop chronic bronchitis at twice the rate that men do in the United States ^[7]

If you have recurring bronchitis and are unsure of the impact that acute bronchitis vs. chronic bronchitis will have on your health, talk to your doctor about changes you can make in your lifestyle to improve your respiratory health.

Diagnosis of Bronchitis ^[1]

Acute bronchitis is generally easy for your doctor to detect through a physical examination and description of your symptoms. During your physical exam, your doctor will listen to your lung sounds with a stethoscope; wheezing or a whistling sound in your chest is usually indicative of acute bronchitis.

Diagnosis of chronic bronchitis may include a chest X-ray, lung function tests and a measurement of the amount of oxygen in your blood. Tests such as these help your doctor determine how well your lungs are working and to what degree they are impaired.

Treatment of Different Types of Bronchitis

Treatment for acute bronchitis vs. chronic bronchitis is different, so it is important to see your doctor to ensure you get the correct diagnosis and treatment for your particular case. If you tend to get recurring bronchitis, it is especially important to follow your doctor’s instructions to help minimize the potential of future lung damage.

Because acute bronchitis is generally the result of a respiratory virus,taking antibiotics will likely not provide a cure Most of the time, drinking plenty of fluids, getting adequate rest and avoiding smoke and other airway irritants is the standard treatment while the virus runs its course. If your symptoms are severe, your doctor may order a bronchodilator inhaler to help relax your airways and/or a prescription cough suppressant. They may also advise you to take aspirin or Tylenol to reduce any physical discomfort.^[1]

Smoking cessation is the single most important aspect of treatment for chronic bronchitis to help prevent worsening symptoms. If you continue to smoke, your chronic bronchitis symptoms will continue to worsen quickly, and you will experience more and more trouble breathing. In addition to quitting smoking, your doctor may prescribe any of the following:^[2]

Medical treatments

• Oral steroids to reduce inflammation
• Phosphodiesterase-4 inhibitors to suppress inflammation and prevent exacerbations Bronchodilator inhalers to relax constricted airways
• Antibiotics (if a bacterial infection is present)
• An expectorant (not a cough suppressant as coughing helps rid the airways of mucus
• Supplemental oxygen to increase blood oxygen levels
• Keep current on vaccines: an annual flu shot and a pneumonia vaccine (depending upon your age, co-existing medical conditions and if you have had one in the past)

Pulmonary Rehab

• Exercise – Physical activity can help strengthen the muscles that help you breathe.
• Nutritional counseling and weight loss (reduces strain on the heart)
• Breathing strategies – Pursed-lip breathing can sometimes provide relief when you’re having difficulty breathing. People with COPD who use breathing exercises report improvements in exercise capacity, reduced shortness of breath and improved quality of life.
• Counseling

Lifestyle changes

• Breathing in warm, moist air from a humidifier can help ease coughs and loosen the mucus in your airways
• Taking steps to limit the amount of irritants you inhale may also help reduce inflammation and coughing.

Prevention of Bronchitis

The most important thing you can do to reduce your risk for chronic bronchitis is to avoid or stop smoking. Severe lung damage can occur when you inhale smoke over an extended period. If you quit smoking, your lungs will begin to heal and you’ll be able to breathe much easier. You’ll also lower your risk of developing lung cancer. Talk with a doctor or other HCP about quitting smoking or visit the American Lung Association website for tips.

Additionally: ^[1]

• Stay away from cigarette smoke.
• Get the flu vaccine since you can get bronchitis as a secondary bacterial infection after the flu or a cold.
• Make sure your pertussis vaccine is up to date.
• Wash your hands often.
• Wear a mask when you’re around things that bother your lungs, such as paint fumes.

Preventing Exacerbations of Chronic Bronchitis

If you have chronic bronchitis, you may experience exacerbations, or periods of time when your symptoms worsen. Acute episodes such as these can be prevented, or reduced, by frequent hand washing, flu and pneumonia vaccines, avoiding people who are sick and maintaining a healthy diet and exercise program. Remember, when it comes to your health, an ounce of prevention is always worth a pound of cure! ^[1]

When prevention is not enough, you may need extra help treating chronic bronchitis. If so, your doctor may prescribe oxygen therapy to help you breathe easier. Supplemental oxygen can provide the extra oxygen you need to feel and function better each day. If you are struggling to breathe because of chronic bronchitis,^[1] talk to your doctor about whether oxygen therapy treatment can help you, and contact Inogen today to find out how our products can help you treat your chronic bronchitis symptoms with a single solution for oxygen at home or away, all day, every day.

Frequently Asked Questions: Acute Bronchitis vs. Chronic Bronchitis

Which is worse: acute bronchitis vs. chronic bronchitis?

Unlike acute bronchitis, which usually develops from a respiratory infection such as a cold and goes away in a week or two, chronic bronchitis is a more serious condition that develops over time. Symptoms may get better or worse, but they will never completely go away. These extended periods of inflammation cause sticky mucus to build up in the airways, leading to long-term breathing difficulties.^[2]

Can acute bronchitis become chronic?

Unfortunately, yes, it can over time. If you have recurring bronchitis, the repetition of the infection can eventually lead to chronic bronchitis down the road. If you have a tendency to get acute bronchitis frequently, it is likely that you smoke or are often exposed to other lung irritants. Talk to your doctor about how to make changes in your health and your life to help minimize the risk of developing chronic bronchitis.^[2]

Why does my bronchitis keep coming back?

More than likely, you are being repeatedly exposed to an irritant that is causing the inflammation in your bronchial tubes. Very often, that irritant is cigarette smoke, so if you are a smoker, it is essential to quit. If you do not smoke, you may be experiencing repeated exposure to secondhand smoke, air pollution or dust that is causing the irritation. If you have recurring bronchitis, see your doctor to ascertain what is causing the irritation and to make sure you do not have chronic bronchitis.^[2]

References

1. WebMD. Understanding Bronchitis – the Basics. Reviewed at May 7, 2013. Bronchitis (Acute and Chronic): Symptoms, Causes, Diagnosis, and Treatment (webmd.com)
2. Chronic Bronchitis: Symptoms, Treatment, Causes, and More (healthline.com)
3. Highlights: Overview of Findings Regarding Respiratory Diseases (cdc.gov)
4. Smoking and COPD | Overviews of Diseases/Conditions | Tips From Former Smokers | CDC
5. Understanding Mucus in Your Lungs | American Lung Association
6. https://www.cdc.gov/nchs/fastats/copd.htm
7. COPD Trends Brief – Prevalence | American Lung Association