What to Know About Chest Colds

Winter is upon us. The leaves have fallen, the air is crisp, and all you want to do is wrap yourself in your favorite blanket, sip hot cocoa, and read a good book by a crackling fire. It’s also that time when entering a public place means exposure to every germ imaginable. No matter how careful you are or how many times you wash your hands, chances are you or someone around you will get a virus this winter, and this can turn into a chest cold – also known as bronchitis.

What is bronchitis?

Todd Rudolph, MD Medical Director, AFC Urgent Care & Family Care East Tennessee (formerly Doctors Express)
Todd Rudolph, MD
Medical Director, AFC Urgent Care & Family Care East Tennessee (formerly Doctors Express)

Bronchitis occurs when the smaller airways (bronchi) in your lungs become inflamed and overproduce mucus. Usually hitting three to four days after a cold or the flu, it can turn a seasonal illness into a month-long ordeal.
Bronchitis causes a persistent cough, which is the body’s way of expectorating (that is, ejecting or expelling) excess mucus in the lungs. Other symptoms include wheezing, chest discomfort, and shortness of breath.
According to Dr. Todd Rudolph, medical director at AFC Urgent Care & Family Care East Tennessee (formerly Doctors Express), the symptoms of bronchitis are a result of the actions of your immune system.
“When a virus enters your system and irritates your lungs, your immune system enters in ‘attack mode.’The inflammation in the lining of your lungs is the result of this immune response at work.”
Do I have bronchitis?
Did your spouse kick you out of the bedroom because you kept him up with your coughing? Have your kids asked you to watch television in the other room so they can hear the dialogue? If you answered “yes” to either of these questions and you’ve recently had a cold or virus, chances are you have bronchitis.
The telltale persistent cough can be so severe that it impacts your ability to sleep. Bronchitis usually begins with a dry cough that becomes wet (producing clear or colored mucus) within a few hours or days, and this cough can last 10 to 20 days.
Since bronchitis tends to follow the cold or flu, its symptoms can coincide with typical viral complaints like sore throat, fever, aches, runny nose, and fatigue.
Should I take antibiotics?
Jonathan Thompson, MD Medical Director, Emergency Department, Hamilton Medical Center
Jonathan Thompson, MD
Medical Director, Emergency Department, Hamilton Medical Center

The short answer is: probably not. The vast majority of bronchitis cases are viral, as opposed to bacterial. Since antibiotics only treat bacterial infections, they won’t be an effective treatment in more than 90% of cases.
If a microscopic exam of your phlegm reveals large numbers of bacteria, your doctor may diagnose you with a bacterial infection and prescribe antibiotics. However, most incidences of bronchitis must run their course.
“Many people think that antibiotics will get rid of symptoms when the only thing they can do is get rid of any overgrowth of bacteria in the mucus,” says Dr. Rudolph.
The good news is that bronchitis almost always gets better on its own. It just might take two to three weeks for you to see
Can antibiotics hurt me?  
When we go to the doctor, most of us expect to walk out with more than a box of tissues and a directive to get more rest. We want something to help our body get better fast, and for most Americans this equates to a prescription for antibiotics. According to a recent study published in Morbidity and Mortality Weekly Report in July, as many as 25% of Americans who visit their doctor for a cold expect to receive a prescription for antibiotics.
However, if you take antibiotics when you don’t need them, they can harm your body. First, each antibiotic has its own risk profile.  “Some potential adverse reactions, such as an allergic reaction to penicillin, may be life threatening,” says Dr. Jonathan Thompson, medical director of Hamilton Medical Center’s Emergency Department.
Secondly, according to Dr. Randy Heisser, family practice physician with Kindred Hospital Chattanooga, over prescription of antibiotics has led to a rise in drug-resistant bacteria.
Dr. Thompson agrees, explaining the phenomenon. “In these cases, the antibiotic kills most of the bacteria, but a small percentage of it, the bacteria most resistant to the drug, survives and begins to multiply.”
Antibiotics can also upset the balance of the normal bacteria flora in your GI tract. “This makes you susceptible to developing colitis, which is a type of inflammation in the colon that can become life threatening,” Dr. Thompson says.
How else can I treat bronchitis?  
Randy R. Heisser, MD Family Medicine Physician, Kindred Hospital Chattanooga
Randy R. Heisser, MD
Family Medicine Physician, Kindred Hospital Chattanooga

If antibiotics won’t help you get over your cough, how do you cope? Magic cures aside, symptom relief is available in the form of rest and lung care. “The best way to help your natural defenses is to treat your symptoms,” says Dr. Heisser.
Take an over-the-counter decongestant (which can help you breathe easier) or expectorant (which can loosen mucus), try a nasal saline, and use a humidifier to keep the air moist and ease the discomfort
of your cough. Make sure you drink plenty of non-caffeinated fluids, and take warm showers and baths to help thin and expel the mucus from your lungs.
“Symptomatic therapies like these have little risk of harm,” says Dr. Thompson. “It’s simply a matter of finding something that makes you feel better as you wait for your illness to run its course.” If you are in pain,  try over-the-counter pain relievers such as acetaminophen and ibuprofen. Try to sleep as much as you can – rest is always critical and you should make sure to take it easy when you are sick. If the inflammation of the lungs becomes severe and you feel your airways are constricted, talk to your doctor about prescribing an inhaler or oral steroids to ease your symptoms.
Should I take cough medicine?
If you’ve been saddled with a wet cough for a week or longer, your first instinct might be to take a swig of the strongest cough medicine you can get your hands on. Wait. While this treatment may give you temporary relief, it can inhibit the body’s healing process. When you have a wet cough, your body is expelling the phlegm and mucus produced by the inflammation of the bronchial tubes. This is a good thing. Suppressing the cough can slow the healing process.
That being said, a cough suppressant can sometimes be a good option if you have a dry cough that keeps you up at night. If you’re having trouble sleeping, look for an over-the-counter suppressant like dextromethorphan. Prescription cough suppressants, which are narcotic-based, aren’t typically appropriate for bronchitis.
What do I do if it doesn’t go away?
While bronchitis isn’t normally considered a dangerous condition, it can become serious in young children, the elderly, or individuals with weak immune systems. It can also be dangerous for those with pre-existing lung conditions like asthma. If you fall into one of these categories or you feel your cough continues to worsen, it’s time to see a medical professional.
You’ll also want to visit your doctor if your cough has persisted for more than two to three weeks, you are running fevers, you have significant difficulty breathing, you are wheezing, you are coughing up blood, or if you are coughing up thick green or yellow phlegm. These symptoms suggest your bronchitis may have progressed into something more serious like pneumonia. A physician can do an exam to ensure you haven’t developed a secondary condition.
How can I prevent it?
According to Dr. Rudolph, good hand washing and good hygiene are the most effective ways to fight bronchitis. These measures will kill any viruses before they get into your body. “The real story is that bronchitis cases go up when people are in closer proximity to each other at school and the store,” he says.
Dr. Heisser also recommends getting a flu shot. “This will keep you from getting what often causes bronchitis in the first place,” he says.

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