Acute vs Chronic Bronchitis

Acute bronchitis is more common during cold and flu season. Acute inflammation is caused by a virus or bacterial infection and usually resolves on its own except for people with:
1. Respiratory irritants such as cigarette smoke, pollutants, chemicals
2. Lowered immune system- such as children, elderly, pregnancy, cancer,
diabetes, HIV
3. Heartburn- GERD
4. Respiratory conditions- Asthma, Chronic Obstructive Pulmonary Disease
(COPD)
Symptoms usually began with upper respiratory set the symptoms such as sore throat stuffy nose and cough. The cough starts as a dry hacking nonproductive and usually interrupts sleep. After a few days mucus production begins. Chest X rays may be normal or show inflammation. Scattered wheezing may be noted, and fever may be present. Respiratory infections can last up to 3 weeks. Symptoms include cough with little to no sputum, low grade fever or chills, sore throat, body aches, tightness or pressure of the chest. Sputum tests look for type of respiratory infection such as pertussis.

Chronic bronchitis involves excessive mucus production. There is a relationship between the amount and duration of cigarette smoking and severity of bronchitis. But in advanced stages of chronic bronchitis, emphysema can develop as well as heart failure, increased airway obstruction, and Polycythemia which can result in pulmonary embolism. Diagnosis occurs when the cough and increased mucus production occurs three months each year for two years. Advanced stages of chronic bronchitis can resemble emphysema. Over time chest xray results would show hyperinflation of the lungs. Pulmonary function tests show airway obstruction.

Seek medical care if:
1. Cough lasts more than 3 weeks
2. Prevents you from sleeping
3. Fever of more than 100.4
4. Yellow/green/dark colored mucus or having streaks of blood
5. Having wheezing or SOB

Treatment includes bed rest, and increase of fluid intake as well as:
1. An antibiotic if infection is bacterial
2. Cough medicine- to help expectorate mucus. Cough suppressant only at
bedtime allows for better sleep
3. Inhalers to reduce inflammation and open narrowed passages in your lungs
4. Wear mask if your exposed to respiratory irritants at work
5. Use humidifier
6. Vaccines- flu, and pneumonia
7. Hand washing to prevent spread of viral infections.
8. Use hand sanitizers

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Heartburn!

Heartburn, or acid indigestion, is a burning sensation mid chest that worsens when you bend over or lay day. It usually occurs after eating and at night.  It is caused by reflux. Reflux occurs when the acid in your stomach backs up into your food pipe (esophagus), resulting in inflammation.  It is considered a disease when you have symptoms more than 2 times a week.

Gastroesophageal Reflux Disease (GERD) is a condition of digestion that allows stomach acid to go up the esophagus due to a weakening of the muscle at the point where the esophagus ends and your stomach begins. GERD often interferes with routine daily activities, and result in damage to your esophagus.

Symptoms- heartburn, vomiting or spitting up blood, bitter taste in mouth, burning chest pain, dry cough, painful throat, painful swallowing, and hoarse voice.

Complications- scarring of esophagus, bleeding in stomach or esophagus, ulcer formation in esophagus or stomach

Risk Factors

Spicy or hot foods

Alcohol, soda, caffeine

Fatty foods

Gassy foods (certain vegetables)

Pregnant

Obese

Smokers

Abdominal hernias

Treatment for GERD

Antacids– help to neutralize the acids in your stomach, but will not treat the inflammation of the esophagus. Over use can cause constipation and diarrhea.

Gaviscon

Tums

Maalox

Mylanta

Rolaids

Histamine-2 (H2) Blockers -Reduce production of acid in stomach. May not be as good for treating esophagitis (inflammation that occurs in the esophagus). Histamine stimulates acid production, especially after meals, so H2 blockers are best taken 30 minutes before meals. They can also be taken at bedtime to suppress nighttime production of acid. Examples of prescription H2 blockers:

Nizatidine (Axid)

Famotidine (Pepcid)

Cimetidine (Tagamet)

Ranitidine (Zantac)

 

These drugs are useful at relieving heartburn, but may not be as good for treating esophagitis (inflammation that occurs in the esophagus).

Side effects can include headache, abdominal pain, diarrhea, nausea, gas, sore throat, runny nose, and dizziness.

Proton Pump Inhibitors (PPIs)

Drugs that block acid production more effectively and for a longer period of time than the H2 blockers, PPIs are best taken an hour before meals. They include:

  • Rabeprazole (Aciphex)
  • Esomeprazole (Nexium)
  • Lansoprazole (Prevacid)
  • Omeprazole (Prilosec, Zegerid)
  • Pantoprazole (Protonix)
  • Dexlansoprazole (Dexilant)

Many doctors do not believe that one drug is more effective than the others in treating GERD. These medications are also good for protecting the esophagus from acid so that esophageal inflammation can heal.

Side effects can include headache, diarrhea, abdominal pain, bloating, constipation, nausea, and gas.

Home Care

Avoid eating foods and drinks that trigger heartburn. fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, citrus fruits (Pineapple, strawberries), vinegar, foods that can cause gas (peppers, cabbage,) and caffeine may make heartburn worse.

Do not over eat.  Try eating smaller frequent meals.

Do not lie down after a meal, and wait 2- three hours after eating before lying  down or bending over

Elevate the head of your bed

Do not smoke.

Avoid medications that can irritate your stomach, like NSAID’s (Aspirin, Aleve, Ibuprofen)

Weight loss may help to reduce abdominal pressure pushing acid into the esophagus

Avoid wearing tight clothes

Seek medical attention if symptoms occur for more than 2 times a week, and over the counter medications do not help, if you have difficulty swallowing, nausea, vomiting, or weight loss.