Bronchitis refers to inflammation of the large breathing tubes of the lungs (as contrasted with pneumonia, which means infection or foreign material in the air sacs). These tubes are lined with glands that secrete mucus to trap any foreign material (dust and germs mainly) that get down in the lungs. When the lining of the bronchi is irritated and inflamed, the response is swelling of the lining (which makes the tubes smaller inside and harder to breathe through), and the secretion of increased amounts of mucus. The mucus may get thicker and stickier as well.

Ordinarily, mucus in the lungs is pretty watery. This allows the cleaning system (cilia - billions of microscopic "fingers" on the lining cells of the tubes that all wave in the same direction - up and out of the lungs) to pump it out of the lungs, up the windpipe (trachea) and out through the larynx (voicebox) to be swallowed and sterilized by the acid in the stomach.

As mentioned above, when a patient has bronchitis, the mucus becomes very thick and sticky - hard to pump up. So we have to cough it up. This is a prominent feature of asthmatic bronchitis - asthma. The irritation of the nerves in the bronchial tubes also stimulates the cough reflex.

Treatment of bronchitis really depends on what the underlying cause is; usually, some loosening agents for the thick mucus are given (such as guafenesin - Robitussin® etc.), and if the bronchitis is asthmatic, of course the underlying inflammation is treated. True bacterial bronchitis, that is a pure bronchitis without pneumonia caused by a bacterial germ, while it does afflict adults (especially smokers), either doesn't exist in childhood or is about as common as hen's teeth. Just remember that as a basic rule of thumb, bronchitis in school age children is asthma-related or at most viral.

See also bronchiolitis.

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