You thought you were finally shaking that cold, but this morning your cough is worse than ever. You're coughing up phlegm by the cupful, and it feels as if someone spent the night tap-dancing on your chest. You've probably developed bronchitis, an often-painful infection in the major bronchial tubes leading to the lungs.
"Bronchitis has many causes, the two most common being bacterial infections and viruses that weaken the immune system and leave the respiratory passages vulnerable to secondary infection," explains Evan T. Bell, M.D.. a specialist in infectious diseases at Lenox Hill Hospital in New York. "Its hallmark symptom is a cough that is productive of thick, yellowish or greenish sputum in large amounts," he continues. But other symptoms can include a low-grade fever, chills, aches, and pains. "You may also experience some rattling noises in the lungs and chest," adds W Paul Glezen, M.D., professor of microbiology and immunology and of pediatrics and chief epidemiologist at Baylor College of Medicine in Houston, Texas.
"Unlike cold and flu viruses, which are easily passed through respiratory excretions in the air, bronchitis tends to be particular to an individual and is rarely contagious," says Bell.
And while bronchitis sounds horrible, its bark is worse than its bite. According to Marcia Kielhofner, M.D., a clinical assistant professor of medicine at Baylor College of Medicine in Houston, Texas, the two most worrisome symptoms tend to be the characteristic burning or aching chest pain directly under the breastbone and the sometimes blood-streaked sputum produced by the cough.
Unless you have a severe underlying disease or have asthma and allergies, you may have to let bronchitis run its course. But there are some things you can do to move the process along.

Humidify your environment.
Use a warm- or cool-mist humidifier to add moisture to the air. "While the cough is an irritative thing, it is the bodys natural response for getting rid of the infection, says Bell. "For this reason, it is best to help it along rather than to suppress it with an over-the-counter cough remedy" he advises. Any added humidity will help to
bring the sputum up and out of the body. Standing in a steamy shower with the bathroom door closed or keeping a pan of boiling water on the stove can also help loosen and bring up phlegm.
Drink plenty of liquids.
Taking in extra liquids helps to keep the sputum more fluid. It doesnt really matter what type of liquid you take in, although warm liquids may feel better than cold ones. "Warm liquids, such as teas and soups, work very well to relieve the sore throat that accompanies the cough," says Kielhofner.

Gargle with warm salt water.
Gargling with salt water may provide a double dose of relief by soothing the inflammation in the throat and by cutting through some of the mucus that may be coating and irritating the sensitive throat membranes, according to Bell. It only takes one teaspoon of salt in a glass of warm water; too much salt causes burning in the throat, and too little is ineffective. Gargle as often as needed for relief.

Rest, rest, rest.
Since the bronchitis probably followed on the heels of a cold or the flu, you may find it hard to sit still any longer. But according to Kielhofner, youll need to take it easy a little longer. Walking around with bronchitis will only make you feel worse.

Take aspirin or ibuprofen to relieve the chest pain.
These over-the-counter remedies are extremely helpful for relieving the discomfort resulting from the chest pain, says Kielhofner. Acetaminophen tends not to help much with the aches and pains.

Use a cough remedy as a last resort.
The best cough medicines for a productive cough contain guaifenesin to help bring up the sputum, says Bell. If you really want to suppress it, which we generally dont recommend, look for something that contains dextromethorphan, he advises. Combination products should generally be avoided. Decongestants, antihistamines, and alcohol (common ingredients in combination products) have no role in the treatment of coughs; they may even increase discomfort by causing side effects. Most of the candy-type cough drops act as demulcents on the throattheir soothing properties are due largely to their sugar content.

Keep an eye out for complications.
While letting nature take its course is generally the best treatment for bronchitis, complications can sometimes occur, and youll need to stay alert for signs that its time to see your doctor. The complications that are most worrisome include pneumonia, sinus infections, and ear infections, all of which need to be treated with prescription antibiotics. Signs that one or more of these complications may be present include a persistent high fever (which is not normally characteristic of bronchitis), shortness of breath, prolonged coughing spells, and severe chest pain.
In addition, Kielhofner offers the following warning: While blood-streaked sputum is often a normal symptom of bronchitis, it can also signal several more-serious problems and should be checked out just to be safe. Any distinct change in sputum color or consistency also warrants a trip to the doctor.

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Bronchitis and Smokers
Smoking is a habit that is continually under fire for its negative impact on a persons health. And rightly so. It has been proven to be a significant contributing factor in emphysema, lung cancer, heart disease, and several other serious illnesses. Bronchitis is no exception. Smoking leaves a person much more vulnerable to chronic bronchitis.
Bronchitis often occurs in patients who dont tolerate respiratory infections, such as smokers, says Evan T Bell, M. D. As a result, smokers tend to make up the largest group of individuals who suffer from chronic bronchitis, he continues.
Even though a bronchial infection is not in the lung tissue itself its getting quite close, which is always a worry, says Bell. Because the bronchial pass ages of smokers are already irritated, the added inflammation resulting from a bronchial infection also makes medical attention more of a necessity for these individuals, according to W Paul Glezen, M.D.
Marcia Kielhofner, M D., stresses that smokers who develop bronchitis should certainly take it upon themselves to refrain from smoking throughout the course of the illness. Of course, the healthiest move would be to kick the habit for good.

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