2015-12-06

Bronchitis and sinusitis- What do these words mean?

Bronchitis and Sinusitis- 
What do these Words Mean?

Every winter, when colds and flus create floods of runny noses and blasts of prolonged coughing, the words bronchitis and sinusitis erupt.   It makes sense to take a moment and understand what these words mean, and how they are currently used, and misused.

-Itis and Inflammation
The best place to start is with the common medical suffix, -itis.  This ending keeps showing up in all sorts of places when we talk about illness and disease.  Some uses are very familiar, like dermatitis, or appendicitis, or arthritis.   But in every instance, the ending -itis always means the same thing, inflammation.
Inflammation means that some tissue is red, swollen, tender, warm, and or has lost some function.  Perhaps the most familiar example of inflammation is a mosquito bite, where the skin gets red, warm, tender, swollen.  The inflammation is so mild there is no loss of function in this example.  But the point is that inflammation is a response to a threat in the body.  That threat can be a chemical in the mosquito's bite, and infection, or the body's own self attacking itself for no good reason.

In the case of bronchitis and sinusitis, the inflammation is in the airways of the lung (bronchitis) or the sinuses of the head (sinusitis).  And for both, the cause is an infection.  This is where it gets interesting.

Bacterial v. Viral infection
The real confusion in the use of the terms bronchitis and sinusitis comes from the widely assumed meaning, namely that if you say the word bronchitis or the word sinusitis, you have proven you have a bacterial infection.    But the truth is that bronchitis and sinusitis can be caused be either viruses or bacteria.   If a virus infects your lung's airways or sinuses, you have a viral bronchitis or sinusitis.  If a bacteria infects either, it's a bacterial bronchitis or sinusitis.

A major difference between any respiratory viral infection (except influenza) and any bacterial infection is that there is no antibiotic or medication that can decrease the impact of a viral illness, but regular antibiotics kill bacteria very well.

Bronchitis
Now to the illnesses themselves.   Bronchitis literally means, inflamed airways of the lungs.  This can happen, as noted, as a result of either a viral or bacterial infection.   It turns out that, with few exceptions, every time you get a cold, you have a viral bronchitis.  After all, a cold is when the virus inflames the lining of the nose, throat, and lungs, and when the lungs get inflamed, you have a viral bronchitis.   It's the lung inflammation in a cold that causes the horrible experience of a cough.  And you can't really get your lungs inflamed without the airways being affected.   So, all colds are bronchitis.

But that's not what is meant when a doctor tells someone has bronchitis.  When that happens, what is usually implied is that a cold has developed into something more complicated, that a bacterial infection has erupted.

Now, the question is, how does one tell if your child has a viral bronchitis (a cold) or a bacterial bronchitis?

It turns out this is very hard to tell, since both cause the same symptoms.

There are no findings on exam, or blood tests, or X-rays that can tell the difference.

At a certain point, the question really turns on how long your child has been ill, since typical cold symptoms last up to about 25 days, and symptoms persisting longer than that may be due to bacteria getting involved.  Or, sometimes it is clear that the illness is getting much worse when it should be getting better.  As you can see, this question is truly best answered by a judicious weighing of all the facts, more than a test.

Sinusitis
The exact same discussion goes for sinusitis.

Literally the word simply means inflamed sinuses, that is sinus linings that become red, swollen, and make a lot of mucus.  But the word is usually used as a code word to imply that someone has a bacterial infection and that antibiotics are needed and will cure the condition.

Unfortunately, as with bronchitis, most sinusitis situations are caused by infections with viruses.

In fact, a cold can be truly thought of as a viral sinusitis.  A cold is a situation where a virus attacks the lining of the airways.  That attack destroys the linings of the nose and its sinuses, throat, and lung.  This is physically no different than a shallow burn.   The viral burn in the sinuses cause the lining to get very red, swollen, and make loads of mucus.  This is clearly a sinusitis.

But, as noted above, viruses are not killed or slowed by antibiotics, and antibiotics do nothing to heal the burn created by the virus.  So if your child's sinus infection is due to a virus, an antibiotic offers no help, only harm from side effects.

And, as with bronchitis, X-rays and CT scans and MRI's do not help.  These imaging technologies cannot tell the difference between mucus from a virus and pus from bacteria.

So once again ,the distinction relies on the course of illness.  Colds typically last 1-3 weeks.  So, unless some unusual experiences are noted, someone with a runny nose, fever, achy and feeling ill, for less than 10 days almost certainly has a viral infection, and antibiotics will not help.

BOTTOM LINES
1.  Everyone gets colds.  These are viral infections that cannot be helped in any way by antibiotics.
2.  Bronchitis and sinusitis are terms broadly used to imply that a person's illness has advanced beyond a cold to a bacterial infection that antibiotics could help.
3.  If someone has been ill with runny nose, fever, cough, and feeling achy and ill for less than 10 days, unless some other unusual symptoms are present, it is very, very likely the illness is a viral infection, and antibiotics will not work.  These viral infections can cause some symptoms, especially cough, to last well beyond 10 days, often for 3-4 weeks!
4.  So the words bronchitis and sinusitis turn out not to mean one has a bacterial infection, only the course of the illness can determine that.
5.  We at Advanced Pediatrics are happy to help you determine if your child's runny nose, cough, or such illness is typical for a viral infection, or if other signs have appeared to suggest bacteria are now involved.   This will help determine if an antibiotic would help or hurt the situation.

To your health,
Dr. Arthur Lavin








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3 comments:

  1. The question is “ is bronchitis contagious “ So chronic bronchitis isn't contagious, but it's a severe health issue that needs a doctor's concern. Acute Bronchitis is contagious, which can last for 1 to 3 weeks? It's usually caused by cold or flu viruses. Since these viruses are contagious, acute bronchitis usually is, too.

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  2. Thanks for sharing this extremely informative article on bronchitis. I recently read about what is bronchitis on website called breathefree.com. I found it extremely helpful.

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  3. Most symptoms of bronchitis and pneumonia can develop from other cold illness like flu and a common cold. To get a proper diagnosis, you must consult with your physician, as only they will be able to determine the proper course of treatment.

    Do you know Is Bronchitis Contagious And How Does It Spread?
    To prevent this, try to cease contact with others while you have bronchitis, as both bronchitis and the flu can be contagious.

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