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Q: A very close friend of mine has a bad case of bronchitis. Warm weather seems to help, but it's not a cure. Is there anything that can help?

-- J.B., Monroe Township, N.J.

A: The bronchi are the main tubes that carry air in and out of the lungs. Air travels through these tubes to reach the air sacs, where oxygen is absorbed and carbon dioxide is given off.

Bronchitis, as the name implies, is inflammation of the lining of the bronchi. There are two types of bronchitis, based on cause. The most common form of bronchitis is caused by infection. It occurs most often in winter. The more people you have contact with, the more likely you are to inhale a microorganism that can cause infection. Infectious bronchitis can be caused by viruses, bacteria, and the bacteria-like organisms Mycoplasma pneumoniae and Chlamydia.

The other form of bronchitis is called irritative bronchitis. This type of inflammation is caused by chemical irritation of the walls of the bronchi. Irritants that affect the bronchi include dusts, fumes, solvents and other industrial chemicals, air pollution and tobacco smoke. In some communities, due to what are called temperature inversions, the air quality gets worse in the winter.

An irritated bronchus is more susceptible to developing an infection. So communities with lower air quality will have more people with infectious bronchitis as well.

Bronchitis is also classified by duration (acute or chronic). Fortunately, the condition is usually acute (short-term) and mild. However, even acute bronchitis can be a serious health problem for people with other long-term illnesses, such as heart and other lung diseases.

Long-term or chronic bronchitis and emphysema are two diseases that are known collectively as chronic obstructive pulmonary disease (COPD). Chronic bronchitis is characterized by chronic cough for three months or more with excessive coughing up of bronchial mucus.

Cough is the typical signal beginning an episode of bronchitis. The cough may be dry at first (doctors call it "non-productive," meaning the cough doesn't produce mucus from the airways). Later, however, especially if the bronchitis is due to infection, coughing may produce yellow or green mucus.

Symptoms of infectious bronchitis are similar to those of the common cold, including: tiredness, chills and fever, muscle aches and sore throat. Diagnosis is based on symptoms. If symptoms persist, X-rays may be recommended to see if pneumonia has developed.

Antibiotics are recommended for a suspected bacterial infection. But remember that they are not effective for other causes of bronchitis. If the bacterial infection is unusually severe or lasts even while taking an antibiotic, a lab culture of coughed-up sputum may be needed. This will help more clearly define the specific type of bacteria involved and what antibiotics are effective against it.

There is another condition, called bronchiectasis, that is very much like chronic bronchitis. In this condition the tubes have become dilated and are inflamed almost all the time, even when no infection or irritants are present.

Smoking greatly increases the risk of developing bronchitis of any kind.

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