For reasons which I have never understood, a diagnosis of bronchitis seems to inspire considerable fear in many people, and their relief on being assured that they do not have bronchitis is almost as great as that which I see when telling someone that their biopsy did not show cancer. Some of this dread of bronchitis may be a carryover from early in the century, when cigarette smoking and heavy pollution in cities like London led to many cases of chronic bronchitis and emphysema.
Bronchitis means inflammation (itis) of the bronchi, the passageways that channel air down into our lungs. Acute bronchitis is actually a very common condition, and your experience of having eight bouts in six years does not strike me as particularly excessive. Most cases of bronchitis result from an upper respiratory viral infection, a cold, and many of the dozens of viruses that cause colds can cause bronchitis as part of the disease. Everyone who has had the typical cold with a scratchy throat, and raspy painful cough has had bronchitis. Depending on the infecting virus, fever may or may not be present. The fever, sore throat and pain on coughing usually only last for about three to four days, but mucus production and cough may continue for several weeks. This persistent cough probably corresponds to the time necessary for the bronchi to repair the damage caused by the inflammation of their lining.
In a healthy non-smoker, this damage to the lining of the bronchi is completely repaired, and causes no permanent problems, even if it happens several times a year. Smoking, or exposure to some industrial pollutants, can cause a chronic bronchitis, and this may slowly and permanently damage the bronchi, leading ultimately to emphysema. Cigarette smoking is implicated in about 85 percent of cases of emphysema. In a long-time smoker or someone with chronic obstructive pulmonary disease (COPD), the acute bronchitis resulting from a cold may be much more serious, since the bronchi have been damaged already, and the process of clearing infection from them and allowing the lining to heal is impaired. Pneumonia, a rare complication of bronchitis in a healthy person, is much more likely to occur in smokers and people with COPD, and can precipitate acute respiratory failure.
The bronchitis accompanying a cold may produce some wheezing, and whistling or rumbling sounds in the chest during breathing are common. These noises do not imply that the infection is more serious than the usual cold. If fever persists for more than the three to four days of a typical cold, or if the sputum being coughed up changes from yellow or white to green, it may indicate that a bacterial infection has been superimposed on the original viral cold. Antibiotics will not help the viral cold, but may be necessary for such a bacterial superinfection. People with COPD who get a cold are commonly treated right away with antibiotics, since they are so much more likely to develop a serious bacterial infection on top of it.
Unfortunately, many people with colds are convinced that an antibiotic will help them, and many doctors go along even though they know it is unnecessary. If one thinks about the typical sequence of symptoms of a cold, first there is the sneezing, runny nose and scratchy throat, then fever, then the painful cough. Most people don’t go to the doctor until the second day of the fever or painful cough, which is probably the third day of the infection. If they then get an antibiotic, and the fever breaks the next day, and the cough stops being painful, they are convinced that the antibiotic brought about the miraculous cure. In fact the fever would have broken on the fourth day anyway, and the painful cough would likely have gone then as well, even without the antibiotic. Even taking the antibiotic immediately with the onset of the sneezing and scratchy throat won’t help prevent the bronchitis, since the cold virus will not be attacked by the antibiotic. (The few exceptions to this rule include infection by the influenza viruses, for which antibiotics are available which will shorten the course of the illness, and bronchitis caused by chlamydia).
There is nothing you can do to prevent a cold from developing into bronchitis, and the only treatment is medication to control the symptoms; aspirin or a non-steroidal like ibuprofen to control the pain and fever, and a good cough medicine. People with seasonal or nasal allergies will generally not have any more difficulty with acute bronchitis than the rest of us. People with asthma, which is often related to allergies, may have an exacerbation of their asthma when they develop acute bronchitis, and then will require more intensive asthma treatment until the bronchitis clears.