Bronchiolitis: causes, symptoms and treatment

Definition

What is bronchiolitis?

Bronchiolitis is a common lung infection. This condition causes inflammation and blockage of the small airways (bronchioles) in the lungs. This condition often occurs in children. Bronchiolitis cases are almost always caused by viruses.

Bronchiolitis begins with symptoms that resemble a cold but then progresses to coughing, wheezing and sometimes difficulty breathing. Symptoms of bronchiolitis can last from a few days to several weeks, even up to a month.

Most children improve with home care. Meanwhile, a small proportion of others require hospitalization.

Complications from severe bronchiolitis can include:

• Blue lips or skin (cyanosis). Cyanosis is caused by a lack of oxygen.
• Pause in breathing (apnea). Apnea usually occurs in premature babies and babies aged 2 months.
• Dehydration.
• Low oxygen levels and respiratory failure.

Bronchiolitis that doesn't go away can be a cause of acute obstructive pulmonary disease (COPD). When you have COPD, you can experience bronchiolitis along with emphysema.

How common is this condition?

This condition is very common. Usually affects small children and babies. Bronchiolitis can be treated by reducing risk factors. Talk to your doctor for more information.

Signs & symptoms

What are the signs and symptoms of bronchiolitis?

• Runny nose
• Nasal congestion
• Cough
• Low-grade fever (not always the case)
• Difficulty breathing
• Whistling sound
• Ear infection (otitis media) in many babies.

There may be signs and symptoms not listed above. If you have concerns about a particular symptom, consult your doctor.

When should I see a doctor?

Quoted from the Mayo Clinic, you must contact your doctor if you experience the following symptoms:

• Gag
• Audible wheezing sound
• Very fast breathing - more than 60 breaths per minute (tachypnea) and shallow
• Shortness of breath - the ribs appear to be sucked inward when the baby breathes
• Sluggish and sleepy
• Refusing to drink, or breathing too fast to eat or drink
• Blue skin, especially on the lips and nails (cyanosis)

This is especially important if your child is under 12 weeks of age or has other risk factors for bronchiolitis — including premature birth or a heart or lung condition.

Cause

What causes bronchiolitis?

Bronchiolitis usually occurs when the virus infects the bronchioles, which are the smallest airways (branches) in the lungs. The infection causes the bronchioles to swell and become inflamed.

Mucus will also accumulate in these airways, making it difficult for air to flow freely to the lungs.

Most cases of bronchiolitis are caused by respiratory syncytial virus (RSV). RSV is a common virus that infects nearly every 2 year old child. Bronchiolitis can also be caused by other viruses, including viruses that cause the flu or cold.

The virus that causes bronchiolitis is easy to spread. You can catch the virus through drooling in the air if an infected person coughs, sneezes, or talks. You can also catch the virus by touching shared objects, such as cutlery, towels or toys, then touching your eyes, nose or mouth.

Risk factors

What increases my risk for bronchiolitis?

There are many risk factors for bronchiolitis, namely:

• Infants under 3 months of age
• Premature birth
• Heart or lung conditions
• Exposure to secondhand smoke
• Never get breast milk - breastfed babies have the mother's immune benefits
• Contact with multiple children, such as at a daycare
• Living in a crowded environment
• Have a relative who is attending school or from child care and carries the infection into the home

Treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

How is this condition diagnosed?

Doctors usually identify problems by observing your child and listening to lung sounds with a stethoscope. If your child is at risk for severe bronchiolitis, the doctor may order tests, such as:

• Chest X-ray. The doctor may order a chest X-ray to see signs of pneumonia.
• Viral testing. The doctor can take a sample of your child's mucus to test for the virus that causes bronchiolitis. This is done using cotton bud which is inserted slowly into the nose.
• Blood test. Sometimes, a blood test can be used to check the white blood cell count. Blood tests can also determine whether oxygen levels have decreased in the child's bloodstream.

The doctor can also ask about signs of dehydration, especially if your child refuses to eat or drink frequently, or is vomiting. Signs of dehydration include sunken eyes, dry mouth and skin, lethargy, little or no urination.

What are the treatment options for bronchiolitis?

Usually, only home treatment is needed for bronchiolitis symptoms. Give your child plenty of fluids to avoid dehydration.

If your baby has a stuffy nose, use it suction bulb to get rid of mucus. Cold medicines (such as acetaminophen or ibuprofen) can help reduce fever discomfort.

Do not give aspirin to people under 20 years of age because of the risk of Reye's syndrome. Over-the-counter cough and cold medicines are not recommended. It's a good idea to consult a doctor.

The doctor may recommend bronchodilator medication if your child shows a tendency to allergic reactions (atopy). In severe cases, your child may need to be hospitalized or receive supplemental oxygen.

Home remedies

What are some lifestyle changes or home remedies that can be used to treat bronchiolitis?

Here are lifestyle and home remedies that can help you deal with bronchiolitis:

• Humidify the air. If the air in the child's room is dry, humidifier or a vaporizer can help humidify the air. This method can help relieve congestion and coughs. Make sure to keep it clean humidifier in order to prevent the growth of bacteria and fungi.
• Keep your child upright. Being in an upright position usually improves breathing.
• Give me a drink. To prevent dehydration, give your child plenty of fluids to drink, such as water or juice.
• Try saline nose drops to relieve congestion. You can buy them at the pharmacy.
• Give painkillers. Pain relievers such as acetaminophen (paracetamol) can relieve sore throat and increase the child's ability to drink fluids. Don't give aspirin to your child. Do not give over-the-counter cold and cough medicines to children younger than 2 years.
• Avoid smoke. Smoke can worsen the symptoms of a respiratory infection.
• Washing hands frequently to prevent the spread of disease.
• Avoid contact with other children who have bronchiolitis or upper respiratory infections.

No vaccine is available to prevent the causes of bronchiolitis (RSV and rhinovirus). However, you can take preventive steps by doing the annual flu vaccine in children over 6 months of age.

If you have any questions, consult your doctor for the best solution to your problem.