Acute Bronchitis

Uses

Principal Proposed Natural Treatments

Other Proposed Treatments

The termbronchitis refers to inflammation of the major air passageways in the lungs,the bronchi. There are two principal types of bronchitis: acute bronchitis andchronic bronchitis. The latter is closely related to emphysema and isdiscussed in the article Chronic ObstructivePulmonary Disease (COPD) . Acute bronchitis, the subject of thisarticle, is a condition that frequently develops during the course of a commoncold. Symptoms may include cough (dry or productive), sensation of heaviness inthe chest, and difficulty breathing. In recent years, it hasbecome clear that, in many cases, symptoms of bronchitis represent temporaryasthma brought on by a respiratory infection. For this reason, anti-asthmadrugs are now commonly a major component of treatment. Antibiotics may be usedas well.

Principal Proposed Treatments

Pelargonium sidoidesAromatic essentialoils , such as eucalyptus oil and peppermint oil(menthol) , have a long history of use as inhalation treatmentsfor respiratory infections. Because the supporting evidence for such treatmentsis quite weak, they are discussed below in Other ProposedTreatments . Considerably better evidence supports the use of certainessential oils when taken by mouth. One combination of essentialoils has been extensively evaluated as a treatment for respiratory problems.This mixture, called essential oil monoterpenes, consists of cineole fromeucalyptus, d-limonene from citrus fruit, and alpha-pinene from pine. Numerous double-blind,placebo-controlled trials , many of substantial size, indicatethat essential oil monoterpenes can aid recovery from sinusitis, bronchitis,and other respiratory conditions. 1-7 One large study evaluated the effectiveness of essential oil monoterpenesfor acute bronchitis. In this 2-week, double-blind, placebo-controlled trial of676 people with acute bronchitis, participants received either placebo,essential oil monoterpenes, or one of two antibiotics. 5 The results indicate that the essential oil mixturewas significantly more effective than placebo and at least as effective asantibiotic therapy. For more information, including dosage and safety issues, see the full Essential Oil Monoterpene article. An alcohol extract made from the herb Pelargonium sidoides has become popular in Germany as a treatment for various respiratory problems. In one double-blind , placebo-controlled study, 468 adults with recent onset of acute bronchitis were given either placebo or a standard alcohol extract of Pelargonium sidoides 3 times daily for a week. 13 The results showed a significantly greater improvement in symptoms in the treatment group as compared to the placebo group. On average, participants who received the real treatment were able to return to work 2 days earlier than those given placebo. Benefits were also seen in two other studies enrolling a total of about 350 people. 14-15 When researchers pooled the results of 4 well-designed, placebo-controlled trials, they found that a standardized extract of Pelargonium performed significantly better than placebo at reducing the symptoms of bronchitis by the seventh day of treatment. 18 For more information, including dosage and safety issues, see the full Pelargonium sidoides article.

Other Proposed Treatments for AcuteBronchitis

A large (361-participant) double-blind, placebo-controlled study found evidence that use of a standardized combination of thyme and primrose root extract enhanced recovery from acute bronchitis. 17 Symptoms improved rapidly in both groups, but improvement was faster and the response rates were higher for the thyme-primrose combination compared to placebo. One double-blind, placebo-controlled studyfound that use of 200 mg per day of vitamin C enhanced recovery among 57 elderly patients hospitalized for respiratoryconditions. 8 Researchers have also studied the possible role of vitamin A in preventing and treating respiratory tract infections. A review of 10 trials involving over 33,000 children under age 7 years found that, in the majority of cases, vitamin A did not reduce the incidence of infection or symptoms in young children. 19 In two of the studies, vitamin A was beneficial for undernourished children. However, children with adequate nutrition actually faired worse. As mentioned above, inhaled essentialoils have a long, traditional use for respiratory infections.However, while there is some preliminary scientific support for suchtreatments, 9-12 it is still far too weak torely upon. One study provides weak evidence that a standardized combination of horseradish and nasturtium might be helpful for the treatment of bronchitis in children. 16 Numerous herbs have a reputation for helpingbronchitis. These include: elecampane , horehound , licorice , marshmallow , mullein , slippery elm ,and yerbasanta . It is widely believed by many proponents ofalternative medicine that cow’s milk and related dairy products increase mucusin the lungs and sinuses, and should therefore be avoided by people withbronchitis problems. However, there has not been sufficient scientificinvestigation into this belief to either confirm or deny it. Because acute bronchitis tends to develop during the course of a commoncold, all of the natural treatments used to prevent or treat colds are worthconsidering. See the CommonCold article for detailed information on these options. Inaddition, because bronchitis is often a form of temporary asthma, thetreatments discussed in the Asthma article areworth considering, as well.

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References

1
Sengespeik HC, Zimmermann T, Peiske C, etal. Myrtol standardized in the treatment of acute and chronic respiratoryinfections in children. A multicenter post-marketing surveillance study [inGerman; English abstract]. Arzneimittelforschung .1998;48:990-994.

2
FederspilP, Wulkow R, Zimmermann T. Effects of standardized Myrtol in therapy of acutesinusitis—results of a double-blind, randomized multicenter study compared withplacebo [in German; English abstract]. Laryngorhinootologie .1997;76:23-27.

3
Behrbohm H,Kaschke O, Sydow K. Effect of the phytogenic secretolytic drug Gelomyrtol forteon mucociliary clearance of the maxillary sinus [in German; English abstract]. Laryngorhinootologie . 1995;74:733-737.

4
Meister R, Wittig T, Beuscher N, et al.Efficacy and tolerability of Myrtol standardized in long-term treatment ofchronic bronchitis. A double-blind, placebo-controlled study. Study GroupInvestigators. Arzneimittelforschung . 1999;49:351-358.

5
Matthys H, de Mey C, CarlsC, et al. Efficacy and tolerability of Myrtol standardized in acute bronchitis.A multi-centre, randomised, double-blind, placebo-controlled parallel groupclinical trial vs. cefuroxime and ambroxol. Arzneimittelforschung . 2000;50:700-711.

6
Ulmer WT, Schott D. Chronic obstructivebronchitis. Effect of Gelomyrtol forte in a placebo-controlled double-blindstudy [in German; English abstract]. Fortschr Med .1991;109:547-550.

7
Dorow P,Weiss T, Felix R, et al. Effect of a secretolytic and a combination of pinene,limonene and cineole on mucociliary clearance in patients with chronicobstructive pulmonary disease [in German; English abstract]. Arzneimittelforschung . 1987;37:1378-1381.

8
Hunt C, Chakravorty NK, Annan G, et al. Theclinical effects of vitamin C supplementation in elderly hospitalised patientswith acute respiratory infections. Int J Vitam Nutr Res .1994;64:212-219.

9
EuropeanScientific Cooperative on Phytotherapy. Menthae Piperitae Aetheroleum(peppermint oil) . Exeter, UK: ESCOP, 1996-1997:1-6. Monographs on theMedicinal Uses of Plant Drugs, Fascicule 3.

10
Morice AH, Marshall AE, Higgins KS,Grattan TJ. Effect of inhaled menthol on citric acid induced cough in normalsubjects. Thorax . 1994;49:1024-1026.

11
Cohen BM, Dressler WE. Acute aromaticsinhalation modifies the airways. Effects of the common cold. Respiration . 1982;43:285-293.

12
Ferley JP, Poutignat N, Zmirou D, et al.Prophylactic aromatherapy for supervening infections in patients with chronicbronchitis. Statistical evaluation conducted in clinics against a placebo. Phytotherapy Research . 1989;3:97-100.

13
Matthys H, et al. Efficacy and safety of an extract of Pelargonium sidoides (EPs 7630) in adults with acute bronchitis. A randomised, double-blind, placebo-controlled trial. Phytomedicine. 2003;10(suppl 4):7-17.

14
Chuchalin AG, Berman B, Lehmacher W. Treatment of acute bronchitis in adults with a pelargonium sidoides preparation (EPs 7630): a randomized, double-blind, placebo-controlled trial. Explore (NY) . 2006;1:437-45.

15
Matthys H, Heger M. Treatment of acute bronchitis with a liquid herbal drug preparation from Pelargonium sidoides (EPs 7630): a randomised, double-blind, placebo-controlled, multicentre study. Curr Med Res Opin . 2007;23:323-331.

16
Goos KH, Albrecht U, Schneider B. On-going investigations on efficacy and safety profile of a herbal drug containing nasturtium herb and horseradish root in acute sinusitis, acute bronchitis and acute urinary tract infection in children in comparison with other antibiotic treatments]. Arzneimittelforschung. 2007;57:238-246.

17
Kemmerich B. Evaluation of efficacy and tolerability of a fixed combination of dry extracts of thyme herb and primrose root in adults suffering from acute bronchitis with productive cough. A prospective, double-blind, placebo-controlled multicentre clinical trial. Arzneimittelforschung. 2007;57:607-615.

18
Agbabiaka TB, Guo R, Ernst E. Pelargonium sidoides for acute bronchitis: A systematic review and meta-analysis. Phytomedicine. 2008 Jan 25.

19
Chen H, Zhuo Q, Yuan W, Wang J, Wu T. Vitamin A for preventing acute lower respiratory tract infections in children up to seven years of age. Cochrane Database Syst Rev. 2011;(1):CD006090.

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