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On Steroid Treatment For Bronchitis, Improved Breathing. Using Inhaler. Will The Air Passage Will Be Inflamed Again?

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Posted on Fri, 24 May 2013
Question: Hi,
I am in Day 5 of my Steroid 6-day pack treatment for acute Bronchitis. I am afraid that once I stop the Steroid treatment completely, the inflamation of my air passages will return. The steroid treatment worked well for my breathing. I noticed a slight wheeze while I am in bed this morning. It is not on every breath. I am using an inhaler which I hope will help. I am extremely nervous about this situation. I don't want the inflamation to return. I thought I was on the road to recovery.
doctor
Answered by Dr. Satyadeo Choubey (1 hour later)
Hi,

Thanks for your query.

Short course of oral steroid is meant to relieve acute exacerbation of respiratory symptoms and it can be discontinued without tapering. After this you can continue with steroid inhaler and long acting inhaled bronchodilator. But the problem is that many things are wrongly labelled as acute bronchitis most commonly asthma and allergic rhinitis.

I wish if you could answer the following.
1) Do you suffer symptoms like frequent cough and colds.
2) Do you have allergy to dust, fumes, pollen etc.
3) Any family history of allergies, asthma, any kinf of breathlessness.
4) Since how long you are using nasal spray.
5) Have you undergone spirometry test ever. If yes then will you please, show me the result.

Waiting for your response,
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Satyadeo Choubey (1 hour later)
1)No
2) No
3) No
4) i recently have been using nasal spray. Been using it off and on for about a week. But in the last day or so, been using it about every 4 hours when I am awake.
5) no test ever given.

My chest x-ray is good, my EKG is good, my blood work is good. My ER doctor said bronchitis along with about 4 other doctors. Since I wtote you, I used albutetol inhaler and the wheezing has been much better.
I was told to use the inhaler every 4 hours even if I was not short of breath. Directions are "Inhale 2 puffs every 4 hours." Not "as needed." I don't plan on using the six day Methylprednisolone pack past Tuesday (only one pill tomorrow). I had a doctor tell me that yesterday ( Sunday). I am just scared right now.
4) nasal spray: i use afrin whenever i get a cold and omnaris if i get addicted to afrin. I am using afrin now to ensure my nasal passages are clear. Sorry if i confused you.
Also, i never had a problem such as this until a coworker was out with bronchitis. I and another person then started going the same problems shortly thereafter.
doctor
Answered by Dr. Satyadeo Choubey (44 minutes later)
Hi,

Thanks for follow up.

You seems to be on the road of recovery. I think you have got a viral bronchitis, (may have contracted from the fellow worker), where the airway becomes hyper-reactive causing dry irritating cough and wheezes due to airway constrictions. Albuterol helps in relaxing airway muscles, so increases the caliber of the airways, thus reduces wheeze. Methyl prednisolone helps combat inflammation.

Omnaris or ciclesonide nasal spray is used to combat rhinitis of allergic origin and Afrin usually do not have addiction potential.

Don't worry you may discontinue the methyl prednisolone and ask your doctor for steroid inhalers, if needed. If symptoms recur you may take the oral steroid for up to 2 weeks.

If symptoms recur after being cured, better go for methacholine challenge testing and spirometry to rule out asthma.

Hopefully answered your query.

Best wishes.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Satyadeo Choubey (2 hours later)
By oral steroid, do you mean the pill form for 2 weeks. Can I take steroid inhalers long-term. By which I mean daily for 2/3 months or something. . I really don't want to have to go back to the pill form.
doctor
Answered by Dr. Satyadeo Choubey (34 minutes later)
Hi,

Thanks for follow up.

Yes, by oral steroid for 2 weeks, I meant pill form.

Steroid inhalers can be taken for longer term i.e 2-3 months or even longer. They have doses in micrograms, which is too little to cause significant adverse effect. You can safely opt for that.

Thanks,
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Satyadeo Choubey

Pulmonologist

Practicing since :2006

Answered : 554 Questions

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On Steroid Treatment For Bronchitis, Improved Breathing. Using Inhaler. Will The Air Passage Will Be Inflamed Again?

Hi,

Thanks for your query.

Short course of oral steroid is meant to relieve acute exacerbation of respiratory symptoms and it can be discontinued without tapering. After this you can continue with steroid inhaler and long acting inhaled bronchodilator. But the problem is that many things are wrongly labelled as acute bronchitis most commonly asthma and allergic rhinitis.

I wish if you could answer the following.
1) Do you suffer symptoms like frequent cough and colds.
2) Do you have allergy to dust, fumes, pollen etc.
3) Any family history of allergies, asthma, any kinf of breathlessness.
4) Since how long you are using nasal spray.
5) Have you undergone spirometry test ever. If yes then will you please, show me the result.

Waiting for your response,