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Chronic Bronchitis
What is chronic bronchitis?
Chronic bronchitis is a long-term inflammation of the bronchi, which results in increased production of mucus, as well as other changes.
To be classified as chronic bronchitis:
cough and expectoration must occur most days for at least three months per year, for two years in a row.
other causes of symptoms, such as tuberculosis or other lung diseases, must be excluded.
Chronic bronchitis is an inflammation, or irritation, of the airways in the lungs. Airways are the tubes in your lungs that air passes through. They are also called bronchial tubes. When the airways are irritated, thick mucus forms in them. The mucus plugs up the airways and makes it hard for you to get air into your lungs. Symptoms of chronic bronchitis include a cough that produces mucus (sometimes called sputum), trouble breathing and a feeling of tightness in your chest.
What causes chronic bronchitis?
Cigarette smoking is the main cause of chronic bronchitis. When tobacco smoke is inhaled into the lungs, it irritates the airways and they produce mucus. People who have been exposed for a long time to other things that irritate their lungs, such as chemical fumes, dust and other substances, can also get chronic bronchitis.
What are the symptoms of chronic bronchitis?
The following are the most common symptoms for chronic bronchitis. However, each individual may experience symptoms differently. Symptoms may include:
cough
expectoration (spitting out) of mucus
Chronic bronchitis may cause:
frequent and severe respiratory infections
narrowing and plugging of the breathing tubes (bronchi)
difficult breathing
disability
Other symptoms may include:
lips and skin may appear blue
abnormal lung signs
swelling of the feet
heart failure
The symptoms of chronic bronchitis may resemble other lung conditions or medical problems. Consult your physician for a diagnosis.
What are the causes of chronic bronchitis?
In acute bronchitis, bacteria or viruses may be the cause, but in chronic bronchitis there is no specific organism recognized as the cause of the disease.
Cigarette smoking is cited as the most common contributor to chronic bronchitis, followed by:
bacterial or viral infections
environmental pollution
Chronic bronchitis is often associated with other pulmonary diseases such as:
pulmonary emphysema
pulmonary fibrosis
asthma
tuberculosis
sinusitis
upper respiratory infections
How is chronic bronchitis diagnosed?
In addition to a complete medical history and physical examination, your physician may request the following:
pulmonary function tests - diagnostic tests that help to measure the lungs' ability to exchange oxygen and carbon dioxide appropriately. The tests are usually performed with special machines that the person must breathe into, and may include the following:
spirometry - a spirometer is a device used by your physician that assesses lung function. Spirometry, the evaluation of lung function with a spirometer, is one of the simplest, most common pulmonary function tests and may be necessary for any/all of the following reasons:
to determine how well the lungs receive, hold, and utilize air
to monitor a lung disease
to monitor the effectiveness of treatment
to determine the severity of a lung disease
to determine whether the lung disease is restrictive (decreased airflow) or obstructive (disruption of airflow)
peak flow monitoring (PFM) - a device used to measure the fastest speed in which a person can blow air out of the lungs. During an asthma or other respiratory flare up, the large airways in the lungs slowly begin to narrow. This will slow the speed of air leaving the lungs and can be measured by a PFM. This measurement is very important in evaluating how well or how poorly the disease is being controlled.
arterial blood gas (ABG) - a blood test that is used to evaluate the lungs' ability to provide blood with oxygen and remove carbon dioxide, and to measure the pH (acidity) of the blood.
pulse oximetry - an oximeter is a small machine that measures the amount of oxygen in the blood. To obtain this measurement, a small sensor (like a Band-Aid) is taped onto a finger or toe. When the machine is on, a small red light can be seen in the sensor. The sensor is painless and the red light does not get hot.
x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
computed tomography scan (Also called a CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
Treatment for chronic bronchitis: Signs and symptoms
A cough that brings up yellowish-gray or green mucus (sputum) is one of the main signs of bronchitis. Mucus itself isn't abnormal — your airways normally produce up to several tablespoons of mucus secretions every day. But these secretions usually don't accumulate, because they're continuously cleared into your throat and swallowed with your saliva.
When the main air passageways in your lungs (bronchial tubes) are inflamed, they often produce large amounts of discolored mucus that comes up when you cough. If this persists for more than three months, it is referred to as chronic bronchitis. Mucus that isn't white or clear usually means there's a secondary infection.
Still, bronchitis symptoms can be deceptive. You don't always produce sputum when you have bronchitis, and children often swallow coughed-up material, so parents may not know there's a secondary infection. Many smokers have to clear their throat every morning when they get up. While they may think this is normal for everyone, it's not. If it continues for more than three months, it may be chronic bronchitis.
Accompanying symptoms of an upper respiratory infectionAcute bronchitis also may be accompanied by common signs and symptoms of an upper respiratory infection, including:
Soreness and a feeling of constriction or burning in your chest
Sore throat
Chest congestion
Sinus fullness
Breathlessness
Wheezing
Slight fever and chills
Overall malaise
Sometimes chronic sinusitis — an ongoing infection in the lining of one or more of the cavities in the bone around your nose — can mimic bronchitis. That's because the signs and symptoms of chronic sinusitis include a thick, yellow or green postnasal discharge and a chronic cough that's triggered when you try to clear your throat of mucus draining from your sinuses, instead of your lungs, as is the case with bronchitis.
Specific treatment for chronic bronchitis will be determined by your physician based on:
your age, overall health, and medical history
extent of the disease
your tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference
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