Chronic Bronchitis
(Bronchitis, Chronic)
Pronounced: KRON-ik bron-KYE-tis
Definition
Chronic bronchitis is a condition in which the airways in the lungs become inflamed. In chronic bronchitis, the condition lasts for a long time or continues to recur. Chronic bronchitis is one form of an illness called chronic obstructive pulmonary disease (COPD).
When these airways become inflamed or irritated, thick mucus forms inside the airways. This makes it difficult to breathe.
Prognosis depends on the severity of the bronchitis. If you have mild or moderate chronic bronchitis, you can usually keep the condition well-controlled with medication and therapy to improve lung function. If you have severe chronic bronchitis, you may have a more difficult time controlling symptoms.
The best ways to improve prognosis of chronic bronchitis is to begin treatment early and stop smoking .
Chronic Bronchitis
Causes
The most common causes of chronic bronchitis include:
- Cigarette smoking
- Exposure to secondhand cigarette smoke
- Air pollution, infections, and allergies worsen symptoms of bronchitis
Risk Factors
Cigarette smoking is the single greatest risk factor for developing chronic bronchitis. The more you smoke and the longer you smoke, the greater your risk is of developing chronic bronchitis. Frequent and long-term smoking also increases the risk that the chronic bronchitis will be severe.
The following factors may also increase your chance of developing chronic bronchitis:
- Long-term exposure to chemicals, dust, and other substances that have been inhaled
- Long-term cigar or marijuana smoking
- Uncontrolled asthma
- Long-term exposure to air pollution
Symptoms
Symptoms include:
- Coughing up mucus
- Coughing up mucus streaked with blood
- Shortness of breath or difficulty breathing, especially after mild activity or exercise
- Recurring respiratory infections that cause symptoms to worsen
- Wheezing when breathing
- Fatigue
- Swelling of the ankles, feet, and legs on both sides
- Headaches
Diagnosis
To diagnose chronic bronchitis, symptoms of productive cough must have been present for three or more months in at least two consecutive years, and not have been caused by another condition. Your doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include the following:
- Breathing tests to check lung function
- Arterial blood gas tests
- Chest x-ray —a test that uses radiation to take a picture of structures inside the chest
- Blood tests to determine complete blood count and oxygen saturation of the blood
- Exercise stress testing to test lung function
- CT scan of the chest—a type of x-ray that uses a computer to make pictures of structures inside the chest
Treatment
There is no cure for chronic bronchitis, but there are treatments that can reduce symptoms and improve lung function. The best way to reduce symptoms is to stop smoking.
Talk with your doctor about the best treatment plan for you. Treatment options include:
Medication
Short acting bronchodilator medications may be prescribed to help open the airways in the lungs and improve breathing. These may include:
- Albuterol (eg, Ventolin)
- Terbutaline (eg, Brethine, Brethaire, Bricanyl)
- Theophylline (eg, Elixophyllin, Theo-24)
- Ipatropium bromide
Long acting bronchodilator medication may be prescribed, as well.
Steroids may be prescribed to help improve breathing. They can include:
-
Inhaled:
- Beclomethasone (eg, Vanceril, Beclovent)
- Triamcinolone (eg, Azmacort)
- Flunisolide (eg, Aerobid)
- Fluticasone (eg, Flovent)
- Dexamethasone (eg, Dexamethasone Intensol)
-
Orally:
- Prednisone (eg, PredniSONE Intensol, Sterapred)
- Prednisolone (eg, Econopred Plus, Millipred)
- Methylprednisolone (eg, Medrol, Medrol DosePak)
Antibiotics are rarely prescribed to treat bronchitis. But, they may be needed to treat a lung infection that often accompanies the illness. A small percentage of patients may need chronic antibiotic therapy.
Oxygen Therapy
Oxygen therapy can restore oxygen to parts of the body depleted because of chronic bronchitis.
Exercises
- Breathing exercises—These can help improve lung function. They are usually done under the supervision of a respiratory therapist
- Regular exercise program —This can reduce symptoms and improve lung function.
If you are diagnosed with chronic bronchitis, follow your doctor's instructions.
CANADIAN RESOURCES:
Canadian Lung Association
http://www.lung.ca/
Quit Smoking
Health Canada
http://www.hc-sc.gc.ca/
References:
Chronic bronchitis. American Academy of Family Physicians website. Available at: http://familydoctor.org/online/famdocen/home/articles/280.html . Accessed January 27, 2009. .
Chronic bronchitis. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed January 27, 2009.
Chronic bronchitis. Medline Plus Medical Encyclopedia. US National Library of Medicine website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000119.htm . Accessed January 27, 2009. .
Halbert RJ, Natoli JL, Gano A, et al. Global burden of COPD: systematic review and meta- analysis. Eur Respir J 2006;28:523.
Lopez AD, Shibuya K, Rao C, et al. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J 2006;27:397.
Respiratory disorders: chronic bronchitis. University of Virginia Health System website. Available at: http://www.healthsystem.virginia.edu/uvahealth/adult_respire/chrnbron.cfm . Accessed January 27, 2009.
Last reviewed January 2009 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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