Chronic Bronchitis

What is chronic bronchitis?

Chronic bronchitis is a long-term condition causing inflammation and irritation of the bronchial tubes – the airways through which air passes to and from the lungs. People with chronic bronchitis will typically experience a persistent cough that will often bring up mucus. Other symptoms include fatigue, wheezing and shortness of breath.[1]

Chronic bronchitis is differentiated from acute bronchitis by its persistent nature. Acute bronchitis – which shares the same symptoms as chronic bronchitis – is a short-term condition that typically fades in two to three weeks, whereas chronic bronchitis is a permanent or constantly recurring condition, most often caused by smoking or the inhalation of irritants or dust.

According to the World Health Organisation (WHO), bronchitis can be classified as chronic if it affects a person in two consecutive years, over a duration of at least three months each time. Although chronic bronchitis cannot be cured, treatment options are available to manage the condition.[2]

Chronic bronchitis, along with emphysema, is part of a group of conditions known as chronic obstructive pulmonary disease (COPD).

Symptoms of chronic bronchitis

A cough and the production of mucus are the principal symptoms of chronic bronchitis. The severity of the coughing and the amount of mucus produced will differ from person to person, but these symptoms will generally persist for a minimum of three months at a time. Mucus, which is brought up when coughing, may be blood-tinged. Nasal mucus can vary in colour, and can be green, yellow or clear.. Often, mucus production will be at its height early in the day.[3]

Other symptoms of chronic bronchitis include:

  • Nasal congestion
  • Shortness of breath (dyspnea)
  • Wheezing
  • Sore throat
  • Fatigue
  • Headaches
  • Muscle aches

The symptoms of chronic bronchitis can on occasion become exacerbated. If this occurs, symptoms will include:

  • Severe coughing and chest pain
  • Blue or grey skin discolouration, typically on the nails
  • High fever

When to see a doctor

To prevent damage to the lungs, it is important to seek medical attention if chronic bronchitis is suspected. Contact a doctor if the following symptoms occur:[4]

  • Symptoms persist for three weeks or longer
  • The condition is disturbing sleep
  • Fever is 100.4 F or above
  • Mucus is discoloured
  • Wheezing or shortness of breath occurs

Always consult a doctor if there is blood present in mucus; this can be an indication of other serious conditions, such as lung cancer.

Causes of chronic bronchitis

Chronic bronchitis is caused by smoking in the majority of cases. Smoking can cause severe damage to the cilia – the tiny hairs that protect the lungs against germs and mucus – leading to repeated bouts of mucus buildup, as well as inflammation and irritation of the bronchial tubes. The longer an individual has smoked, the more severe the condition is likely to be. In some cases, chronic bronchitis can be caused by continual exposure to secondhand smoke.

Less commonly, chronic bronchitis can also be triggered by the inhalation of irritants such as air pollution, chemical fumes or toxic gas. Repeated exposure to such irritants increases the chances of developing the condition. People with certain underlying conditions, e.g. asthma or cystic fibrosis, as well as those with a genetic predisposition, are more likely to develop the chronic bronchitis.[5]

Risks

Chronic bronchitis is a condition where the small airways in the lungs (the bronchi and bronchioles) are irritated and inflamed. This causes swelling and narrowing of these airways. If this goes on for a long time, this swelling and narrowing become permanent. The most common cause for this condition is smoking. Other causes include long-term exposure to chemical irritants at work or air pollution. These substances irritate the airways and cause them to become inflamed. Chronic bronchitis is most common in middle aged men, although it can affect anyone who has breathed in irritating substances over a long period of time.

Diagnosing chronic bronchitis

In order to diagnose chronic bronchitis, a doctor will typically begin by inquiring about the symptoms an individual is experiencing and performing a full physical examination. For further confirmation, a number of tests may also be ordered. These include:[6]

  • Pulmonary Function Test (PFT): A series of tests to measure lung volume, capacity and other functions that gives doctors a rounded picture of lung health.
  • Chest X-ray: Useful in diagnosing chronic bronchitis and other lung conditions.
  • Sputum examination: Sputum, or mucus, can be tested to determine the cause of mucus buildup.
  • High Resolution Computed Tomography (HRCT): A type of CT scan that allows doctors to image the lungs.

Chronic bronchitis treatment

There is no cure for chronic bronchitis – it can, however, have its symptoms managed effectively through a combination of medical treatments and lifestyle changes.[7]

Medication

A number of medications are available to help manage chronic bronchitis, by treating the symptoms. The chosen treatment route will depend on the severity of the condition.

  • Bronchodilator: A medicinal substance breathed in through an inhaler which helps open up the bronchial tubes and aids breathing.
  • Theophylline: Particularly useful for treating shortness of breath, this oral medication relaxes the muscles in the airways in order to help with breathing. Usually, this is only used under direct medical supervision, in a clinical setting.
  • Steroids: Corticosteroids help bring bring many of the condition’s symptoms under control, specifically by reducing both mucus production and the inflammation of the bronchial tubes.

Lifestyle changes

There are a number of lifestyle changes that can be made to help manage chronic bronchitis, including:

  • Quitting smoking: Smoking is the leading cause of chronic bronchitis and can help aggravate its symptoms. Doctors can recommend methods for quitting, if necessary.
  • Avoiding irritants: Those who live in areas with high levels of air pollution, or those who come into regular contact with other airborne irritants should wear a mask or take other steps to avoid them.
  • Use a humidifier: Regular exposure to warm, moist air from a humidifier can be helpful in managing symptoms.
  • Exercise: Ideally for at least 30 minutes, three days per week. Exercise can help strengthen the muscles used to breathe.

Those experiencing chronic bronchitis may also benefit from pulmonary rehabilitation (PR), a program designed to help improve the overall well-being of those with respiratory problems. Typically, the program will involve exercise training, nutritional education, breathing strategies and counselling.[8]

Prevention

Giving up smoking and avoiding substances which are harmful to the lungs helps to reduce the risk of developing chronic bronchitis. This may involve using protective equipment at work if irritating chemicals are used. People who have chronic bronchitis should be vaccinated against the flu to prevent episodes of severe symptoms.


  1. Healthline. “What is Chronic Bronchitis?” January 29, 2016. Accessed August 14, 2017.

  2. MedlinePlus. “Chronic Bronchitis.” April 21, 2017. Accessed August 14, 2017.

  3. MedicineNet. “What are the signs and symptoms of chronic bronchitis?” November 11, 2016. Accessed August 14, 2017.

  4. Healthline. “When Should I See My Doctor?” January 29, 2016. Accessed August 14, 2017.

  5. MedicineNet. “What are the causes of chronic bronchitis?” November 11, 2016. Accessed August 14, 2017.

  6. UCSF Medical Center. “Chronic Bronchitis Diagnosis.” Accessed August 14, 2017.

  7. Healthline. “How is Chronic Bronchitis Treated?” January 29, 2016. Accessed August 14, 2017.

  8. National Heart, Lung, and Blood Institute. “What is Pulmonary Rehabilitation?” August 1, 2010. Accessed August 14, 2017.