Chronic bronchitis is one of several lung diseases that are collectively known as chronic obstructive pulmonary disease, or COPD (chronic obstructive pulmonary disease). Chronic bronchitis is defined as the presence of a mucus-producing cough that persists for at least three months in at least two consecutive years.
Such a cough occurs when the lining of the bronchi—branches of the trachea through which inhaled air and exhaled gas pass—becomes irritated and inflamed. Though the onset is gradual, relapses become more frequent as the condition worsens and eventually the cough may become continuous.
Long-standing chronic bronchitis causes the passageways of the lungs to become irreversibly narrowed, which can seriously impair breathing. Chronic bronchitis cannot be cured, but treatment can provide symptom relief and help prevent such complications.
What Causes Chronic Bronchitis?
- Cigarette smoking is the main cause of chronic bronchitis. Among those with the disorder, 90 percent have a history of smoking. Secondhand smoke can also contribute to chronic bronchitis.
- Lung irritants, such as industrial or chemical fumes, can damage the airways. Air pollution may also contribute to the disorder.
- Repeated lung infections may damage the lungs and exacerbate the disorder.
- Exposure to irritants such as occupational dusts and wood-burning stoves
- Bacterial (and possibly viral) infections, which can be spread through coughing and through touching the mouth, nose or eyes after coming in contact with infected respiratory fluids
Symptoms of Chronic Bronchitis
- Cough that may produce thick white, yellow or greenish mucus, especially in the morning
- Shortness of breath
- Wheezing (a whistling or hissing sound with breathing)
- Frequent chest infections
- General malaise (feeling ill)
- Fever (usually low grade)
- Soreness or tightness in the chest
- In severe cases, respiratory failure, which can cause the lips and fingernails to turn bluish due to a lack of oxygen, heart and liver enlargement, and fluid build up in the legs may develop.
Prevention of Chronic Bronchitis
- Quitting smoking or avoiding it in the first place is the best way to prevent chronic bronchitis.
- Avoiding lung irritants and places with poor air quality is also advisable.
- Washing your hands often can help prevent the spread of germs that cause bronchitis — especially during cold and flu season.
- Vaccination against influenza and the most common form of bacterial pneumonia (pneumococcal pneumonia) is recommended for patients with chronic bronchitis.
- Avoid secondhand smoke, which increases the risk for viral infections and airway congestion.
- Get plenty of rest and eat right to help your body’s immune system fight germs.
Diagnosis of Chronic Bronchitis
- Physical exam and patient history strongly indicate the diagnosis of chronic bronchitis.
- Pulmonary function tests that measure breathing capacity confirm that patients have reduced lung function.
- Chest x-ray can identify lung damage and help rule out other disorders, such as lung cancer.
- Arterial blood samples are taken to measure oxygen and carbon dioxide levels.
How to Treat Chronic Bronchitis
- Smoking cessation can slow the progression of the disorder. Avoiding secondhand smoke and other lung irritants is also recommended.
- Moderate aerobic activity may help prevent progression of the disease and will generally improve the capacity for exertion.
- Taking measures to prevent chest infections, which include frequent hand washing and vaccinations, is advisable.
- Get plenty of rest, drink enough fluids, eat well and breathe moist air (for example, by using a humidifier) help thin mucus secretions. Avoid breathing cold, dry air.
- A bronchodilator—medication that widens the bronchial passages—may be prescribed to ease breathing.
- Antibiotics are usually not prescribed because most cases of bronchitis are caused by a cold virus. However, they may be prescribed to treat a new infection and prevent worsening of symptoms. Ongoing antibiotic therapy is not recommended.
- Oral or inhaled steroids may be prescribed if bronchodilator therapy proves unsuccessful. Patients taking steroids should be monitored to determine whether breathing improves. If a patient doesn’t clearly respond to steroids, the prescribing physician may discontinue steroid therapy.
- Supplemental oxygen is helpful for patients with reduced blood oxygen levels; in these patients, it may help prolong life.
- Certain exercises may help clear mucus from the lungs and improve breathing. A doctor can give instructions regarding such exercises.
- Use of cough suppressants and expectorants is not recommended; such products should be avoided by patients with chronic bronchitis.
When to Call a Doctor
- Call a doctor if you have a chronic cough with mucus production and the mucus production worsens, the color of the mucus darkens, or you see blood in the mucus.
- Call a doctor if you develop an ongoing, mucus-producing cough or morning cough.
- Call a doctor if you experience shortness of breath or other difficulty breathing.
- EMERGENCY. Seek emergency medical assistance if your complexion turns a blue or purple tint.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media