Overview, Causes, & Risk Factors
Chronic bronchitis is a type of chronic obstructive airway disease, or COPD. People with COPD have limitations in the flow of air through their airways. Chronic bronchitis is an ongoing inflammation of the breathing tubes.
What is going on in the body?
Chronic bronchitis results from long-term exposure of the airways to irritants. These irritants include tobacco smoke, air pollution, and chemicals. They cause the airways to secrete excess mucus and to become inflamed. With time, the inflammation becomes widespread. The cells lining the airways change. The glands that produce the mucus become enlarged. Inflammation and excess mucus combine to cause a cough that produces sputum, or phlegm, almost every day.
The World Health Organization, also known as WHO, has recently developed a classification system for the severity of chronic bronchitis and other forms of COPD. There are four stages of severity, as outlined below:
What are the causes and risks of the condition?
Cigarette smoking is the most common cause of chronic bronchitis. The risk goes up with the amount of tobacco smoked and the number of years of smoking. Chronic bronchitis is most common in countries where smoking is prevalent. It is less common in countries where people smoke less. Passive smoking, or exposure to secondhand smoke, does increase a person’s risk for chronic bronchitis.
Other risk factors for chronic bronchitis include the following:
Symptoms & Signs
What are the signs and symptoms of the condition?
Individuals with chronic bronchitis have a chronic cough that produces sputum. Less commonly, they may develop fever and shortness of breath. The shortness of breath worsens with exertion.
Diagnosis & Tests
How is the condition diagnosed?
Diagnosis of chronic bronchitis begins with a medical history and physical examination. Lung function tests can identify chronic bronchitis in Stage 0, even before the individual has symptoms. Lung function tests measure how much air a person can take in with a deep breath. They also measure how fast the person can push the air back out of the lungs. The healthcare provider may also order a chest X-ray and blood tests.
Prevention & Expectations
What can be done to prevent the condition?
Many risk factors for chronic bronchitis can be completely eliminated. Smoking cessation is vital for those who smoke. Sources of indoor air pollution can be identified and removed. It is also important to avoid secondhand smoke.
What are the long-term effects of the condition?
Chronic obstructive pulmonary diseases, including chronic bronchitis, are the fourth leading cause of death in the world. The long-term effects depend on how severe the disease is when diagnosed and if a reduced exposure to the lung irritant occurs. The most effective treatment is quitting smoking. This will typically result in a modest improvement or no further decline in function.
People with chronic bronchitis have a higher mortality than those with normal lung function. Causes of death include respiratory failure, lung infections such as pneumonia and influenza, and other diseases related to smoking. These include cancer, heart disease, and stroke.
What are the risks to others?
Chronic bronchitis is not contagious and poses no risk to others.
Treatment & Monitoring
What are the treatments for the condition?
WHO has identified the following four components for management of chronic bronchitis:
Assessment and monitoring
Assessment and monitoring of the disease incorporates the following steps:
Reducing risk factors
Reducing the person’s risk factors includes the following recommendations:
Managing stable chronic bronchitis
Management of stable chronic bronchitis includes the following:
WHO recommendations for management of chronic bronchitis are broken down by the severity of the disease. Recommendations for Stage 0 chronic bronchitis include the following:
Recommendations for Stage I chronic bronchitis are the same as those for Stage 0. In addition, people with Stage I chronic bronchitis should use short-acting bronchodilators as needed. Bronchodilators relieve coughing and shortness of breath by opening the airways. In general, WHO recommends inhaled bronchodilators rather than oral medications.
Recommendations of Stage II chronic bronchitis include the recommendations from Stage I. Additional measures are recommended for times when symptoms are present. They include the following:
WHO recommendations for Stage III chronic bronchitis are as follows:
Managing worsening symptoms
People with chronic bronchitis may have worsening, or exacerbation, of symptoms when they develop a respiratory infection. Symptoms may also be worsened by cigarette smoke, as well as other factors. Following are the WHO guidelines for management of worsening symptoms:
What are the side effects of the treatments?
Bronchodilators may cause an increased heart rate and blood pressure. Oral glucocorticosteroids can cause increased risk for infection, high blood sugar, and osteoporosis. Antibiotics can cause rash, stomach upset, and allergic reaction.
What happens after treatment for the condition?
Early diagnosis of chronic bronchitis and effective treatment can slow its progression. People who eliminate risk factors and follow treatment guidelines have better outcomes. Those who continue to smoke may be increasingly disabled by breathing problems and complications of chronic bronchitis.
How is the condition monitored?
Chronic bronchitis is monitored through regular visits with the healthcare provider. Lung function tests can be used to monitor limitations in airflow. Any new or worsening symptoms should be reported to the healthcare provider.
Article type: xmedgeneral