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Chronic Bronchitis
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Chronic Bronchitis

(Chronic Obstructive Pulmonary Disease; COPD; Emphysema)

Pronounced: KRON-ik bron-KYE-tis

En Español (Spanish Version)

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 , or COPD.

When these airways become inflamed or irritated, a thick mucus forms inside the airways. This makes it difficult to breathe.

Prognosis depends on the severity of the bronchitis. Patients with mild or moderate chronic bronchitis can usually keep the condition well-controlled with medication and therapy to improve lung function. Patients with severe chronic bronchitis 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

© 2008 Nucleus Medical Art, Inc.

Causes

The most common causes of chronic bronchitis include:

  • Cigarette smoking
  • Exposure to secondhand cigarette smoke
  • Air pollution, infections, and allergies may worsen symptoms of bronchitis

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. 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
  • 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 body, in this case 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 of chronic bronchitis 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
  • Ipatropium bromide

Long acting bronchodilator medication may be prescribed as well.

Steroids may be prescribed to help improve breathing. They can include:

  • Inhaled:
    • Beclomethasone (Vanceril, Beclovent)
    • Triamcinolone (Azmacort)
    • Flunisolide (Aerobid)
    • Fluticasone (Flovent)
    • Dexamethasone
  • Orally:
    • Prednisone
    • Prednisolone
    • Methylprednisolone (Medrol, Medrol DosePak)

Antibiotics are rarely prescribed to treat bronchitis but may be needed to treat a lung infection that often accompanies the illness. A minority of COPD patients will require chronic antibiotic therapy. The type of antibiotic used will depend on what bacterium is causing the lung infection.

Oxygen Therapy

Oxygen therapy can restore oxygen to parts of the body depleted because of chronic bronchitis.

Breathing Exercises

Breathing exercises can help improve lung function. They are usually done under the supervision of a respiratory therapist.

A regular exercise program can also reduce symptoms and improve lung function.

Prevention

If you are a smoker, the best way to prevent chronic bronchitis is to stop smoking. If you are not a smoker, avoiding smoking will prevent developing chronic bronchitis.

Also, early diagnosis and treatment of the condition will preserve lung function and reduce symptoms.

RESOURCES:

American Lung Association
http://www.lungusa.org

University of California, San Francisco
http://www.ucsfhealth.org/

CANADIAN RESOURCES:

BC HealthGuide
http://bchealthguide.org/

Canadian Lung Association
http://www.lung.ca

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 June 27, 2007.

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 June 27, 2007.

DynaMed website. Available at:
http://dynamed102.ebscohost.com/Detail.aspx?style=1&docid=/dynamed/9740052baf1fd1cc852562d600800393 . Accessed June 27, 2007.

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 June 27, 2007.



Last reviewed April 2008 by Jill D Landis, 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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