Chronic bronchitis

Alternative names
Bronchitis - chronic

Definition

Chronic bronchitis is an inflammation of the bronchi, the main air passages in the lungs, which persists for a long period or repeatedly recurs.

The condition is characterized by excessive bronchial mucus and a productive cough that produces sputum for 3 months or more in at least 2 consecutive years, without any other disease that could account for this symptom.

Causes, incidence, and risk factors

Cigarette smoking is the main cause. The longer and heavier a person smokes, the more likely it becomes that the person will get bronchitis and that the bronchitis will be severe. Secondhand smoke may also cause chronic bronchitis. Air pollution, infection, and allergies make it worse.

Chronic bronchitis is one form of chronic obstructive pulmonary (lung) disease. Chronic bronchitis, emphysema, and asthma as a group are a leading cause of death in the U.S.

Symptoms

• Cough that produces mucus (sputum), which may be blood streaked
  
• Shortness of breath aggravated by exertion or mild activity
  
• Frequent respiratory infections that worsen symptoms
  
• Wheezing
  
• Fatigue
  
• Ankle, foot, and leg swelling that affects both sides
  
• Headaches

• Pulmonary function tests
  
• Arterial blood gas
  
• Chest x-ray
  
• Pulse oximetry (oxygen saturation testing)
  
• Complete blood count (CBC)
  
• Exercise testing
  
• Chest CAT scan

There is no cure for chronic bronchitis. Treatment is aimed at relieving symptoms and preventing complications. It is crucial to quit smoking to prevent worsening of chronic bronchitis, and other respiratory irritants should be avoided.

Inhaled medications that dilate the airways and decrease inflammation may help reduce symptoms, such as wheezing. Antibiotics may be prescribed for infections as needed. Corticosteroids may occasionally be used during flare-ups of wheezing, or in people with severe bronchitis not responding to other treatments.

Physical exercise programs, breathing exercises, and patient education programs all contribute to the treatment plan. Oxygen therapy may be needed in severe cases. In very severe cases, lung transplantation may be recommended.

Support Groups
For organizations that provide support and additional information, see lung disease resources.

Expectations (prognosis)

Mild or moderate cases of chronic bronchitis may often be controlled well with routine medications and pulmonary rehabilitation programs. Advanced bronchitis is more difficult to treat and may require the use of oxygen or consideration of lung transplantation.

Early recognition, early treatment, and smoking cessation significantly improve the odds of a good outcome.

Complications

• Acute bronchitis
  
• Pneumonia
  
• Cor pulmonale
  
• Emphysema
  
• Respiratory failure
  
• Cardiac arrhythmia

Call your health care provider if respiratory infection or unexplained symptoms develop, or you are short of breath, wheezing, or coughing up blood.

Prevention

Early recognition and treatment may prevent the progression of the disease in people who also stop smoking.

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