Definition of Chronic Bronchitis

Chronic Bronchitis vs Acute Bronchitis - Symptoms and Causes

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Definition: Chronic Bronchitis

Chronic bronchitis is a form of chronic obstructive pulmonary disease (COPD) caused by chronic inflammation of the bronchi, the airways leading from the trachea to the lungs.  

Now considered the 3rd leading cause of deaths in the United States (behind heart disease and smoking), chronic bronchitis is thought to occur in 3.6 percent of the population. 

Criteria for Chronic Bronchitis: Acute vs Chronic Bronchitis

Chronic bronchitis is defined as a cough that produces sputum that occurs every day for three months in a row, with those periods occurring at least two years in a row.

The most common cause is smoking, but exposure to secondhand smoke, air pollution, and on-the-job chemicals may also cause this condition.

In contrast to acute bronchitis (a temporary condition related to a viral infection or environmental exposures), chronic bronchitis is a serious disease involving permanent damage to the airways.

Chronic Bronchitis is a Form Of Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease is now considered the 3th leading cause of deaths in the United States. Other forms of COPD include emphysema and bronchiectasis.

How Common is Chronic Bronchitis?

In 2017 it's estimated there were 8.7 million people diagnosed with chronic bronchitis in the United States—3.6 percent of the population, as noted above. Yet even though fewer people are smoking, the incidence of COPD chronic bronchitis has continued to rise.

Not everyone who has chronic bronchitis, however, has been diagnosed.

Studies suggest that significant irreversible lung damage has usually been done by the time many people develop mild symptoms.

Symptoms of Chronic Bronchitis

Symptoms of chronic bronchitis are similar to several other lung conditions and may include:

  • Shortness of breath, at first only with activity, and later on at rest.
  • Wheezing - A whistling sound that is produced by partial obstruction of the airways.
  • Chest pain - Pain with breathing, called pleuritic chest pain may occur for a number of reasons, both due to inflammation in the lungs (particularly the lung linings), from muscle strains due to breathing.

Coughing, in turn, can cause muscle soreness, fatigue, headaches, and a sore throat. Some people have even broken ribs from coughing.

Risk Factors/Causes

Certainly, smoking is the most common risk factor for chronic bronchitis, but there are several other risk factors for the disease as well. In addition, risk factors may add together to increase risk. Some risk factors include:

  • Smoking - Smoking is considered the cause of roughly 90 percent of cases.
  • Occupational exposures to fumes or dust - In this setting, chronic bronchitis may be referred to as "industrial bronchitis." In addition to chronic bronchitis, on-the-job exposures may increase the risk of lung cancer and it's thought that up to 27 percent of lung cancers in men have an occupational component. (If you believe your chronic bronchitis may be related to work exposures, make sure to talk to your doctor about lung cancer screening.)
  • Increasing age.
  • Poor immune function.
  • Repeated respiratory infections.

Diagnosis

Your doctor will first perform a careful history and physical, with careful attention to any risk factors you may have. On physical examination, she will not only listen to your lungs but look for other signs of chronic obstructive pulmonary disease such as weight loss and even skin wrinkling. Tests may include:

  • A chest x-ray
  • A chest CT scan or bronchoscopy may be done more to exclude conditions such as lung cancer or tuberculosis
  • Sputum analysis
  • Sputum culture - To look for any signs of infection
  • Pulmonary function tests - Lung function tests including spirometry may help make the diagnosis as well as determine the severity

Treatments

Treatments for chronic bronchitis will depend on many factors including the severity of your symptoms and often include both medications and physical treatments such as pulmonary rehabilitation. Since chronic bronchitis is by definition irreversible, treatments are aimed at slowing the progression of the disease and improving comfort. Some treatments used include:

Medications for Treating Chronic Bronchitis

Several different medications are used to help slow the progression of chronic bronchitis. These treatments work in different ways and may reverse the part of obstruction which is reversible, decrease inflammation in th eairways, or treat infection.

Other Treatments for Chronic Bronchitis

In addition to medications, several lifestyle factors, as well as oxygen and respiratory therapy are an important part of treating chronic bronchitis.

  • Exercise - Physical activity can make a tremendous difference for people living with chronic bronchitis.
  • Oxygen therapy - There are several benefits of oxygen therapy for COPD
  • Home remedies - Check out these 12 home remedies for coughing
  • Pulmonary rehabilitation 
  • Postural drainage
  • Avoidance of risk factors - A very important part of managing chronic bronchitis is the avoidance of substances which can exacerbate your symptoms or worsen inflammation. Your doctor will talk to you about smoking cessation if you smoke, avoidance of secondhand smoke, and safe exposure to vapors and fumes  
  • Clinical trials - Many promising clinical trials are in progress looking at ways to improve the symptoms of people with COPD as well as ways to prevent progression

Chronic Bronchitis and the Risk of Lung Cancer

It's not surprising that COPD (such as chronic bronchitis) and lung cancer can go together as smoking can lead to both conditions. Yet we're learning that COPD is an independent risk factor for lung cancer as well. What that means is that chronic bronchitis alone raises the risk of lung cancer substantially. Learn more about COPD as a risk factor for lung cancer.

Complications

Chronic bronchitis increases the risk of lung infections, and may also raise your risk of developing lung cancer.

Sources:

Centers for Disease Control and Prevention (CDC). Chronic Obstructive Pulmonary Disease Includes: Chronic Bronchitis and Emphysema. Updated 01/20/17. https://www.cdc.gov/nchs/fastats/copd.htm

National Library of Medicine. MedlinePlus. Chronic Bronchitis. Updated 02/28/17 https://medlineplus.gov/chronicbronchitis.html

Poole, P., Chong, J., and C. Cates. Mucolytic agents versus placebo for chronic bronchitis or chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2015 Jul 29;7:CD001287.

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