Chronic Bronchitis

What is chronic bronchitis?

Bronchitis is swelling and irritation of the bronchi, which are the airways that connect the windpipe to the lungs. Chronic means the symptoms occur year after year for months at a time.

Chronic bronchitis is a type of chronic obstructive pulmonary disease, or COPD. COPD is one of the leading causes of death in the US.

How does it occur?

The main cause of chronic bronchitis is smoking. Even if you are not a smoker, you can get chronic bronchitis from spending a lot of time around others who smoke. Smoke and sometimes other air pollutants can irritate the airways, causing them to swell and produce mucus. The swelling makes the inside of the airways become smaller. The airways become blocked by the mucus, making it hard for air to pass in and out of your lungs. This causes wheezing and trouble breathing. Chronic bronchitis slowly gets worse, gradually reducing your ability to breathe.

Frequent bacterial infections of the upper respiratory system can also cause chronic bronchitis. The upper respiratory system includes the nose, sinuses, voice box (larynx), and the trachea (windpipe).

Your risk of getting chronic bronchitis may also be increased if:

• You have spent a lot of time breathing dust or chemicals at your job.
• You have breathed a lot of smoke and fumes from cooking and heating fuels over the years.

What are the symptoms?

The main symptom of chronic bronchitis is a deep cough that produces a lot of mucus or phlegm from the lungs on most or all days for months at a time. You may also have wheezing and breathlessness.

How is it diagnosed?

Your healthcare provider will ask about your symptoms, medical history, work history, and smoking habits. Your provider will examine you. You may have the following tests:

• lab tests of sputum (to look for bacterial infection and other medical problems that might be the cause of your symptoms)
• chest X-ray
• a pulmonary function test called spirometry (you breathe into a tube to measure airflow into and out of your lungs to see how well your lungs are working)
• blood tests.

How is it treated?

Your healthcare provider may prescribe:

• Medicine that relaxes and opens the airways (called a bronchodilator), making it easier to breathe. Bronchodilators are usually taken with an inhaler, but they are also available as pills or liquid. Sometimes this medicine needs to be used with a nebulizer. A nebulizer is a machine used to inhale moisturized medicine through a face mask or breathing tube.
• Antibiotics to treat bacterial infection. (Be sure to tell your provider if you are allergic to any antibiotics or other drugs.)

If you are a smoker, your provider will tell you how important it is for you to stop smoking.

If it is hard for you to cough up mucus, your healthcare provider may recommend one of the following methods to help clear your airways. These treatments may be done by a nurse or a respiratory therapist. Or a family member may learn how to do it.

• chest percussion: striking a part of your chest with short, sharp blows
• postural drainage: helping you get into a position that helps drain secretions from the lungs.

You may have a follow-up visit with your healthcare provider to be sure any infections have been cleared up. Your provider may want you to schedule regular exams to check for possible complications.

How long will the effects last?

Treatment will help control your symptoms. The symptoms may get better but then occur again more than once each year, especially during the winter. If your condition worsens, your symptoms will last longer and each recovery will take longer.

The disease will worsen if:

• You smoke.
• You have a heart problem that causes symptoms, such as shortness of breath.
• You keep being around a lot of dust, chemicals, or fumes.
• You have other lung problems.
• You live where the air pollution is bad.

How can I take care of myself?

• If you smoke, quit.
• Follow your healthcare provider's instructions.
• Take any medicine, prescription or nonprescription, as directed by your provider.
• Avoid other people's secondhand smoke.
• If possible, avoid working or living in damp, cold, dusty, or air-polluted conditions.
• Avoid close contact with people who have colds or the flu.
• Wash your hands often and well when around people with a cold or the flu.
• Ask about getting flu and pneumonia shots.
• Follow good health practices, such as a healthy diet.
• Get regular exercise, according to your provider's recommendations.
• Be sure to call your healthcare provider if your symptoms do not get better and especially if they get worse. If you cough up blood, call your healthcare provider right away.

How can I help prevent chronic bronchitis?

• Don't smoke.
• Avoid exposure to smog and other air pollutants, including secondhand smoke.
• Try to avoid frequent infections. When you do have symptoms of an infection, get treatment right away.