BRONCHITIS, CHRONIC

General Information

DEFINITION--Chronic inflammation and degeneration of the bronchial tubes, with or without active infection. It is most commonly associated with cigarette smoking.

BODY PARTS INVOLVED--Bronchial tubes (bronchi).

SEX OR AGE MOST AFFECTED--All ages, but most common in adults, usually men.

SIGNS & SYMPTOMS

• Frequent cough or coughing spasms.
• Shortness of breath.
• Sputum that is thick and difficult to cough up. Sputum production varies according to whether infection is present.
• Barrel chest (in the late stages).

CAUSES--Repeated irritation or infection in the bronchial tubes, causing them to thicken, narrow and lose elasticity. Underlying irritants include allergens, air pollution and tobacco smoke.

RISK INCREASES WITH

• Smoking (the greatest risk factor).
• Any lung illness that has lowered resistance.
• Family history of tuberculosis or other disease of the respiratory tract.
• Exposure to air pollutants.
• Poor nutrition.
• Obesity.
• Crowded living conditions.

HOW TO PREVENT

• Don't smoke. This is the most reversible risk.
• Avoid irritating fumes in the environment.
• Obtain prompt medical treatment for respiratory infections.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies of sputum and pulmonary function.
• X-rays of the chest.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment. Many lung and heart disorders cause symptoms identical to those of chronic bronchitis. Your doctor must exclude these possibilities to make a diagnosis.
• Treatment does not cure, but it can relieve symptoms and help prevent complications.

POSSIBLE COMPLICATIONS

• Recurrent pneumonia.
• Chronic obstructive pulmonary disease (COPD). COPD is incurable. It is characterized by purple lips and nails and congestive heart failure.

PROBABLE OUTCOME--Chronic bronchitis is usually curable with treatment--if you are a non-smoker and don't have an underlying chronic disease, such as congestive heart failure, bronchiectasis or tuberculosis. Chronic bronchitis usually reduces life expectancy if you smoke and don't stop, or if you have an underlying chronic disease.

How To Treat

GENERAL MEASURES--

• Stop smoking.
• If you work or live in an area with heavy air pollution, do everything you can to avoid or reduce it. Consider changing jobs and installing air-conditioning with a filter and humidity control in your home.
• Avoid sudden temperature changes or exposure to cold, wet weather.
• Avoid talking loudly, laughing loudly, crying and exertion, if these trigger coughing episodes.
• Practice bronchial drainage and deep-breathing techniques. Your physician will provide instructions.
• Sleep with 5-inch blocks under the foot of your bed.
• See Resources for Additional Information.

MEDICATION--

• Don't take cough suppressants; they make chronic bronchitis worse.
• Your doctor may prescribe: Antibiotics to fight chronic or recurrent infection. Expectorants to loosen secretions. Bronchodilators to open bronchial tubes. Drugs to treat severe depression or anxiety if they occur.

ACTIVITY--No restrictions. A regular exercise routine is important as prolonged inactivity leads to excessive disability.

DIET--No special diet. Increase fluid intake to 8 to 10 glasses a day.

Call Your Doctor If

• You have symptoms of chronic bronchitis.
• You develop fever.
• Blood appears in the sputum.
• Chest pain increases.
• Shortness of breath occurs even when you are resting or not coughing.
• Sputum thickens despite efforts to thin it.