What is chronic bronchitis?
Bronchitis is inflammation of the breathing tubes. These are the airways called bronchi. This inflammation causes too much mucus production and other changes. Although there are several different types of bronchitis, the most common are acute and chronic.
Chronic bronchitis is long-term inflammation of the bronchi. It is common among smokers. People with chronic bronchitis tend to get lung infections more easily. They also have episodes of acute bronchitis during which symptoms are worse. Acute bronchitis is covered in a separate document.
To be classified as chronic bronchitis:
- You must have a cough and mucus most days for at least 3 months a year, for 2 years in a row.
- Other causes of symptoms, such as tuberculosis (TB) or other lung diseases, must be ruled out.
People with chronic bronchitis have chronic obstructive pulmonary disease (COPD). This is a large group of lung diseases that includes chronic bronchitis. These diseases can block air flow in the lungs and cause breathing problems. The two most common conditions of COPD are chronic bronchitis and emphysema.
What causes chronic bronchitis?
Chronic bronchitis is not caused by a virus or bacteria. Most experts agree that the main cause of chronic bronchitis is cigarette smoking. Air pollution and your workplace may also play a role, especially when combined with cigarette smoking.
Chronic bronchitis often happens with other lung diseases, such as:
- Pulmonary emphysema
- Pulmonary fibrosis (scarring of the lungs)
- Upper respiratory infections
What are the symptoms of chronic bronchitis?
Below are the most common symptoms of chronic bronchitis. But each person may have slightly different symptoms.
Symptoms may include:
- Cough. This is often called smoker's cough.
- Coughing up mucus (expectoration)
- Chest discomfort
People with chronic bronchitis usually have a cough and make mucus for many years before they have shortness of breath.
Chronic bronchitis may cause:
- Frequent and severe infections that affect your airways
- Narrowing and plugging of your breathing tubes (bronchi)
- Trouble breathing
Other symptoms may include:
- Bluish fingernails, lips, and skin because of lower oxygen levels
- Wheezing and crackling sounds with breathing
- Swelling of the feet
- Heart failure
The symptoms of chronic bronchitis may look like other lung conditions or medical problems. See your health care provider for a diagnosis.
How is chronic bronchitis diagnosed?
Your health care provider will take a complete medical history and do a physical exam. He or she may order the tests below.
Pulmonary function tests (PFTs)
These tests help to measure the lungs' ability to move air in and out of your lungs. The tests are usually done with special machines that you breathe into. They may include the following:
A spirometer is a device used to see how well your lungs are working. Spirometry is using the spirometer to look at your lung function. It is one of the simplest, most common PFTs. It may be used for any or all of these reasons:
- To find out how well your lungs take in, hold, and move air
- To keep watch on a lung disease
- To see how well treatment is working
- To find out how serious your lung disease is
- To find out whether your lung disease is restrictive or obstructive. Restrictive means less air will get into your lungs. Obstructive means less air will get out of your lungs.
Peak flow monitor (PFM)
This test measures the fastest speed you can blow air out of your lungs. Inflammation and mucus in the large airways in the lungs narrows the airways. This slows the speed of air leaving the lungs and can be measured with a PFM. This measurement is very important in telling how well your disease is being controlled.
Arterial blood gas (ABG)
This blood test is used to check the amount of oxygen and carbon dioxide in your blood. It also measures the pH (acidity) of your blood.
An oximeter is a small machine that measures the amount of oxygen in your blood. To get this measurement, a small sensor is taped or clipped onto a finger or toe. When the machine is on, a small red light can be seen in the sensor. The sensor is painless, and the red light does not get hot.
This test makes pictures of your internal tissues, bones, and organs, including the lungs.
Computed tomography (CT) scan
This imaging test uses a combination of X-rays and computer technology to make horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
How is chronic bronchitis treated?
Treatment for chronic bronchitis is aimed at treating the symptoms. It may include:
- Quitting smoking
- Avoiding secondhand smoke and other lung irritants
- Taking oral medicines to open airways and help clear away mucus
- Taking inhaled medicines, such as bronchodilators and steroids
- Getting oxygen from portable containers
- Having lung reduction surgery to take out damaged areas of the lung
- Getting a lung transplant (in rare cases)
- Humidifying the air
- Getting pulmonary rehab to help you learn how to live with your breathing problems and stay active
Key points about chronic bronchitis
- Bronchitis is inflammation of the breathing tubes (bronchi). There are several types of bronchitis, but the most common are acute and chronic.
- Chronic bronchitis is often part of chronic obstructive pulmonary disease (COPD). This is a group of lung diseases that cause airflow blockage and breathing problems.
- The most important cause of chronic bronchitis is cigarette smoking. Air pollution and your workplace may also play a role.
- Chronic bronchitis causes a cough that's often called smoker’s cough. It also causes you to cough up mucus, wheeze, and have chest discomfort. These may get worse over time and lead to severe breathing problems.
- Tests that help measure how well your lungs are working are used to diagnose chronic bronchitis. Blood tests, breathing tests, and imaging tests may also be used to see how severe the problem is and watch it over time.
- The goal of treatment for people with chronic bronchitis is to live more comfortably by controlling symptoms. A key part of treatment is to quit smoking.
Tips to help you get the most from a visit to your health care provider:
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
- Stump-Sutliff, Kim, RN, MSN, AOCNS
- Ziegler, Olivia Walton, MS, PA-C