Chronic Bronchitis

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Introduction

What is chronic bronchitis?

Chronic bronchitis, which is a form of chronic obstructive pulmonary disease (COPD), is an ongoing inflammation of the airways leading to the lungs (bronchi). It is characterized by a cough, mucus production, shortness of breath, and wheezing that persist for longer than three months.

Chronic bronchitis is a common respiratory disorder in the United States. People of all ages can develop chronic bronchitis, but it is most common in people over age 45. Chronic bronchitis affects about 10 million people in the United States, and the condition affects more than twice as many women as men (Source: ALA).

The most common cause of chronic bronchitis is smoking, and the risk of chronic bronchitis increases with the longer you smoke. Exposure to air pollution, secondhand smoke, gases, and chemical fumes can also increase your risk of chronic bronchitis.

Treatment for chronic bronchitis includes bronchodilators, anti-inflammatory drugs, and chest physical therapy for loosening mucus in the lungs. Healthy lifestyle practices, including hand washing to prevent infection, drinking plenty of fluids, following a well-balanced diet, getting plenty of rest, and refraining from smoking, can reduce your risk of chronic bronchitis and improve your symptoms.

Left untreated, chronic bronchitis can be associated with serious or even life-threatening symptoms. Seek immediate medical care (call 911) for severe difficulty breathing, which may be accompanied by pale or blue lips, rapid heart rate, sweating, and anxiety.

Seek prompt medical care if you are being treated for chronic bronchitis but mild symptoms recur or are persistent.

Symptoms

What are the symptoms of chronic bronchitis?

Chronic bronchitis causes inflammation of the bronchi, resulting in a number of respiratory symptoms, including wheezing and a cough with mucus. The symptoms can vary in intensity among individuals.

Common symptoms of chronic bronchitis

You may experience chronic bronchitis symptoms daily or just once in a while. At times, any of these chronic bronchitis symptoms can be severe:

  • Chest pain or pressure

  • Coughing up clear, yellow, light brown, or green mucus

  • Fatigue

  • Shortness of breath or rapid breathing (tachypnea)

  • Wheezing (whistling sound made with breathing)

Serious symptoms that might indicate a life-threatening condition

Left untreated, chronic bronchitis can be life threatening in some cases. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Bluish coloration of the lips or fingernails

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Rapid heart rate (tachycardia)

  • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

Causes

What causes chronic bronchitis?

Chronic bronchitis is a form of chronic obstructive pulmonary disease that causes inflammation in the bronchi, resulting in a cough, mucus production, and shortness of breath. The most common cause of chronic bronchitis is smoking. Your risk of chronic bronchitis is increased by certain jobs, including those involving livestock, grain, textiles, manufacturing, and coal mining, as well as by exposure to inhaled irritants, such as chemical fumes and gas vapor.

What are the risk factors for chronic bronchitis?

A number of factors increase the risk of developing chronic bronchitis. Not all people with risk factors will get chronic bronchitis. Risk factors for chronic bronchitis include:

  • Age over 45 years
  • Air pollution, including fumes from cars and cooking fuel and smoke from fires
  • Alcohol consumption
  • Allergies to animal dander, dust particles, or pollen
  • Female gender
  • Fumes from chemicals or gases
  • Jobs working with livestock, grain, textiles or coal
  • Preexisting lung disease
  • Respiratory infection
  • Secondhand smoke (passive smoking)
  • Smoking

Reducing your risk of chronic bronchitis

You may be able to lower your risk of chronic bronchitis and sudden flare-ups by:

  • Getting pneumococcal and annual flu vaccines
  • Practicing good hygiene by always washing your hands
  • Refraining from smoking and avoiding secondhand smoke
  • Taking medicine as prescribed, even if you do not have symptoms
Treatments

How is chronic bronchitis treated?

Treatment for chronic bronchitis begins with seeking medical care from your health care provider. The goal of treatment for chronic bronchitis is to reduce inflammation and congestion and improve breathing. Chronic bronchitis is not typically treated with antibiotics, except in cases of sudden exacerbations. Quitting smoking is the best way to improve symptoms. Treatment for chronic bronchitis includes bronchodilators, anti-inflammatory drugs, and chest physical therapy for loosening mucus in the lungs.

Treatment options for chronic bronchitis

There are a number of options for the treatment of chronic bronchitis. Examples include:

  • Antibiotics during flareups to reduce the risk of complications

  • Bronchodilators to open airways, such as albuterol sulfate (ProAir, Proventil, Ventolin, AccuNeb Inhalation solution), formoterol (Foradil), ipratropium (Atrovent), levalbuterol HCl (Xopenex), salmeterol (Serevent), and tiotropium (Spiriva)

  • Chest physical therapy (CPT) to loosen mucus in the lungs

  • Inhaled corticosteroids to reduce inflammation, such as fluticasone (Flovent) and budesonide (Pulmicort)

  • Inhalers that include both a bronchodilator and a corticosteroid, such as budesonide-formoterol (Symbicort) and fluticasone-salmeterol (Advair)

  • Medication to help with smoking cessation, such as varenicline (Chantix) or bupropion hydrochloride (Zyban)

  • Oxygen therapy if blood oxygen levels are low

What you can do to improve your chronic bronchitis

In addition to reducing your exposure to chronic bronchitis triggers, you can also prevent or limit chronic bronchitis by:

  • Drinking plenty of fluids

  • Getting plenty of rest

  • Home oxygen use, when prescribed

  • Taking all medications as prescribed

  • Vaccinate against influenza and pneumococcal infection

What are the potential complications of chronic bronchitis?

Complications of untreated or poorly controlled chronic bronchitis can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of chronic bronchitis include:

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Nov 12
  1. Bronchitis - acute. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002078/.
  2. What is bronchitis? National Heart, Lung, and Blood Institute Diseases and Conditions Index. http://www.nhlbi.nih.gov/health/dci/Diseases/brnchi/brnchi_whatis.html
  3. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.
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