Causes and Risks:

Chronic bronchitis is a condition of excessive bronchial mucus with a cough producing sputum for 3 months or more in at least 2 consecutive years without any other disease that could account for this symptom. Chronic bronchitis is one form of chronic obstructive pulmonary (lung) disease. Cigarette smoking (active and passive exposure) is the chief cause of this disease, with air pollution, infection, familial factors, and allergies as exacerbating factors. The severity of the disease relates to the amount and duration of smoking. Chronic bronchitis, emphysema, and asthma as a group are the fifth leading cause of death in the US. 13.8 million men and women in the U.S. had chronic bronchitis as of 1993.

Prevention:

Early recognition and treatment of in people who smoke, combined with smoking cessation, may prevent the progression of the disease.

Symptoms:

• Cough that produces mucus (sputum), may be blood streaked
• Shortness of breath aggravated by exertion or mild activity
• Frequent respiratory infections which worsen symptoms
• Wheezing
• Rales
• Fatigue
• Ankle, feet, and leg swelling that affects both sides
• Headaches
• Vision abnormalities

Signs and Tests:

• Pulmonary function tests
• Arterial blood gas
• Chest X-ray
• Pulse oximetry (oxygen saturation testing)

Treatment:

There is no cure for chronic bronchitis. Treatment is aimed at relieving symptoms and preventing complications. Smoking and all other respiratory irritants should be avoided. Inhaled medications that may dilate the airways such as ipratropium bromide or albuterol may help reduce symptoms such as wheezing. Antibiotics are prescribed for infections, as needed. Respiratory treatments including nebulizers and postural drainage facilitate the removal of thick mucus from the airways. Corticosteroids may occasionally be used during flares of wheezing or in those with severe disease not responding to the above treatments. Physical exercise programs, breathing exercises, and patient education programs all contribute to the treatment plan. Oxygen therapy may be needed in severe cases.

Support Groups: The stress of illness can often be helped by joining a support group where members share common experiences and problems. See lung disease - support group.

Prognosis:

The chance for recovery is poor for advanced disease. Early recognition and treatment combined with smoking cessation improves the chance of a good outcome significantly.

Complications:

• Acute bronchitis
• Pneumonia
• Cor pulmonale
• Emphysema
• Cardiac arrhythmia

Call your health care provider if respiratory infection or unexplained symptoms develop, or you are short of breath, wheezing, or coughing up blood.