is an
Obstructive Pulmonary Disease characterized by
Inflammation of the
Bronchi of the
Lung s. It is a common disease of habitual
Tobacco Smokers and residents of
Polluted cities.
Like many disorders, bronchitis can be
Acute (short-term), or
Chronic (long-lasting). Chronic bronchitis is defined clinically as a persistent
Cough that produces
Sputum for at least three months in two consecutive years.
Chronic bronchitis has also been linked to excessive alcohol consumption and exposure to cold and draught.
1
A physical examination will often reveal decreased intensity of breath sounds (
Rhonchi ) and extended
Expiration . Most doctors rely on the presence of a persistant dry or wet cough as evidence of bronchitis. They will also listen to your lungs, take your temperature, check, with a finger cuff, the oxygen saturation of your blood, and ask you questions to help them understand your illness more effectively. (How long have you had this cough? Fever? Tightness of chest? Allergies? Do you smoke? Any exposure to environmental fumes? etc)
For some patients, doctors may request a
Sputum Culture . In this test, a sample of sputum from a patient's cough is stained and examined for the presence of bacteria that can cause this disease.
There are a variety of lab test results that indicate the presence of chronic bronchitis in a patient, namely:
Diagnosis of acute bronchitis is aided by finding an elevation in the level of the
Diaphragm on chest x-ray.
Doctors will also try to decide if you have pneumonia or bronchitis. (Generally, speaking, pneumonia patients have a higher, longer fever than the bronchitis patients, and pneumonia patients generally feel worse overall.)
Acute bronchitis often follows a cold or infection. It may be viral (in which case antibiotics do not help) or bacterial (rarer, but helped by antibiotics).
Another type of bronchitis is called chronic bronchitis. This is a bronchitis condition that lasts at least three months for two years. This long term problem is mostly likely due to environmental irritation of the bronchial tubes and is often caused by smoking.
The initiating event in developing chronic bronchitis appears to be chronic irritation due to inhalation of certain substances (especially cigarette smoke). The earliest clinical feature of bronchitis is increased secretion of mucus by
Submucousal Gland s of the
Trachea and
Bronchi . Damage caused by irritation of the airways leads to
Inflammation and infiltration of the lung tissue by neutrophils. The neutrophils release substances that promote mucosal hypersecretion. As bronchitis persists to become chronic bronchitis, a substantial increase in the number of goblet cells in the small airways is seen. This leads to further increased mucous production that contributes to the obstruction of the airways.
The role of infection in the pathogenesis of chronic bronchitis appears to be secondary. However, although infection is not responsible for initiating bronchitis, it may have an important role in maintaining it. Acute exacerbations of the long-standing bronchitis may result from infections.
Drinking lots of fluids (mainly
Water ) is beneficial for sufferers of acute bronchitis. Many doctors now recognize that most acute bronchitis is caused by viruses, so antibiotics, while popular with patients, will not help treat this type of bronchitis.
Some bronchitis is bacterial, but since most bronchitis is viral, most patients will instead receive advice for rest, lots of liquids, and aspirin or Tylenol for fever. Occasionally, a doctor may prescribe a steroid to help open the bronchial tubes to help with coughing.
Coughing is an essential mechanism to help clear the mucus present in the irritated bronchial tubes. Expectorant cough medicine can help you make those coughs more productive by thinning the mucus; supressant cough medicine may help you sleep by suppressing the dry coughs so prevalent in the early stages of the illness.
The single most important thing a patient can do to improve chronic bronchitis is to quit smoking.
Oxygen Therapy ,
Bronchodilator drugs,
Antibiotics , and
Lung Volume Reduction Surgery are also used to treat chronic bronchitis.
Acute bronchitis usually lasts approximately 10 or 11 days. It may accompany or closely follow a cold or the flu, or it may arrive unaccompanied by any other condition. It is contagious, and it starts out with a dry cough, frequently waking you up at night. After a few days, it progresses to a wetter, productive cough, which may be accompanied by a low grade fever, fatigue, and headache. The fever, fatigue, and malaise may last only a few days, but the wet cough may last up to a few weeks to a few months. For some people, the cough may last as long as a few months as the bronchial tubes slowly heal.
Should your cough last longer than a month, many doctors recommend seeing a doctor to see if a cause other than bronchitis is causing the irritation. It's possible that having irritated bronchial tubes for as long as a few months may inspire asthmatic conditions in some patients.
In addition, if you start coughing up mucus tinged with blood, you should see a doctor. In many cases, this (small amount of blood) is alarming but not endangering; in other cases, doctors may conduct tests to see if you have a more serious condition such as TB or lung cancer.
The prognosis for patients with severe chronic bronchitis varies, but recovery is harder for those patients with additional severe illnesses (lung diseases or heart conditions).
Pulmonary Hypertension ,
Cor Pulmonale , and
Chronic Respiratory Failure are possible complications from chronic bronchitis.
Doctors think the best way to avoid acute bronchitis is to wash your hands frequently and thoroughly, to get lots of rest, and to drink lots of fluids. Acute bronchitis is most commonly caused by a bacteria or a virus, which spread via coughing droplets in the air and/or from touching contaminated surfaces.
Chronic bronchitis is often preventable. The main action to reduce your risk is to eliminate exposure to cigarette smoke and other environmentally hazardous fumes. Smokers in the early stages of chronic bronchitis can change and improve the course of the disease by quitting smoking. Your doctor will have more specific methods of prevention and reduction of the effects of this condition.
Bronchitis was originally named and described by
Charles Bedham in
1808 .
''Section'' Online medical references
- "Chronic bronchitis." ''Springhouse Handbook of Diagnostic Tests, 2nd ed.'' (1999). ISBN 0-87434-982-6
- "Chronic obstructive pulmonary disease." ''2005 Current Medical Diagnosis and Treatment.'' ISBN 0-07-143692-8
- Kumar, Vinay, Abul Abbas, and Nelson Fausto. ''Robbins and Cotran Pathologic Basis of Disease, 7th ed.'' (2005). ISBN 0-7216-0187-1
- Skinner, Henry Alan. ''The Origin of Medical Terms.'' (1970).
Deaths from Chronic Bronchitis: 1,172 deaths (NHLBI 1999)
