What is Chronic Bronchitis?
The bronchi are air passages connecting the windpipe (trachea) with the sacs of the lung (alveoli) where oxygen is taken up by the blood. Bronchitis is an inflammation of the bronchi causing excessive mucous production and swelling of the bronchial walls. Many people suffer a brief attack of acute bronchitis with
fever, coughing, and spitting when they have a severe cold. Chronic bronchitis, however, is the term applied when this coughing and spitting continue for months and returns each year, generally lasting slightly longer each time. Undue breathlessness on exertion is eventually noticed, due to obstruction to airflow in the air passages caused by swelling of the bronchial wall and the presence of mucus that cannot be cleared.
Emphysema is a
disease in which there is the destruction of the walls of the air sacs of the lung, and it is frequently preceded by chronic bronchitis. Emphysema adds to the breathlessness suffered by the patient with chronic bronchitis.
What does it feel like?
Initially, it begins as a “smoker’s cough” the expectoration of small amounts of phlegm each morning. It is usually worse in the wintertime and when the person has a head cold. In these early phases of chronic bronchitis, the person may lead an entirely normal life, including vigorous sports. Although alarming, breathing tests can give early indications of permanent lung damage that might be happening even before any symptoms become evident. The cough becomes more frequent during the daytime and even at night, disturbing sleep. The patient then notices that activities previously tolerated well, cause shortness of breath and perhaps some wheezing.
As the disease progresses, shortness of breath may be caused by very ordinary activities such as getting dressed in the morning or having a bath. Individuals with progressed bronchitis might find it difficult to move around or go upstairs without extra oxygen support. Shortness of breath and the progression of heart failure may lead to the person being confined to a chair or bed, particularly during the later stages of this disease. Minor chest infections in patients with severe chronic bronchitis may require intensive treatment in the hospital. As the disease is not rapidly fatal, it becomes an important cause of disability and the annual cost of this disease in terms of time lost from work, disability pensions, and medical therapy may approach one hundred million dollars annually in Canada.
What causes Chronic Bronchitis?
Cigarette smoking is the most important cause of chronic bronchitis which rarely occurs in the non-smoker. Environmental pollution may contribute to the development of chronic bronchitis. Some smokers are resistant to the development of chronic bronchitis, but as yet there is no way of predicting which smokers will not develop chronic bronchitis. The decreased incidence of chronic bronchitis among women probably reflects the difference in smoking habits between the sexes. As these differences have diminished we are seeing an increasing incidence of chronic bronchitis in women.
How is Chronic Bronchitis treated?
To avoid developing chronic bronchitis, the best course of action is to steer clear from smoking.
Chronic Bronchitis is an incurable condition that does not improve even if smoking is stopped. The cough of chronic bronchitis will diminish within weeks of smoking cessation and usually disappears entirely within three months. Obstruction to airflow caused by swelling of the walls of the bronchi persists, although medications to dilate the bronchi (bronchodilators) may diminish the breathlessness. It is essential to be reminded that those with chronic bronchitis who persist in smoking will progressively get worse rapidly.
Quitting smoking can help prevent any further decline in your lifestyle and may even result in an improvement in your quality of life. It is an important step towards leading a healthier life.
Anti-inflammatory
When managing asthma, the key is to use anti-inflammatory medications along with bronchodilators as required for quickly and temporarily alleviating symptoms.
- Anti-Inflammatory – Anti-inflammatories are used to treat the inflammation that is present in this condition.
- Bronchodilators – Bronchodilators are used to relieve bronchoconstriction when an asthmatic component is present.
The successful approach to management, both in and out of hospital settings, is dependent upon the use of anti-inflammatory treatments with bronchodilators being prescribed for immediate and occasional relief of symptoms.
- Prevent symptoms such as cough, wheezing, and breathlessness
- Need to be taken on a regular basis
- Are slow-acting (hours or weeks)
There are steroidal and non-steroidal anti-inflammatory drugs. The most common ones include:
Steroids
Corticosteroid inhalers
They work by reducing and preventing airway inflammation, swelling and mucus.
Side Effects of Corticosteroid Inhalers
- few side effects at low doses
- side effects, in general, are usually restricted to the throat:
- hoarseness and sore throat
- thrush or yeast infection
- This can be prevented by rinsing the mouth and gargling, and by using a holding chamber.
Corticosteroid tablets
Corticosteroid tablets or Prednisone®:
- are used when inflammation becomes severe
- reduce inflammation, swelling & mucus, and help bronchodilators work better
- start to work within a few hours, but may take several days to have a full effect
- often are used for short periods of time to get the inflammation under control
- there are many side effects if used long-term, such as water retention, bruising, puffy face, increased appetite, weight gain, and stomach irritation
Many physicians prescribe antibiotics for acute chest infections which may shorten their duration and help prevent pneumonia. Annual vaccinations against influenza and a once-only vaccination against bacterial pneumococcal pneumonia may help prevent the pulmonary complication of infections in chronic bronchitis. The sufferer of chronic bronchitis should avoid excessive dust and fumes although, under normal circumstances, the contribution of atmospheric pollution to chronic bronchitis is extremely small. Regular exercise is even more important for patients suffering from chronic bronchitis than for healthy individuals. Exercise does not improve the ability of the lungs to take up oxygen, but the effects of physical fitness on the cardiovascular system will compensate somewhat for the impaired lung function.
Physical fitness in patients with chronic bronchitis leads to a reduction in breathlessness during physical activity.
Chronic bronchitis is a preventable illness, and it’s not common among non-smokers. It’s never too late to kick the smoking habit Taking action to treat bronchitis at its earliest stages can result in far better outcomes for those suffering from chronic bronchitis.
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