Chronic Bronchitis
Medical Reference: Comprehensive information on chronic bronchitis, a persistent respiratory condition affecting the bronchi (medium-size airways) in the lungs.
🫁 Understanding Chronic Bronchitis
Medical Definition
Bronchitis is an inflammation of the bronchi (medium-size airways) in the lungs. Unlike acute bronchitis, which is typically caused by viruses or bacteria and lasts days to weeks, chronic bronchitis is a long-term condition.
Clinical Definition:
Chronic bronchitis is clinically defined as a persistent cough that produces sputum (phlegm) and mucus for at least three months in two consecutive years. It is generally part of a syndrome called chronic obstructive pulmonary disease (COPD).
Key Distinction
Chronic bronchitis is not necessarily caused by infection, unlike acute bronchitis. It's a structural and functional change in the airways that persists over time.
🔍 Signs and Symptoms
Primary Symptoms
Respiratory Symptoms
Expectorating Cough
Also known as productive cough - brings up mucus
Shortness of Breath
Medical term: dyspnea
Wheezing
High-pitched whistling sound when breathing
Additional Symptoms
Chest Pains
Occasional discomfort
Fever
May occur during exacerbations
Fatigue or Malaise
General feeling of being unwell
🔬 Mucus Characteristics
Mucus produced is typically green or yellowish-green in color, indicating the presence of inflammatory cells and possible bacterial involvement.
🩺 Diagnostic Procedures
Physical Examination Findings
- • Decreased intensity of breath sounds
- • Wheeze (rales) - abnormal lung sounds
- • Prolonged expiration - difficulty breathing out
- • Persistent dry or wet cough - primary diagnostic indicator
🧪 Diagnostic Tests
1. Pulmonary Function Tests (PFT)
Also known as Spirometry
Must be performed in all patients presenting with chronic cough
COPD Indicator:
An FEV1/FVC ratio below 0.7 that is not fully reversible after bronchodilator therapy indicates COPD presence, requiring more aggressive therapy and carrying a more severe prognosis.
2. Chest X-Ray
• Hyperinflation - over-expanded lungs
• Collapse and consolidation - may indicate pneumonia
• Underlying conditions - identifies predisposing factors
3. Laboratory Tests
Sputum Analysis
- • Neutrophil granulocytes (inflammatory white blood cells)
- • Culture for pathogenic microorganisms
- • Common finding: Streptococcus species
Blood Tests
- • Elevated white blood cell count
- • Raised C-reactive protein
- • Indicates inflammation presence
🔬 Disease Process (Pathophysiology)
Sequential Disease Development
Airway Irritation
Damage caused by irritation leads to inflammation
Neutrophil Infiltration
Neutrophils infiltrate lung tissue, aided by airway damage
Mucosal Hypersecretion
Substances released by neutrophils promote excessive mucus production
Airway Obstruction
More goblet cells in small airways cause further obstruction (typical of chronic bronchitis)
Important Note: While infection is not the primary cause of chronic bronchitis, it is seen to aid in sustaining and exacerbating the condition.
💊 Treatment Options
🌿 Alternative Treatment
Colloidal Silver
Some studies suggest colloidal silver may have antimicrobial properties that could benefit bronchitis treatment. Consult with healthcare providers about this option.
💊 Antibiotics
For Acute Exacerbations
• Amoxicillin/clavulanic acid
• Macrolides
• 2nd or 3rd generation cephalosporins
• Quinolones
Meta-analysis shows these may be more effective
🫁 Bronchodilators
Airway Opening Medications
Help open airways and improve breathing during acute exacerbations
Evidence: American College of Physicians guidelines support use
💉 Corticosteroids
Anti-inflammatory Treatment
Reduce inflammation in airways during acute exacerbations
Evidence: American College of Physicians clinical practice guidelines
🚭 Smoking Cessation
Most Important Treatment
Stopping smoking is the single most effective intervention for chronic bronchitis. It can slow disease progression and improve symptoms.
🌍 Environmental Considerations
Air and Water Quality
Many disease-causing organisms and toxins are transmitted via air and water, which can exacerbate respiratory conditions like chronic bronchitis.
🌬️ Air Filtration
Consider investigating air filtration systems to remove airborne pollutants, allergens, and pathogens from your living environment.
💧 Water Purification
Purifying or treating your drinking water can help reduce exposure to waterborne toxins and contaminants that may affect overall health.
📚 References
[1] Dimopoulos G, Siempos II, Korbila IP, Manta KG, Falagas ME (2007). "Comparison of first-line with second-line antibiotics for acute exacerbations of chronic bronchitis: a metaanalysis of randomized controlled trials." Chest 132(2): 447-55.
[2] Bach PB, Brown C, Gelfand SE, McCrory DC (2001). "Management of acute exacerbations of chronic obstructive pulmonary disease: a summary and appraisal of published evidence." Ann. Intern. Med. 134(7): 600–20.
Source Attribution: This article is licensed under the GNU Free Documentation License and uses material from Wikipedia.org. Additional information and photos added by Avianweb.