Q&A with an expert: Stephanie Canham, M.D., internal medicine physician
What is chronic bronchitis?
Bronchitis occurs when the bronchi airways, the two breathing tubes that carry air to the lungs, become inflamed, causing too much mucus production and other changes. When this inflammation occurs for a longer duration of time, the person has chronic bronchitis. To qualify as chronic bronchitis, other conditions must have been ruled out as the cause, and the person must have a cough and mucus for at least three months yearly for two years in a row.
What causes chronic bronchitis?
Chronic bronchitis is a chronic obstructive pulmonary disease (COPD), which is a large group of lung diseases including chronic bronchitis. COPD can block airflow in the lungs, causing breathing problems. Most experts agree the main cause of chronic bronchitis is cigarette smoking. Additional contributing factors include air pollution and work environment, especially in combination with cigarette smoking. Chronic bronchitis often occurs with other lung diseases including pulmonary emphysema, sinusitis, tuberculosis, asthma, upper respiratory infections and pulmonary fibrosis.
What are the symptoms of chronic bronchitis?
Each person experiences symptoms differently. The most common symptoms include a cough (often referred to as a smoker’s cough), coughing up mucus, chest discomfort, fatigue, wheezing and shortness of breath. Chronic bronchitis symptoms may look like other lung conditions or medical problems. A primary care physician should be seen for a diagnosis.
Does chronic bronchitis increase risk for other conditions?
Those with chronic bronchitis tend to get lung infections more easily and also have episodes of acute bronchitis during which symptoms are worse. Over time, chronic bronchitis may cause disability, frequent or severe infections of the airways, narrowing and plugging of the bronchi, and trouble breathing.
How is chronic bronchitis diagnosed?
A physician completes a medical history, physical examination and may order additional testing, including:
- Arterial blood gas: measures the amount of oxygen and carbon dioxide in the blood
- Chest X-ray: takes pictures of the internal organs
- CT scan: provides detailed imaging of parts of the body
- Peak flow monitor: measures the fastest speed air can be blown out of the lungs
- Pulmonary function tests: measure the lungs’ ability to move air in and out of the lungs
- Pulse oximetry: measures the amount of oxygen in the blood
- Spirometry: measures how well lungs are functioning
How is chronic bronchitis treated?
The aim is treating symptoms and may include quitting smoking and avoiding secondhand smoke and other lung irritants. A physician may prescribe oral medication or inhalants to open airways and clear mucus. Treatment can also include humidifying the air, pulmonary rehabilitation, getting oxygen from portable containers and having lung reduction surgery to remove the damaged areas of the lung. In rare cases, patients may need a lung transplant.