Chronic bronchitis: Signs, Causes and Treatment

Chronic bronchitis is a condition where the patient undergoes symptoms of bronchitis for at least three months, over two years.

Are you facing continuous cough with excessive mucus formation, wheezing, whistling sound when you breath and shortness of breath? These can all be considered major symptoms of chronic bronchitis, especially if it stretches for more than three months. You might also be experiencing frequent respiratory infections such as a flu or a cold.

If a case of chronic bronchitis is left untreated, it can even have more severe symptoms such as loss of weight, swollen ankles, swollen feet and legs as well as weakness in lower muscles. Therefore, it is essential to diagnose and treat chronic bronchitis as soon as possible. Interventional Pulmonology and Lung transplant specialist Dr Srivatsa Lokeshwaran tells us all that there is to know about this condition.

What is chronic bronchitis?

If you are coughing with phlegm production for at least three months in a year for two consecutive years then you have a high possibility of having chronic bronchitis. “Bronchitis means swelling or inflammation of the breathing tubes. Most of the time chronic bronchitis is secondary to a long standing smoking habit. Other causes could be a long standing asthma,” says Dr Lokeshwaran.

A woman crushing cigarettes.
Smoking is the biggest cause of chronic bronchitis. Image courtesy: Freepik

What is the difference between acute and chronic bronchitis?

Acute bronchitis is when the inflammation in the airway is very brief as triggered by an infection like viral flu or secondary to an allergic swelling, pollutants or irritants. This is brief and usually reversible. Chronic bronchitis is a recurring condition.

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Symptoms of chronic bronchitis

Symptoms of Bronchitis would include the following.

  • Cough
  • Phlegm production which maybe yellow or white
  • Breathlessness which is worse on exertion
  • Wheezing
  • Fatigue
  • Headache
  • Palpitations
  • In advanced cases swelling in the legs and turning blue due to the poor oxygen levels.

Also Read: Bronchitis during pregnancy: Know if it can harm your baby

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Causes of chronic bronchitis

Chronic bronchitis is caused by irritants that can damage or lungs or impact airways. The most common cause for bronchitis is a long standing smoking habit. “The chemicals during smoking cause swelling of the breathing tubes. The normal hairlike structures on the breathing tubes become sluggish in their action and hence there is a pile up of secretions,” says Dr Lokeshwaran. The glands in the airway start hyperfunctioning producing more secretions. The muscles around the breathing tube increase in size and tighten up there by choking the breathing tubes.

Other causes might include excessive exposure to air pollution, chemical fumes or dust.

How do you diagnose chronic bronchitis?

Chronic bronchitis is primarily a clinical diagnosis based on symptoms and signs. “We have the patients take a detailed pulmonary function test to understand the airway calibre and also whether oxygen is passing without hurdle in the distal airspaces. Their exercise tolerance can be measured by tests like the 6 minute walk test. Imaging like CT scan can give us a better understanding of the areas of lung damage and other associated features,” says Dr Lokeshwaran. Sometimes, a strain on the lung affects the heart as well necessitating an evaluation of the heart with an ECG or Echocardiography.

A woman working out
Physical activity is an effective way to treat chronic bronchitis. Image courtesy: Freepik

How to treat chronic bronchitis?

Treatment of Chronic bronchitis is usually with:

1. Bronchodilators

This is a type of medication that makes it easier to breathe. It relaxes the lungs and widens the airways, relieve the choking in the airway tubes.

2. Antibiotics

Antibiotics can be very useful if there is an infection which is instigating the problem. This is useful when a bacterial infection is the root cause.

3. Glucocorticosteroids

This is an anti-inflammatory therapy. This helps to reduce the inflammation in the breathing tubes and is also a great therapy for asthma.

4. Anti-inflammatory medications

Anti-inflammatory medications such as phosphodiesterase 4 inhibitors can also helps treat chronic bronchitis. This will help with the symptoms of chronic bronchitis.

5. Mucolytics

These can be used to thin the phlegm. These medications help break down the mucus so that it can clear out effectively from your lungs.

6. Oxygen

Oxygen can be used to maintain oxygen levels. This is very helpful with chronic bronchitis, especially in cases where oxygen is low due to the poor lung reserves.

7. Physical rehabilitation

Physical activity and exercise play a vital role in bringing back the patient to normal functioning.

8. Lifestyle changes

Quitting smoking is the first and most important lifestyle change that needs to be implemented. Avoid any second hand smoke. Eat well, as that will help strengthen your immunity as well.

Also Read: Bronchitis giving you a hard time? 5 home remedies to ease the symptoms

How to live with chronic bronchitis?

Chronic bronchitis can take time to go and here are some ways to living with it. “Meet a pulmonologist who is specialised in taking a holistic care of your problem and take regular medications,” says Dr Lokeshwaran. Additionally, got for constant checks on your lung capacity and enrol yourself in a rehab program for improving exercise capacity.