Chronic Bronchitis

One type of COPD

The inflamed bronchi produce a lot of mucus. This leads to cough and difficulty getting air in and out of the lungs. Cigarette smoking is the most common cause. Breathing in other fumes and dusts over a long period of time may also cause chronic bronchitis. Treatment will help your symptoms, but chronic bronchitis is a long-term condition that keeps coming back or never goes away completely.

Diagnosis

A physical examination will often reveal diminished breath sounds, wheezing and prolonged expiration. Most doctors rely on the presence of a persistent dry or wet cough as evidence of bronchitis.

A variety of tests may be performed in patients presenting with cough and shortness of breath:

  • Pulmonary Function Tests (PFT) (or spirometry) must be performed in all patients presenting with chronic cough. An FEV1/FVC ratio below 0.7 that is not fully reversible after bronchodilator therapy indicates the presence of COPD, that requires more aggressive therapy and carries a more severe prognosis than simple chronic bronchitis.
  • A chest X-ray that reveals hyperinflation; collapse and consolidation of lung areas would support a diagnosis of pneumonia. Some conditions that predispose to bronchitis may be indicated by chest radiography.
  • A sputum sample showing neutrophil granulocytes (inflammatory white blood cells) and culture showing that has pathogenic microorganisms such as Streptococcus spp.
  • A blood test would indicate inflammation (as indicated by a raised white blood cell count and elevated C-reactive protein).
  • Neutrophils infiltrate the lung tissue, aided by damage to the airways caused by irritation.
  • Damage caused by irritation of the airways leads to inflammation and leads to neutrophils being present
  • Mucosal hypersecretion is promoted by a substance released by neutrophils
  • Further obstruction to the airways is caused by more goblet cells in the small airways. This is typical of chronic bronchitis
  • Although infection is not the reason or cause of chronic bronchitis it is seen to aid in sustaining the bronchitis.

Treatment

Since Cigarette smoking is the most common cause, smoking cessation is most important. For further information please see COPD Treatment.