Chronic bronchitis refers to a persistent inflammation of the airways that results in coughing and sputum for at least three months in two consecutive years. In industrialized countries, chronic bronchitis affects about one in ten people.
What is chronic bronchitis?
In chronic bronchitis, the mucous membranes of the bronchial tubes are permanently inflamed. As a result, they produce increased mucous secretions that must be coughed up. The function of the cilia, which normally have the task of removing harmful substances from the lungs, is impaired. In chronic bronchitis, the cilia are stuck together and invading viruses and bacteria can no longer be fended off as easily. Chronic bronchitis is divided into three stages:
In the first stage, “simple chronic bronchitis,” there are frequent coughing attacks and mucous sputum. The bronchi are not constricted at this stage and there is no shortness of breath yet. In the second stage of the disease, the bronchi are already constricted. This stage of “chronic obstructive bronchitis” is particularly noticeable during physical exertion due to shortness of breath. In the final stage of chronic bronchitis, pulmonary emphysema develops, i.e. overinflation of the lungs, which in the long term also causes blood pressure to rise and damages the heart. If chronic obstructive bronchitis and emphysema occur at the same time, it is called COPD.
Causes
The cause of chronic bronchitis is mostly pollutants that enter the lungs. In the first place, smoking is to be mentioned here. The tar contained in cigarettes causes the cilia to stick together and thus promotes inflammatory processes in the lungs. In addition to smoking, pollutants in the air can also trigger chronic bronchitis. Fine dust, vapors, and gases can severely impair the respiratory system. In addition, a genetic predisposition and a weak immune system with the consequence of frequent infections in the wet and cold season also play a role. In up to ninety percent of cases, however, the occurrence of chronic bronchitis can be traced back to years of intensive smoking.
Symptoms, complaints and signs
Chronic bronchitis is the most common lung disease, which mostly affects male smokers around the age of 40. Chronic bronchitis is particularly noticeable by so-called productive coughing, namely when mucus is secreted during coughing. In the case of an infection, this mucus is often yellowish-purulent or bloody. If it is particularly viscous, a doctor should be consulted as soon as possible. Productive coughing is particularly intense in the morning. In most cases, chronic bronchitis hardly or very rarely affects shortness of breath. However, if left untreated for a long time, it can cause shortness of breath and sometimes morning headaches. Shortness of breath is often the cause of loss of body weight, decrease in performance as well as weakness. During physical exertion, the shortness of breath often leads to acute [[[oxygen deficiency|oxygen hypoxia]] and a very rapid breathing rhythm, also known as tachypnea. This is quickly evident by the blue discoloration of the lips and nail beds. Other symptoms of chronic bronchitis include increased resistance to flow in the pulmonary vessels, which can cause significant stress on the heart. In late stages of this bronchitis, the stresses on the heart can be seen in edema of the legs as well as congested neck vessels.
Diagnosis and course
The diagnosis of chronic bronchitis is understood as the interaction of specific examinations combined with a conversation between the doctor and the patient. Because the symptoms of cough, sputum, and shortness of breath also allow for other clinical pictures, such as asthma, questioning the patient about his or her habits and living conditions is particularly important. Listening to the lungs for lung sounds, a lung function test as well as an X-ray examination and an electrocardiogram, ECG for short, allow further differentiation from other respiratory diseases. In addition, a blood test, in which the blood is tested for an oxygen deficiency characteristic of chronic bronchitis, leads to clarity. If chronic bronchitis is still in its early stages, a complete cure is possible.If an existing condition is suspected, a physician should be consulted as soon as possible to avoid more extensive and long-term damage such as emphysema, lung cancer, or pneumonia.
Complications
Several complications can occur in association with chronic bronchitis. Patients with simple chronic bronchitis who do not avoid the triggering toxins, such as tobacco smoke, gases, dusts, or fumes, are most likely to experience complications. Chronic bronchitis then often progresses to stage 2, which is chronic obstructive bronchitis. At this stage, the bronchial tubes are permanently constricted, and there is shortness of breath and a drop in performance. As the disease progresses, chronic bronchitis can progress to stage 3. In this case, the lungs become overinflated, resulting in what is known as pulmonary emphysema. Pulmonary emphysema can cause complications to the heart. With an overinflated lung, the blood pressure in the pulmonary vessels increases. Consequently, the heart becomes overworked and weakened. Heart failure may result. Chronic bronchitis can lead to lung cancer (bronchial carcinoma). In addition, chronic bronchitis can cause pneumonia and purulent bronchitis. In chronic bronchitis, bronchial tubes can leak, and so-called bronchiectasis forms. Other complications associated with chronic bronchitis include metabolic syndrome and osteoporosis. Patients with chronic bronchitis may be particularly susceptible to infections.
When should you see a doctor?
Chronic bronchitis is a very serious condition that should always be treated by a doctor. While bronchitis itself is usually more annoying than dangerous, it can lead to very serious complications if left untreated. A common cause of the chronic course of bronchitis is a cold that has been carried over, the flu that has not been properly cured, or heavy smoking. A chronic course of the disease can often be prevented if the patient goes to the doctor in time. Anyone who repeatedly catches a cold within short intervals, suffers for days from a severe cough that does not improve or is accompanied by viscous sputum, should not try to treat these symptoms alone with the help of over-the-counter medications. Professional medical help should always be sought at the latest if the symptoms do not subside or even worsen after three or four days. Smokers should also not simply dismiss a constant irritating cough as harmless. If left untreated, it can very quickly develop into bronchitis or another disease. Smokers should therefore always consult a doctor promptly at the first signs of problems with the lungs and respiratory tract.
Treatment and therapy
Chronic bronchitis is treated by avoiding harmful substances. Smoking should be given up. Passive smoking in company is also harmful in chronic bronchitis and should be avoided. In addition, it is advisable to prevent infections, which can put additional strain on the bronchial tubes. Many patients find a stay by the sea or in the mountains to be relieving. In addition to avoiding harmful substances, chronic bronchitis can be treated with medication. Antibiotics, expectorant drugs and drugs to dilate the bronchial tubes are used here. The goal of drug treatment is, on the one hand, to combat newly occurring infections as quickly as possible, as well as to alleviate existing symptoms of chronic bronchitis.
Outlook and prognosis
The prospects of recovery from chronic bronchitis depend on the strength of the immune system, the patient’s lifestyle, and medical care. With absolute abstinence from nicotine, cure is possible in many cases. Inhalation of other pollutants such as exhaust fumes or toxins from the craft sector as well as building utensils must also be completely avoided for a good prognosis. If comprehensive and good treatment takes place, the patient of chronic bronchitis can achieve freedom from symptoms. However, if obstruction occurs, there is a risk of developing COPD. This is a chronic lung disease with constriction. The disease is associated with a decrease in overall life expectancy. If chronic bronchitis spreads further, the cells of the airways and lungs are permanently damaged.This means that a cure is only possible to a limited extent. Due to the damage to the cells on the cell walls, emphysema can develop with lifelong health impairments. Chronic bronchitis often leads to other diseases in people with compromised health. With a weakened immune system, susceptibility to infection increases sharply. There is also an increased incidence of osteoporosis or heart failure. Thus, the general health of the patient is largely responsible for a prognosis outlook of chronic bronchitis.
Prevention
The most effective prevention of chronic bronchitis is to avoid smoking and pollutants. Strengthening the respiratory system, such as with inhalations, can be equally helpful. Basically, a strong immune system is important, which can be achieved through a healthy diet as well as adequate sleep and plenty of exercise. To avoid serious infections, a flu vaccination is useful.
Follow-up
Once chronic bronchitis is under therapy and the patient is stabilized to that extent, there are some important things to keep in mind for aftercare and prevention. For example, it is essential to avoid exposing the patient to high levels of pollutants. These include fine dust pollution (high traffic volume in inner cities), work with emitting substances (paints, varnishes, disinfectants) and, of course, smoking. The patient should stay away from parties with a smoking audience or avoid the area exposed to smoke. Passive smoking is as harmful as active smoking. Further infections of other kinds should also be avoided at all costs. In addition to avoiding exposure to pollutants, precautionary medication can also be taken in consultation with the attending physician. Mucolytic agents, antibiotics and drugs to dilate the bronchial tubes are the drugs of choice here. In particular, the aim is to prevent a new infection or to combat it in a targeted and timely manner. Relief of the acute symptoms of existing chronic bronchitis are also a priority here. The famous “air exchange” is a therapeutic tool that should not be underestimated, especially in the case of chronic bronchitis. Visits to the seaside with the beneficial salty air contribute to the well-being of the patient. The same can be achieved with a longer stay in clear mountain air. It is important to note that chronic bronchitis weakens the patient’s immune system and may result in further infections.
What you can do yourself
Self-help measures for chronic bronchitis depend on the stage of the disease. If the bronchial tubes are already too severely damaged (collapsed, spastically constricted or degenerated) due to continuous stress, self-help measures can at best have a palliative effect. This includes, for example, expectorants and antispasmodics. Steam inhalations, sprays and candies containing sage, and rubbing the chest and throat with pungent essential substances such as mint oil or eucalyptus oil have proven effective here. Treatment with homeopathic remedies can provide complementary relief, but cannot replace regular treatment. The choice of remedies depends on the ailment. However, the progression of chronic bronchitis can be slowed down and in rare cases stopped. In addition to the unconditional renunciation of cigarettes and the avoidance of other harmful substances, breathing techniques are particularly helpful. The so-called lip-brake is the best known of these. Other breathing techniques can be learned with or without the help of an appropriate therapist and may also include technical support. In this way, the bronchi can be kept open for a longer period of time, which favors the cleansing and thus relief of the same. It also strengthens the respiratory muscles. Regular walks in the fresh air and sporting activities that promote lung volume should – despite the symptoms of stress – be integrated into everyday life by those affected. Lung sports groups can be found in many places.
