Similar to chronic bronchitis, chronic obstructive bronchitis is a chronic lung disease. Obstructive here means that the bronchial tubes are narrowed. As a result, the main symptoms are cough, shortness of breath, and sputum.
What is chronic obstructive bronchitis?
Chronic obstructive bronchitis refers to a permanent (chronic) lung disease that causes narrowing (obstruction) of the airways. The diameter of the bronchioles contained in the lungs is regulated by parasympathetic (nerves) and sympathetic (nerves) nervous systems. The parasympathetic nervous system constricts the bronchioles, while the sympathetic nervous system expands them. However, dysregulation (smoking, chemical vapors) can also occur, causing the bronchial muscles to tighten more, making breathing more difficult. At first there is a “normal” chronic bronchitis, which is then increased to chronic obstructive bronchitis with the symptom of acute shortness of breath. This disease is not contagious, but also cannot be completely reversed by any treatment. In the later stages of the respiratory disease, cilia are destroyed and the mucosa of the small alveoli is damaged. Therefore, the alveoli continuously increase in instability during exhalation and collapse. The inflamed bronchial mucosa thickens and has a narrowing effect on the airways.
Causes
Triggers of chronic obstructive bronchitis can be observed to be regular smoking, and less commonly, air pollutants such as dust, chemical fumes, and gases. Passive smoking can also lead to severe diseases of the lungs. In addition, a congenital weakness of connective tissue or reduced resilience of the respiratory tract promote the transition from chronic- to chronic obstructive bronchitis.
Symptoms, complaints, and signs
In this disease, patients suffer from a number of different respiratory symptoms. As a result, the patient’s quality of life is significantly reduced and restricted, so that there are also severe limitations in the daily life of the affected person. Patients mainly suffer from a strong cough, which is also associated with sputum. The cough occurs without any particular reason and, above all, is permanent. Shortness of breath may also occur. Shortness of breath can also occur during sleep, leading to sleep problems. Likewise, many patients suffer from increased blood pressure and may also die of a heart attack in the process. If the disease is not treated, it usually leads to pneumonia, which can also lead to death. Especially in smokers, the symptoms can be severe. Many sufferers also appear tired and fatigued and can therefore no longer actively participate in everyday life. Without treatment, the life expectancy of the affected person is also honestly reduced. Likewise the illness can lead to strong psychological complaints. The capacity of the lungs decreases significantly in the process, so that in severe cases it can lead to gasping for breath.
Diagnosis and course
Chronic obstructive bronchitis is manifested primarily by sputum, cough, and shortness of breath. Initially, the symptoms resemble those of chronic bronchitis. There is a persistent irritating cough with sputum (white or green-yellow in the case of bacterial infection), which initially appears only under stress, in the case of more severe disease also at rest. This is exacerbated by acute shortness of breath. In the further course of the respiratory disease, a pathological overinflation of the lungs (pulmonary emphysema) develops, which causes permanent damage to the lungs. Increased blood pressure develops via the emphysema in the pulmonary vessels, which ultimately chronically damages and weakens the heart (cor pulmonale, right heart failure). The most common complications are bronchial infections and pneumonia. Diagnosis begins with taking the history of the disease,with pulmonary function diagnostics (vital capacity (maximum voluntary capacity of the lungs to hold air). Two-thirds of the air is exhaled in the first second, and the rest in one to two more seconds. If the person being examined can exhale less than two-thirds of the vital capacity, the bronchi are already more or less constricted), allergy diagnostics and further blood tests in the laboratory. A more precise determination can be made by whole-body plethysmography (measurement of the resistance that the airways offer to the inhaled and exhaled air).A pulmonologist may also develop other diagnoses.
Complications
Chronic obstructive bronchitis, as is often the case with smokers, can end in several serious complications. First, bronchitis causes constant secretions. This increases the risk of infection by bacteria, which can worsen the clinical picture (exacerbation). In some cases, there may be an accumulation of air in the alveoli (air sacs). This can cause them to overinflate, resulting in emphysema. As a result, the alveoli can burst and the air escapes into the pleural space. This can cause a pneumothorax to develop. The heart is also overloaded by the emphysema, since due to the overinflation the pulmonary vessels are compressed, so that the heart has to apply a higher pressure to ensure the blood flow. This can then develop into heart failure of the right heart (right heart failure). A further complication is the development of edema, especially in the lower extremities. The combination of chronic bronchitis and emphysema is also called COPD (chronic obstructive pulmonary disease). In this case, life expectancy is reduced by five to seven years. Chronic bronchitis also means that the affected person is more frequently exposed to toxins in the ambient air. These can damage the bronchial tubes. In addition, the risk of developing lung cancer is increased in this case.
When should you go to the doctor?
With cough, sputum, shortness of breath and other signs of chronic obstructive bronchitis, a doctor should always be consulted. It is even better to already have chronic bronchitis medically clarified and treated. A visit to the doctor is recommended at the latest when the typical shortness of breath is noticed. Fever, a feeling of tightness in the chest and increasing sputum are also medical emergencies that must be treated immediately. In the event of an acute emergency – i.e. shortness of breath and circulatory collapse – the emergency medical services must be alerted. It may be necessary to ventilate the affected person until the doctor arrives. If chronic obstructive bronchitis is not adequately treated, complications such as right heart failure or lung cancer can occur – both serious conditions that require inpatient treatment. Smokers and patients with chronic respiratory infections are particularly susceptible to the disease. Anyone who belongs to these risk groups is best advised to consult their family doctor if they experience any of the symptoms mentioned above. Other contacts are the pulmonary specialist, an internist or the ENT physician.
Treatment and therapy
The first and most important treatment is to stop smoking. This, of course, applies only to actual smokers. Otherwise, very “dusty” activities (dusting, vacuuming) should be performed only with a respiratory mask on. Active exercise can stop the progression of chronic obstructive bronchitis, but not prevent it. It improves the physical resilience and thus also the quality of life of the patient. In special training sessions, the patient can learn how to properly manage the prescribed medication and live normally with the disease. These are also steps to stabilize the functioning of the lungs. In very severe cases, mucus may need to be aspirated or the patient may need to be artificially ventilated. However, this can be prevented by timely prophylaxis. To facilitate breathing, an application for a cure at the seaside is recommended.
Outlook and prognosis
The prognosis in chronic obstructive bronchitis does not allow for any prospect of cure. However, the course can be highly variable. It is true here that a complete lack of treatment promotes a negative course. In addition, rapid intervention is relevant in the case of secondary and concomitant diseases. Life expectancy may be shortened to a greater or lesser extent. Continued smoking will strengthen the damage caused by the disease and accelerate the course of the disease. The affected person’s shortness of breath may increase as the disease progresses, usually due to further narrowing of the airways. Chronic obstructive bronchitis thus also triggers rest stress in some patients. Overloading of the right part of the heart can be the result and can lead to water retention, cardiac arrhythmias and an enlarged ventricle.The persistent inflammation of the airways causes more and more small bronchial tubules and alveoli to perish. The result is emphysema. A worsening episode can be caused by a variety of factors, including bacterial or viral infections (the susceptibility to infections also increases with the duration of the disease) and a sudden increase in the workload on the lungs. Such an aggravation can leave traces and permanently cause a deterioration of the health condition, which is manifested in an intensification of all the symptoms associated with chronic obstructive bronchitis. Financially and psychologically, the disease can also become a burden, as it can lead to missed work, secondary illnesses and depressive moods.
Prevention
Chronic obstructive bronchitis develops only when conditions are favorable for it. That is why it is possible to prevent the disease very well. In the event that bronchitis was often present in childhood, one should refrain from smoking in later years. Also, do not choose a job that exposes you to dusts, gases or vapors. If this is the case, preventive examinations and appointments of this kind should be attended in any case. Sufficient hardening through cold showers and enough exercise is helpful. In centrally heated rooms, complete room humidification, preferably germ-free, should be provided.
Aftercare
Follow-up care and prevention are closely linked in chronic obstructive bronchitis. Essentially, the goal is to eliminate all factors that can further damage the bronchial tubes, either completely or at least as best as possible. Smoking is an important factor in this context. In the case of nicotine dependence, the patient may need professionally assisted withdrawal. Paints and varnishes as well as other substances that could emit toxic or other harmful vapors should also be avoided as far as possible. This explicitly applies not only to the private but also to the professional context. In order to be able to easily cough up mucus, which is often associated with chronic obstructive bronchitis, when it occurs, it is ideally liquefied. This means that the patient should make sure to drink a sufficient amount of fluids. Still water and herbal teas are particularly suitable here. An infection should be avoided by all means. This includes all measures that strengthen the immune system, but also avoiding contact with people who are currently suffering from an acute infection. Air exchange is recommended in many cases for patients with chronic obstructive bronchitis. For example, the salty air of the North Sea and Baltic Sea is often the ideal setting for optimal aftercare. The mountains with their pure and low-pollen air are also well suited for a stay.
What you can do yourself
Sufferers of chronic obstructive bronchitis can relieve the suffering with measures they can carry out themselves. This applies in particular to acute coughing attacks and the risk of the onset of shortness of breath. For example, smoking should be avoided at all costs. Dust, chemical vapors and other sources of irritating particles should be avoided. If necessary, certain areas should be entered only with a respirator. While cough with sputum can be considered positive in some cases, dry cough is merely agonizing and unproductive. To alleviate and also avoid this, sufferers can resort to inhalations with steam. Breathing through the nose with the mouth closed also calms the bronchial tubes with the warmer air. Throat lozenges with herbal remedies can have an expectorant, sedative or even slightly paralyzing effect on the bronchial tubes – which substances may be used should be clarified with the attending physician. Sufferers should try to maintain or improve their breathing and performance despite chronic obstructive bronchitis. Better breathing can be achieved, for example, by practicing lip-blocking, by targeted breathing training – also with the aid of technical equipment – and by lung sports. However, the type of sport that is suitable must be clarified with the doctor in view of the secondary symptoms of the disease (heart failure, lung cancer, etc.). In addition, special techniques relating to breathing and posture can greatly facilitate expectoration.
