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Chronic Bronchitis

Chronic bronchitis is an inflammation of the main air passages (bronchi) to the lungs, which results in the production of excess mucous, a reduction in the amount of airflow in and out of the lungs and shortness of breath.

In chronic bronchitis, there is excessive bronchial mucus with a productive cough for three months or more over two consecutive years without any other disease that could account for these symptoms.

In the early stages of chronic bronchitis, a cough usually occurs in the morning. As the disease progresses, coughing persists throughout the day. This chronic cough is commonly referred to as "smoker's cough."

Also In the early stages of chronic bronchitis, only the larger airways are affected, but eventually all airways are involved. Over time the patient experiences abnormal ventilation-perfusion: insufficient oxygenation of blood (hypoxemia), labored breathing (hypoventilation) and right-sided heart failure (cor pulmonale).

Compared with acute bronchitis, which may respond quickly to medications, such as antibiotics, chronic bronchitis can be difficult to treat because many patients with chronic bronchitis are susceptible to recurring bacterial infections. 

Excessive mucous production in the lungs provides a good environment for infection, which also causes inflammation and swelling of the bronchial tubes and a reduction in the amount of airflow in and out of the lungs.

Therefore, at the first signs of a lung infection, people with chronic bronchitis should seek immediate medical treatment. Waiting until an infection is well established, usually leads to hospitalization and long intensive care (ICU) stays. 

In the later stages of chronic bronchitis, the patient cannot clear this thick, tenacious mucus, which then causes damage to the hair-like structures (cilia) that help sweep away fluids and/or particles in the lungs. This in turn impairs the lung's defense against air-borne irritants.

Cigarette smoking is the most common cause of chronic bronchitis. People who have been exposed for a long time to irritants, like chemical fumes, dust and other noxious substances, can also get chronic bronchitis. 

As chronic bronchitis often coincides with emphysema, it is frequently difficult for a physician to distinguish between the two. Chronic bronchitis also can have an asthmatic component.

Lying down at night can worsen the condition, so some people with advanced chronic bronchitis must sleep sitting up. In late, severe stages people who often have emphysema as well, are called "blue bloaters" because lack of oxygen causes the skin to have a blue cast (cyanosis) and because the body is swollen from fluid accumulation caused by congestive heart failure.

There is no cure for chronic bronchitis. Treatment is aimed at relieving symptoms and preventing complications. 


Last modified: January 25, 2011

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