Chronic Bronchitis

What is chronic bronchitis?

Chronic bronchitis is a chronic (long term) inflammatory condition in the lungs that causes the respiratory passages to be swollen and irritated. It also increases mucus production and may damage the lungs. The symptoms are coughing and breathlessness, which will get worse over the years.

When lung damage results in airflow restriction, the term 'COPD' (chronic obstructive pulmonary disease) is used. The term ‘chronic bronchitis’ tends not to be used anymore, and is instead included within the ‘COPD’ diagnosis.

Why does a person get chronic bronchitis and COPD?

Smoking is the most important cause of chronic bronchitis. Air pollution and allergy can also make chronic bronchitis worse. The seriousness of the disease depends on how much and for how long a person has been smoking.

What does chronic bronchitis feel like?

The usual symptoms of chronic bronchitis are;

  • Coughing a lot, usually every day
  • Getting easily short of breath
  • Producing thick, often coloured sputum (phlegm or mucus) that is thick and difficult to cough up

What can I do to help myself?

  • If you smoke, quit. This is the best  action you can take to improve the health of your lungs. It is never too late to quit - your doctor or pharmacist can provide advice on smoking cessation (quitting smoking) products and techniques
  • Avoid irritations in your surroundings, such as smoke
  • Make sure any lung infections are treated immediately
  • Avoid passive smoking

How can the doctor tell if I have COPD?

Some other lung and heart diseases give the same symptoms as COPD so X-ray examinations, lung function tests, ECG, and blood samples may be necessary to make an exact diagnosis and assess the severity of the condition.

What's the difference between chronic obstructive pulmonary disease and asthma?

Although asthma and COPD cause similar symptoms, they are different diseases;

In COPD there is permanent damage to the airways. The narrowed airways stay that way, and so symptoms are chronic (persistent). Treatment to open up the airways is therefore limited. In asthma there is inflammation in the airways which makes the muscles in the airways constrict. This causes the airways to narrow. The symptoms tend to come and go, and vary in severity from time to time. Treatment to reduce inflammation and to open up the airways usually works well.

COPD is more likely than asthma to cause a chronic cough with phlegm.

Night time waking with breathlessness or wheeze is common in asthma but uncommon in COPD.

COPD is rare before the age of 35 whilst asthma is common in under-35s.

There is also more likely to be a history of asthma, allergies, eczema and hay fever in people with asthma.

How can I make my life a bit easier?

Again, the most important thing you must do is quit smoking. If you live in an area with heavy air pollution, try to do all you can to avoid or reduce the risk from this. Avoid sudden temperature changes or cold, moist weather. It is important to try and keep active so take regular walks or other exercise.

Those with known COPD who continue to smoke suffer a more rapid decline in their lung function than those who stop completely. The message is clear – smoking is extremely bad for your health, but it is never too late to stop however old you may be.

Medication for COPD

The main drive in COPD treatment is of prevention rather than cure. It is important to maintain a positive attitude to treatment of COPD. Although it is not curable it can often be improved, and anyone with COPD always deserves a full trial of potential treatments. The difference between COPD and asthma, is that in asthma the airway obstruction is reversible with treatment, whereas in COPD it is largely irreversible. However, this small degree of reversibility in COPD can be exploited in treatment, for example by using drugs also of benefit in asthma such as bronchodilators (beta-agonists and anticholinergics).

People with moderate to severe COPD should be seen by a specialist in chest medicine with a view to establishing if they will benefit from steroid therapy, either by inhaler or by mouth, or from other drugs such as oral theophylline.

COPD patients are also prone to have short-term exacerbations (worsening) of their condition, during which they feel more breathless. These exacerbations are generally the result of lung infections so usually need treatment with antibiotics. COPD patients should take advantage of annual vaccinations against influenza as well as ensuring they have had a vaccination against pnemococcal infection which is recommended for anyone with COPD aged 65 or over. For those patients who have become severely limited by COPD, home oxygen treatment may be required.

COPD does occur in non-smokers but the vast majority of sufferers smoke, and their likelihood of developing the disease is related to the amount they smoke. There is an extra factor – that of individual susceptibility – which cannot be predicted in advance.