Unlike acute bronchitis that lasts for a short period, chronic bronchitis occurs at least three months a year for at least two years in a row.
Chronic bronchitis falls under the umbrella of chronic obstructive pulmonary disease (COPD). COPD is a group of lung diseases that block airflow and create ongoing breathing-related problems.
Symptoms
Symptoms often start out mild and get worse over time.
Symptoms can include:
A persistent cough that usually produces mucusWheezingShortness of breath (especially with physical activity)A whistling or squeaky sound when breathingChest tightness/discomfortFrequent respiratory illnesses such as cold or flu (in some people)Recurring morning coughPostnasal drip or sinus congestionBad breathTrouble taking a deep breath
Symptoms of severe chronic bronchitis include:
Weight lossWeakness in lower musclesSwelling in ankles, feet, or legsBluish fingernails, lips, and skin because of lower oxygen levelsWheezing and crackling sounds with breathingHeart failure
Causes
Exposure to cigarette and other tobacco smoke is the main cause of chronic bronchitis. At least 75% of people who have chronic bronchitis smoke or used to smoke. Secondhand smoke can also contribute to chronic bronchitis.
Your symptoms are more severe or prolonged than your usual day-to-day COPD symptoms. You have extreme shortness of breath. You have chest pain. You become agitated, confused, or drowsy.
Other risk factors include:
Long-term exposure to irritants such as air pollution or work/environmental hazards (chemical fumes, dust, etc. ) Being over age 40 A family history of COPD Alpha-1 antitrypsin deficiency (a genetic condition) Frequent respiratory illnesses and infections
Diagnosis
To diagnose chronic bronchitis, a healthcare provider will do a physical examination that usually includes:
A discussion about symptomsGetting a personal and family health historyQuestions about lifestyle, work, environment, etc. Listening to the lungs and other body examinations
Diagnostic tests may also be run.
Pulmonary Function Tests
These tests use tools or devices that you breathe into to measure the lungs’ ability to move air in and out of the lungs.
They may include:
Spirometry: A spirometer device is used in-office to measure how much air is inhaled, how much is exhaled, and how quickly you exhale. Peak flow monitor: This measures the fastest speed you can blow air out of your lungs.
Other Tests for Chronic Bronchitis
Other tests and procedures that may be used in diagnosing chronic bronchitis include:
Arterial blood gas: A blood test used to check the amount of oxygen and carbon dioxide in the blood and the acidity of the blood Pulse oximetry: Involves a small sensor taped or clipped onto a finger or toe that measures the amount of oxygen in the blood Chest X-ray: Takes pictures of the chest, lungs, and other tissues to look for abnormalities CT scan: A combination of X-rays and computer technology used to make images of the body that are more detailed than an X-ray alone
Treatment
First and foremost, treatment for chronic bronchitis begins with removing the exposure to the irritant or irritants causing the problem. In most cases, this is tobacco smoke such as cigarettes.
Chronic bronchitis cannot be cured, but it can be managed.
Lifestyle Changes
Quit smoking (if you are a smoker). Avoid secondhand smoke and other lung irritants (this may mean a change in housing, job, or other environmental factors). Consult with a healthcare provider about a nutritious meal plan and how to safely exercise for overall health benefits.
Medications
Medications for chronic bronchitis include:
Bronchodilators
Usually taken through an inhaler, these medications relax the muscles around the airways, which opens the airways and makes breathing easier. The inhaler may also contain steroids to reduce inflammation in more severe cases.
One type of bronchodilator, beta-adrenergic agonists, comes in short-acting form and long-acting form.
Types of short-acting beta-adrenergic agonists include:
Ventolin, Proair, Proventil (albuterol)Xopenex (levalbuterol)MetaproterenolBricanyl (terbutaline)
Types of long-acting beta-adrenergic agonists include:
Salmeterol (a component of Advair)Performomist (formoterol)Arcapta (indacaterol)Brovana (arformoterol)
Symbicort is a two-in-one medication that combines formoterol with an inhaled corticosteroid known as budesonide.
Vaccines
People with chronic bronchitis should get the flu and pneumococcal pneumonia vaccines to help avoid the serious problems of these diseases for which they are at higher risk.
Antibiotics
While not used to treat chronic bronchitis directly, antibiotics can be used to treat a lung infection that can be triggered by or aggravate chronic bronchitis.
Oral Medications
Oral medications are sometimes prescribed to open airways and help clear away mucus.
Oxygen Therapy
Oxygen therapy is also known as oxygen and supplemental oxygen.
Oxygen therapy involves oxygen being administered through tubes resting in the nose, a face mask, or a tube placed in the trachea (windpipe). The goal of oxygen therapy is to increase the amount of oxygen the lungs receive and deliver to the blood, thus increasing blood oxygen levels in people whose blood oxygen is too low.
Oxygen therapy can be administered in the hospital or given at home, depending on needs and accessibility. It can be for short-term or long-term use.
The oxygen is supplied either from a storage tank that is filled professionally and delivered or using a device called an oxygen concentrator, which uses oxygen in the air.
Pulmonary Rehabilitation
Pulmonary rehabilitation is a supervised program for people who have lung conditions or breathing problems.
The program may include:
Exercise trainingHealth educationBreathing techniquesDisease management trainingNutritional counselingPsychological counseling
Pulmonary rehabilitation can be done in the hospital or a clinic, or physical therapy and/or breathing exercises may be done at home.
Activity monitors or smartphone-based lessons or monitoring may also be used.
The personal pulmonary rehabilitation plan is tailored to your needs by a team of healthcare professionals.
Lung Transplant
This procedure, which involves replacing diseased lungs with healthy donor lungs, can be used as a last resort for people who have severe chronic bronchitis.
Prognosis
Although chronic bronchitis/COPD cannot be cured, quality of life can be improved through symptom management.
Outlook for the future depends on the symptoms, the severity of the condition, how well the lungs are working, and response and commitment to the treatment plan.
Coping
In addition to a medical treatment plan, ways to help manage chronic bronchitis at home include:
Exercise: Start slow and build up, aiming for at least 2. 5 hours of physical activity a week. Always check with your healthcare provider before starting or increasing new physical activities. Breathing techniques: For example, breathing through pursed lips can help reduce shortness of breath. Develop healthy eating habits: Regular, healthy meals are important for overall health. Using bronchodilators about an hour before eating can make it easier to eat. Eating several small meals instead of three large ones may be easier on your body. Save beverages until the end of the meal, and avoid foods that are hard to chew.
A Word From Verywell
Without proper treatment, chronic bronchitis can worsen and greatly impact your quality of life.
Thankfully, although it can’t be cured, treatments such as medications, oxygen therapy, and pulmonary rehabilitation can help keep symptoms at bay and allow you to continuing doing the things you love.
If you think you might have chronic bronchitis, it is important to see a healthcare provider promptly to slow the progression of the condition.
The best thing you can do to both prevent and treat chronic bronchitis is to quit smoking (or never start) and avoid others when they are smoking.
