Chronic Bronchitis

GENERAL INFORMATION:

What is chronic bronchitis? Chronic bronchitis (brong-KEYE-tis) is a long-term disease of the lungs. Chronic bronchitis is one of a group of lung diseases called COPD, or chronic obstructive pulmonary disease. Bronchitis is an inflammation (swelling) of the lining of the air passages in your lungs. The inflammation causes more mucus (sputum) than normal to be made in the lungs. Swelling and increased mucus causes air flow through the lungs to become partly blocked. The irritation may also damage your lungs. This lung damage often gets worse over time, and it usually cannot be reversed (cured). People with chronic bronchitis may later get another chronic obstructive pulmonary disease called emphysema as well.

What causes chronic bronchitis?

• Smoking or being around smokers: Cigarette smoking causes most cases of COPD, including chronic bronchitis. Other types of smoke, such as pipe and cigar smoke, can also cause COPD. The more you smoke, the more damage you do to your lungs. Children of heavy smokers also have an increased risk of having chronic bronchitis later in life. People who do not smoke but who live or work around the smoke of others may get chronic bronchitis.
  
  
• Exposure to things that irritate your lungs: Working around some dusts and fumes (gases) can damage your lungs over time. Living in an area that has heavy air pollution also increases your risk of lung problems. Living or working around dusts, fumes, or pollution when you have chronic bronchitis can make your illness worse. Lung irritants that may cause chronic bronchitis over time include:
  
  
  • Working around smoke from burning structures or grasses on a regular basis.
    
    
  • Fumes from chemicals, such as ammonia or chlorine.
    
    
  • Dusts, such as coal dust, grain dust, or dust from metals.
  
  
• Frequent lung infections: Having very frequent lung infections may damage your lungs over time.
  
  
• Family history of COPD: You may be more likely to get a lung disease if someone else in your family had one.
  
  
• AAT deficiency: Alpha-1 antitrypsin, or AAT, is a protein found in blood that helps protect your lungs from damage. A deficiency (lack) of AAT can greatly increase your risk of lung problems, including COPD. AAT deficiency is a rare genetic (inherited) problem that can be treated. If someone in your family had lung problems at an early age, tell your caregiver.

What are the signs and symptoms of chronic bronchitis?

• Early signs and symptoms: At first, chronic bronchitis may have few symptoms. You may have a morning cough that brings up mucus from the lungs. Smokers may mistake this cough for a "normal smoker's cough". (A smoker's cough is never "normal" and may mean that your lungs are already damaged by smoking.) You may have shortness of breath (trouble breathing). As time passes, the amount of mucus coughed up from your lungs begins to increase. The cough also starts to last longer during the day. Some people may have a runny nose, or have headaches and feel like their nose is blocked (sinus congestion). Some people may have a bad taste in their mouth or bad breath.
  
  
• Later signs and symptoms: As chronic bronchitis worsens over time, you may notice more symptoms. Your skin, nail beds, or lips may turn dusky or blue. You may become more short of breath and get tired more easily. You may not be able to walk as far as you used to. At times, you may make a high-pitched noise when you breathe, which is called wheezing. You may notice your breathing is faster than it used to be.
  
  
• Signs and symptoms of heart problems: Advanced (very bad) chronic bronchitis may lead to heart problems. This happens when the heart has to work harder because of the damage to your lungs. You may get swelling in your ankles, legs, or abdomen (belly). You may have blood pressure problems or chest pain. Keep all appointments with your caregiver so that any new problems with your heart or lungs can be found and treated early.

What is an exacerbation of chronic bronchitis?

• When a person has COPD, they may have times where their symptoms get worse very quickly. These are called exacerbations (eg-zas-er-BAY-shuns). Exacerbations of chronic bronchitis can be triggered (started) by infections such as colds or the flu. Being around lung irritants such as air pollution, dusts, fumes, or smoke can also trigger an exacerbation. Other medical conditions, such as heart problems or infection elsewhere in the body, can make your breathing problems worse. Exacerbations of chronic bronchitis can be serious, even life threatening.
  
  
• The main symptom of a chronic bronchitis exacerbation is increasing shortness of breath. Other symptoms include coughing up more mucus than usual, or mucus that is a different color than usual. Exacerbations of chronic bronchitis need to be treated as soon as possible. If you have increasing trouble breathing, signs of an infection, new confusion (trouble thinking), or new chest pain or pressure, see a caregiver right away.

How is chronic bronchitis diagnosed? Your caregiver may ask you many questions about your work, lifestyle, and the signs and symptoms you have. Your caregiver will examine you and listen to your heart and lungs through a stethoscope. You may need tests such as blood tests or a chest x-ray. You may need an EKG test to check your heart. Pulmonary function tests may also be needed. Pulmonary function tests are also called lung function tests. These tests measure how well your lungs can take in, hold, and use air. Spirometry is a type of lung test used to help diagnose chronic bronchitis.

How is chronic bronchitis treated?

• The most important thing you can do to help your bronchitis is to stop smoking. Other treatments may be needed to help you feel better and to keep your lungs as healthy as possible. You may need to see a special lung doctor called a pulmonologist. You may need special caregivers to help you learn about such things as a healthy diet, exercise, and activity planning.
  
  
• You may need to sleep with your upper body elevated (raised) to help you breathe more easily. You may need to learn special breathing exercises, such as pursed-lip breathing. You may need medicines to help you breathe easier. These may include inhalers, oxygen, and steroids. Always follow the directions given to you by your caregiver when using oxygen and taking medicines.
  
  
• During exacerbations, you may need to go into the hospital for tests or treatments. Always call your caregiver at the first sign of illness, such as a cold or the flu. You may need special treatment to prevent a serious lung infection, such as pneumonia. Rarely, surgery (such as a lung transplant) is done for people with severe COPD.

Risks: The risks of chronic bronchitis depend on how bad your bronchitis is and your general health. As chronic bronchitis gets worse over time, you may have pain, trouble sleeping, or anxiety. You may need to use oxygen to help you breathe. You may lose too much weight. Having COPD may increase your risk of having lung cancer. Smoking also increases this risk, and increases the risk of your bronchitis getting worse. Lung infections in people with chronic bronchitis may be life threatening.

For more information:

• Chronic bronchitis is a life-changing disease for you and your family. Accepting that you have chronic bronchitis is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Let them help you. Encourage those close to you to talk to your caregiver about how things are at home. Your caregiver can help your family better understand how to support a person with chronic bronchitis.
  
  
• You may also want to join a support group. This is a group of people who also have chronic bronchitis or other kinds of COPD. Ask your caregiver for the names and numbers of support groups near you. You may also contact the following for more information:
  • American Lung Association
    61 Broadway, 6th floor
    New York City, NY 10006
    Phone: 1-800-586-4872
    Web Address: http://www.lungusa.org
    
  • Centers for Disease Control and Prevention
    1600 Clifton Road
    Atlanta, GA 30333
    Phone: 1-404-6393311
    Phone: 1-800-3113435
    Web Address: http://www.cdc.gov
    

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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