Chronic bronchitis
introduction
Chronic bronchitis was defined by the WHO (World Health Organization) as follows: Chronic bronchitis is present if a productive cough (that is, with sputum) for at least three months consists. In addition, the Symptoms have persisted for at least two consecutive years. This means that the diagnosis of chronic cough can only be made after 6 months at the earliest.
In general, chronic bronchitis is a chronic one permanent inflammation of the bronchi. As part of the lungs and airways, the bronchi are used to carry air into them Pulmonary alveoliwhere the Gas exchange of oxygen and carbon dioxide. They are covered by a special layer of cells called the Ciliated epithelium.
This ciliated epithelium is used to transport foreign bodies and germs from the lungs to the throat in order to keep the lungs too clean. By Cigarette smoke or other poisonous gases, the mucous membrane in the airways is excessively irritated and inflamed. As a result, the ciliated epithelium can no longer fulfill its task of cleaning the lungs. This leads to an even stronger inflammatory reaction and thus to chronic bronchitis with mucus production, which constant urge to cough caused.
In the past, significantly more men than women were affected by chronic bronchitis. At the moment it is Ratio still 3: 1although the proportion of women is steadily increasing. This is because the Smoke is one of the main causes of chronic bronchitis. Since significantly more men than women smoked in the past, it was mainly men who developed chronic bronchitis.
The disease can take different courses. In some patients, there is only a mild course with minor symptoms. However, it can too difficult courses with a so-called chronic obstructive pulmonary disease (COPD), or also "Smoker's lung", come that is not curable. Such a severe course is associated with a significant reduction in the quality of life and a shortening of life.
You can find more about smoking at: Illnesses from Smoking
In addition to cigarette smoke, air pollution, bronchopulmonary Infections (affecting bronchi and lung tissue) or affecting the lungs embryonic development disorders increase the likelihood of chronic bronchitis leading to COPD. Chronic bronchitis and its differentiations count worldwide the fourth leading cause of death.
You can find more about lung cancer at: How do you recognize lung cancer?
Symptoms
In contrast to an acute one bronchitisChronic bronchitis, which almost everyone has once in their life and where symptoms such as cough, fever, sore throat and chest pain caused by bacteria or viruses disappear again permanent symptoms.
The main symptoms of chronic bronchitis include Cough and sputum over an extended timespan. Depending on the course, these are very weak to very strong. The tough sputum that is coughed up is usually whitish and slimy. After a cough, the symptoms often go away for a few hours. Typically, sputum expectorates especially in the morning. Symptoms usually worsen when patients also have one Respiratory infection to get.
Also can polluted air and toxic substances the symptoms of chronic bronchitis worsen. In simple chronic bronchitis, there is no such thing Shortness of breath. The symptoms can also improve or disappear completely if the patient avoids the triggering factors (such as cigarette smoke). Chronic bronchitis can develop into more severe forms such as chronic obstructive bronchitis (COPD) or emphysema. Both forms are incurable.
In the chronic obstructive bronchitis The bronchi (airways of the lungs) constrict due to functional restructuring processes of the lung tissue, which leads to shortness of breath and coughing, especially during physical exertion. Difficulty breathing can also occur during rest. Often patients complain about Inefficiency and fatigue.
The Emphysema refers to an expansion of the lung alveoli due to a loss of elasticity in the lung tissue. This is where the gas exchange takes place, which is no longer fully guaranteed due to remodeling processes and expansion of the alveoli. In addition, the blood pressure in the pulmonary vessels increases due to increased pressure in the lungs, which in turn can damage the heart.
Please also read our article on this Symptoms of bronchitis
Diagnosis
In the case of chronic bronchitis or the corresponding symptoms, such as a cough that has persisted for several months, the diagnosis begins with the medical interview (anamnesis). From the patient's information too Duration, quality, trigger and accompanying symptoms the doctor can already gain directional information for the diagnosis. It is also important to review any medication you have taken and questions about smoking.
The next step in diagnostics is that physical examination. Of the Doctor listens including the Lungs with the stethoscope and can thus assess, for example, whether the air flow is impaired or whether there is possibly liquid or mucus in the lungs.
If necessary, will also Blood drawn and this among other things Inflammation values examined. Also one special study of lung function can be useful for assessing the disease. In some cases, the next step is a X-ray of the lungs made if, for example, there is a suspicion that a lung infection present. In special cases, a more accurate method of imaging is like a CT examination necessary (computed tomography). With the main symptom of chronic bronchitis, the long-standing cough with sputum, a malignant lung disease is also possible in some cases (especially in long-term smokers). For this reason, imaging procedures such as X-rays and CT are often used to diagnose chronic bronchitis as a precaution so as not to overlook such a serious disease.
causes
The causes of chronic bronchitis can be in exogenous (from the outside) and endogenous (from within) causes can be divided.
To the external factors Above all, smoking (cigarette, cigar, pipe, passive smoking) belongs to that too 90% as the cause of chronic bronchitis applies. As another cause must Air pollution to be named. Especially at Workers In the toxic industry or in mining, the risk of chronic bronchitis is increased. Also can often recurring infections cause chronic bronchitis.
You can find more on the topic at: The bronchi become mucous from smoking
A internal factor would be e.g. a Lack of antibodies of the IgA group, which offer protection against invading germs. In the event of a deficiency, e.g. to frequent infectionswhich can develop into chronic bronchitis. The lack of antibodies and the resulting impairment of the protective function of the lungs cause the airways to become permanently inflamed and thus lead to excessive mucus production. If the damaging triggers are not avoided, the worst case scenario will be strong remodeling processes of the lung tissueThis can lead to functional restrictions of the lungs that are extremely stressful and impair the quality of life.
More about this topic can be found: COPD
therapy
The most important measure to treat chronic bronchitis is that Avoidance of harmful substancesthat promote the development of chronic bronchitis.
This means that smoking patients should stop smoking immediately and for life. Symptoms should improve significantly after a few weeks of stopping smoking.
If the patient is exposed to hazardous substances in the workplace, they should be through Protective measures also be avoided. If this is not feasible, a change of job is recommended.
There are currently none Medicationthat reverse the remodeling processes in the lung tissue and enable the healing of advanced chronic bronchitis. In chronic bronchitis, drugs are only used for Symptom relief. If there is an additional bacterial infection, one usually takes place Antibiotic therapy.
More about this topic can be found: Antibiotics for bronchitis
If the airways are already narrowed and there is shortage of breath, you can Anticholinergics or Sympathomimetics inhaled, which widen the airways. Has chronic bronchitis become one COPD further developed, often has to cortisone be inhaled. Furthermore are Vaccinations like the annual flu vaccination or pneumococcal vaccination.
More about this topic can be found: COPD therapy
Home remedies for chronic bronchitis
Home remedies can help relieve symptoms of chronic bronchitis. The home remedies can improve the cough, have anti-inflammatory and expectorant effects, but should by no means replace medical treatment.
For one, curd compresses that have been warmed to body temperature can help pull the inflammation out of the bronchi. The quark should not be applied directly to the skin, as the dried quark is difficult to remove from the skin.
More information can be found here: Chest wrap
Patients should also take care to drink enough fluids during the day. Anti-inflammatory teas such as sage or fennel can be drunk here. The warming tea also liquefies the mucus, which is then easier to cough up.
In addition, taking onion juice daily can help thin the mucus and make it easier to cough up.
Inhaling saline or essential oils, as well as the warmth of going to the sauna and red light, can also help relieve symptoms.
You might also be interested in: Home remedies for coughs and Homeopathy for bronchitis
Over-the-counter medication for chronic bronchitis
This is more important and significantly more effective than all drugs in combating chronic bronchitis Quit smoking. In the event of exposure to fine dust or similar harmful substances at the workplace or in the residential area, a Change of job or place of residence appropriate to counteract the progression of the disease. Supportive, over-the-counter medications for chronic bronchitis are Expectorant, known medically as secretolytics or mucolytics. However, there is no scientific proof of the positive influence on the development of the disease with these agents.
Prescription medication for chronic bronchitis
If the basic measures, such as smoking cessation and possibly a change of job or place of residence, have been exhausted, various prescription drugs are available to alleviate the symptoms and to positively influence the course of the disease. Depending on the severity certain drugs are used, which can be supplemented by others. First of all, so-called Beta-2 sympathomimetics as a spray for inhalation prescribed (e.g. Salbutamol spray). These work on the bronchi by causing them to dilate.
If the symptoms are more severe In addition, a spray with a cortisone-like active ingredient or, if necessary, a spray with both active ingredients is prescribed. This should also counteract the inflammatory and remodeling reactions in the bronchi. In the case of chronic bronchitis, the Increased risk of bacterial infection. Should it come to that, the use of Antibiotics necessary. If the measures mentioned are not sufficient to enable the body to function adequately with breathing, one can ultimately also Long-term treatment with pure oxygen from a bottle through a breathing mask may be necessary. However, this option is only available to people who no longer smoke, otherwise there is a risk of explosion.
Chronic bronchitis in the child
In children, too, one speaks of chronic bronchitis if the child develops bronchitis more often in one year or if the symptoms such as cough and sputum persist for a longer period of time.
The reason for chronic bronchitis can be common and always recurring infections be. Of course there are also environmental toxins, e.g. by Passive smoking, as a cause of chronic bronchitis in childhood. Also can congenital malformations the respiratory tract, congenital Metabolic disordersthat with a increased susceptibility to infection go hand in hand, be causal.
A chronic disease of the lungs can lead to a remodeling of the lung tissue and thus to it lifelong functional restrictions to lead. Therefore, a diagnosis should be made by the doctor as quickly as possible so that possible causes of cough and shortness of breath, such as bronchial asthma or Cystic fibrosis can be excluded.
Please also read our article on this Bronchitis in the baby
Is Chronic Bronchitis Contagious?
Since chronic bronchitis is mainly caused by inhaled pollutants such as cigarette smoke or harmful fumes, it is in itself not infectious. Since the lung tissue is disturbed in its function to clean the airways by the harmful substances, more mucus forms. The inflammation weakens the lung tissue, which makes it easier for bacteria and viruses to cause an infection. This Infection is then contagious and can be transferred to fellow men.
More about this topic can be found: How contagious is bronchitis?
Chronic bronchitis and smoking
Smoking is the main cause of chronic bronchitis. The symptoms are therefore made worse by smoking. It threatens the transition to COPDwhich is associated with remodeling processes in the lungs that cannot be reversed and lead to a lifelong limitation of physical and mental performance. Therefore you should definitely try with the To stop smoking or at least reduce the amount of cigarettes consumed. Quitting smoking can do that too Effectively reduces the risk of diseases such as lung cancer, heart attack or stroke regardless of age or level of tobacco consumption. Your family doctor, among others, can provide information about support in giving up smoking. Occupational exposure to fine dust can be just as harmful as tobacco consumption.
Chronic bronchitis and exercise
Anyone suffering from chronic bronchitis should do not generally do without sport. On the contrary, sufficient physical activity has a positive effect on health. At a acute infection with other complaints such as fever, body aches or fatigue, however, larger loads should be avoided. Strict bed rest is not appropriate here either. It is also important to take care of your body. who during physical exertion like exercising due to chronic bronchitis If you feel short of breath or palpitations, you should stop or at least reduce the stress.
Duration
The duration of chronic bronchitis depends on the stage of the disease and when treatment is started. Chronic bronchitis that is untreated can develop into chronic obstructive pulmonary disease (COPD), which leads to narrowing of the airways and thus shortness of breath.
The prognosis and the chances of recovery increase especially if toxic pollutants or other triggers of bronchitis are avoided or treated. However, if the patient continues to be exposed to the disease-causing substances, chronic bronchitis can become a dangerous and incurable disease in which the patient has to reckon with additional damage to the lungs and heart.
Please also read our article on this Duration of bronchitis and superinfection
Chronic obstructive bronchitis
Chronic obstructive bronchitis is one Subtype of chronic bronchitiswhich is present when in addition to coughing, a narrowing of the airways (obstruction) present. Consists also impaired lung function, then one speaks of one COPD (English: chronic obstructive pulmonal disease). This is a serious lung disease that occurs in the vast majority of cases from smoking for many years arises. The harmful tobacco gases lead to a remodeling of the lung tissue and a narrowing of the airways. This is especially the Exhalation made more and more difficult and it often comes to one Emphysema (Overinflation of the lungs). The resulting shortness of breath leads to severe impairment in everyday life. Also, the risk is a lung infection to suffer increased many times. Various drugs are available to treat the symptoms of COPD. The most important measure to prevent further disease progression is that Giving up smoking.
The chronic obstructive bronchitis is often a transitional form from non-obstructive bronchitis (only cough with sputum) to COPD. While the In chronic obstructive bronchitis, the lungs can often recover by not smoking, with COPD, there are irreversible remodeling processes. The only goal can then be to counteract a deterioration in the situation.
