Chronic Bronchitis

An estimated 2 million people in the UK are affected by chronic bronchitis



Immune System Expert
@AVogelUK
Ask Dr. Jen Tan

An introduction to chronic bronchitis

Chronic bronchitis is a long-term, often irreversible lower respiratory condition that occurs when the lining of the bronchial tubes become scared and damaged as a result of being irritated and inflamed over a prolonged period of time.

The consequences are excessive amounts of mucus being produced which block the airways and a persistent long-term cough.

According to the NHS, it is estimated that around 2 million people in the UK are affected by chronic bronchitis, most of whom are adults over the age of 50.1 Many people with chronic bronchitis also develop another respiratory disease called emphysema.

Both of these conditions are part of a group of lung diseases called chronic obstructive pulmonary diseases (COPD).

While chronic bronchitis is a long-term condition, there is another type of bronchitis which is called acute bronchitis. This type of bronchitis is short-term and is usually caused by a viral or bacterial infection, most commonly after a common cold or flu.

What causes chronic bronchitis?

Chronic bronchitis occurs when the airways of the lungs (the bronchial tubes) become irritated and inflamed from long-term exposure to airborne irritants or extended illness.

When this occurs, excessive amounts of mucus start to build up, blocking the airways, restricting the amount of air going in and out of the lungs, and the feeling of being difficult to breathe. The blockage in airflow can worsen over time.

Coughing is the body’s way of trying to expel mucus to clear your blocked airways, which is why a productive cough (one that brings up thick mucus) is the most common symptom of chronic bronchitis.

The most common causes include:

Smoking: This is the most common irritant to damage the airways and cause chronic bronchitis, and one of the characteristic symptoms is the ‘smoker’s cough’.

Smoke inhaled into the lungs contains thousands of harmful chemicals that irritate the lining of the bronchial tubes. This leads to inflammation and over time, damage to tissue. Persistent, long-term inflammation can cause serious damage to the bronchial tubes, making them narrower.

This on-going irritation and inflammation can also cause the mucous membranes of the bronchial tubes to produce more mucus than usual, clogging the airways, restricting airflow and causing you to develop a persistent productive (mucus-producing) cough and difficulty breathing.

Clogged with mucus, the bronchial tubes are then vulnerable to viral and bacterial infections, and repeated bouts of infection can further damage lung tissue.

Smoking and other irritants can also paralyse the tiny hair-like structures called cilia which line the respiratory system. The function of these delicate structures is to protect the body from infection by sweeping away bacteria, viruses, irritants and excess mucus. When the cilia stop working properly, mucus is more likely to clog the airways and infection is more likely.

Passive Smoking: Children of heavy smokers also have an increased risk for developing chronic bronchitis, as do non-smoking adults who are repeatedly exposed to the cigarette smoke of others (passive smoking).

Environmental & Airborn Irritants: Inhaling other environmental and airborne irritants such as pollution, chemical fumes and dust over a long period of time may also cause chronic bronchitis.

Those continually exposed to industrial dust and chemical fumes in the workplace are also at risk of developing chronic bronchitis. This is commonly referred to as 'occupational bronchitis'.

Acute Bronchitis: Chronic bronchitis can also develop from repeated bouts of acute bronchitis (a short-term condition that affects the lower respiratory tract) and other recurring respiratory infections, which over time damage and weaken the lining of the bronchial tubes.

Recurrent respiratory tract infections during early childhood can also lead to chronic bronchitis.

What are the symptoms of chronic bronchitis?

The term ‘chronic’ means a condition that lasts a long time. Chronic bronchitis is defined as daily mucus-producing cough that persists for 3 months or more, at least 2 years in a row, as opposed to acute bronchitis symptoms, which usually only lasts a few weeks.

The most common symptom of chronic bronchitis is a persistent, mucus-producing cough. The mucus may be yellow, green or white. As the airways become increasingly irritated, mucus production worsens.

The severity and intensity of coughing and the amount and frequency of mucus produced varies from person to person. However, the cough is often described as being worse in the morning.

Other common symptoms of chronic bronchitis include wheezing and difficulty breathing, as well as chest discomfort – this is often described as a heavy, tight feeling in your chest.

You may find that your symptoms can often worsen during different parts of the year, for example the winter months, when symptoms can be aggravated due to the increased risk of respiratory infections such as colds, flu and acute bronchitis.

If this happens, you may find that you cough up more mucus than usual or you experience an increased shortness of breath.

Other medical conditions such as heart problems and infections in other parts of the body can also worsen chronic bronchitis symptoms.

How is chronic bronchitis diagnosed?

To diagnose chronic bronchitis, your doctor will firstly perform a physical examination; then ask about your medical history, your smoking habits or if you live with someone who smokes, if you have a history of on-the-job exposure to airborne irritants, as well as the symptoms you are experiencing, their severity and how long they have lasted.

If your doctor thinks you have chronic bronchitis, they may recommend tests to make a definite diagnosis and to check for lung damage.

You might have a pulmonary function test to see how well your lungs are functioning. This test involves a series of breathing manoeuvres that measure the airflow and volume of air in your lungs. Your doctor may also order blood tests and a chest X-ray to look for lung enlargement or bronchial scarring.

What treatments are there for chronic bronchitis?

If you have chronic bronchitis, the main goal is to reduce your exposure to whatever is irritating your bronchial tubes. If it’s being caused by smoking, the most important thing to do is to quit smoking to prevent ongoing damage to your lungs and to stop symptoms worsening.

Unfortunately, lung damage cannot be reversed. However, there are several treatments that your doctor may recommend to help ease the symptoms of chronic bronchitis and slow the progression of the condition, and these include:

Bronchodilator inhalers: These help to relax the muscles of the bronchial tubes, opening up the airways to allow increased airflow, making it easier to breathe.

Mucolytics: This type of medication can make the mucus easier to cough up.

Steroids: These can help to reduce the swelling and inflammation of the airway tissue.

Pulmonary rehabilitation: This is an exercise programme that teaches you ways to breathe that can help to ease your symptoms, slowly building up the lung capacity while allowing you to breathe more easily.

Oxygen therapy: If you have severe airflow limitation, you may require oxygen therapy at home, where oxygen is administered via nasal probes or a mask to increase blood oxygen levels.

Antibiotics: In general, these will only be prescribed by your doctor if you develop a bacterial infection along with your chronic bronchitis.

Are there any herbal remedies that can help?

Persistent coughs are often one of the most prominent symptoms when it comes to chronic bronchitis. These coughs may or may not be accompanied by the production of mucus.

Coughs with lots of mucus are known as productive coughs. To help ease a chesty or mucus cough, use the herbs Ivy and Thyme found in Bronchoforce.

Ivy is naturally anti-spasmodic and can work well to help loosen any stubborn mucus, whilst thyme is gently anti-septic, helping to thin any mucous, making it easier to expel.

Next, if chronic bronchitis has instead given rise to a persistent, dry cough Bronchosan Pine Cough Syrup may be helpful.

Made from fresh spruce shoots combined with honey, this fragrant mix helps to move any persistent mucus, whilst also helping to soothe the length of your respiratory tract.

Finally, people affected by chronic bronchitis may be more prone to picking up infections such as colds or flu which could also be exacerbating your symptoms.

Echinaforce may be a useful addition to help treat any further symptoms, and can help to support the immune system longer-term.

Are there any self-help measures for chronic bronchitis?

Although the damage to your lungs is often irreversible, there are several things you can do to help ease your symptoms and to stop them from worsening. If you have chronic bronchitis, you should:

Quit smoking: If you smoke the best way to prevent chronic bronchitis from getting worse is to quit smoking. Easier said than done, but if you do continue to smoke it will further damage your lungs. If you have chronic bronchitis and don't smoke, then it is important to try to avoid exposure to second-hand/passive smoke or smoky environments.

Avoid people who are ill: Viral infections such as colds and flu can worsen chronic bronchitis symptoms, so it’s important to limit your exposure to infected people. If you do develop a respiratory infection such as a cold or flu, it is important to treat it immediately to prevent it from worsening your symptoms.

Wash your hands regularly: This helps to prevent exposure to viruses and bacteria which can cause an infection in your lungs and worsen your symptoms.

Try to avoid other things that can irritate your lungs: Everyday items that contain chemicals, such as aerosol products like hairspray, spray deodorants, air fresheners and cleaning products such as bleach can aggravate your already irritated lungs. Also avoid breathing in dust or chemical fumes.

Use steam treatments: Taking a hot shower, bath or using a steam inhaler can help to loosen mucus and relieve chest congestion. You can also make a steam tent by filling a bowl or sink with hot water, bending over it and covering your head with a towel, then breathing in deeply. Adding some essential oils such as peppermint and eucalyptus oil can help to clear your respiratory passages and provide some extra soothing relief.

Use a humidifier: Humidifiers help to add moisture to the air. When your airways are irritated, keeping them hydrated with moist air will help to soothe them, as well as break up and loosen mucus, making it easier to cough up.

Try to keep active: Physical activity can strengthen the muscles that help you breathe. Ideally, you should exercise at least three times per week for 30 minutes. If you are just starting to become more active, then start out slowly and gradually increase the length and intensity of your exercise routine.

Try pursed-lip breathing: This is a common breathing technique which can help provide relief when you’re having difficulty breathing.

It works by slowing the pace of your breathing, helping you restore your normal breathing. To do pursed-lip breathing, breathe in slowing through your nose for two seconds, keeping your month closed. Then pucker or ‘purse’ your lips (as if you are about to whistle or blow out a candle) and breathe out slowly for four seconds. Repeat.

Avoid or limit your intake of mucus producing foods: Some people find that eating dairy products such as milk and cheese causes them to produce more mucus than normal. Sugary, fried and processed foods have also been found to exacerbate mucus production.

When should I go to the doctor with chronic bronchitis?

You should consult your doctor if you notice blood in your sputum, suffer chest pains or if you are wheezing severely or shortness of breath is persistent.

References

1. NHS Inform {www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/bronchitis}

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