Chronic bronchitis is different from acute bronchitis; bronchial inflammation lasts and is getting worse. This dangerous disease occurs so insidiously that many in the initial stages of the disease and not know they have it. Frequent infection of the bronchi and bronchioles lead to thickening and distortion of the lining of these tubes which are narrowed and seaIed of excessive secretion of mucus and excessive contraction of muscles in the walls.
The first symptom is a morning cough with sputum (phlegm). Smokers often consider that cough as a “normal” smoker’s cough. With age, the amount of mucus is gradually increasing, and the cough begins to occur during the day. Shortness of breath and wheezing become progressively more galling.
In the initial stages only bad cold or the flu attacks cause sudden outbreaks. Later, however, each weak fever leads to high fever seizures. Many have several kinds of such bronchitis every winter. Therefore, the accepted medical definition of chronic bronchitis is: frequent cough with sputum that occurs almost every day for at least three months a year (usually in winter) at least two years in a row. In the late stages, the cough, shortness of breath and wheezing are severe and almost steady.
In the UK, 30 000 people die per year from chronic bronchitis (i.e. one person out of 2000). Arround one million people are suffering from the disease, although many of them don’t know that. The main cause is smoking. Children of heavy smokers can get this disease, too; small children are particularly prone to attacks of acute bronchitis and pneumonia, and such seizures increase the risk of chronic bronchitis. The disease is more common in men than in women; mortality of men is three times higher. An important factor is air pollution, but the disease is more common in industrialized countries and urban areas. The UK has the highest rate of the disease in the world – therefore chronic bronchitis is also called “English” disease.
Since the disease has increased, the vicious circle of bronchial infection, which causes more lung damage and leads to greater affinity for further infection, is almost inevitable. Major diseases, which may be caused by chronic bronchitis, include pulmonary heart, emphysema and decompensation of the right side of the heart. If the infection spreads to the alveoli, the consequences are likely to be pneumonia.
Some patients with chronic bronchitis gradually turn blue around the mouth and on the face due to lack of oxygen and eventually suffer from respiratory failure – their lungs can no longer supply the body with sufficient oxygen. Other are likely to develop lung cancer, not because of chronic bronchitis, but because smoking often causes both diseases. Exhaustion of a person with chronic bronchitis – e.g. more frequent shortness of breath and change in the nature of cough – may be the first sign of the development of lung cancer.
What to do?
If, in the morning, you cough with sputum and if you smoke, stop smoking. If bronchitis persists, consult a doctor who will examine you and, after taking into consideration factors such as smoking and place of residence, eventually decide to refer you for further tests. Those tests will probably include x-ray of the chest and testing of lung functions.
Self-help: stop smoking and avoid smoky areas. Do not approach people who suffer from cold. What is simply a cold for person with healthy lungs, can worsen the pain and strengthen the disease to a person with chronic bronchitis. If you work in a place where air is polluted, it would be wise to change the workplace or even, if possible, to move to a place with a warm, dry climate. People with chronic bronchitis are at greater risk if they spend the winter in cold, damp areas.
Professional help: Treatment usually depends on how advanced the disease is before you went to the doctor. If you are troubled by shortness of breath, your doctor will probably recommend an aerosol inhalation which will help you if you use it three or four times a day, because it will loosen the muscles of the walls of the bronchi and thus expand the airways. If you have a severe attack of infections and cough up phlegm, the doctor will probably prescribe an antibiotic, usually in the form of tablets or capsules, which you will take three to four times a day. In severe forms of the disease, injections of antibiotics would be the fastest way to solve the source of infection.
Some doctors tend to prescribe, as a protective measure, small doses of antibiotics that you take a few weeks or months. They can recommend that you take a full dose at the first sign of a sudden outbreak. Doctors do not have a unified position regarding the best way to treat chronic bronchitis. Although antibiotics do not act on the viral infection, they are often prescribed even when the virus, but not bacteria, is the cause of the disease, because viral infection increase the sensitivity of the lungs to the penetration of bacteria.