Chronic Bronchitis

What is chronic bronchitis?

Chronic bronchitis is an inflammation of the airways (trachea, bronchi or bronchioles) in your lungs. People with chronic bronchitis have symptoms like a cough and shortness of breath most days of the month, three months out of the year, for two years or longer.

Chronic bronchitis is commonly used to refer to chronic obstructive pulmonary disease (COPD). Though you may still hear the term “chronic bronchitis,” it’s now more accurately called COPD. Very few people have chronic bronchitis without the airway blockage (obstruction) of COPD.

Acute vs. chronic bronchitis

Acute bronchitis is usually caused by a virus like the common cold or the flu. It lasts a few days to a few weeks. Chronic bronchitis is when you get symptoms of bronchitis frequently for two years or longer. It’s usually caused by smoking or other lung irritants.

What’s the difference between chronic bronchitis and emphysema?

Chronic bronchitis and emphysema are both forms of COPD. They cause similar symptoms but affect different parts of your lungs. Chronic bronchitis causes swelling and mucus in your airways, or tubes, that bring air in and out of your lungs. Emphysema affects the small air sacs at the end of your airways (alveoli) and causes them to collapse. People with COPD often have some damage to both their airways and alveoli.

Who does chronic bronchitis affect?

Chronic bronchitis/COPD often affects people who smoke or used to smoke, but you can also be at risk if you:

• Are around someone who smokes.
• Are frequently exposed to air pollution, dust or chemical fumes.
• Have asthma.

What happens when you have chronic bronchitis?

Chronic bronchitis is when you have a cough and shortness of breath frequently, caused by damage to your lungs. Irritation in your airways causes an immune system reaction that makes them swell up and fill with mucus.

Usually, bronchitis is temporary, but when your airways get irritated frequently (like from cigarette smoke or air pollution), it can cause damage that creates too many cells that make mucus (goblet cells). Additionally, sometimes the tiny, hair-like structures (cilia) that clear mucus out aren’t working properly. This damage makes your airways swell and fill with mucus often. This makes you cough and have trouble breathing.

You’re also more likely to get viral and bacterial infections in your lungs, making your symptoms worse.

What are the symptoms of chronic bronchitis?

The main symptom of chronic bronchitis/COPD is a persistent (stubborn) cough with mucus that happens frequently for at least two years. Other symptoms include:

• A whistling sound when you breathe (wheezing).
• Shortness of breath (dyspnea).
• Fast heart rate (tachycardia).
• Tiredness (fatigue).

What causes chronic bronchitis?

Smoking is the leading cause of chronic bronchitis/COPD. Pollutants in the air or other lung conditions, like asthma, can also increase your risk. In some cases, you won’t know the cause.

Is chronic bronchitis contagious?

Chronic bronchitis/COPD isn’t contagious. But if you have chronic bronchitis, contagious diseases like a cold or the flu might be more likely to make your symptoms worse (exacerbation).

How is chronic bronchitis diagnosed?

A healthcare provider will diagnose chronic bronchitis/COPD by determining how well your lungs are working. They’ll ask you about your health history and symptoms and listen to your heart and lungs. They’ll give you lung function tests and might order chest X-rays or other imaging.

What tests will be done?

Tests for chronic bronchitis/COPD include:

• Pulmonary function tests.Pulmonary function tests give your provider an idea of how well your lungs are working. Spirometry is a common lung function test your provider may use if they think you have chronic bronchitis.
• Chest X-ray or CT scan. Imaging can show your provider if there’s any damage or areas of concern in your lungs. They’ll use a machine to take pictures of your heart and lungs. They’ll look for signs of diseases that could be causing your symptoms.
• Blood tests. Your provider may do blood tests, using a needle in your arm, to check your overall health. They may do an arterial blood gas test, a special kind of blood test taken from the artery in your forearm. This checks the levels of oxygen and carbon dioxide in your blood.
• Electrocardiogram (ECG or EKG). Your provider might use an ECG or EKG to check how well your heart is working.

How is chronic bronchitis treated?

Chronic bronchitis/COPD treatment focuses on managing symptoms. Depending on how severe your symptoms are, your provider might suggest many types of therapy, including:

• Smoking cessation. If you smoke, quitting can help you breathe better and keep chronic bronchitis from getting worse.
• Bronchodilators. Bronchodilators are medicines that help open your airways. You usually use an inhaler to take them.
• Steroids. Your doctor might prescribe corticosteroids — in an inhaler or as a pill — to reduce inflammation.
• Pulmonary rehabilitation.Pulmonary rehabilitation teaches you exercises and other strategies to help you breathe better and improve your quality of life.
• Oxygen therapy. If chronic bronchitis is severe, you may not be getting enough oxygen. Oxygen therapy delivers extra oxygen through a mask on your face or a tube in your nose.
• Antibiotics. As having chronic bronchitis can make you susceptible to getting sick frequently, your provider might give you antibiotics to take when they think you have an infection.
• Vaccination. Getting vaccinated against the flu, COVID-19, pneumococcal disease and other infectious diseases can help prevent you from getting sick, which can make your symptoms worse.

How long does chronic bronchitis usually last?

Healthcare providers call bronchitis “chronic” if you have symptoms at least three months out of the year. Your symptoms may sometimes get better or worse, but — unlike acute bronchitis — chronic bronchitis never fully goes away and may get worse over time.

How can I prevent chronic bronchitis?

The best ways to reduce your risk of chronic bronchitis/COPD include:

• Not smoking, quitting smoking and avoiding exposure to tobacco smoke.
• Avoiding chemicals, air pollution and other lung irritants.
• Managing asthma or other conditions that affect your breathing.

What’s the outlook for chronic bronchitis?

Chronic bronchitis/COPD can be mild or very serious. It’s usually a sign that you have lung damage that can get worse over time. You can’t cure the damage, but your provider can help you manage your symptoms, slow down its progression and reduce flare-ups. Your provider can tell you what to expect for your specific condition.

Can chronic bronchitis be cured?

Chronic bronchitis/COPD usually can’t be cured, but your symptoms can improve with treatment. Treatment can improve your quality of life and sometimes keep your condition from getting worse.

How do I take care of myself?

The best way to take care of yourself is to develop a treatment plan with your provider based on your specific condition. Talk to your provider if you’re using prescribed treatments and therapies as recommended and not seeing improvement.

You can reduce your risk of worsening symptoms (exacerbations) by avoiding getting sick with respiratory illnesses. Getting vaccinated, washing your hands and avoiding large groups of people (especially during cold and flu season) can all help reduce exacerbations and your risk of getting seriously ill.

When should I see my healthcare provider?

Talk to a healthcare provider if you think you have chronic bronchitis. Getting on a treatment plan as soon as possible can slow down its progression and improve your quality of life. See a provider if you:

• Have a cough that lasts more than three weeks or keeps coming back.
• Have frequent shortness of breath or wheezing.
• Have a high fever (103 degrees Fahrenheit or 39.4 degrees Celsius) or a fever that lasts more than five days.
• Are coughing up blood.

What questions should I ask my provider?

Make sure you understand your treatment plan, how to take any medications and how to use any medical devices (like an inhaler or supplemental oxygen). Other questions you can ask your provider include:

• Will my condition get worse over time?
• How much can I expect my condition to improve with treatment?
• How long should it take for my symptoms to improve?
• Which new or worsening symptoms should I look out for?
• What should I do if I don’t think my treatment plan is working?

A note from Cleveland Clinic

Being diagnosed with a chronic illness like chronic bronchitis/COPD can be daunting. But it’s important to remember that statistics can’t tell you what will happen in your specific situation. Having honest conversations with your provider can give you an idea of what to expect as you manage your illness. There are treatments and education that can help minimize the impact chronic bronchitis has on your life.