Chronic Bronchitis

Chronic bronchitis is a condition that can develop when you have long-term inflammation in your airways. It happens when cigarette smoke or other irritants cause your airways to swell and fill with mucus. 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.

On the other hand, acute bronchitis lasts a few days to a few weeks. Airway and lung infections are the most common cause of acute bronchitis.

Many people still use the term “chronic bronchitis.” But it’s now more accurately called chronic obstructive pulmonary disease (COPD). Chronic bronchitis isn’t the same as a chronic cough.

Symptoms of chronic bronchitis

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

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

Chronic bronchitis causes

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

When your airways are irritated for a long time — like from smoking or breathing in dust or smog — it can cause damage that leads to too many mucus-making cells. And sometimes, the tiny, hair-like structures (cilia) that clear mucus out stop working properly. The damage causes your airways to swell and fill with mucus often. This makes you cough and affects your breathing.

Risk factors

Chronic bronchitis 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 dust or chemical fumes
• Have asthma

Complications

If you have chronic bronchitis, you’re more likely to get frequent respiratory infections. These can lead to pneumonia. Complications of airway obstruction include:

• High levels of carbon dioxide in your blood (hypercapnia)
• Low levels of oxygen in your blood (hypoxemia)
• Respiratory failure
• High blood pressure in your lungs
• Right-sided heart failure
• Collapsed lung
• Making too many red blood cells (polycythemia)

How doctors diagnose chronic bronchitis

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.

Tests that can confirm the diagnosis include:

• Pulmonary function tests: These give your provider an idea of how well your lungs are working.
• Imaging: Chest X-rays and CT scans can show inflammation and damage in your lungs.
• Blood tests: Blood tests can check your overall health.
• Arterial blood gas test: This is a special kind of blood test, taken from an artery, that checks the levels of oxygen and carbon dioxide in your blood.
• Electrocardiogram (ECG or EKG): This test checks how well your heart is working.

How is chronic bronchitis treated?

Chronic bronchitis treatment focuses on managing symptoms and reducing your risk for further damage. Depending on how severe your symptoms are, treatment options could include:

• Smoking cessation: If you smoke, quitting can help you breathe better and keep chronic bronchitis from getting worse.
• Bronchodilators: These are inhaled medications that open your airways.
• Steroids: Inhaled or oral corticosteroids reduce inflammation in your lungs.
• Biologic medications: Dupilumab (Dupixent®) and mepolizumab (Nucala®) are injectable medications that improve lung function and reduce flare-ups in some people with chronic bronchitis/COPD.
• Ensifentrine (Ohtuvayre®): This is an inhaled medication that relaxes your airway muscles and lowers inflammation in your lungs.
• Roflumilast (Daliresp®): This is an oral medication used to reduce inflammation and help prevent COPD flare-ups.
• Oxygen therapy: You might need extra oxygen if you have severe damage that prevents you from getting enough oxygen.
• Antibiotics: Your provider might prescribe antibiotics when you have a bacterial infection in your lungs.
• Pulmonary rehabilitation: Pulmonary rehabilitation teaches you exercises and other strategies to help you breathe better and improve your quality of life.

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 help 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

Go to the ER if you:

• 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
• Have sudden or severe shortness of breath

Does chronic bronchitis go away?

Chronic bronchitis isn’t usually curable. Healthcare providers call bronchitis “chronic” if you have symptoms at least three months out of the year. Your symptoms can improve with treatment, but — unlike acute bronchitis — chronic bronchitis never fully goes away and may get worse over time. Treatment can improve your quality of life and sometimes keep your condition from getting worse.

What’s the outlook for chronic bronchitis?

Chronic bronchitis can be mild or very serious. It’s usually a sign that you have lung damage that can worsen 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 situation.

You can take steps to reduce your risk of worsening symptoms (exacerbations) by avoiding getting sick with respiratory illnesses. This includes:

• Getting recommended vaccinations
• Washing your hands
• Avoiding large groups of people, especially during cold and flu season

Can this be prevented?

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

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

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.

Emphysema affects the small air sacs at the ends of your airways (alveoli) and causes them to collapse.

People with COPD often have some damage to both their airways and alveoli.