Chronic bronchitis causes persistent productive cough and airflow obstruction, most often from long-term tobacco exposure. Diagnosis requires clinical assessment and spirometry. Treatment prioritizes smoking cessation, inhaled bronchodilators, pulmonary rehabilitation, vaccination, and oxygen therapy for advanced disease. Preventing exposure to smoke and pollutants remains the cornerstone of prevention.
What is chronic bronchitis?
Chronic bronchitis is inflammation of the bronchi that leads to excess mucus production and persistent productive cough. Clinically, it's defined by a productive cough most days for at least three months in two consecutive years. The airway inflammation narrows airways and makes it harder to move air in and out of the lungs, causing shortness of breath and reduced exercise tolerance.
Causes and risk factors
The most common cause is long-term exposure to tobacco smoke. Air pollution, occupational dusts and chemicals, and repeated respiratory infections also increase risk. While anyone can develop chronic bronchitis, current and former smokers account for the majority of cases.
Symptoms and how it differs from acute bronchitis
Symptoms include a daily productive cough, wheeze, breathlessness on exertion, fatigue, and sometimes mild chest discomfort. Acute bronchitis is usually short-lived and often follows a cold or viral infection; chronic bronchitis is persistent and part of the spectrum of chronic obstructive pulmonary disease (COPD).
Diagnosis: what clinicians look for
Clinicians confirm suspicion with a history and physical exam. Spirometry (pulmonary function testing) is essential to document airflow obstruction and distinguish chronic bronchitis from other conditions. A chest X-ray may show hyperinflation or increased bronchovascular markings but cannot diagnose the condition alone. In advanced cases, arterial blood gas testing can show low oxygen and elevated carbon dioxide levels.
Treatment principles
Treatment focuses on relieving symptoms, preventing flare-ups (exacerbations), and slowing disease progression.
- Smoking cessation is the single most effective action to slow disease progression.
- Bronchodilators (short- and long-acting inhaled medications) reduce symptoms and improve airflow.
- Inhaled corticosteroids may be used in patients with frequent exacerbations or overlapping asthma features.
- Pulmonary rehabilitation (exercise training, education, and support) improves function and quality of life.
- Long-term oxygen therapy benefits patients with chronic low blood oxygen.
- Antibiotics and short courses of oral steroids are used during bacterial exacerbations as directed by clinicians.
- In selected severe cases, lung volume reduction procedures or lung transplantation may be considered.
Prevention and self-care
The best prevention is avoiding tobacco smoke and limiting exposure to air pollutants and workplace irritants. Regular physical activity, good nutrition, and staying up to date with vaccinations help reduce complications. People with chronic cough should seek medical evaluation early - timely spirometry and treatment improve outcomes.
Where to get reliable information
Authoritative resources include the Centers for Disease Control and Prevention (CDC), the National Heart, Lung, and Blood Institute (NHLBI), the American Lung Association, and the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Talk with your primary care provider or a pulmonologist for diagnosis and personalized treatment.
FAQs about Chronic Bronchitis
How is chronic bronchitis different from acute bronchitis?
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News about Chronic Bronchitis
Chronic Bronchitis Widespread and Overlooked in Low-Income Countries - European Medical Journal [Visit Site | Read More]
Proposed treatment algorithms for dogs with chronic bronchitis associated with irreversible airway changes: bronchiectasis and/or bronchomalacia - Frontiers [Visit Site | Read More]
Chronic Obstructive Pulmonary Disease (COPD): Practice Essentials, Background, Pathophysiology - Medscape eMedicine [Visit Site | Read More]
Sympathovagal Imbalance in Drug-Naïve Chronic Obstructive Pulmonary Disease Patients: A Physiological Mechanism to Cope With the Severity of Airway Obstruction in an Observational Study - Cureus [Visit Site | Read More]