Chronic inflammation of the bronchi (chronic bronchitis)
Chronic bronchitis is a persistent inflammation of the mucous membrane of the bronchi , in which too much mucus is formed . In healthy people, the lining of the respiratory tract contains cilia that transport particles of dirt and mucus from the lungs . In the case of chronic bronchitis, these cilia are damaged or even destroyed. The walls of the bronchi become thinner and more unstable, which can lead to their narrowing. If the bronchi are narrowed permanently, it is chronic obstructive pulmonary disease ( COPD ).
What are the causes of chronic bronchitis?
The main cause of this disease is cigarette smoking , probably including passive smoking . Other factors may include:
- pollutants in the air at the workplace (e.g. dust during mining) or in the environment,
- previous cold or infection (e.g. measles ),
- congenital heart defects or congenital respiratory tract defects ,
- aspiration of food or foreign bodies,
- cystic fibrosis ( hereditary metabolic disorder ),
- alpha-1-antitrypsin enzyme deficiency ,
- gastroesophageal reflux ,
- use of certain drugs (e.g. ACE-inhibitors , beta-blockers , amiodarone, methotrexate , gliptins).
Information about the risks associated with exposure to harmful substances at the workplace is provided by the labor inspectorate, company doctors and occupational medicine specialists . Information about air pollution can be found on the website of the Ministry of the Environment [1] or the Czech Hydrometeorological Institute [2].
In some cases, the cause of the cough symptoms cannot be determined at all. Such a disease is called idiopathic chronic cough .
What are the symptoms of chronic bronchitis ?
The main symptoms of chronic bronchitis are cough and mucus production . If the airways are narrowed, shortness of breath also occurs . In addition, whistling or creaking sounds are heard during breathing in this case. People suffering from chronic bronchitis are usually more prone to infections (e.g. frequent colds).
Note: Bronchitis symptoms may be similar to those of COVID-19 . More information can be found in the category COVID-19 .
How is the diagnosis made?
By taking a detailed medical history, the doctor obtains information about the course of the disease and its symptoms. Listening ( auscultation ) and tapping ( percussion ) on the chest cavity, as well as a general physical examination , can then help the doctor to specify and confirm the diagnosis . Other examinations include radiological imaging methods (e.g. lung X-ray ), pulmonary function tests , blood gas tests , and, if necessary, bronchoscopy and blood sampling.
According to the WHO definition, the diagnosis of non-obstructive chronic bronchitis (see below) is made if cough or sputum occurs for at least three consecutive months in two consecutive years while excluding other possible causes (e.g. asthma ).
What are the forms of chronic bronchitis?
There are two forms of chronic bronchitis:
Non-obstructive chronic bronchitis: If the causative factors (eg, smoking, dust exposure) are removed, non-obstructive bronchitis usually resolves on its own. Depending on individual symptoms or triggering factors, the doctor will recommend appropriate therapy or preventive measures (e.g. smoking cessation , inhalation , respiratory physiotherapy ). Disease progression and other late complications (e.g. pulmonary emphysema ) can thus often be prevented.
Obstructive chronic bronchitis: This form of chronic bronchitis is one of the components of chronic obstructive pulmonary disease ( COPD ; the other is emphysema or emphysema , a disease in which the alveoli are damaged). In chronic obstructive bronchitis, the airways are permanently narrowed. This disease usually develops over many years. Unfortunately, once it develops, all damage cannot be fully reversed. With treatment, however, it is possible to prevent further progression of the disease. More information on prevention, diagnosis , therapy, treatment of acute exacerbation and rehabilitation can be found in the COPD category .
Note: If treatment is ineffective or symptoms worsen, you should contact your doctor immediately.
Who can I contact?
If you suspect that you suffer from bronchitis (either chronic or acute), you can contact your general practitioner , or a specialist in internal medicine ( internist ) or pulmonary medicine ( pulmonologist ). An occupational doctor or company doctor can also help you . If a child or teenager suffers from bronchitis, do not delay a visit to the pediatrician .
