Chronic bronchitis is one of the most common respiratory diseases. The persistent cough mainly affects smokers and can have serious consequences.
Like acute bronchitis, chronic bronchitis is also characterized by a cough with sputum, but this lasts longer. According to the World Health Organization (WHO), bronchitis is chronic if the mucous cough appears on almost every day within three months and in two consecutive years. Chronic bronchitis can progress to chronic obstructive pulmonary disease (COPD). It is one of the most common causes of death. The transition is fluid.
Most smokers suffer from chronic bronchitis. But environmental factors, exhaust fumes, professional circumstances, frequent respiratory infections or chronic sinus infections can also lead to chronic bronchitis.
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| Chronic bronchitis |
Causes and risk factors
Cigarette smoke and other pollutants that can cause chronic bronchitis irritate and damage the bronchial lining. She produces more mucus because of the irritation. At the same time, however, the cilia suffer. They no longer fulfill their function of transporting the mucus out of the lungs by means of a coordinated wave movement as well. The phlegm must be coughed up. This irritates the bronchi again. Inflammation can start, become self-perpetuating and trigger adverse remodeling of the bronchial walls. In addition, smoke and other pollutants weaken the immune system locally. Because there is always a lot of mucus, bacteria can easily settle and often cause respiratory infections.
According to surveys, cigarette consumption is responsible for eight to nine out of ten cases of chronic bronchitis.
Frequent respiratory infections are suspected of promoting the development of chronic bronchitis. However, the connection is not clear: it is also possible that people who are predisposed to or already have mild chronic bronchitis simply get more respiratory infections. In any case, it seems that people who had many such infections as children suffer from constant coughing more often than others as adults.
Other diseases such as chronic sinusitis, asthma or cystic fibrosis are sometimes also associated with chronic bronchitis.
In addition to smoking, the biggest risk factors are male gender and age: most of those affected are smoking men over 40 years of age. According to some studies, every second cigarette user over the age of 40 suffers from chronic bronchitis. Women are less often affected – for now.
Symptoms
Do you cough regularly for long periods of time, especially in the morning?
Is the cough productive, i.e. associated with mucous sputum?
Chronic bronchitis usually manifests itself through these symptoms. In contrast to acute bronchitis, a previous cold plays no role in the chronic cough. It doesn't go away after a few weeks either. The cough, which is particularly noticeable in the morning, continues. The mucus that is expelled is usually light-colored and whitish.
Affected people may not have any symptoms other than a morning cough. A lot of people get used to it. When they notice their cough, they find it annoying rather than distressing or dangerous. In addition, many people with chronic bronchitis are physically fit, especially at the beginning. They often get enough air during sports and other physical exertion. That is why very few people take their illness seriously and do not seek appropriate treatment. The disease often progresses until physical performance and quality of life are noticeably reduced. Life expectancy is also falling. Early danger signals are shortness of breath during physical exertion and possible (whistling) noises when exhaling.
Chronic bronchitis can develop into obstructive forms (chronic obstructive bronchitis, a form of COPD), in which the airways are narrowed or closed (obstruction, Latin: obstruere = to close). This reduces the life expectancy of those affected by five to seven years. Simple chronic bronchitis, on the other hand, does not shorten life.
Treatment
In principle, chronic bronchitis can be cured. However, it can gradually and seamlessly transition into COPD that is no longer curable. Treatment and giving up cigarettes should therefore start as early as possible, which unfortunately rarely happens. In the beginning, cough, lung function and performance improve quickly if you completely avoid the triggers of the disease. Most of the treatment options below are then superfluous. With progression, the time and the therapeutic effort to achieve improvements increase. The later the therapy begins, the higher the stakes and the lower the chances of success. At the latest when there are constrictions or blockages in the airways, i.e. COPD has developed, the functional restrictions of the lungs can no longer be reversed. Specialists do lung function tests to find out. They measure the one-second capacity (FEV1). It indicates the maximum amount of air the test subject can exhale in one second.
Avoid cigarettes and other triggers
The first priority is to eliminate the cause of the cough. In the vast majority of cases, this means that those affected must stop smoking. Smokers with a persistent cough should not hesitate to use aids (e.g. nicotine preparations, anti-smoking pills) and professional help (e.g. professional cessation courses, acupuncture) in the fight against cigarettes. Anything that helps you on your way to becoming a non-smoker is useful: the function of the lungs improves after just a few days of not smoking. In the case of other pollutants or harmful influences (e.g. dust, exhaust fumes, smoke, heat), it is necessary to reduce exposure as much as possible. If environmental factors (e.g. air pollution, climate) or professional circumstances (e.g. fine dust in mining) are decisive, those affected may have to change their place of residence or profession. If secondhand smoke plays a role, it is necessary to involve others in therapy. For the sake of your health, partners, relatives, friends and acquaintances should smoke on the balcony or in front of the door. If it is unclear where the chronic bronchitis comes from, the cause should be thoroughly investigated.
General Measures
The slime has to go. It narrows the airways and can serve as food for bacteria, increasing the risk of complications. Those affected should drink enough to make it easier to cough up the secretions of the mucous membranes. In the case of some diseases (e.g. of the heart, kidneys or liver), it is advisable to discuss suitable drinking quantities with specialists.
Movement maintains physical performance and maintains lung function. As soon as the air becomes scarce during physical activity, many sufferers avoid exertion and sport. However, lack of exercise leads to a further decrease in condition, lung function and the resilience of the cardiovascular system. The risk of chronic bronchitis progressing also increases. In order not to overstrain, sport should be adapted to the ability to perform.
Being overweight can make breathing difficult. Experts often advise overweight patients with chronic bronchitis to aim for a normal weight.
Tapping, breathing techniques, coughing techniques, and certain postures can improve breathing and clearing of mucus. They are rarely necessary in the early stages.
Medication
Expectorant agents are designed to liquefy the coughing mucus so that it can be coughed up more easily. Synthetic substances are mostly used (e.g. acetylcysteine, ambroxol). Many find the funds a relief, although their benefits are unclear. They are not or only partially suitable for pregnant and breastfeeding women, children and people with certain diseases. Also because of possible side effects, professional advice is recommended, especially if you want to use the funds for a longer period of time.
Other active ingredients, such as those that inhibit inflammation or expand the bronchi, are usually only used in obstructive forms, i.e. when the bronchi have partially narrowed or closed.
Prevention
Never starting to smoke or quitting immediately is the best way to prevent chronic bronchitis. Non-smokers hardly have to fear the disease, unless they are exposed to pollutants at work or in other ways. Then you should try to minimize them. It is also advantageous not to permanently expose oneself to extreme climatic conditions (e.g. heat, dryness, cold).
Otherwise the possibilities are limited to keeping the body and mucous membranes fit. Dry mucous membranes are more easily irritated. On the other hand, lozenges and a reasonably humid room air (45 to 60% humidity) help. Physical exercise strengthens the respiratory muscles and the cardiovascular system and increases general resistance. The risk of chronic bronchitis progressing should also be reduced.