From the Research
Introduction to Chronic Bronchitis
Chronic bronchitis is a clinical diagnosis characterized by a cough productive of sputum for over three months' duration during two consecutive years and the presence of airflow obstruction 1.
Diagnosis of Chronic Bronchitis
The diagnosis of chronic bronchitis is based on the presence of a chronic cough and sputum production, as well as the presence of airflow obstruction 1. Pulmonary function testing, such as spirometry, can aid in the diagnosis of chronic bronchitis by documenting the extent of reversibility of airflow obstruction 1.
Clinical Features of Chronic Bronchitis
Clinical features of chronic bronchitis include a chronic cough and sputum production, as well as shortness of breath and wheezing 1, 2.
Differential Diagnosis
The differential diagnosis of chronic bronchitis includes other conditions that cause a chronic cough and sputum production, such as asthma, bronchiectasis, and tuberculosis 1.
Treatment of Chronic Bronchitis
Treatment of chronic bronchitis includes:
- Inhaled ipratropium bromide and sympathomimetic agents to manage airway inflammation and relieve bronchospasm 1
- Theophylline, although its use is limited by a narrow therapeutic range and interaction with other agents 1
- Oral steroid therapy, which should be reserved for use in patients with demonstrated improvement in airflow not achievable with inhaled agents 1
- Antibiotics, which play a role in acute exacerbations but have been shown to lead to only modest airflow improvement 1
- Strengthening of the respiratory muscles, smoking cessation, supplemental oxygen, hydration, and nutritional support, which also play key roles in long-term management of chronic bronchitis 1
Caveats
It is essential to note that the diagnosis of chronic bronchitis can be challenging, and a thorough evaluation, including pulmonary function testing and imaging studies, may be necessary to confirm the diagnosis 1, 2. Additionally, the treatment of chronic bronchitis should be individualized and based on the severity of symptoms and the presence of airflow obstruction 1.
Grading Severity of Chronic Bronchitis
The severity of chronic bronchitis can be graded based on symptoms and the presence of fixed airflow obstruction, and this grading system can correlate with health status, exposures injurious to the lung, biomarkers of inflammation, and measures of airway wall thickening 3.
Long-term Management
Long-term management of chronic bronchitis is crucial to prevent disease progression and improve health outcomes 1, 4, 5. This includes smoking cessation, avoidance of exposure to lung irritants, and regular monitoring of lung function and symptoms 1.