Chronic Bronchitis: What It Is, Symptoms, and Diagnosis

A cough that does not go away within three weeks is easy to dismiss as a lingering cold. In chronic bronchitis, the cause is ongoing inflammation of the bronchial tubes, and over time breathing changes. Below is how to recognize this form and which tests confirm the diagnosis.

Chronic bronchitis: what kind of disease it is

Chronic bronchitis is inflammation and irritation of the bronchial tubes, the airways leading from the trachea to the pulmonary alveoli. The walls swell, mucus accumulates in the tubes, and it becomes harder for the lungs to deliver oxygen to the blood and remove carbon dioxide. In international practice, chronic bronchitis is classified as COPD — a group of lung diseases that make breathing difficult and worsen over time.

Causes and risk factors of chronic bronchitis

The cause is prolonged inhalation of irritants that damage the airways. Cigarette smoke is first on this list; pipes, cigars, and other forms of tobacco smoke also matter a great deal, especially if the smoke is inhaled. Up to 75% of people with chronic bronchitis smoke or have smoked before — but this is not about blame, it is about what happens to the bronchi.

Other irritants include secondhand smoke, polluted air, chemical vapors, and dust in the workplace. Less often, the cause is hereditary alpha-1 antitrypsin deficiency. Risk factors include age (in most people symptoms first appear after age 40) and a family history of COPD: smokers with such a heredity develop the disease more often.

Symptoms of chronic bronchitis

The disease often begins unnoticed: there is almost no cough, or it is rare. As inflammation worsens, breathing changes — a wheeze or creak appears, as if air is passing through a narrow gap. The main signs of chronic bronchitis:

• frequent cough, often with a large amount of sputum;
• wheezing or creaking breathing;
• shortness of breath, especially during physical exertion;
• tightness in the chest;
• frequent colds and flu.

Sputum may be clear, white, yellowish-gray, or greenish, rarely with streaks of blood. At first the cough may be dry, later sputum appears, and in the late stages it becomes purulent. Fatigue, a mild fever, chills, and chest discomfort are added to the cough. In severe cases — weight loss, weakness of the leg muscles, swelling of the feet and lower legs.

How chronic bronchitis differs from acute

Acute bronchitis is more often caused by viruses, it is contagious and usually comes in the winter months. Cough with sputum in the acute form lasts from 1 to 3 weeks, and in most cases the disease resolves on its own. If the cough persists longer than three weeks, doctors look for other causes.

The chronic form differs in its causes, mechanism, and approach to treatment, and over time it tends to progress. What is more dangerous here is not the cough with mucus itself, but the airway obstruction that may accompany it. The chronic form cannot be completely cured, but its progression can be slowed.

Diagnosis of chronic bronchitis

The diagnosis is not made by eye. The doctor asks about symptoms and their duration, clarifies the family history of lung diseases, then orders tests: pulmonary function testing (spirometry), chest X-ray or computed tomography, blood tests. The doctor selects the set of tests individually.

Possible complications and when to see a doctor

A severe course makes itself known not only by cough: weight loss, weakness of the leg muscles, swelling of the feet and lower legs appear, and colds and flu are harder to get through. Inflammation over the years can lead to irreversible lung damage, so it is better not to delay a visit. See a doctor if the cough persists longer than three weeks and is not subsiding, if blood appears in the sputum, if chest pain comes in waves or worsens with breathing and coughing, if shortness of breath appears or it becomes difficult to do usual activities. A separate reason for consultation is age over 65, pregnancy, diabetes, heart, lung, or kidney disease, weakened immunity, including during chemotherapy.

Chronic bronchitis by itself is not a reason to call an ambulance. Dial 103 or 112 if a person is gasping for breath, cannot speak, or is gasping for air; if the lips or skin have become very pale, blue, or gray — on darker skin this is noticeable on the palms, lips, tongue, gums, and under the nails; if sudden confusion appears and the person does not understand where they are.

This material is for reference: it explains what happens to the bronchi and how the diagnosis is confirmed, but it does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer