Chronic obstructive bronchitis

It is similar to chronic bronchitis chronic obstructive bronchitis a chronic lung disease. Obstructive here means that the bronchi are narrowed. The main symptoms are coughing, shortness of breath and sputum.

What is chronic obstructive bronchitis?

Chronic obstructive bronchitis is a permanent (chronic) lung disease that leads to a narrowing (obstruction) of the airways.

The diameter of the bronchioles contained in the lungs is regulated by the parasympathetic (nerves) and sympathetic (nerves). The parasympathetic nervous system narrows the bronchioles and the sympathetic nervous system widens them. However, this can also lead to incorrect regulation (smoking, chemical vapors) in which the bronchial muscles tighten more and thus make breathing more difficult.

First there is a "normal" chronic bronchitis, which is then increased to chronic obstructive bronchitis with the symptom of acute shortness of breath. This disease is not contagious, but it cannot be completely reversed even by any treatment.

In the later stages of the respiratory disease, cilia are destroyed and the lining of the small alveoli is damaged. Therefore, as you exhale, the alveoli continue to grow in instability and collapse. The inflamed bronchial mucosa thickens and narrows the airways.

causes

Regular smoking and, more rarely, air pollution such as dust, chemical vapors and gases can be observed as a trigger for chronic obstructive bronchitis. Passive smoking can also lead to serious lung diseases.

In addition, a constitutional weakness of the connective tissue or reduced resilience of the respiratory tract promote the transition from chronic to chronic obstructive bronchitis.

Symptoms, ailments & signs

With this condition, patients suffer from a number of different respiratory problems. As a result, the patient's quality of life is considerably reduced and restricted, so that there are also severe restrictions in the everyday life of the person concerned. The patients mainly suffer from a strong cough, which is also associated with an expectoration.

The cough occurs without a particular reason and, above all, permanently. It can also lead to shortness of breath. Breathlessness can also occur during sleep and lead to sleep problems. Many patients also suffer from high blood pressure and can also die of a heart attack.

If the disease is not treated, pneumonia usually occurs, which can also lead to death. The symptoms can be particularly pronounced in smokers. Many of those affected also seem tired and exhausted and can therefore no longer actively participate in everyday life.

Without treatment, the life expectancy of the person affected is also honestly reduced. The disease can also lead to severe psychological complaints. The capacity of the lungs drops significantly, so that gasping for breath can occur in severe cases.

Diagnosis & course

Chronic obstructive bronchitis manifests itself primarily through expectoration, coughing and shortness of breath. Initially the symptoms are similar to those of chronic bronchitis. There is a persistent, irritable cough with sputum (white or green-yellow in the case of a bacterial infection), which initially only appears under stress, and in the case of a more severe clinical picture also appears at rest.

The whole thing is increased by the acute shortness of breath. In the further course of the respiratory disease, a pathological overinflation of the lungs (pulmonary emphysema) develops, which causes permanent damage to the lungs.

The pulmonary emphysema in the pulmonary vessels causes increased blood pressure, which ultimately chronically damages and weakens the heart (cor pulmonale, right heart failure). The most common complications are bronchial infections and pneumonia.

The diagnosis begins with the recording of the medical history, with a lung function diagnosis (vital capacity (maximum, arbitrary capacity of the lungs in air). In the first second, two thirds of the air is exhaled, the rest in one or two more seconds. If the person to be examined is less than two thirds of the vital capacity can exhale, the bronchi are already more or less narrowed), allergy diagnostics and further blood tests in the laboratory.

A more precise determination can be carried out with whole-body plethysmography (measurement of the resistance that the airways oppose to the air that is inhaled and exhaled). A pulmonologist can also develop further diagnoses.

Complications

Chronic obstructive bronchitis, as is often the case with smokers, can result in various serious complications. On the one hand, bronchitis constantly excretes secretions. This increases the risk of bacterial infections, which can worsen the disease (exacerbation).

In some cases, air can accumulate in the alveoli. This can cause them to over-inflate and this leads to emphysema. As a result, the vesicles can burst and the air escapes into the pleural space. This can cause a pneumothorax to develop.

The heart is also overloaded by the emphysema, since the pulmonary vessels are compressed due to the overinflation, so that the heart has to exert higher pressure to ensure the blood flow. This can lead to weakness of the right heart (right heart failure). Another complication is the development of edema, especially in the lower extremities.

The combination of chronic bronchitis and emphysema is also known as COPD (chronic obstructive pulmonary disease). Life expectancy is reduced by five to seven years. Chronic bronchitis also means that the person affected is more frequently exposed to toxins in the surrounding air. These can damage the bronchi. The risk of developing lung cancer is also increased.

When should you go to the doctor?

With cough, sputum, shortness of breath and other signs of chronic obstructive bronchitis, a doctor should always be consulted. It is even better to have chronic bronchitis medically clarified and treated. At the latest when the typical shortness of breath is noticed, a visit to the doctor is recommended. Fever, chest tightness, and increased sputum are also medical emergencies that need to be addressed immediately. In the event of an acute emergency - i.e. shortness of breath and circulatory collapse - the emergency services must be alerted.

It may be necessary to ventilate the patient until the doctor arrives. If chronic obstructive bronchitis is not adequately treated, complications such as right heart failure or lung cancer can occur - both serious illnesses that require hospitalization. Smokers and those with chronic respiratory infections are particularly susceptible to the condition. If you belong to these risk groups, it is best to consult your family doctor about the symptoms mentioned. Other contacts are the pulmonologist, an internist or the ENT doctor.

Doctors & therapists in your area

Treatment & Therapy

The first and foremost treatment is to quit smoking. Of course, this only applies to actual smokers. Otherwise very "dusty" activities (wiping dust, vacuuming) should only be carried out with the breathing mask on.

Active physical activity can stop the progression of chronic obstructive bronchitis, but it cannot prevent it. The physical resilience and thus the quality of life of the sick person improves.

In special training courses, the patient can learn to properly classify the prescribed medication and to live normally with the disease. These are also steps to stabilize the functioning of the lungs. In very severe cases it may be that mucus has to be sucked out or the sick person needs artificial ventilation. However, this can be prevented with timely prophylaxis.

To make breathing easier, an application for a cure by the sea is recommended.

Outlook & forecast

The prognosis for chronic obstructive bronchitis shows no prospect of a cure. However, the course can be very different. It applies here that a complete waiver of treatment promotes a negative outcome. Rapid intervention in the event of secondary and concomitant diseases is also relevant. Life expectancy can be shortened to a greater or lesser extent. Continuing to smoke will strengthen the effects of the damage caused by the disease and accelerate the course of the disease.

The affected person's shortness of breath can worsen as the disease progresses, which is usually due to further narrowing of the airways. Chronic obstructive bronchitis thus also triggers resting stress in some patients. Overloading of the right part of the heart can result and can lead to water retention, cardiac arrhythmia and an enlarged heart chamber. The persistent inflammation of the airways causes more and more small ducts in the bronchi and alveoli to go under. Pulmonary emphysema is the result.

A worsening spurt can result from a variety of causes, including bacterial or viral infections (the susceptibility to infections also increases with the duration of the disease) and a sudden increase in the burden on the lungs. Such deterioration can leave its mark and lead to a permanent deterioration in the state of health, which manifests itself in an intensification of all symptoms associated with chronic obstructive bronchitis.

The illness can also become a financial and psychological burden, as it can lead to absenteeism, secondary illnesses and depressive moods.

prevention

Chronic obstructive bronchitis only develops under favorable conditions. That is why the disease can be prevented very well. In the event that bronchitis was common in childhood, one should refrain from smoking in later years.

In addition, you should not choose a job that exposes you to dust, gases or vapors. If you do, you should definitely keep your checkups and appointments of this kind. Sufficient hardening by taking a cold shower and getting enough exercise is helpful. In centrally heated rooms, complete room air humidification, as germ-free as possible, should be ensured.

Aftercare

Follow-up care and prevention are closely linked in chronic obstructive bronchitis. The main thing is to completely or at least as best as possible eliminate all factors that can further damage the bronchi. Smoking is an important factor in this context.

In the case of nicotine addiction, the patient may need professionally supported weaning. Paints and varnishes as well as other substances that could emit toxic or otherwise harmful vapors should be avoided as far as possible. This specifically applies not only to the private, but also to the professional context.

In order to be able to easily cough up mucus, which is often associated with chronic obstructive bronchitis, when it occurs, it is ideally liquefied. This means that the patient should ensure that they drink enough water. Still water and herbal teas are particularly suitable here.

Infection is to be avoided by all means. This includes all measures that strengthen the immune system, but also avoiding contact with people who are currently suffering from an acute infection. A change of air is recommended in many cases for patients with chronic obstructive bronchitis. The salty air of the North Sea and Baltic Sea is often the ideal backdrop for optimal aftercare. The mountains with their pure, low-pollen air are also ideal for a stay.

You can do that yourself

Those affected by chronic obstructive bronchitis can alleviate the suffering with self-administered measures. This applies in particular to acute coughing attacks and the risk of the onset of shortness of breath.

It is essential to refrain from smoking. Avoid dust, chemical vapors and other sources of irritating particles. If necessary, certain areas should only be entered with a respirator. While coughing with phlegm is positive in some cases, dry cough is only excruciating and unproductive.

In order to alleviate and also avoid this, those affected can resort to inhalations with steam. Breathing through the nose with the mouth closed also calms the bronchi thanks to the warmer air. Throat sweets with herbal products can have an expectorant, calming or even slightly paralyzing effect on the bronchi - which substances can be used must be clarified with the attending physician.

Sufferers should try to maintain or improve their breathing and efficiency despite having chronic obstructive bronchitis. Better breathing is achieved, for example, by practicing the brake lip, through targeted breathing training - also with the help of technical equipment - and through lung sports.

Which sport is suitable, however, must be clarified with the doctor against the background of the sequelae of the disease (heart failure, lung cancer, etc.). In addition, with the help of special techniques that affect breathing and posture, coughing up can be made much easier.