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Chronic bronchitis

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Chronic bronchitis

Chronic bronchitis: is characterized by chronic cough and sputum production for at least 3 months/ year for 2 consecutive years. It is caused by hypersecretion and overproduction of mucus by goblet cells which leads to luminal obstruction of small airways, remodelling of the epithelial cells, and alteration of the airway surface tension leading to collapse.

How does it all happen?

• There is inflammation of the bronchial tubes lining through which the air passes to and fro from the lungs.

• Primary mechanism is the excessive mucus production which results due to hypersecretion and overproduction by the goblet cells and decreased rate of mucus elimination.

• Mucus metaplasia is common in COPD (chronic obstructive pulmonary disease) patients.

Causes:

Environmental stimuli: Smoking, being the most common cause. Passive smoking also results in being a cause of chronic bronchitis. Then environmental factors like air pollution, engine & welding fumes, dust particles, fire smoke, house paints in case of building contractors and certain hair products/sprays for individual working at hair salon.

• Accompanied with other diseases like tuberculosis, asthma, COPDs, Pulmonary fibrosis and in immunocompromised patients.

• GERD causes repetitive episodes of reflux in the throat which irritates the throat lining predisposing it to developing bronchitis.

Symptoms:

• Cough which is often referred to as smokers’ cough.

• Mucus production, can have a yellow discoloration to it.

• Chest discomfort experienced in form of tightness of chest and shortness of breath.

Wheezing

Alarming signs:

• If fever is higher than 100.4 F/ 38 oC.

• Discoloured mucus or if it is associated with blood.

• Bluish discoloration of fingers, skin or nails (cyanosis) which occurs secondary to decreased oxygen levels.

Complications:

Decreased lung function: chronic mucus hypersecretion has shown consistently to be associated with severe decline in FEV1 and with an increase in hospitalization due to COPD.

• Increased risk of COPD exacerbation.

• Associated with Increased respiratory symptoms and severe health related quality of life (HRQoL).

Chronic bronchitis is a risk factor for respiratory related deaths caused due by pulmonary infections.

Diagnosis:

Lung function test – Spirometer devices are used to assess the pulmonary functioning in form of how long the lung can hold , take in and move out the air. (less air in – restrictive type; less air out- obstructive type of lung disease). It is also helpful in assessment of the the on going treatment and in grading the seriousness the disease.

Prevention:

• Avoid cigarette smoke. Quit cigarette smoking and avoid being a passive smoker as well.

• Wear a mask (N95 respirators) to avoid environmental stimuli like pollution , dust, fire smokes, by professionals at salons and building contractors.

• Vaccines: Getting a flu vaccine to prevent influenza and virus and vaccine to prevent certain types of pneumonia.

• Maintaining hygiene: Simple steps like washing hands, use of hand sanitizers, and wearing a mask can prevent from infections and its spread.

Treatment:

• Cessation of smoking as it improves the mucociliary function with decrease in the hyperplasia of the goblet cells.

• Including Pulmonary rehabilitation like chest physiotherapy, flutter valve and high frequency chest wall oscillators since they augment the shear stress to improve the mucociliary clearance.

Remedies:

• Getting good sleep overcomes the fatigue caused by chronic bronchitis and helps in repairing the damaged tissues. One should try sleeping with head raised by use of pillows since this facilities a smooth breathing process and helps in clearing the mucus.

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