Clinical criteria

• Cough and expectoration must occur most days for at least three months per year, for two years in a row.
• Other causes of symptoms, such as tuberculosis or other lung diseases, must be excluded.

Clinical signs and symptoms

• Cough with expectoration
• Frequent and severe respiratory infections
• Wheezing
• Dyspnea- difficulty in breathing
• Orthopnea- difficulty in breathing in lying down position
• Narrowing and plugging of breathing tubes
• Cyanosis- bluish discoloration of skin and lips
• Swelling of the feet
• Disability, tiredness, sweating
• Exhausted (accessory muscles of respiration in action)

Causes of chronic bronchitis

Cigarette smoking is cited as the most common contributor to chronic bronchitis, followed by:

• bacterial or viral infections
• environmental pollution

Chronic bronchitis is often associated with other pulmonary diseases such as:

• pulmonary emphysema
• pulmonary fibrosis
• asthma
• tuberculosis
• sinusitis
• upper respiratory infections

Complications

• Heart failure- Cor pulmonale
• Acute exacerbation of chronic bronchitis
• Lung collapse or atelcetasis
• Respiratory failure
• Pneumonia
• Cardiac arrhythmia

Tests and diagnosis

• Pulmonary function tests – spirometry
• Complete blood test
• Chest X-ray
• Arterial blood gas analysis
• Pulse oximetry
• CT- chest

Treatment

Specific treatment for chronic bronchitis will be determined by the physician based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Treatment includes

• Oxygen supplementation 5lts/min
• Bronchodilators inhaled medications (salbutamol, ipratropium bromide)
• Steroids inhalation and IV route
• Lung reduction surgery
• Lung transplantation