Chronic bronchitis, one of the two major diseases of the lung grouped under COPD, is diagnosed when a patient has excessive airway mucus secretion leading to a persistent, productive cough. An individual is considered to have chronic bronchitis if cough and sputum are present on most days for a minimum of 3 months for at least 2 successive years or for 6 months during 1 year. In chronic bronchitis, there also may be narrowing of the large and small airways making it more difficult to move air in and out of the lungs. An estimated 12.1 million Americans have chronic bronchitis.
Emphysema and chronic bronchitis are chronic (long-term) lung diseases that make it hard to breathe. Both diseases are chronic obstructive pulmonary diseases (COPD), meaning they are conditions that cause a limitation in airflow. Emphysema and chronic bronchitis can occur separately or together and are usually the result of cigarette smoking. In addition, although it happens rarely, a genetic form of emphysema can occur early in adulthood, even if you never smoked.
Cigarette smoking is the most common cause of COPD. Most people with COPD are smokers or former smokers. Breathing in other kinds of lung irritants, like pollution, dust, or chemicals, over a long period of time may also cause or contribute to COPD.
With chronic bronchitis, the airways that carry air to the lungs are inflamed and produce a lot of mucus. The mucus and inflammation cause the airways to narrow or become obstructed, making it difficult to breathe. Once the airways are irritated over a long period, the lining of the airways becomes thickened. This thickening of the airways results in an irritating cough, hampered airflow, and lung scarring. The damaged airways then become a breeding place for bacterial infections such as pneumonia.
Breathing tests enable your doctor to measure the rate at which air can move out of your lungs. A breath-holding test can also be used to check the severity of your emphysema. Sometimes the oxygen level in the blood stream is measured either through the skin or from the blood itself.
Blood tests, laboratory examination of the phlegm, and chest X-rays may help in the diagnosis of emphysema and chronic bronchitis. These tests are especially useful during acute infections to detect the presence of pneumonia.
The following guidelines can help emphysema or chronic bronchitis:
* Good hygiene can decrease respiratory infections such as colds. Prevent the spread of a cold virus by making sure you and your family members wash your hands regularly.
* Check with your doctor about a pneumonia and influenza vaccine. You need a flu shot every year. One pneumonia shot is usually enough to protect you from a specific type of bacterial pneumonia.
* Avoid crowds during cold and flu season, since colds and flu can cause serious problems for people with COPD.
* Pay attention to healthy lifestyle habits by avoiding cigarette smoke and air pollutants; eating a balanced, healthy diet; and exercising to stay strong.
* Sinus infections can trigger breathing problems for those with emphysema and chronic bronchitis. Be aware of your sinus symptoms and report them immediately to your doctor to prevent worsening of breathing difficulties.
A lot can be done to improve function and relieve symptoms associated with the two conditions, but unfortunately it is not possible to reverse the processes, which have already taken place. If you give up smoking, this alone will help reduce coughing and production of phlegm and reduce breathlessness and other symptoms, and will also reduce the speed that the problem deteriorates.
The use of medications and inhalers should be discussed with your doctor. Cough mixtures, expectorants, or broncho-dilators may be prescribed to help reduce inflammation in the airways and make them wider. it is important to stay on your prescribed medications for emphysema and chronic bronchitis. Then, to decide how to treat cold symptoms, it’s best to talk with your doctor. You might treat the body aches and fever associated with a cold with acetaminophen or ibuprofen. In addition, you should avoid antihistamines that thicken mucus and make it even more difficult to cough up.
Chest infections make chronic bronchitis and emphysema worse, so these should be treated with antibiotics. Ideally, they should be taken at the first signs of infection – usually an increase in the amount of mucus or a change in its colour. A cortico-steroid or ‘cortisone’ may be used during infections. Discuss with your doctor whether it is worth keeping a small supply of these medications ready at home.
To find out if oxygen can help, you will need a referral to a respiratory physician who may order additional tests. These will include breathing tests, measurement of the amount of oxygen in the blood and possibly a simple exercise test. If the amount of oxygen in your blood is found to be very low, and you have stopped smoking for good, the specialist may arrange for you to have an oxygen supply at home. This is usually a machine called an oxygen concentrator but oxygen cylinders are sometimes used. The oxygen concentrator is an electrically driven machine that extracts oxygen from the air and is more convenient and cheaper than using oxygen cylinders.
Portable oxygen cylinders are sometimes recommended if you get very breathless when walking. These oxygen cylinders contain enough oxygen for an hour or so and can be placed on a shoulder pack or in a small hand-pushed trolley to make shopping or travelling easier.
Some scientists believe that nonfamilial emphysema, usually called “smoker’s emphysema,” also results from an imbalance between elastin-degrading enzymes and their inhibitors. The elastase-AAT imbalance is thought to be a result of the effects of smoking, rather than inherited as in familial emphysema. Some evidence for this theory comes from studies on the effect of tobacco smoke on lung cells. These studies showed that tobacco smoke stimulates excess release of elastase from cells normally found in the lung. The inhaled smoke also stimulates more elastase-producing cells to migrate to the lung which in turn causes the release of even more elastase. To make matters worse, oxidants found in cigarette smoke inactivate a significant portion of the elastase inhibitors that are present, thereby decreasing the amount of active antielastase available for protecting the lung and further upsetting the elastase-antielastase balance.
Tags: adulthood, bacterial infections, breathing tests, chronic bronchitis, chronic obstructive pulmonary diseases, cigarette smoking, copd, emphysema, irritants, lung diseases, lung scarring, mucus secretion, obstructive pulmonary diseases, sputum