Chronic bronchitis symptoms

Written by Wang Xiang Yu
Pulmonology
Updated on September 09, 2024
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Chronic bronchitis is also known as "old chronic bronchitis." From the name, it can be inferred that its cough and expectoration last for a long time and its onset is slow, which can manifest as acute exacerbation. The main symptoms of chronic bronchitis are cough and expectoration, either with or without wheezing. The cough in chronic bronchitis usually occurs in the morning, meaning that the cough is more pronounced upon waking up. The sputum is generally white, sticky, mucoid, or frothy, and may occasionally contain streaks of blood but generally is not associated with coughing up blood. In addition to coughing and expectoration, a small number of patients may experience wheezing or shortness of breath. In cases where the wheezing is more pronounced, it is also referred to as asthmatic bronchitis.

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Written by Wang Xiang Yu
Pulmonology
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Chronic bronchitis auscultation characteristics

Most patients with chronic bronchitis, for the most part, show no abnormalities upon lung auscultation. This means their breath sounds are relatively clear, without diminished or enhanced breath sounds, nor any dry or wet rales typically heard. This is the case for the majority of patients; however, a small number of patients during acute exacerbations might present with some dry or wet rales at the back or the base of the lungs. Moreover, these rales may disappear after the patient coughs, indicating that in chronic bronchitis, the sounds heard upon auscultation can change and are not constantly present. You might hear dry or wet rales one moment, and after the patient coughs or receives treatment, these sounds could potentially alleviate. Additionally, if a patient with chronic bronchitis starts to wheeze or develops asthma, they might exhibit sounds such as wheezing or prolonged expiration.

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Written by Liu Xiao Li
Pulmonology
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How to treat chronic bronchitis?

Chronic bronchitis is divided into acute exacerbation phase and remission phase. The treatment during acute exacerbation mainly focuses on controlling infections, and administrating antitussive, expectorant, and asthma-relieving medications. To control infections, antibiotics are empirically selected based on the common pathogens in the area. If the pathogen can be cultured, an antibiotic sensitive to the organism can be chosen based on the test. Oral administration is generally sufficient. In severe cases, medication can be administered intravenously. Patients with asthma are given bronchodilators. During the remission phase, treatment involves quitting smoking, avoiding inhalation of harmful gases and other harmful particles, strengthening physical health, preventing colds, and for patients with repeated respiratory infections, vaccines or immunomodulators may be administered to enhance immunity.

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Written by Liu Xiao Li
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Symptoms of chronic bronchitis

The symptoms of chronic bronchitis primarily include coughing, expectorating phlegm, or accompanied by wheezing. Coughing generally occurs mainly in the morning, with bouts of coughing or expectoration during sleep. The sputum is white, viscous, or serous foamy, and is more prevalent in the morning. Getting up or changing body position can stimulate expectoration. In patients with prominent wheezing symptoms, it is referred to as asthmatic bronchitis, and some may also develop bronchial asthma. However, the presence of emphysema can manifest as shortness of breath after labor or activity. If the condition persists for three months each year, for two consecutive years or more, it can be clinically diagnosed as chronic bronchitis.

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Is chronic bronchitis hereditary?

The etiology of chronic bronchitis is not very clear at present. It is considered that many factors work over a long period to cause chronic bronchitis. The most common factors include long-term irritation from harmful gases and particles, such as cigarette smoke, smog, dust, irritating gases like sulfur dioxide, nitrogen dioxide, etc., as well as infectious factors. There might also be a certain relationship with the occurrence of chronic bronchitis, but so far, no close relationship has been found between chronic bronchitis and genetics, and there is no evidence to prove that chronic bronchitis is a hereditary disease.

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Written by Wang Xiang Yu
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How to treat chronic bronchitis?

How to treat chronic bronchitis, first of all we need to know that chronic bronchitis can be divided into two phases, one is the remission phase, the other is the acute exacerbation phase. Since most patients are in the remission phase most of the time, that is, their symptoms of cough and expectoration are relatively stable, more or less the same every day, with no significant change in the amount and nature of the sputum, no purulent sputum, no significant increase in sputum, and no fever or other symptoms of infection. In such cases, the first step in treating chronic bronchitis patients is to target some possible causes of their condition, such as smokers must quit smoking. Most chronic bronchitis patients experience some relief in cough and expectoration after quitting smoking. Furthermore, some patients' chronic bronchitis may be due to exposure to dust or irritant gases. It is crucial to avoid contact with these harmful gases as much as possible. In addition, patients in a stable condition should engage in physical exercise, enhance their physical fitness, and prevent colds. Some chronic bronchitis patients who frequently suffer from respiratory infections can consider using immunomodulators or some traditional Chinese medicine to regulate immunity and enhance resistance. Additionally, since chronic bronchitis can acutely exacerbate, which means the patient’s condition has changed, their cough and expectoration frequency may increase, the amount of sputum may increase, or there may be some purulent sputum, or fever and other symptoms. In such cases, the primary treatment may still be infection control, commonly using antimicrobial drugs, often referred to as anti-inflammatory drugs. The types of anti-inflammatory drugs are numerous, the most common ones include penicillin, erythromycin, levofloxacin, amoxicillin, and some cephalosporins. In such cases, it is necessary to choose medication under the guidance of a doctor. Additionally, in these situations where the patient’s cough and expectoration are worsened, and sputum increases, medications for cough suppression and expectoration, commonly known as expectorants and cough relievers, are also needed. There are some proprietary Chinese medicines, such as licorice preparations, and Western medicines such as bromhexine and ambroxol as well. Moreover, a very small portion of patients may experience wheezing, meaning some patients might also have symptoms like chest tightness and shortness of breath. In such cases, it would be necessary to use bronchodilators under the guidance of a doctor, such as theophylline or doxophylline, and these medications must be used under medical supervision.