Is chronic bronchitis treatable?

Written by Wang Xiang Yu
Pulmonology
Updated on September 15, 2024
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Chronic bronchitis exists, but before treating it, we must first have a correct understanding of the disease. Chronic bronchitis is a long-term illness that can have a slow onset and may last for decades, with the possibility of acute exacerbations throughout one's life. Moreover, there is no cure for chronic bronchitis yet. Currently, the treatment for patients with chronic bronchitis mainly depends on the stage of the disease and its symptoms. Most of the time, patients are in the remission phase. The primary treatment during this phase involves addressing risk factors. For instance, patients who smoke must quit smoking, as most patients experience significant relief from cough and phlegm after quitting. Additionally, patients with a history of dust exposure or harmful gas exposure should avoid further contact as much as possible. Furthermore, when the condition is stable, patients may engage in physical exercise to improve their physical condition and prevent colds. A small number of patients may experience respiratory infections and repeated aggravations, in which case, consider using immunomodulators or traditional Chinese medicine as adjunctive therapies. Patients with chronic bronchitis may experience acute exacerbations of their condition, meaning an increase in cough and phlegm, or the appearance of purulent sputum that is difficult to expectorate. In these cases, the main treatment method is still anti-infection therapy. Commonly used anti-infection medications include quinolones, macrolides, and cephalosporins. Some patients may experience frequent and severe cough and phlegm, and have difficulty expectorating the mucus. In such cases, mucolytic and cough suppressant medications are required for symptomatic treatment, commonly using drugs such as ambroxol, bromhexine, and eucalyptus menthol. A few patients may also experience wheezing, known as asthmatic bronchitis, which may require the use of anti-asthmatic medications such as aminophylline and various nebulized medications. (Note: The use of specific medications should be under the guidance of a doctor.)

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Written by Liu Xiao Li
Pulmonology
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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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Written by Wang Xiang Yu
Pulmonology
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Chronic bronchitis etiology

The etiology of chronic bronchitis is not very clear at present, and it is now believed to be caused by the long-term interaction of various factors. The most closely related factors are harmful gases or particles that act on the respiratory tract for a long time, causing damage to some structures of the respiratory tract, such as cigarette smoke, fumes, dust, irritating gases, sulfur dioxide, nitrogen dioxide, etc. These physicochemical factors cause damage to the airways. Additionally, some infectious agents, such as bacteria, mycoplasma, or viral infections, along with some immune-related factors, are believed to play a certain role in the development of chronic bronchitis.

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Written by Wang Xiang Yu
Pulmonology
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What are the symptoms of chronic bronchitis?

Chronic bronchitis is also colloquially known as "old chronic bronchitis." From this name, we can tell that patients usually develop the disease slowly with a long duration, lasting for years, even decades. The symptoms, such as coughing and expectoration, can acutely worsen repeatedly. Most patients cough and produce phlegm mostly when indoors, particularly noticeable upon waking in the morning and also possibly at night. The phlegm is typically white, sticky, or serous and foamy; occasionally, it may be blood-streaked. During acute exacerbations of chronic bronchitis or when accompanied by an infection, pus-like yellow phlegm or green bloody sputum may appear. Additionally, a small number of patients may experience wheezing, also known as asthmatic bronchitis.

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Written by Wang Xiang Yu
Pulmonology
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Chronic bronchitis chest X-ray manifestations

Patients with chronic bronchitis may have completely normal chest X-rays or lung CT scans in the early stages, meaning that if a patient exhibits symptoms of chronic bronchitis, such as coughing and expectorating for more than three months continuously or over two consecutive years, they can still be diagnosed with chronic bronchitis even if their chest X-ray appears normal. Additionally, as chronic bronchitis progresses over time, some patients may develop thickening of the bronchial walls or interstitial inflammation in the small bronchioles and alveoli, etc. These conditions can manifest on chest X-rays as coarse, disordered lung textures in a net-like or strip-like pattern, or as patchy shadows, which are generally more evident in the lower fields of both lungs. Observing these changes on a chest X-ray can assist in diagnosing chronic bronchitis. Furthermore, as the disease progresses, some patients with chronic bronchitis may develop into chronic obstructive pulmonary disease (COPD) or pulmonary heart disease, and corresponding changes might be observable on chest X-rays. Additionally, patients with chronic bronchitis often experience acute exacerbations or concurrent infections, which may lead to patchy exudates visible on the chest wall.

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Written by Hu Bai Yu
Pulmonology
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Chronic Bronchitis Clinical Characteristics

Chronic bronchitis often presents with symptoms of coughing, which are long-term, recurrent, and progressively worsen. Coughing is a very prominent manifestation of this condition. For mild cases, symptoms typically flare up during the winter and spring seasons, especially noticeable upon waking in the morning, with less coughing during the day. In the summer and fall, the coughing may lessen or disappear. In severe cases, patients may experience coughing throughout the year. It's crucial to take note and, under a doctor's guidance, use corresponding anti-inflammatory and anti-infection medications, along with cough suppressants and expectorants to alleviate symptoms. Another characteristic is the presence of phlegm, typically white mucous sputum or serous foamy sputum. It's advised to use expectorants for treatment. During treatment, avoid smoking and alcohol, and maintain a light diet. Additionally, if there are symptoms of asthma or wheezing, it may be necessary to take medications to alleviate these symptoms. (Note: The answer is for reference only; medication should be administered under the guidance of a professional physician and should not be taken blindly.)