Chronic bronchitis auscultation characteristics

Written by Wang Xiang Yu
Pulmonology
Updated on September 05, 2024
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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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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
1min 3sec home-news-image

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 Wang Xiang Yu
Pulmonology
58sec home-news-image

Chronic bronchitis symptoms

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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Can chronic bronchitis be treated?

Chronic bronchitis, commonly known as "chronic obstructive bronchitis," is treatable. The primary symptoms of chronic bronchitis are coughing and expectoration. If the disease occurs for more than three months each year, for two consecutive years, while excluding other organic diseases, chronic bronchitis can be diagnosed. Treatment for chronic bronchitis is divided into two parts. During acute exacerbations, which typically present with worsened coughing and expectoration, increased sputum volume, or the presence of purulent sputum and possibly accompanied by wheezing and fever, the main treatment is anti-infection. The primary medications for anti-infection are antimicrobial drugs, which include macrolides, quinolones, cephalosporins, etc. Additionally, treatment can be aimed at alleviating symptoms of coughing and expectoration and might include expectorants and cough suppressants, such as ambroxol. For wheezing, medications like aminophylline or nebulized treatments may be necessary. Most of the time, patients with chronic bronchitis are in a remission phase. The primary treatment here initially involves addressing known triggers, such as insisting smokers quit and minimizing exposure to dust or harmful gases at work. Chronic bronchitis patients are encouraged to exercise moderately, strengthen their physique, and prevent colds. For patients who experience repeated respiratory infections, vaccination or immune modulators, such as BCG, may be considered. Always follow a physician’s guidance regarding specific medication use.

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Written by Wang Xiang Yu
Pulmonology
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How is chronic bronchitis diagnosed?

Chronic bronchitis: how is it diagnosed? First, we need to understand what chronic bronchitis is defined as. It refers to the chronic nonspecific inflammation of the trachea, bronchial mucosa, and surrounding tissues. We emphasize the chronic process, and currently, diagnosis is primarily based on clinical symptoms. This means the patient must exhibit symptoms such as coughing and expectoration, and these symptoms must persist for more than three months for at least two consecutive years. Additionally, it is crucial to exclude other diseases. Any organic disease that presents with symptoms of coughing, expectoration, and wheezing must be ruled out, such as tuberculosis, pneumoconiosis, lung abscess, lung cancer, heart disease, bronchiectasis, bronchial asthma, gastroesophageal reflux, and pulmonary interstitial fibrosis, among others.