Chronic Bronchitis Overview

Introduction

When the airways in the lungs, known as the bronchi, become inflamed, it is called bronchitis.  This inflammation often results in severe coughing accompanied by the production of mucus, wheezing, chest pain, and shortness of breath. 

There are two main types of bronchitis, namely acute and chronic bronchitis. Acute bronchitis is usually caused by respiratory infections such as colds and can go away within a week or two, while chronic bronchitis is more severe and develops over a long time.1

What is chronic bronchitis?

Chronic bronchitis occurs when there is a cough that lasts for more than three months occurring within a two-year time period. Chronic bronchitis has shown to be associated with smoking and is often secondary to Chronic Obstructive Pulmonary Disease (COPD).2  Statistics have shown that about 3% to 7% of healthy persons in the general population have chronic bronchitis and, among those who have been diagnosed with COPD, it may be as high as 74%. 

Many people in the general population who have chronic bronchitis symptoms might not have a confirmed respiratory diagnosis. Studies have shown that healthy people under the age of 50 with chronic bronchitis are at a higher risk of morbidity and mortality compared to other healthy people. Chronic bronchitis is known to be more common as people get older and among tobacco smokers.2

Symptoms

People may experience a wide range of symptoms of chronic bronchitis, but the most common symptoms include: 

  • Smoker’s cough: A kind of chronic cough that is due to smoking, usually phlegmy rather than dry and may produce mucus.
  • Wheezing 
  • Discomfort in the chest 
  • Shortness of breath 
  • Fatigue
  • Slight fever and chills
  • Bluish fingernails 
  • Swollen feet 
  • Heart failure 3

Causes

There are numerous causes of chronic bronchitis, and exposure to cigarette smoke whether through active smoking or passive smoking remains the most significant cause. Smog, industrial pollutants, and hazardous chemicals are just a few of the respiratory system irritants that can cause chronic bronchitis when inhaled. 

Although bacterial and viral infections typically result in acute bronchitis, chronic bronchitis can also be brought on by persistent infection exposure. Viruses like Influenza types A and B and bacteria like Staphylococcus, Streptococcus, and Mycoplasma pneumonia are the most common viral and bacterial causes of the disease.2

Risk factors

Factors that increase the risk of getting chronic bronchitis include:

  • Asthma: This occurs as asthma can cause narrowing of the lungs' airways. The mucus  is then created by the irritated airways4.
  • Prolonged breathing in of chemicals, dust, and other substances 
  • Constantly being around people who smoke (secondhand smoke)
  • Having a family history of Chronic Obstructive Pulmonary Disease (COPD)
  • Having a lot of lung diseases before the age of two. 

You can reduce your risk of chronic bronchitis by making a few changes to your lifestyle

The following lifestyle factors have the greatest impact on your risk of chronic bronchitis. We will also look at what you can do to reduce your risk from today.

Nutrition

Nutrition plays an important role in reducing chronic bronchitis, as the food we eat can affect our breathing. Nutrition and breathing are related as food and oxygen are raw materials for the process of producing energy in the body. This process produces energy which the body uses for different needs. Carbon dioxide is one of the waste products and is breathed out. Therefore, the right combination of food can help you breathe better. 

When metabolised, carbohydrates produce the most carbon dioxide for the amount of oxygen used compared to fats that produce the least. Therefore, some COPD sufferers find that eating a diet high in fat and low in carbohydrates makes it easier for them to breathe.5

Physical activity

Regular physical activity has been shown to improve how the lungs use oxygen. A form of physical training called exercise training is internationally recommended as the best available method for enhancing muscle function and exercise tolerance in people with COPD and is considered the cornerstone of pulmonary rehabilitation. 

Exercise training increases physical fitness, lowers anxiety and depression symptoms, and reduces dyspnea and weariness in COPD patients. It is yet to be seen whether and how much an increase in daily physical activity will enhance these results.6

Obesity

Obesity has been found to increase the risk of bronchitis.7 Therefore, reducing body weight will ease breathing, consequently reducing the risk of chronic bronchitis. 

In general, short-term weight loss is promoted by treatment plans that include nutritional and exercise plans as well as medication. For example, complex carbohydrates, fresh fruits and vegetables are encouraged compared to white bread and pasta for weight loss.1

Alcohol

Alcohol use has been linked to an increased risk of bronchitis, with heavy drinkers having a greater chance of having chronic bronchitis compared to moderate drinkers.8 Therefore, reducing alcohol consumption can lower the risk of chronic bronchitis.

Hydration

In chronic bronchitis, poor hydration of lung airways can reduce the clearance of mucus in the lungs, resulting in the worsening of chronic bronchitis symptoms.9 In order to facilitate sputum clearance in the lungs, patients with chronic lung illnesses are typically urged to drink a lot of fluids.10 This helps to ease the symptoms of the disease and thin the mucus produced.

Sleep

Having a good night's sleep is important if you have COPD, as it helps in ensuring that you can breathe easily. According to the American Thoracic Society, studies have shown a positive relationship between poor sleep and an increase in COPD symptoms as well as a higher risk of the condition's consequences.11 

Mental health

Studies have shown that people assigned female at birth (AFAB) with chronic bronchitis were more likely to experience psychological discomfort. Anxiety and depression were largely associated with chronic bronchitis among people AFAB with a high level of exposure to smoking. Therefore it is important for people with chronic bronchitis to positively manage the symptoms of chronic bronchitis in order to reduce symptoms of anxiety and depression.12

Wellness

Keeping your emotional health balanced is necessary for your physical health. Self-care is important for overall good health. 

Reports have supported the idea that greater well-being significantly reduces the risk of COPD.  Interventions aimed at enhancing well-being may also help lower the prevalence of COPD in older individuals and the intrinsic advantages of greater well-being.13 

Conclusion

Chronic bronchitis is the result of repeated inflammation, which is characterised by severe coughing accompanied by the production of mucus, wheezing, chest pain, and shortness of breath. There are many causes, including having asthma, breathing in a lot of cigarette smoke or smog, and indirect lifestyle habits, such as being overweight, that increase your chances of developing bronchitis. Making changes to your lifestyle may help you to significantly reduce the risk of developing chronic bronchitis.

Diagnostic testing

At Klarity we use the latest technology when it comes to diagnostic testing. Our home blood tests give you health insights and personalised recommendations. Find out which test you should take. 

References

  1. American Lung Association. Chronic Bronchitis. [Online].; 2022 [cited 2022 August 11. Available from: https://www.lung.org/lung-health-diseases/lung-disease-lookup/chronic-bronchitis.
  2. Widysanto A MG. Chronic Bronchitis. In StatPearls..: Treasure Island (FL): StatPearls Publishing; 2022.
  3. Medicine JH. Chronic Bronchitis. [Online]. [cited 2022 August 11. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-bronchitis.
  4. Healthline. Asthmatic Bronchitis: When Asthma Leads to Bronchitis. [Online].; 2016 [cited 2022 August 13. Available from: https://www.healthline.com/health/asthma/asthma-bronchitis.
  5. American Lung Association. Nutrition and COPD. [Online].; 2021 [cited 2022 August 14. Available from: https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/living-with-copd/nutrition.
  6. Spruit MA, Burtin C, De Boever P, Langer D, Vogiatzis I, Wouters EFM, et al. COPD and exercise: does it make a difference? Breathe (Sheffield, England). 2016; 12.
  7. Lee YL, Chen YC, Chen YA.. Obesity and the Occurrence of Bronchitis. Obesity journal. 2013 January; 21.
  8. Suadicani P. Exposure to cold and draught, alcohol consumption, and the NS-phenotype are associated with chronic bronchitis: an epidemiological investigation of 3387 men aged 53-75 years: the Copenhagen Male Study. Occupational and Environmental Medicine [Internet]. 2001 Mar 1 [cited 2022 Sep 8];58(3):160–4. Available from: https://oem.bmj.com/lookup/doi/10.1136/oem.58.3.160
  9. Anderson WH, Coakley RD, Button B, Henderson AG, Zeman KL, Alexis NE, et al. . The Relationship of Mucus Concentration (Hydration) to Mucus Osmotic Pressure and Transport in Chronic Bronchitis. American Journal of Respiratory and Critical Care Medicine. 2015 April.
  10. Shim C, King M, Williams MH. Lack of effect of hydration on sputum production in chronic bronchitis. Chest. 1978 October; 92.
  11. Orenstein BW. How to sleep better with COPD [Internet]. EverydayHealth.com..; 2021 [cited 2022 August 12. Available from: https://www.everydayhealth.com/hs/managing-copd/sleep-tips-for-copd/.
  12. Umoh VA, Ibok A, Edet B, Essien E, Abasiubong F. Psychological Distress in Women with Chronic Bronchitis in a Fishing Community in the Niger Delta Region of Nigeria. International Journal for Family Medicine. 2013 December; 2013.
  13. Okely JA, Shaheen SO, Weiss A, Gale CR.  Wellbeing and chronic lung disease incidence: The Survey of Health, Aging and Retirement in Europe. PloS one. 2017 July; 12.

Fuanyi Awatboh

M.Sc. in Epidemiology and Control of Infectious Diseases, University of Buea, Cameroon

I am a professional Quality Assurance Mentor with Global Health Systems Solutions. My job is to enhance HIV testing, Care, and treatment by making sure that all entry points in the three hospitals under me follow standard testing algorithms, have all necessary tools and equipment needed for testing, train testers if need be, and monitor that all positive cases are under treatment among other duties. I have also mentored laboratories to increase their quality of service and standards of operations.

Klarity is a citizen-centric health data management platform that enables citizens to securely access, control and share their own health data. Klarity Health Library aims to provide clear and evidence-based health and wellness related informative articles.