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Am Fam Physician. 1998;57(10):2376-2378

See related article on chronic bronchitis.

What is chronic bronchitis?

Chronic bronchitis is an inflammation, or irritation, of the airways in the lungs. Airways are tubes in your lungs that air passes through. They are also called bronchial tubes. When the airways are irritated, thick mucus gets into the tubes. The tubes get plugged up with mucus. The mucus blocks the airways and makes it hard for you to get air into your lungs. Symptoms of chronic bronchitis include a cough that makes mucus (sometimes called sputum), troubled breathing and a feeling of tightness in your chest. Chronic bronchitis is a form of chronic obstructive pulmonary disease (which is often called COPD). Another type of COPD is emphysema. Mucus is not the main problem in emphysema.

What causes chronic bronchitis?

Cigarette smoking is the main cause of chronic bronchitis. When tobacco smoke is breathed into the lungs, it irritates the airways and causes mucus production. Sometimes people who don't smoke get chronic bronchitis. People who have been exposed for a long time to things that irritate their lungs, like chemical fumes, dust and other substances, can also get chronic bronchitis.

What tests might be done if my doctor thinks I have chronic bronchitis?

Before you have tests, your doctor will ask you about your symptoms: Are you coughing up mucus? Are you having trouble breathing? Does your chest feel tight? Do you smoke cigarettes? How many cigarettes do you smoke each day? How many years have you been smoking? Have you been breathing in other things that can irritate your lungs?

If your doctor thinks you have chronic bronchitis, you may be tested to find out if your lungs are damaged. You might have a pulmonary function test to see how well your lungs are working: you breathe into a machine that measures the amount of air in your lungs. Your doctor may also order blood tests and a chest x-ray.

What can be done to improve my breathing and reduce my coughing?

If you smoke, the most important thing you can do is to stop smoking. The more smoke you breathe into your lungs, the more lung damage you'll have. Ask your doctor to help you stop smoking. If you stop smoking, you'll breath better and your lungs will begin to heal. You'll also have less chance of getting lung cancer.

It's important to try to avoid other things that can irritate your lungs. It's best if you don't breathe in aerosol products, like hairspray, spray deodorant and spray paint. Also avoid breathing in dust or chemical fumes. To protect your lungs, wear a filtering mask over your nose and mouth if you are using something that can irritate your lungs, such as paint remover, varnish, paint or anything else with strong fumes.

Can medicine treat chronic bronchitis?

Yes, your doctor may prescribe several medicines, called bronchodilators, to treat your chronic bronchitis. The medicine opens, or dilates, the airways in your lungs and helps you breathe better.

Medicine for chronic bronchitis is usually inhaled (breathed in) rather than taken as a pill. An inhaler is used to get the medicine into your lungs. It's important to use your inhaler the right way, so you get the most benefit from the medicine. Ask your doctor to show you how to use the inhaler. Then, show your doctor how you are using the inhaler so you can be sure you're using it the right way. Your doctor may also prescribe medicines for you to take as pills. Theophylline is one kind of medicine that is taken as a pill for chronic bronchitis. It's the same medicine that is used by people with asthma.

If your symptoms don't get better with these medicines, your doctor may prescribe steroids. You can take steroids either with an inhaler or in pills.

Will antibiotics help chronic bronchitis?

In general, antibiotics don't help chronic bronchitis. But antibiotics may be helpful if you get a lung infection along with your chronic bronchitis. If you have a lung infection, the amount of mucus you cough up may increase. This mucus might be yellow or dark green. You also may have a fever. Your shortness of breath might get worse.

Because chronic bronchitis increases your risk of getting lung infections, be sure to get a flu shot every year. Also, get a pneumococcal vaccination to protect yourself against pneumonia.

What about oxygen therapy?

Because of the damage from chronic bronchitis, your lungs may not be able to get enough oxygen into your body. Your doctor may prescribe oxygen if your chronic bronchitis is severe and medicine doesn't help you feel better. If your doctor prescribes oxygen for you, be sure to use it day and night to get the most benefit from it. Oxygen can help you breathe better and live longer.

Can I do anything else to help my lungs?

Yes. Exercising regularly can strengthen the muscles that help you breathe. Try to exercise at least three times a week. Start by exercising slowly and for just a little while. Then slowly increase the amount of time you exercise each day and how fast you exercise. For example, you might begin exercising by walking slowly for 15 minutes three times a week. Then, as you get in better shape, you can increase your walking speed. You can also increase the length of time you walk to 20 minutes, then 25 minutes, then 30 minutes.

You could ask your doctor about an exercise program called pulmonary rehabilitation to help you improve your breathing. Pulmonary rehabilitation is often given by a respiratory therapist (a health care professional who knows about lung treatments). Your doctor may refer you to the pulmonary rehabilitation program at your local hospital.

A breathing method called “pursed-lip breathing” may help you: take a deep breath and then breathe out slowly through your mouth while you hold your lips as if you're going to kiss someone. Pursed-lip breathing slows down the fast breathing that goes with chronic bronchitis. It may help you feel better.

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