How to treat chronic bronchitis?

Written by Wang Xiang Yu
Pulmonology
Updated on September 11, 2024
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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.

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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 Wang Xiang Yu
Pulmonology
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Does chronic bronchitis hurt?

Chronic bronchitis, commonly known as "chronic bronchitis", generally does not involve pain. The main symptoms of chronic bronchitis are coughing and expectorating phlegm, which may or may not be accompanied by wheezing. The coughing and expectorating in chronic bronchitis are typically long-term and gradual, with recurrent episodes. The symptoms are usually more pronounced in the morning, characterized by white, sticky phlegm, and generally do not involve chest pain or pain in other areas. If a patient with chronic bronchitis experiences pain in various parts of the body, it is typically considered that they might have other concurrent illnesses.

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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.

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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.