Chronic Bronchitis: Causes, Symptoms, Diagnosis & Treatment

Chronic Bronchitis: Causes, Symptoms, Diagnosis & Treatment

Question. Write a short note on chronic bronchitis.

Answer. Chronic bronchitis may be defied as a “condition where there is persistent productive cough for at least three consecutive months in at least two consecutive years”.

Etiology chronic bronchitis.

1. Cigarett smoking
2. Air pollution and clinical factors
3. Infections, i.e. upper respiratory tract infection in smokers
4. Occupation
5. Familial and genetic factors
6. Alpha-1 antitrypsin defiiency.

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clinical Features chronic bronchitis.

Symptoms

1. It affcts male more commonly than the females
2. Chronic bronchitis is present with recurrent attcks of cough
3. Cough may occur in paroxysms or is more in elderly hours of morning.
4. Cough is dry when start but later sputum is bringing out which is mucoid to mucopurulent sometimes, it is blood tinged.
5. Patient complains sense of tightness in chest, breathlessness and asthma­like picture.
6. Fever and toxemia appear when infection supervenes

Signs chronic bronchitis.

1. There is increase in respiratory rate.
2. Inspiratory and expiratory ronchi and presence of crepitation at the base of lungs.

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Investigation chronic bronchitis.

1. X-ray: In early stage, it is normal and later it shows widening of intercostal spaces, ribs placed more horizontally,diaphragm displaced downwards and some patient shows patches of pneumonia.
2. Sputum for culture and sensitivity test is usually sterile.
3. Lung function tests:

1. Decrease in FEV1
2. Subnormal FEV1/VC
3. Decrease in PEF
4. Normal lung volumes except with emphysema
5. Normal diffsing capacity.

4. Blood gas analysis: In severe cases, there is increase in hypercapnia and decrease in hypoxaemia.

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Management chronic bronchitis.

1. Bronchial irritants should be avoided, i.e.

1. Smoking should be strictly stopped.
2. Passive smoking is stopped.
3. Gas smoke is avoided by housemakers.
4. Aerosols such as hair spray, insecticide spray and aerosols should be avoided.
5. Polluted atmosphere should be strictly avoided.

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2. Treatment ofan infection:

1. Ampicillin 250–500 mg every 6 hourly is given for 5 to 7 days.
2. Cotrimazole 960 mg can be given as BD dose.
3. Antibiotics should be given till purulent mucous become mucoid.
4. If necessary modify antibiotics as per culture and sensitivity test.

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3. Bronchodilators:

1. In mild­to­moderate chronic bronchitis oral theophylline 150 mg BD or inhaled salbutamol 200 μg 6 hourly can be given.
2. In severe bronchitis, ipratropium bromide 40–80mcg 6 hourly is added.

4. Mucolytic agents: Bromhexine and carbocystein are to be given.

5. Corticosteroids: Prednisolone 30 mg/day for 2 weeks is given. If improvement occur by oral steroids, they are replaced by inhalational steroids.

6. Domiciliary oxygen therapy: Long­term oxygen therapy in low concentration i.e. 2 L/min by nasal cannula is given to reverse or to delay development of pulmonary hypertension.