Chronic Bronchitis
Respiratory (12%) Core Clinical Conditions
1A: Able to diagnose and manage
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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management
Definition
Chronic Bronchitis is a form of chronic obstructive pulmonary disease (COPD). There is an Inflammation of the bronchial tubes which results in an excess of mucus production.
Aetiology
Long term exposure to irritants which causes damage and inflammation to the airways e.g. smoking.
Other causes:
Exposure to air pollution, dust and chemicals.
Genetic predisposition.
Recurrent infections which damage the airways.
Ageing.
Background of Asthma, allergies or other respiratory conditions.
Pathophysiology
Chronic inflammation of bronchial tubes (caused by irritants e.g. cigarette smoking or air pollution).
Inflammation causes bronchial tubes to swell up and narrow = reduced airflow.
Chronic: structure change of the airways + thickening of walls + hypersecretion of mucous glands.
Increased mucus production = more narrowed airways.
Mucus trap bacteria and other pollutants = increased susceptibility to respiratory infections.
Reduced lung function which can cause heart failure (HF) or respiratory failure.
Risk factors
Smoking, air pollution and other environmental causes.
Genetic predisposition.
Ageing.
Repeated respiratory infections.
Asthma.
Male gender.
Sign and symptoms
Cough with excess mucus production often lasting more than three months.
Wheeze, SOB and fatigue.
Repeated chest infections.
Diagnosis and investigations
Physical examination: respiratory examination + pulse oximetry, respiratory rate and capillary refill, smoking history.
Oxygen saturation measurement.
Chest X-ray / CT scan.
Blood test: full blood count (FBC), C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR).
Sputum culture.
Spirometry.
Management
Smoking cessation.
Medications: inhalers (check local guidance), corticosteroids or antibiotics (if evidence of infections).
Chest physiotherapy.
Oxygen therapy.
Vaccination (pneumonia + flu) to prevent respiratory infections.
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