Bronchitis
( see Pictures of Bronchitis)

Definition :
An inflammation of the bronchi, the main air passages to the lungs.

Causes, Incidence and Risk Factors :
Acute bronchitis generally follows a viral respiratory infection. The viral infection produces bronchial inflammation which sets the stage for bronchitis and secondary bacterial infection. Chronic bronchitis is a long-term condition of excessive bronchial mucus with a productive cough. Chronic bronchitis is also known as chronic obstructive pulmonary disease. Cigarette smoking (active and passive exposure) is the chief cause of this disease. Factors that make it worse include air pollution, infection, familial factors, and allergies. The severity of the disease relates to the amount and duration of smoking. Chronic bronchitis, emphysema, and asthma as a group are the fifth leading cause of death in the US. The incidence is 2 out of 100 people.

Symptoms :
Cough that produces mucus (sputum), may be blood streaked, shortness of breath aggravated by exertion or mild activity, frequent respiratory, infections (such as colds), wheezing, fatigue; ankle, feet, and leg swelling, that affects both sides; reddish face, palms, or mucous membranes (such as the inside of the mouth), reddish cheeks, headaches, vision abnormalities.

Signs And Tests :
Abnormal breath sounds, pulmonary function tests, arterial blood gas, chest X-ray.

Treatment :
Treatment is aimed at relieving symptoms and preventing complications. Smoking and all other respiratory irritants should be avoided. Antibiotics are prescribed for infections, as needed. Respiratory treatments including nebulizers and postural drainage facilitate the removal of thick mucus from the airways. Home oxygen therapy, physical exercise programs, breathing exercises, and patient education programs all contribute to the treatment plan.

Expectations (Prognosis) :
The chance for recovery is poor for advanced disease. Early recognition and treatment combined with smoking cessation improves the chance of a good outcome significantly.

Complications :
Acute bronchitis, pneumonia, cor pulmonale, emphysema.

Prevention :
Early recognition and treatment of small airway disease in people who smoke, combined with smoking cessation, may prevent the progression of the disease.

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