Chronic bronchitis is the most common cause for chronic cough in middle aged and elderly men and women. It occurs due to chronic inflammation of the medium and large airways of the lungs which transport air both ways in the lungs.
Cigarette smoking is said to be the most common cause for chronic bronchitis. But it also occurs due to chronic exposure to smoke or different types of fumes or dust.
People working in mines, fields, construction work, who are constantly exposed to dust, are all prone to develop chronic bronchitis, later in life. Women who are exposed to smoke chronically while cooking on charcoal or wood are equally susceptible to develop this condition.
Most characteristic feature of chronic bronchitis is cough which is chronically present. It is associated with scanty white coloured phlegm, which occurs due to the excess secretions from the inflamed air tubes or bronchi. The expectoration is greatest in the morning when the patient wakes up.
In case of associated infection, the person can develop fever, chest pain and blood tinged sputum. Due to infection, the expectoration may become yellow or green coloured. There is also associated breathlessness, particularly when the person walks.
In later stages, the lungs get hyper inflated due to the stress placed on them to carry out their normal function of breathing and exchange of gases. This condition is called emphysema. On external appearance, the individual though cachexic, has an inflated chest (known as barrel chest) Due to inefficient ventilation carried out by the diseased lungs; there is chronic deficiency of oxygen in the body. This leads to bluish coloration of the lips and swelling of tips of fingers.
Once chronic bronchitis develops, it is an irreversible condition. Unlike asthma, the closed airways do not open up, when the offending substance is removed.
Medicines given provide only palliative relief but do not cure the condition absolutely.
If exposure to the causative substance continues, the walls of the airways get damaged and can collapse. At this stage, the affected person gets severe constant cough with profuse expectoration.
People suffering from chronic bronchitis become more prone to infections like pneumonia and lung abscess, due to presence of secretions chronically in the lungs. The weakened lungs can succumb to T.B. also easily. In later age, one can develop lung cancer.
Chronic bronchitis is diagnosed easily by the typical history of chronic cough with expectoration, present recurrently. It is confirmed by lung function tests which show irreversible obstruction of the airways.
Smoking is harmful not only for the lungs but for the entire body, hence smokers should be motivated to quit smoking before they develop chronic bronchitis.
People working in occupations involving chronic exposure to smoke, fumes or dust should be encouraged to cover their noses while working to minimize the inhalation of these harmful substances. They should be educated about chronic bronchitis so they can take treatment at the earliest symptoms and prevent its exacerbation.
Government of Rwanda is doing a very appreciable job in encouraging people to use bio-gas for cooking and providing it at affordable cost. This will minimize the chronic exposure to smoke which occurs by using charcoal or wood.
Treatment of chronic bronchitis is mainly directed towards relief of symptoms. Antibiotics have to be used judiciously only if there is evidence of infection. These persons inadvertently undergo X-rays many times and consume a lot of antibiotics. Because they visit the hospitals number of times seeking relief from the cough and as many number of times, they are investigated and treated.
Drinking much water every day is useful for the person suffering from chronic bronchitis as it helps to clear the expectoration and reduces cough. Drinking warm water 2 or 3 times adds to this benefit of water.
Different types of breathing exercises of yoga are also very useful in increasing the ventilatory function of the lungs in case of chronic bronchitis.
An individual can adopt all these measures to prevent aggravation of chronic bronchitis and its later complications.