One of the manifestations of chronic bronchitis is a productive cough accompanied by phlegm, which obstructs the free flow of air in the bronchial tubes. Chronic bronchitis is a long-term disorder that can last as long as two years. It is the fourth largest killer in the United States of America, and around ten million people fall victim to this disorder every year. About 40,000 deaths due to chronic bronchitis have been recorded annually. It is considered to be the most comman chronic obstructive pulmonary illnesses (CODP).
Causes of Chronic Bronchitis
Certain lifestyle habits such as cigarette smoking is mainly responsible for chronic bronchitis. People who live in highly polluted atmospheres also fall prey to this disorder. The above-mentioned factors weaken the lungs and the body’s immune system to such as extent that the person is easily infected by bacteria and viruses that attack the respiratory system.
Studies reveal that more than 90 percent of the people who contract chronic bronchitis comprise smokers. About 15 percent of the cigarette smokers are ultimately diagnosed with respiratory disorders charaterized by obstruction of the airways. Biopsies of bronchial samples of people who have quit smoking thirteen years ago still reveal persistent marks of bronchial inflammation.
Tests conducted on patients suffering from chronic bronchitis reveal yet another disturbing factor–the presence of three varieties of bacteria: Moxarella catarrhalis, Haemophilus influenzae, and Streptococcus pneumoniae.
Methods of Managing Chronic Bronchitis
Two methods of managing chronic bronchitis are in vogue at present–inhalation of ipratropium bromide and treatment through sympathomimetic agents. Theophyllinne is also an important therapy, but its uses are limited to a certain cases of the disorder. Patients who exhibit a remarkable improvement in airflow are not given any steriods. Antibiotics have a crucial part to play in the battle against acute infections. Supplemental oxygen is given to those patients who experience difficulties in breathing. Patients are also strongly advised to quit smoking for good, take plenty of nutritional supplements and fluids, and perform exercises to strengthen their respiratory muscles.
Tests to Determine Chronic Bronchitis
A series of tests are necessary to determine a variety of factors. Needless to say, testing is also essential to make a correct diagnosis of the condition. The results of tests also confirm the extent to which the air passages are obstructed. Some of the tests include pulmonary function testing, blood tests, chest radiograph, electrocardiogram, biopsies, and sputum cultures.
The ratio between the measured forced expiratory volume (FEVI) and the forced vital capacity (FVC) defines the severity of chronic bronchitis. One of the signs of severe and long-term chronic bronchitis is progressive decline of FEVI rates. Factors such as age affect the elasticity of the lungs due to which the pulmonary testing of most adults over middle age show a 30ml decline in FEVI. In addition, the blocking of the bronchi due to an increase in the production of sputum does not always indicate chronic bronchitis. Pulmonary testing documents the reversible characteristics of air passage obstruction, and this helps physicians properly diagnose this disorder.
A sample of arterial blood is taken in order to do a blood test, which can determine conditions such as mild polychthemia.
Chest radiographs reveal conditions such as blebs, diaphragmatic flattening, peribronchial markings, hyperinflation, and bullae. However, the test results cannot be taken as final proof of the existence of chronic bronchitis.
Electrocardiograms pinpoint distrubances, such as arterial fibrillation or flutter and atrial tachycardia having “P” pulmonale, in the supraventricular rhythm.
Airway biopsies can reveal submucosal and mucosal inflammation, hyperplasia of goblet cells, and abnormal smoothness of the muscles on the small noncartilaginous air passage.
Sputum culture is done in case of patients who have not been hopitalized but display acute exacerbations of chronic bronchitis. It is one of the methods used to determine the requirement for antibiotic therapy. Protected-tip sputum cultures are done in case of patients who are in hospitals especially if atypical organisms are suspected to cause the excarberation.
Mortality rate after the diagnosis of chronic bronchitis is fifty percent. The terminal event of chronic bronchitis is respiratory failure. Respiratory failure is due to bacterial infections characterized by purulent sputum, fever, and poor ventilation symptoms. The other factors responsible for respiratory failure are seasonal changes, infections of the upper respiratory system, medications, and prolonged exposure to polluting and irrtating agents.
An understanding of the factors responsible for inflammation in chronic bronchitis makes it easier to manage, control, and treat this disorder.