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'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
__NOTOC__
'''For Chronic bronchitis patient information click [[Chronic bronchitis (patient information)|here]]'''
 
'''''see also:''''' [[Acute bronchitis]], [[COPD]]


{{DiseaseDisorder infobox |
  Name        = Bronchitis |
  ICD10      = {{ICD10|J|42||j|40}}|
  ICD9        = {{ICD9|491}} |
  MeshID      = D029481 | Bronchitis, Chronic [C08.127.446.567]
}}
{{Chronic bronchitis}}
{{Chronic bronchitis}}
{{CMG}}{{AE}}{{MehdiP}}
==[[Chronic bronchitis overview|Overview]]==


{{CMG}}
==[[Chronic bronchitis historical perspective|Historical Perspective]]==


==Overview==
==[[Chronic bronchitis classification|Classification]]==
'''Bronchitis''' is an [[inflammation]] of the [[bronchus|bronchi]] (medium-size airways) in the [[lung]]s. ''[[Acute bronchitis]]'' is usually caused by [[virus]]es or [[bacteria]] and may last several days or weeks. '''Chronic bronchitis''' is not necessarily caused by infection and is generally part of a syndrome called [[chronic obstructive pulmonary disease]] (COPD); it is defined clinically as a persistent [[cough]] that produces [[sputum]] (phlegm) and mucus, for at least three months in two consecutive years.


==Signs and symptoms==
==[[Chronic bronchitis pathophysiology|Pathophysiology]]==
Bronchitis may be indicated by an [[expectorate|expectorating]] [[cough]] (also known as a productive cough, i.e. one that produces [[sputum]]), shortness of breath ([[dyspnea]]) and wheezing. Occasionally [[chest pain]]s, [[fever]], and [[Fatigue (physical)|fatigue]] or [[malaise]] may also occur. Mucus is normally green or yellowish green.


==Diagnosis==
==[[Chronic bronchitis causes|Causes]]==
A [[physical examination]] will often reveal decreased intensity of breath sounds, wheeze ([[rales]]) and prolonged [[Exhalation|expiration]].  Most doctors rely on the presence of a persistent dry or wet cough as evidence of bronchitis.


A variety of tests may be performed in patients presenting with cough and shortness of breath:
==[[Chronic bronchitis differential diagnosis|Differentiating Chronic bronchitis from other Diseases]]==
* Pulmonary Function Tests (PFT) (or [[spirometry]]) must be performed in all patients presenting with chronic cough. An [[FEV1]]/[[FVC]] ratio below 0.7 that is not fully reversible after bronchodilator therapy indicates the presence of [[COPD]], that requires more aggressive therapy and carries a more severe prognosis than simple chronic bronchitis.
* A [[chest X-ray]] that reveals hyperinflation; collapse and consolidation of lung areas would support a diagnosis of [[pneumonia]]. Some conditions that predispose to bronchitis may be indicated by chest radiography.
* A sputum sample showing [[neutrophil granulocyte]]s (inflammatory white blood cells) and [[microbiological culture|culture]] showing that has pathogenic microorganisms such as [[Streptococcus|Streptococcus spp.]]
* A [[blood test]] would indicate inflammation (as indicated by a raised [[white blood cell]] count and elevated [[C-reactive protein]]).
*Neutrophils infiltrate the lung tissue, aided by damage to the airways caused by irritation.
*Damage caused by irritation of the airways leads to inflammation and leads to neutrophils being present
*Mucosal hypersecretion is promoted by a substance released by neutrophils
*Further obstruction to the airways is caused by more goblet cells in the small airways. This is typical of chronic bronchitis
*Although infection is not the reason or cause of chronic bronchitis it is seen to aid in sustaining the bronchitis.'''''


==[[Chronic bronchitis epidemiology and demographics|Epidemiology and Demographics]]==


==Treatment==
==[[Chronic bronchitis risk factors|Risk Factors]]==


===Antibiotics===
==[[Chronic bronchitis screening|Screening]]==
For acute exacerbations of chronic bronchitis, if antibiotics are used a [[meta-analysis]] found that "amoxicillin/clavulanic acid, macrolides, second-generation or third-generation cephalosporins, and quinolones" may be more effective.<ref name="pmid17573508">{{cite journal |author=Dimopoulos G, Siempos II, Korbila IP, Manta KG, Falagas ME |title=Comparison of first-line with second-line antibiotics for acute exacerbations of chronic bronchitis: a metaanalysis of randomized controlled trials to Joe Fo Sho |journal=Chest |volume=132 |issue=2 |pages=447-55 |year=2007 |pmid=17573508 |doi=10.1378/chest.07-0149}}</ref>


===Bronchodilators===
==[[Chronic bronchitis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
For acute exacerbations of chronic bronchitis, a [[clinical practice guideline]] by the [[American College of Physicians]] found that [[bronchodilator]]s may help.<ref name="pmid11281745">{{cite journal |author=Bach PB, Brown C, Gelfand SE, McCrory DC |title=Management of acute exacerbations of chronic obstructive pulmonary disease: a summary and appraisal of published evidence |journal=Ann. Intern. Med. |volume=134 |issue=7 |pages=600–20 |year=2001 |pmid=11281745 |doi=}}</ref>


===Corticosteroids===
==Diagnosis==
For acute exacerbations of chronic bronchitis, a [[clinical practice guideline]] by the [[American College of Physicians]] found that [[corticosteroid]]s may help.<ref name="pmid11281745"/>
[[Chronic bronchitis history and symptoms|History and Symptoms]] | [[Chronic bronchitis physical examination|Physical Examination]] | [[Chronic bronchitis laboratory findings|Laboratory Findings]] | [[Chronic bronchitis electrocardiogram|Electrocardiogram]] | [[Chronic bronchitis chest x ray|Chest X Ray]] | [[Chronic bronchitis CT|CT]] | [[Chronic bronchitis echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Chronic bronchitis other imaging findings|Other Imaging Findings]] | [[Chronic bronchitis other diagnostic studies|Other Diagnostic Studies]]


===Smoking cessation===
==Treatment==
{{main|smoking cessation}}
[[Chronic bronchitis medical therapy|Medical Therapy]] | [[Chronic bronchitis primary prevention|Primary Prevention]] | [[Chronic bronchitis secondary prevention|Secondary Prevention]] | [[Chronic bronchitis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Chronic bronchitis future or investigational therapies|Future or Investigational Therapies]]


== References ==
==Case Studies==
<references/>
[[Chronic bronchitis case study one|Case Study #1]]


{{Respiratory pathology}}
==Related Chapters==
{{SIB}}
* [[Emphysema]]
* [[Acute bronchitis]]
* [[Acute bronchitis (patient information)]]
* [[Emphysema (patient information)]]
{{clr}}


[[Category:Inflammations]]
[[Category:Pulmonology]]
[[Category:General practice]]
[[Category:Overview complete]]


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Latest revision as of 20:56, 29 July 2020

For Chronic bronchitis patient information click here

see also: Acute bronchitis, COPD

Chronic Obstructive Pulmonary Disease Page

Bronchitis Main Page

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Chronic bronchitis from other Diseases

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Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

Echocardiography or Ultrasound

Treatment

Medical Therapy

Lung Transplant

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Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Chronic bronchitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Chest X Ray | CT | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case Study #1

Related Chapters


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