Chronic Bronchitis

Chronic bronchitis is long-standing inflammation of the lower airways (bronchi), with a productive cough most days for at least 3 months in 2 consecutive years. It is one of the two main conditions that make up chronic obstructive pulmonary disease (COPD); the other is emphysema. Most people with chronic bronchitis also have some emphysema.

Main causes

• Smoking — cigarettes, bidis — the biggest cause
• Secondhand smoke
• Long-term exposure to air pollution — outdoor (Indian cities face some of the highest particulate levels) and indoor (biomass cooking fuels)
• Occupational dust and fumes — quarry work, stone-crushing, welding, chemicals
• Repeated respiratory infections in childhood

Symptoms

• Persistent cough, often with phlegm
• Breathlessness, especially with activity
• Wheezing
• Chest tightness
• Worsening symptoms (flare-ups) during infections or pollution spikes
• Tiredness

Diagnosis

A doctor uses history, examination, chest X-ray, and spirometry (a breathing test) to confirm COPD. In India, persistent cough also warrants TB testing.

Treatment

• Stop smoking — the single most important step; progression slows sharply once smoking stops
• Reduce exposure to air pollution and occupational dust
• Inhaler medicines to open the airways and reduce inflammation
• Oxygen therapy for advanced disease
• Pulmonary rehabilitation — breathing exercises, graded physical activity
• Annual flu vaccine and pneumococcal vaccine
• Prompt treatment of chest infections; flare-ups may need a short course of antibiotics and steroids
• Surgery or lung transplant — for very selected severe cases

See a doctor if you have a cough lasting weeks, breathlessness that's getting worse, or frequent chest infections. Early diagnosis and stopping smoking make a significant difference.