In acute bronchitis, most patients complain of severe coughing and later also pain in the chest, very tough, slimy expectoration, fever and headache. A serious infection can trigger the classic flu symptoms such as cold, throat and body aches.
Chronic bronchitis is characteristically accompanied by coughing and mucous expectoration. Most patients complain of agonizing cough, especially in the morning hours. The mucus in the bronchi is tough and therefore hard to cough up. This so-called "smoker's cough" is often tolerated for years without the patients visiting a doctor. With continued cigarette consumption, the disease can severely worsen.
Chronic bronchitis: causes and development
The persistent irritation of the bronchial mucosa by cigarette smoke or other harmful influences such as fine dust leads to chronic inflammation. As a result, the cilia of the mucous membranes are damaged and can no longer fulfill their function - the cleaning of the respiratory tract of mucus and dust particles.
In addition, the mucus-producing cells proliferate in the walls of the bronchi and produce tougher mucus, which can not be sufficiently removed by the damaged cilia. There is accumulation of mucus and swelling of the bronchial mucosa. This stage is referred to as chronic obstructive bronchitis, because in addition to the chronic inflammation there is a narrowing (obstruction) of the bronchi. These changes affect oxygen uptake into the blood. Patients complain of increased respiratory distress - initially only during exercise, but then at rest - and a general decline in performance.
Pneumonia as a possible consequence
The lung, previously damaged by acute or chronic bronchitis, is more susceptible to additional bacterial infections. Frequent complication is therefore purulent bronchitis. The visible sign of this is purulent, turbid, yellowish-green sputum. If the inflammation continues, pneumonia can also occur.
Complications of bronchitis
Especially in chronic bronchitis, the development of so-called pulmonary emphysema is a possible complication: if the inflammation penetrates into the alveoli, its walls can be damaged by immigrant immune cells. Since the exhalation is made difficult by the narrowing of the bronchi, there is an increased pressure in the lungs, which the alveoli can then no longer withstand. They are overstretched, which eventually leads to damage to the lung tissue.
The continued shortage of oxygen also causes a constriction of the pulmonary vessels, which increases the blood pressure in the pulmonary circulation. As a result, the right half of the heart, which pumps the blood into the pulmonary circulation, must work against a strong resistance. If this overload persists, the right half of the heart increases and loses strength (cor pulmonale). This can lead to right heart failure.
Treat bronchitis early
Since these consequential damages can not be partially reversed, it is already at the beginning of chronic bronchitis, the necessary treatment measures to initiate to prevent further deterioration.
Patients with chronic bronchitis also have an increased risk of developing a malignant lung tumor. Because in the context of persistent inflammation it comes to remodeling of the bronchial mucosa, which increases the risk of degeneration of the cells. The result is the development of a malignant tumor, usually a so-called squamous cell carcinoma.
Diagnosis of bronchitis
The exact survey by the attending physician and a physical examination with listening to the lungs are the first indications of the correct diagnosis.
The radiograph shows no changes in uncomplicated bronchitis. Only in the case of additional bacterial inflammation or the above-described changes in the lungs and the heart appear abnormalities in the radiograph, such as signs of pulmonary hypovolemia or cardiac insufficiency. The examination of the sputum (sputum diagnostics) makes it possible to select the right drug for the treatment of a possible infection with bacteria or fungi.
The pulmonary function test, ie the measurement of the respiratory flow and the total lung volume, provides information about the condition of the lungs and respiratory tract. It provides information on the functional status of the lungs in advanced chronic bronchitis and also serves as a follow-up examination. At home, patients can use a so-called flowmeter to measure the maximum expiratory volume in one second, the so-called one-second capacity, and thus control the current condition of their lungs.
Chronic bronchitis is only present if the classic symptoms, such as cough and sputum, have occurred at least three months a year over a period of two consecutive years. The diagnosis "chronic bronchitis" is in principle an exclusion diagnosis. First of all, all other possible illnesses must be excluded, as there are no clear symptoms and other illnesses can be concealed behind the classic, but relatively unspecific complaints.