What is chronic bronchitis?

Bronchitis is inflammation of the breathing tubes. These are the airways called bronchi. This inflammation causes too much mucus to be made and other changes. Bronchitis can be acute (short-term) or chronic (long-term).

Chronic bronchitis is long-term inflammation of the bronchi. It's common among smokers. People with chronic bronchitis tend to get lung infections more easily. They also may have episodes of acute bronchitis, when symptoms are worse due to a respiratory infection, such as a cold.

Chronic bronchitis is a form of chronic obstructive pulmonary disease (COPD). The other form of COPD is emphysema. Most people who smoke and have chronic breathing problems have some combination of chronic bronchitis and emphysema.

What causes chronic bronchitis?

Most experts agree that the main cause of chronic bronchitis is cigarette smoking. Air pollution and your work environment may also play a role. This is especially true if you also smoke.

Bronchitis symptoms often happen with other lung diseases, such as:

• Asthma.

• Emphysema.

• Scarring of the lungs (pulmonary fibrosis).

• Lung cancer.

• Tuberculosis.

Bronchitis symptoms can also occur with colds, flu, and other respiratory infections.

What are the symptoms of chronic bronchitis?

The most common symptoms of chronic bronchitis include:

• Cough. This is often called a smoker’s cough.

• Coughing up mucus or sputum.

• Wheezing.

• Chest tightness.

• Shortness of breath.

People with chronic bronchitis often have a cough and make mucus for many years before they have shortness of breath.

Chronic bronchitis may cause:

• Disability.

• Frequent and severe infections that affect your airways.

• Trouble breathing.

Other symptoms may include:

• Bluish fingernails, lips, and skin because of lower oxygen levels.

• Wheezing and crackling sounds with breathing.

• Swollen feet.

• Heart failure.

The symptoms of chronic bronchitis may look like other lung conditions or health problems. See your doctor for a diagnosis.

How is chronic bronchitis diagnosed?

Your doctor will take a complete health history and do a physical exam. Your doctor may also order tests.

How is chronic bronchitis treated?

Treatment for chronic bronchitis focuses on treating the causes and symptoms. It may include:

• Steps to quit smoking if you smoke. Smoking is the main cause of COPD. Quitting will help you be able to better manage your COPD. Don't use e-cigarettes or vaping products either. Ask your doctor about ways to help you quit smoking.

• Ways to stay away from secondhand smoke and other lung irritants.

• Medicines to take by mouth (oral) to open airways and help clear away mucus.

• Inhaled medicines, such as bronchodilators and steroids.

• Oxygen therapy.

• Surgery to take out damaged areas of the lung.

• A lung transplant.

• Ways to prevent lung infections. Ask your doctor which vaccines you should get, such as flu, COVID-19, and pneumococcal vaccines.

• Pulmonary rehab to help you learn how to live with your breathing problems and stay active. Community-based and home-based programs work as well as hospital-based programs as long as they are held as often and are as intense. Standard home-based pulmonary rehab programs help with shortness of breath in people with COPD. Traditional, supervised pulmonary rehab is the best choice for people with COPD.

• Eating a healthy, balanced diet. This is important to staying as healthy as possible. So is trying to stay at your ideal weight. Being overweight or underweight can affect your health. Eat lots of fruits and vegetables every day. Also eat balanced portions of whole grains, lean meats and fish, and low-fat dairy products.

During each appointment, your doctor will check:

• How well you are coping in your daily life. This may focus on supportive, palliative, or end-of-life care.

• Whether you are using your inhaler, nebulizer, oxygen therapy, and other medicines correctly. Using these treatments the right way can help you manage your COPD.

• How you are coping with other health conditions you have, the medicines you take for them, and how they affect managing your COPD.

Key points about chronic bronchitis

• Bronchitis is inflammation of the breathing tubes (bronchi). Bronchitis can be acute (short-term) or chronic (long-term).

• Chronic bronchitis is a form of chronic obstructive pulmonary disease (COPD). This is a group of lung diseases that cause airflow blockage and breathing problems.

• The most important cause of chronic bronchitis is cigarette smoking. Air pollution and your work environment may also play a role. Stay away from both indoor and outdoor pollution. Indoor pollution includes burning wood, smoke from home cooking, or heating fuels. Outdoor pollution includes dusts, vapors, fumes, gases, and other chemicals.

• This condition causes a cough that’s often called smoker’s cough. It also causes you to cough up mucus, wheeze, and have chest discomfort. These may get worse over time and lead to severe breathing problems.

• Tests that help measure how well your lungs are working are used to diagnose chronic bronchitis. Blood, breathing, and imaging tests will determine how severe the problem is and watch it over time.

• Your vitamin D, hemoglobin, and hematocrit levels may be checked. You may also be screened for a condition called alpha-1 antitrypsin deficiency (AATD). 

• It's important to prevent lung infections. Ask your doctor which vaccines you need.

• The goal of treatment is to live more comfortably by controlling symptoms. A key part of treatment is to quit smoking, including the use of e-cigarettes and vaping products. Remember that cold weather can trigger flare-ups.

Next steps

Tips to help you get the most from a visit to your doctor:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your doctor tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your doctor gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your doctor if you have questions.