What Is Bronchitis?

Bronchitis is a respiratory disease in which the mucous membrane in the lungs' bronchial passages becomes inflamed. As the irritated membrane swells and grows thicker, it narrows or shuts off the tiny airways in the lungs, resulting in coughing spells accompanied by thick phlegm and breathlessness. The disease comes in two forms: acute (lasting less than 6 weeks) and chronic (reoccurring frequently for more than two years). In addition, people with asthma experience an inflammation of the lining of the bronchial tubes called asthmatic bronchitis.

Acute bronchitis is responsible for the hacking cough and phlegm production that sometimes accompany an upper respiratory infection. In most cases the infection is viral in origin, but sometimes it's caused by bacteria. If you are otherwise in good health, the mucous membrane will return to normal after you've recovered from the initial lung infection, which usually lasts for several days.

Chronic bronchitis is a serious long-term disorder that often requires regular medical treatment.

If you are a smoker and come down with acute bronchitis, it will be much harder for you to recover. Even one puff on a cigarette is enough to cause temporary paralysis of the tiny hair like structures in your lungs, called cilia, that are responsible for brushing out debris, irritants, and excess mucus.

If you continue smoking, you may do sufficient damage to these cilia to prevent them from functioning properly, thus increasing your chances of developing chronic bronchitis. In some heavy smokers, the membrane stays inflamed and the cilia eventually stop functioning altogether. Clogged with mucus, the lungs are then vulnerable to viral and bacterial infections, which over time distort and permanently damage the lungs' airways. This permanent condition is called COPD (chronic obstructive pulmonary disease). Your doctor can perform a breathing test, called spirometry, to see if you have developed COPD. WebMD has many resources to help you to successfully quit smoking.

Acute bronchitis is very common among both children and adults. The disorder often can be treated effectively without professional medical assistance. However, if you have severe or persistent symptoms or if you cough up blood, you should see your doctor. If you suffer from chronic bronchitis, you are at risk for developing heart problems as well as more serious lung diseases and infections, so you should be monitored by a doctor.

What Causes Bronchitis?

Acute bronchitis is generally caused by lung infections; approximately 90% of these infections are viral in origin, 10% bacterial. Chronic bronchitis may be caused by one or several factors. Repeated attacks of acute bronchitis, which weaken and irritate bronchial airways over time, can result in chronic bronchitis.

Industrial pollution is another culprit. Chronic bronchitis is found in higher-than-normal rates among coal miners, grain handlers, metal molders, and other people who are continually exposed to dust and fumes. But the chief cause is heavy, long-term cigarette smoking, which irritates the bronchial tubes and causes them to produce excess mucus. The symptoms of chronic bronchitis are also worsened by high concentrations of sulfur dioxide and other pollutants in the atmosphere.

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What is chronic obstructive pulmonary disease (COPD)?

COPD is a lung disease that makes it hard to breathe. It is caused by damage to the lungs over many years, usually from smoking.

COPD is often a mix of two diseases:

• Chronic bronchitis (say "bron-KY-tus"). In chronic bronchitis, the airways that carry air to the lungs (bronchial tubes) get inflamed and make a lot of mucus. This can narrow or block the airways, making it hard for you to breathe.
• Emphysema (say "em-fuh-ZEE-muh"). In a healthy person, the tiny air sacs in the lungs are like balloons. As you breathe in and out, they get bigger and smaller to move air through your lungs. But with emphysema, these air sacs are damaged and lose their stretch. Less air gets in and out of the lungs, which makes you feel short of breath.

COPD gets worse over time. You can't undo the damage to your lungs. But you can take steps to prevent more damage and to feel better.

What causes COPD?

COPD is almost always caused by smoking. Over time, breathing tobacco smoke irritates the airways and destroys the stretchy fibers in the lungs.

Other things that may put you at risk include breathing chemical fumes, dust, or air pollution over a long period of time. Secondhand smoke is also bad.

It usually takes many years for the lung damage to start causing symptoms, so COPD is most common in people who are older than 60.

You may be more likely to get COPD if you had a lot of serious lung infections when you were a child. People who get emphysema in their 30s or 40s may have a disorder that runs in families, called alpha-1 antitrypsin deficiency. But this is rare.

What are the symptoms?

The main symptoms are:

• A long-lasting (chronic) cough.
• Mucus that comes up when you cough.
• Shortness of breath that gets worse when you exercise.

As COPD gets worse, you may be short of breath even when you do simple things like get dressed or fix a meal. It gets harder to eat or exercise, and breathing takes much more energy. People often lose weight and get weaker.

At times, your symptoms may suddenly flare up and get much worse. This is called a COPD exacerbation (say "egg-ZASS-er-BAY-shun"). An exacerbation can range from mild to life-threatening. The longer you have COPD, the more severe these flare-ups will be.

How is COPD diagnosed?

To find out if you have COPD, a doctor will:

• Do a physical exam and listen to your lungs.
• Ask you questions about your past health and whether you smoke or have been exposed to other things that can irritate your lungs.
• Have you do breathing tests, including spirometry, to find out how well your lungs work.
• Do chest X-rays and other tests to help rule out other problems that could be causing your symptoms.

If there is a chance you could have COPD, it is very important to find out as soon as you can. This gives you time to take steps to slow the damage to your lungs.

How is it treated?

The only way to slow COPD is to quit smoking. This is the most important thing you can do. It is never too late to quit. No matter how long you have smoked or how serious your COPD is, quitting smoking can help stop the damage to your lungs.

It’s hard to quit smoking. Talk to your doctor about treatments that can help. You will double your chances of quitting even if medicine is the only treatment you use to quit, but your odds get even better when you combine medicine and other quit strategies, such as counseling.¹ To learn more about how to quit, go to www.smokefree.gov, or call 1-800-QUITNOW (1-800-784-8669).

Your doctor can prescribe treatments that may help you manage your symptoms and feel better.

• Medicines can help you breathe easier. Most of them are inhaled so they go straight to your lungs. If you get an inhaler, it is very important to use it just the way your doctor shows you.
• A lung (pulmonary) rehab program can help you learn to manage your disease. A team of health professionals can provide counseling and teach you how to breathe easier, exercise, and eat well.
• In time, you may need to use oxygen some or most of the time.

People who have COPD are more likely to get lung infections, so you will need to get a flu shot every year. You should also get a pneumonia shot. It may not keep you from getting pneumonia. But if you do get pneumonia, you probably will not be as sick.

There are many things you can do at home to stay as healthy as you can.

• Avoid things that can irritate your lungs, such as smoke, pollution, and air that is cold and dry.
• Use an air conditioner or air filter in your home.
• Take rest breaks during the day.
• Get regular exercise to stay as strong as you can.
• Eat well so you can keep up your strength. If you are losing weight, ask your doctor or dietitian about ways to make it easier to get the calories you need.

What else should you think about?

Flare-ups:As COPD gets worse, you may have flare-ups when your symptoms quickly get worse and stay worse. It is important to know what to do if this happens. Your doctor can prescribe medicines to help. But if the attack is severe, you may need to go to the emergency room or call 911.

Depression and anxiety:Knowing that you have a disease that gets worse over time can be hard. It’s common to feel sad or hopeless sometimes. Having trouble breathing can also make you feel very anxious. If these feelings last, be sure to tell your doctor. Counseling, medicine, and support groups can help you cope.

End-of-life issues:Be sure to talk to your doctor about what kinds of treatment you want if your breathing problems become life-threatening. You may want to write a living will. You can also choose a health care agent to make decisions in case you are not able to. It can be comforting to know that you will get the type of care you want.

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COPD May Contribute to Mental Decline

July 8, 2009 -- A new study shows that severe chronic obstructive pulmonary disease ( COPD) is associated with greater cognitive impairment in older adults.

Previous research has already linked COPD with impaired cognitive function, or impaired mental skills, but researchers say this is the first study to show the negative impact of COPD on mental performance over time.

"Our findings should raise awareness that adults with severe COPD are at greater risk for developing cognitive impairment, which may make managing their COPD more challenging, and will likely further worsen their general health and quality of life," William W. Hung, MD, MPH, assistant professor at Mount Sinai School of Medicine, says in a news release.

COPD is a progressive disease that affects the lungs and makes it difficult to breathe. The prevalence of the disease increases with age, and it affects nearly 14% of adults over age 75 in the U.S. Emphysema and chronic bronchitis are COPD conditions.

Researchers hypothesize that people with COPD may experience periods of hypoxia or low oxygen levels that may in turn lead to problems in the brain that affect cognitive performance.

COPD Tied to Cognitive Impairment

In the study, researchers compared mental performance in more than 4,150 adults over age 50 with and without COPD who were tested at least twice between 1996 and 2002.

The results, published in the American Journal of Respiratory and Critical Care Medicine, showed that older adults with severe COPD showed signs of significantly more cognitive impairment than those without the condition, even after adjusting for other illnesses and education level. People with severe COPD reported that their COPD affected daily activities and that they required supplemental oxygen.

After controlling for other factors that may affect cognitive impairment, the average cognitive scores of those with severe COPD were significantly lower than those without the disease by an average of about one point on a 35-point scale.

Although a one-point decrease may seem small, Hung says the level of cognitive impairment associated with COPD in the study would affect many daily tasks, such as handling money and medications. Based on prior studies, that level of decline in cognitive function would likely be associated with a 22% increase in the average number of difficulties people with severe COPD would experience in performing daily tasks.

"While this number may not appear to be of major concern on the individual level, on a population level, it is roughly equivalent to nearly a quarter of severe COPD patients experiencing difficulty with a basic life skill," Hung says.

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