Bronchitis

Bronchitis is an obstructive pulmonary diseasecharacterized by inflammationof the bronchiof the lungs. It is a common disease of habitual tobacco smokersand residents of pollutedcities. Like many disorders, bronchitis can be acute(short-term), or chronic(long-lasting). Chronic bronchitis is defined clinically as a persistent coughthat produces sputumfor at least three months in two consecutive years.

Diagnosis

A physical examination will often reveal decreased intensity of breath sounds (rhonchi) and extended expiration.

A common test when evaluating a patient for bronchitis is a sputum culture. In this test, a sample of sputum from a patient is stained and examined for the presence of bacteria that can cause disease.

There are a variety of lab test results that indicate the presence of chronic bronchitis in a patient, namely:

• a chest x-raythat reveals hyperinflation and increased bronchovascular markings
• a pulmonary function testthat shows an increase in the lung's residual volumeand a decreased vital capacity
• arterial blood gasesthat show a decreased level of oxygen in the blood and an increased level of carbon dioxide
• a sputum culture that has pathogenic microorganisms and/or neutrophils in it

Diagnosis of acute bronchitis is aided by finding an elevation in the level of the diaphragmon chest x-ray.

Pathophysiology

The initiating event in developing chronic bronchitis appears to be chronic irritation due to inhalation of certain substances (especially cigarette smoke). The earliest clinical feature of bronchitis is increased secretion of mucus by submucousal glandsof the tracheaand bronchi. Damage caused by irritation of the airways leads to inflammationand infiltration of the lung tissue by neutrophils. The neutrophils release substances that promote mucousal hypersecretion. As bronchitis persists to become chronic bronchitis, a substantial increase in the number of goblet cells in the small airways is seen. This leads to further increased mucous production that contributes to the obstruction of the airways.

The role of infection in the pathogenesis of chronic bronchitis appears to be secondary. However, although infection is not responsible for initiating bronchitis, it may have an important role in maintaining it. Acute exacerbations of the long-standing bronchitis may result from infections.

Treatment

The single most important thing a patient can do to improve chronic bronchitis is to quit smoking. Oxygen therapy, bronchodilatordrugs, and lung volume reduction surgeryare also used to treat chronic bronchitis. Drinking lots of fluids (mainly water) is beneficial for sufferers of acute bronchitis.

Prognosis

Pulmonary hypertension, cor pulmonale, and chronic respiratory failureare possible complications of chronic bronchitis.

The prognosis for patients with severe chronic bronchitis is poor. The median survival time of patients with severe bronchitis is four years (Medical Diagnosis and Treatment).

Prevention

Chronic bronchitis is very preventable. The main action to reduce your risk is to eliminate exposure to cigarette smoke. Smokers in the early stages of chronic bronchitis can change and improve the course of the disease by quitting smoking.

History

Bronchitis was originally named and described by Charles Bedhamin 1808. It was introduced by P. Frank in his work "Interpretationes Clinicae" in 1812.

External links

Section Online medical references

• Acute bronchitisMerck Manual of Diagnosis & Therapy
• BronchitisThe Merck Manual - Second Home Edition
• Chronic Obstructive Pulmonary DiseaseThe Merck Manual - Second Home Edition
• Chronic Obstructive Pulmonary DiseaseThe Merck Manual of Geriatrics
• Bronchitis Lungs OnLine
• Acute BronchitisFamilyDoctor.org (American Academy of Family Physicians)

References

• "Chronic bronchitis." Springhouse Handbook of Diagnostic Tests, 2nd ed. (1999). ISBN 0-87434-982-6
• "Chronic obstructive pulmonary disease." 2005 Current Medical Diagnosis and Treatment. ISBN 0-07-143692-8
• Kumar, Vinay, Abul Abbas, and Nelson Fausto. Robbins and Cotran Pathologic Basis of Disease, 7th ed. (2005). ISBN 0-7216-0187-1
• Skinner, Henry Alan. The Origin of Medical Terms. (1970).da:Bronkitis

de:Bronchitis fr:Bronchite it:Bronchite nl:bronchitis sv:Bronkit

This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Bronchitis Wikipedia article Bronchitis.