Chronic Bronchitis - Entire

What is Chronic bronchitis?

Disease due to long-continued irritation of the bronchial mucosa characterized by cough with expectoration for a period of 3 months in a year and for two consecutive years.

Chronic Bronchitis

Etiology / Causation

Tobacco smoking.

Dust, smoke, and fumes.

Recurrent respiratory infections.

Middle and later adult life.

More in males - May be familial.

General illnesses which favor infections - e.g. obesity, alcoholism, chronic renal disease, diabetes



Symptoms

Cough (winter cough) with expectoration. Wheezing.

Tightness in the chest especially in the morning. Tenacious scanty sputum.

Occasional hemoptysis.

Dyspnea or shortness of breath.

Repeated acute respiratory infection



Signs

Definite physical signs are lacking in the early stage.

The general temperature may be normal or raised depending on the presence of infection.

On examination of chest: Movement of chest wall-normal or symmetrically diminished
No mediastinal displacement.

Percussion note normal.

Breath sounds vesicular with prolonged expiration.

Vocal resonance normal.

Rhonchi usually with some coarse crepitation.

In later stages, features of emphysema will develop



Is Chronic Bronchitis transmit to others?

No, it is acquired or familial.



Investigations

Blood: Leukocytosis in the acute phase of the disease, polycythemia may occur in hypoxemic patients..

X-ray chest: Features of associated emphysema may be present.

Culture of sputum: May show pathogenic organisms.

A pulmonary function test may show some impairment. (Irreversible airway obstruction).



Complications

Emphysema

Bronchial spasm

Fibrosis of lung

Bronchiectasis

Right heart failure(Cor Pulmonale)

Hernia in different sites.



Treatment

Bronchial irritation must be reduced.

No smoking.

The dusty and smoky atmosphere should avoid.

Infection must be treated promptly.

Oxygen therapy: A very effective mode of treatment. For this patient with hypoxia, it is one of the best options. Some benefits of O2 therapy are:
  1. survival rate increased
  2. the drug needs to be decreased

Better quality of life.

Cough training is useful it helps in the mobilization of secretion. It can also be achieved by systemic hydration.



Differential diagnosis

Pulmonary tuberculosis: Evening rise of temperature, progressive emaciation, and weakness, hemoptysis, sputum shows AFB, and X-ray chest often excludes the diagnosis.

Bronchiectasis: Profuse, purulent sputum with relation to posture. Clubbing of fingers and finally, bronchography differentiates the disease.

Bronchogenic carcinoma: Patient middle-aged, chronic smoker with clubbing of fingers, cachectic look, and metastatic lymph nodes often exclude it, yet biopsy and X-ray chest often confirm the diagnosis.

Interstitial fibrosis: This will show a restrictive airway pattern.

Mitral stenosis: Cardiac findings and ECG findings are confirmative.



COPD

Chronic bronchitis and emphysema together called 'Chronic Obstructive Pulmonary Disease (COPD).
In Chronic bronchitis detailed above. In emphysema, lung elasticity losses, and the space is increased in-between two ribs X-ray shows.



Homeopathic medicines

Homeopathy believes in constitutional treatment.
Some medicines are helpful in Chronic bronchitis, such as Ammonium Carb, Bryonia alba, Ipecac, Stannum, Kali Bich, Hepar Sulph.

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