The Enid News and Eagle, Enid, OK

October 10, 2013

Chronic bronchitis: Don’t live with it

By Judy Rupp, columnist
Enid News and Eagle

— At first, you had an extended bout of coughing and throat clearing every morning. Then the coughing, wheezing and shortness of breath started taking up a good part of each day. You call it your smoker’s cough and decide that you’re just going to live with it.

If those are your symptoms and you’ve had them for a while, you probably have chronic bronchitis. It is indeed a smoker’s cough, and you most certainly should not try to live with it.    

Bronchitis is an inflammation of the bronchial tubes that carry air to and from your lungs. Acute bronchitis, often occurring after a cold, is common, and it often lasts much longer than the cold itself. It does eventually pass, while chronic bronchitis does not. It’s officially defined as a daily cough that lasts at least three months for two consecutive years. The cough is wet or “productive,” bringing up sputum.    

Acute bronchitis is usually caused by a virus and does not respond to antibiotics. Chronic bronchitis is usually caused by cigarette smoking, although air pollution, dust, chemical fumes, toxic gases or second-hand smoke can be either a primary cause or a contributing factor. Since there is often a co-existing bacterial infection, antibiotics can sometimes be helpful.    

Usually after about 10 years of smoking, about 50 percent of smokers start to notice a chronic cough with sputum but no other severe symptoms. If smoking cessation occurs at this point, the cough and sputum production clears within about a year and a half. About 10 to 20 percent of those who continue to smoke go on to develop chronic obstructive pulmonary disease (COPD), with progressive and irreversible damage to the lungs and airways.

Chronic bronchitis is one of two major types of COPD. The other is emphysema. The two are linked, and both are life threatening.     

Whereas chronic bronchitis involves mostly the airways, emphysema affects the air sacs in the lungs that are crucial for the exchange of oxygen and carbon dioxide. In both diseases, the end-game is gradual loss of air supply — and death.    

Coughing occurs as the body’s way of clearing the airways of the mucus that is accumulating due to chronic inflammation. As more mucus occurs, coughing gets worse. And the coughing itself inflames the airways even more. Eventually, the bronchial tubes swell and become thickened, narrowing the airways even more. The patient finds it increasingly difficult to keep the airways free, even with frequent coughing. And that’s one reason for the breathlessness.    

In the early stages, the patient may get winded easily during exercise or while climbing stairs. The coughing is worse during the day than at night. Eventually, the breathlessness begins to interfere with every day activities and even occurs during rest. At this stage, coughing becomes worse at night, and the patient may have to sleep sitting up.    

Starved of oxygen, the body compensates by raising heart rate and blood pressure to pump more blood. Heart failure may occur, causing the body to swell from fluid buildup. Aside from the risks of lung damage, cancer and pneumonia, persons with chronic bronchitis have a 50 percent higher risk of dying from coronary artery disease.

The ideal treatment is to catch the smoker’s cough early, before it becomes chronic bronchitis, and to stop smoking. Even when irreversible damage has occurred, smoking cessation lessens inflammation, reduces coughing and makes breathing easier. It also lowers the risk of death by heart disease.    

Patients with chronic bronchitis tend to be obese while many with emphysema waste away, losing muscle mass and bone density. Good nutrition is important for both. Exercise is also an important lifestyle change although it becomes very difficult. Breathing exercises, making use of pursed lips and the diaphragm, can make breathing easier. Nevertheless, many patients need to rely on supplemental oxygen through portable or stationary tanks.    

Four of five Americans with chronic obstructive pulmonary disease are present or former smokers. The longer a person smokes and the larger the number of cigarettes, the greater the risk of either chronic bronchitis or emphysema. A genetic predisposition may also exist.    

Not all smokers get COPD, but for those who do, the toll of disability and suffering is substantial. If you’re just now beginning to notice the daily cough, or if you’ve never experienced it, it’s time to quit.

Send your comments to: Peggy Goodrich, Food For Thought, P.O. Box 1192, Enid, OK 73702.