Chronic Bronchitis    WHAT IS CHRONIC BRONCHITIS? Bronchitis is the inflammation of the lining of the bronchial tubes. When the bronchi are inflamed and/or infected, less air is able to flow to and from the lungs and a heavy mucus or phlegm is coughed up. Many people suffer a brief attack of acute bronchitis with cough and mucus production when they have severe colds. Acute bronchitis is usually not associated with fever. Chronic bronchitis is defined by the presence of a mucus-producing cough most days of the month, three months of a year for two successive years without other underlying disease to explain the cough. This inflammation eventually leads to scarring of the lining of the bronchial tubes. Once the bronchial tubes have been irritated over a long period of time, excessive mucus is produced constantly, the lining of the bronchial tubes becomes thickened, an irritating cough develops, and air flow may be hampered, the lungs become scarred. The bronchial tubes then make an ideal breeding place for infections. Chronic bronchitis may precede or accompany pulmonary emphysema.  These two conditions together are commonly referred to as Chronic Obstructive Pulmonary Disease (COPD). WHAT CAUSES CHRONIC BRONCHITIS?  Cigarette smoking is by far the most common cause of chronic bronchitis. The bronchial tubes of people with chronic bronchitis may also have been irritated initially by bacterial or viral infections. People exposed to industrial dusts and fumes in the workplace, such as coal miners, grain handlers, and metal molders, are also at high risk of developing this disease.  In fact, a recent study found that the fraction of COPD attributed to work was estimated as 19.2% overall and 31.1% among never smokers. Air pollution can worsen chronic bronchitis symptoms when atmospheric concentrations of sulfur dioxide and other air pollutants increase. These symptoms are intensified when individuals also smoke. HOW SERIOUS IS CHRONIC BRONCHITIS? Over 9.1 million Americans are diagnosed with chronic bronchitis by a health professional annually. Chronic bronchitis affects people of all ages, but is higher in those over 45 years old. Females are more than twice as likely to be diagnosed with chronic bronchitis as men.  In 2002, 2.9 million males were diagnosed with chronic bronchitis compared to 6.2 million females. Together with emphysema and other chronic lower respiratory diseases, excluding asthma, chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the U.S, claiming the lives of more than 120,000 Americans. Chronic bronchitis is often neglected by individuals until it is in an advanced state, because people mistakenly believe that the disease is not life-threatening. By the time a patient goes to his or her doctor the lungs have frequently been seriously injured. Then the patient may be in danger of developing serious respiratory problems or heart failure. HOW CHRONIC BRONCHITIS ATTACKS Chronic bronchitis doesn't strike suddenly. After a winter cold seems cured, an individual may continue to cough and produce large amounts of mucus for several weeks. Since people who get chronic bronchitis are often smokers, the cough is usually dismissed as only "smoker's cough." As time goes on, colds become more damaging. Coughing and bringing up phlegm last longer after each cold. Without realizing it, one begins to take this coughing and mucus production as a matter of course. Soon they are present all the time, before colds, during colds, after colds, all year round. Generally, the cough is worse in the morning and in damp, cold weather. An ounce or more of yellow mucus may be coughed up each day. TREATMENT FOR CHRONIC BRONCHITIS The treatment of chronic bronchitis is primarily aimed at reducing irritation in the bronchial tubes. The discovery of antibiotic drugs has been helpful in treating acute bacterial infection associated with chronic bronchitis. However people with chronic bronchitis do not need to take antibiotics continually. Bronchodilator drugs may be prescribed to help relax and open up air passages in the lungs, if there is a tendency for these to close up. These drugs may be inhaled as aerosol sprays or taken as pills. Some physicians believe that inhaled corticosteroids are useful. To effectively control chronic bronchitis, it is necessary to eliminate sources of irritation and infection in the nose, throat, mouth, sinuses, and bronchial tubes. This means an individual must avoid polluted air and dusty working conditions and give up smoking. Your local American Lung Association can suggest methods to help you quit smoking. If the person with chronic bronchitis is exposed to dust and fumes at work, the doctor may suggest changing the work environment. All persons with chronic bronchitis must develop and follow a plan for a healthy lifestyle. Improving one's general health also increases the body's resistance to infections. WHAT SHOULD YOU DO IF YOU HAVE CHRONIC BRONCHITIS? A good health plan for any person with chronic bronchitis should include these rules: See your doctor or follow your doctor's instructions at the beginning of any cold or respiratory infection. Don't smoke! Contact your local American Lung Association at 1-800-LUNG-USA (1-800-586-4872) for information on how to quit smoking. Follow a nutritious, well-balanced diet, and maintain your ideal body weight. Get regular exercise daily, without tiring yourself too much. Ask your doctor about getting vaccinated against influenza and pneumococcal pneumonia. Avoid exposure to colds and influenza at home or in public, and avoid respiratory irritants such as secondhand smoke, dust, and other air pollutants.