Chronic bronchitis

The following important information is missing from this article or section:

• How is diagnosed?
• What kind of tests are there?
• Which tests are covered by the statutory health insurance?

Help Wikipedia by researching and pasting it .

Classification according to ICD-10
J41	Simple and slimy-purulent chronic bronchitis
J41.0	Easy chronic bronchitis
J41.1	Slimy-purulent chronic bronchitis
J41.8	Mixed forms of simple and slimy-purulent chronic bronchitis
J42	Unspecified chronic bronchitis
ICD-10 online (WHO version 2019)

The chronic bronchitis is a form of bronchitis , which according to the World Health Organization is defined (WHO) as a "cough and sputum production on most days for at least three months in two consecutive years."

Prevalence

Chronic bronchitis is one of the most common diseases (15–25%). It is therefore of great relevance from a health economic point of view. Especially men (in the ratio 3: 1) in the fourth decade of life are affected.

causes

In the first place there is inhalative tobacco smoking (90% of the sick are smokers or ex-smokers; therefore, the term smoker's lung is used in this context ), but also environmental factors (air pollution, damp, foggy-cold climate), industrial emissions (e.g. sulfur dioxide ) and occupational exposure (dust, irritant gases, extreme heat) are associated with chronic bronchitis. Frequent infections of the respiratory tract can also damage the mucociliary self-cleaning of the airways . A chronic sinusitis z. B. due to a curvature of the nasal septum (Deviatio septi nasi; septum deviation ) can be the cause of chronic bronchitis.

Emergence

Smoking e.g. B. inhibits the ciliation of the ciliated epithelium , which is responsible for the transport of bronchial secretions towards the throat. After years of tobacco consumption, the cilia degenerate and a transformation ( metaplasia ) into the squamous epithelium begins . The lungs' self-cleaning system is disturbed. The patient has to cough up. After that, he is often symptom-free for hours. Mucus accumulates especially at night, which causes the smoker's typical morning coughing up, but which can often only remove part of the mucus produced. Coughing up in the morning is often perceived as annoying, but not too dangerous.

prevention

• Abstinence from smoking
• clean Air

pathology

Chronic bronchitis often turns into chronic obstructive pulmonary disease (COPD); this transition has the following forms:

Chronic catarrhal bronchitis

There is hypertrophy of the mucous glands and the development of goblet cell hyperplasia . The mucus overtaxes the ciliary clearance , as a result of which germ colonization occurs. The mucous membrane is edematously swollen, the bronchial muscles are occasionally thickened from frequent coughing.

Chronic-slimy-purulent bronchitis

It arises from catarrhal bronchitis caused by bacterial colonization. It is characterized by a strong granulocytic and lymphocytic infiltration of the bronchial wall . The wall thickening leads to the formation of wrinkles (hence the synonym hypertrophic bronchitis ). As a complication, it can lead to the displacement of smaller bronchial branches (bronchioli). It is important that the severely disabled or those who have difficulty coughing up mucus drink plenty of fluids. Coughing up is made easier by taking expectorant drugs.

Chronic atrophic bronchitis

The chronic inflammation destroys the mucous membrane of the bronchi . This changes the underlying layers (the mucosa becomes thinner, the submucosa becomes fibrosis, muscles and cartilage thin). The bronchial walls become flaccid. As a result, individual bronchi can collapse when exhaling intensely.

Symptoms of the transition to COPD

During the transition to a chronic obstructive pulmonary disease , night sweats, fever, wheezing exhalation, shortness of breath during exertion and increased susceptibility to infections occur. Mild signs of inflammation may appear in the blood.

consequences

• Pulmonary emphysema (lung inflation)
• Bronchiectasis
• Atelectasis
• Bronchopneumonia (pneumonia)
• Stenoses in the bronchial system
• In advanced cases, the oxygen saturation in the blood can be reduced, cyanosis (blue rash) with increased CO ₂ can occur.
• An increase in resistance in the pulmonary circulation can lead to chronic cor pulmonale .

therapy

• strict abstinence from tobacco smoking
• Respiratory gymnastics (e.g. breathing against the lip brake , Pasha seat , coachman seat )
• Tapping massages
• adequate hydration
• light endurance sports, strength training, gymnastics
• Medicinal: beta-2 sympathomimetics, parasympatholytics, corticosteroids, theophylline; in the case of additional bacterial infection, antibiotics
• Oxygen administration for respiratory failure

The drug treatment of chronic bronchitis is mainly carried out with inhalable drugs, which are delivered as metered aerosols or powder with the help of inhalers, respectively. Powder inhalers are administered, less often than inhalation solutions, which are nebulised with electrically operated inhalers. Cells and alveoli that have already died cannot regenerate, which is why a full recovery is not possible.

See also

• acute bronchitis

literature

• N. Konietzko: bronchitis. Urban and Schwarzenberg, 1995.

Web links

• ICD-10 GM 2012 - Current Codes for Chronic Bronchitis
• chronic bronchitis - patient information from NetDoktor.at

Individual evidence

1. ↑ smoker's lung. Retrieved October 8, 2019 . 

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !