What are the treatments for the condition?
WHO has identified the following four components for management of chronic bronchitis:
assessing and monitoring of the disease
managing exacerbations, or episodes where symptoms are worse
managing stable chronic bronchitis
reducing the person's risk factors
Assessment and monitoring
Assessment and monitoring of the disease incorporates the following steps:
doing a medical history and physical exam to evaluate symptoms
identifying people at risk for chronic bronchitis, even if they don't have symptoms
performing lung function tests to measure airflow limitations
Reducing risk factors
Reducing the person's risk factors includes the following recommendations:
Avoid vigorous outdoor exercise when air quality is poor.
Eliminate sources of indoor pollution, such as wood-burning stoves.
Limit exposure to secondhand smoke.
Reduce occupational dusts and chemicals.
Stop smoking, if the person smokes.
Managing stable chronic bronchitis
Management of stable chronic bronchitis includes the following:
Learn to identify and avoid risk factors.
Learn to identify problems and seek appropriate treatment.
Take medications as directed.
WHO recommendations for management of chronic bronchitis are broken down by the severity of the disease. Recommendations for Stage 0 chronic bronchitis include the following:
Get a flu vaccine once or twice a year.
Identify and eliminate risk factors.
Use antibiotics only for bacterial infections, but not for chronic bronchitis itself.
Recommendations for Stage I chronic bronchitis are the same as those for Stage 0. In addition, people with Stage I chronic bronchitis should use short-acting bronchodilators as needed. Bronchodilators relieve coughing and shortness of breath by opening the airways. In general, WHO recommends inhaled bronchodilators rather than oral medications.
Recommendations of Stage II chronic bronchitis include the recommendations from Stage I. Additional measures are recommended for times when symptoms are present. They include the following:
Use long-acting bronchodilators on a regular basis.
Use inhaled glucocorticosteroids, for people with significant cough or shortness of breath.
Participate in a pulmonary rehabilitation program that uses teaching and exercise to improve lung function.
WHO recommendations for Stage III chronic bronchitis are as follows:
Use long-acting bronchodilators regularly.
Take short-acting bronchodilators as needed.
Seek treatment for complications, such as pneumonia.
Participate in a pulmonary rehabilitation program.
Use oxygen as needed.
Discuss surgical options with the healthcare provider.
Managing worsening symptoms
People with chronic bronchitis may have worsening, or exacerbation, of symptoms when they develop a respiratory infection. Symptoms may also be worsened by cigarette smoke, as well as other factors. Following are the WHO guidelines for management of worsening symptoms:
Increase the dose and/or frequency of inhaled bronchodilators.
Take oral glucocorticosteroids to decrease airway swelling.
Take antibiotics for bacterial infection.
Take oxygen by mask or cannula.
Use a ventilator, or artificial breathing machine.
What are the side effects of the treatments?
Bronchodilators may cause an increased heart rate and blood pressure. Oral glucocorticosteroids can cause increased risk for infection, high blood sugar, and osteoporosis. Antibiotics can cause rash, stomach upset, and allergic reaction.
What happens after treatment for the condition?
Early diagnosis of chronic bronchitis and effective treatment can slow its progression. People who eliminate risk factors and follow treatment guidelines have better outcomes. Those who continue to smoke may be increasingly disabled by breathing problems and complications of chronic bronchitis.
How is the condition monitored?
Chronic bronchitis is monitored through regular visits with the healthcare provider. Lung function tests can be used to monitor limitations in airflow. Any new or worsening symptoms should be reported to the healthcare provider.
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