Pulmonology
Chronic Bronchitis
만성기관지염
Productive cough ≥3 months/yr for ≥2 consecutive years
- How common
- Common in smokers
- Typical age
- Ages 40+
What is it?
Goblet cell hyperplasia, mucus hypersecretion, and airway inflammation cause chronic productive cough.
Commonly affected: Large and medium bronchi
How it develops
- Smoke/irritantAirway mucosal irritation
- Goblet cell hyperplasiaMucus hypersecretion
- Submucosal gland hypertrophyIncreased Reid index
- Chronic inflammationRecurrent infections
Symptoms
- Chronic productive coughHeavy morning sputum
- CyanosisHypoxemia/hypercapnia
- Obesity/peripheral edemaOften with cor pulmonale
- Wheeze/exacerbationsFrequent infectious exacerbations
How it is examined
- SpirometryFEV1/FVC <0.7 confirms COPD
- Sputum analysisCulture and cytology
Imaging
Bronchial wall thickening ("dirty lung"), enlarged heart.
- Bronchial wall thickening
- Cardiomegaly
Chest CT confirms bronchial wall thickening.
- Bronchial wall thickening
Non-surgical care
- Smoking cessationKey to halting progression
- BronchodilatorsLAMA + LABA
- Mucolytics + vaccinesN-acetylcysteine + flu/pneumococcal vaccines
- Antibiotics for exacerbationsAmoxicillin/doxycycline/azithromycin
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
As for severe COPD
Procedures that may be discussed
- Lung transplant
- LVRS
Outlook
Stable with quit + inhalers; progresses to right heart failure if untreated.