Chronic Bronchitis And Emphysema

What are these Conditions?

Chronic bronchitis and emphysema are characterized by chronically blocked breathing passages. Collectively, asthma, emphysema, and chronic bronchitis or any combination are called chronic obstructive pulmonary disease. Usually, more than one of these underlying conditions coexist; most often, bronchitis and emphysema occur together.

The most common chronic lung diseases, chronic obstructive pulmonary diseases affect an estimated 17 millio
Americans, and their incidence is rising. They are more common in men than women, probably because, until recently, men were more likely to smoke heavily. Chronic bronchitis and emphysema don't always produce symptoms and cause only slight disability in many people. However, these diseases tend to worsen over time.

What causes them?

Predisposing factors include cigarette smoking, recurrent or chronic respiratory infections, air pollution, and allergies. Smoking is by far the most important of these factors. Smoking increases mucus production but impairs its removal from the airways, impedes the function of airway cells that digest disease-causing organisms, causes airway inflammation, destroys air sacs in the lungs, and leads to abnormal fibrous tissue growth in the bronchial tree. Early inflammatory changes may reverse themselves if the person stops smoking before lung destruction is extensive. Family and hereditary factors may also predispose a person to chronic bronchitis or emphysema.

What are the Symptoms?

The typical person with chronic bronchitis or emphysema is a long­term cigarette smoker who has no symptoms until middle age, when his or her ability to exercise or do strenuous work starts to decline and a productive cough begins. Subtle at first, these problems worsen with age and as the disease progresses. Eventually, they cause difficulty breathing on minimal exertion, frequent respiratory infections, oxygen deficiency in the blood, and abnormalities in pulmonary function. When advanced, chronic bronchitis and emphysema may cause chest deformities, overwhelming disability, heart enlargement, severe respiratory failure, and death.

How are they Diagnosed?

A history of cigarette smoking plus the results of blood and pulmonary function studies help confirm these diseases.

How are they Treated?

Treatment aims to relieve symptoms and prevent complications. Because most people with chronic bronchitis or emphysema receive outpatient treatment, they get comprehensive teaching to help them comply with therapy and understand the nature of these progressive diseases. If programs in pulmonary rehabilitation are available, they should consider enrolling.

What can a person with chronic bronchitis or emphysema do?

• Stop smoking and avoid other respiratory irritants.

• Install an air conditioner with an air filter in your home.

• If you're taking antibiotics to treat a respiratory infection, be sure to complete the entire prescribed course of therapy.

• Practice good oral hygiene to help prevent infection, and learn how to recognize early symptoms of infection. Avoid people with respiratory infections. Get Pneumovax (pneumococcal vaccine) and annual flu shots.

• To help remove secretions, learn how to cough effectively. If you have abundant, tenacious secretions, have a family member perform postural drainage (repositioning to drain fluids) and chest physical therapy. (Ask your doctor for instructions on these techniques.) If your secretions are thick, drink at least 6 eight ounce glasses of fluid a day. A humidifier may aid secretion removal, especially in the winter.

• To strengthen your breathing muscles, take slow, deep breaths and exhale through pursed lips.

• If you're receiving home oxygen therapy, make sure you or a family member knows how to use the equipment correctly. Don't increase the oxygen flow or concentration above what the doctor prescribes because too much oxygen may eliminate your respiratory drive and cause confusion and drowsiness. You probably won't need more than 2 to 3 liters per minute .

• Eat a balanced diet. Because you may tire easily when eating, eat frequent, small meals and consider using oxygen, delivered by a nasal cannula, during meals.

• Schedule rest periods throughout the day and exercise daily as directed by your doctor.