The first noticeable symptom of chronic bronchitis is a persistent, mucus-producing cough.
In its early stages, chronic bronchitis has few symptoms. It often begins with a recurring morning cough that brings up mucus from the lungs (phlegm). Smokers often dismiss this cough as a normal smoker's cough. Many people also complain of postnasal drip or sinus congestion, a bad taste in their mouth, or bad breath (halitosis). As time passes, the amount of phlegm gradually increases and coughing continues throughout the day.
Chronic bronchitis can cause wheezing and shortness of breath.
Narrowing of the airways due to inflammation, coupled with increased mucus in the lungs, leads to shortness of breath that worsens over time. This shortness of breath may be accompanied by episodes of wheezing, which is a raspy, whistle-like sound heard with breathing. Wheezing occurs when air moves through the narrowed air passages in the lungs. The wheezing and shortness of breath of chronic bronchitis often occur or worsen with exertion.
In the later stages of the disease, chronic bronchitis may cause the skin and lips to develop a bluish tinge due to a lack of oxygen in the blood. Lack of oxygen in the blood, coupled with the increased work it takes to breathe through obstructed air passages, can cause a person to tire easily with even small amounts of activity.
Chronic bronchitis, and the heart problems it may cause, can lead to swelling (edema) in the legs and ankles.
Swelling in the ankles and legs, and sometimes swelling in the abdomen, may occur in advanced chronic bronchitis. This happens because blood vessels narrow (constrict) to try and divert blood to less damaged areas of the lungs where more oxygen is available. This constriction can lead to high blood pressure in the lungs (pulmonary hypertension). Pulmonary hypertension causes the right side of the heart to work harder than it should. Eventually, that side of the heart may not be able to keep up with the workload. This is called right heart failure, or cor pulmonale. Right heart failure may cause blood to back up in the liver, intestines, and legs. This may cause swelling in the ankles, legs, and abdomen. High blood pressure and chest pain may also occur. It is important to see your clinician regularly so that any new problems with your heart or lungs can be caught early.
A sudden worsening of chronic bronchitis is called an exacerbation. Symptoms of an exacerbation include coughing up more mucus or mucus that is a different color than usual, as well as increased shortness of breath.
Viral infections are the most common trigger of an exacerbation of chronic bronchitis. When chronic bronchitis is in its later stages, even a mild cold can trigger a severe worsening of symptoms.
Exacerbations of chronic bronchitis can make it hard for you to breathe. If you cannot get your breath, begin to wear out from the effort it takes to breathe, become confused, or have a new or worsening dusky tint of the skin of your fingers or mouth, seek medical attention immediately.
Smoking tobacco products increases your risk for chronic bronchitis and chronic obstructive pulmonary disease (COPD).
Cigarette smoking causes approximately 80%-90% of COPD cases. Even after you develop bronchitis or emphysema, your health could still benefit from quitting smoking. Your clinician can inform you of a number of medications and programs available to help you quit smoking.
Children of heavy smokers also have an increased risk for developing chronic bronchitis, as do nonsmoking adults who are repeatedly exposed to the cigarette smoke of others (passive smoke).
Being exposed to environmental pollutants, such as large amounts of dust or irritants, may increase your chance of developing chronic bronchitis.
Chronic bronchitis is more common in urban areas that have air pollution. Exposure to emissions of sulfur dioxide (SO
2, a chemical used in bleaching and as a refrigerant and preservative) in particular has been shown to increase the risk of chronic bronchitis. Workers exposed to dusts, such as coal miners, grain handlers, and metal molders, are also at an increased risk for developing chronic bronchitis.
Frequent respiratory illnesses and infections can increase your chance of developing chronic bronchitis.
People who have repeated episodes of acute bronchitis have an increased risk of developing the chronic form of the disease. Recurrent respiratory tract infections during infancy or early childhood can also lead to chronic bronchitis.
1-antitrypsin (AAT) deficiency, an uncommon hereditary condition, can put you at greater risk of developing COPD and chronic bronchitis.
AAT is a protein that is made in the liver and released into the blood. It plays a role in protecting the lungs. AAT deficiency is an inherited disorder in which there is not enough AAT in the blood. This may leave the lungs less protected against damage. AAT deficiency is uncommon, but if you have it, your risk of developing COPD can be significantly increased. If you have this hereditary deficiency, your clinician may recommend AAT-replacement therapy.
Pneumococcal and influenza vaccines may reduce your risk of having an acute exacerbation (sudden worsening) of your chronic bronchitis.
Any lung infection can make the symptoms of your bronchitis worse. Preventing pneumonia and influenza can help you decrease the risk of bronchitis exacerbations. Ask your clinician about whether you should receive the pneumococcal and influenza vaccines. Both vaccines are usually recommended for people who are over the age of 65, have a chronic illness, or have a weak immune system. The pneumococcal vaccine is effective for 5 years in people who receive it before age 65 for the first time. But people who receive it for the first time who are over 65 only need to get it one time. The influenza vaccine must be taken yearly, because it protects against only that year's strains of influenza viruses.
Smoking increases your risk of developing lung cancer. If you begin to cough up blood, notify your clinician right away. This may be a sign of lung cancer.
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