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ICD-10 code: J20-J21
ICD-9 code: 490-491

Bronchitis is an obstructive pulmonary disease characterized by inflammation of the bronchi of the lungs. It is a common disease of habitual smokers and residents of polluted cities.

Like many disorders, bronchitis can be acute (short-term), or chronic (long-lasting). Chronic bronchitis is defined clinically as a persistent cough that produces sputum for at least three months in two consecutive years.



Signs and symptoms

The primary symptom of chronic bronchitis is a persistent cough that produces sputum. A patient may have only this symptom for many years before others develop. Eventually, the patient will experience shortness of breath (dyspnea) on exertion. As the disease progresses, other symptoms may appear, such as an inability to sufficiently expel carbon dioxide from the lungs (hypercapnia) and insufficient oxygenation of the blood (hypoxemia) leading to cyanosis. Severe chronic bronchitis will commonly lead to cor pulmonale and heart failure


When the airways of a lung affected by chronic bronchitis are viewed under a microscope, several features are usually observed:


A physical examination will often reveal decreased intensity of breath sounds (rhonchi) and extended expiration.

A common test when ordered when evaluating a patient for bronchitis is a sputum culture. In this test, a sample of sputum from a patient is stained and examined for the presence of bacteria that can cause disease.

The are a variety of lab test results that indicate the presence of chronic bronchitis in a patient, namely:

Diagnosis of acute bronchitis is aided by finding an elevation in the level of the diaphragm on chest x-ray.


The initiating event in developing bronchitis appears to be chronic irritation due to inhalation of certain substances (especially cigarette smoke). The earliest clinical feature of bronchitis is increased secretion of mucus by submucousal glands of the trachea and bronchi. Damage caused by irritation of the airways leads to inflammation and infiltration of the lung tissue by neutrophils. The neutrophils release substances that promote mucousal hypersecretion. As bronchitis persists to become chronic bronchitis, a substantial increase in the number of goblet cells in the small airways is seen. This leads to further increased mucous production that contributes to the obstruction of the airways.

The role of infection in the pathogenesis of chronic bronchitis appears to be secondary. However, although infection is not responsible for initiating bronchitis, it may have an important role in maintaining it. Acute exacerbations of the long-standing bronchitis may result from infections.


The single most important thing a patient can do to improve this disease is to quit smoking. Oxygen therapy, bronchodilator drugs, and lung volume reduction surgery are also used to treat chronic bronchitis.


Pulmonary hypertension, cor pulmonale, and chronic respiratory failure are possible complications of chronic bronchitis.

The prognosis for patients with severe chronic bronchitis is poor. The median survival time of patients with severe bronchitis is four years (Medical Diagnosis and Treatment).


Bronchitis is very preventable. The main action to reduce your risk is to eliminate exposure to cigarette smoke. Smokers in the early stages of chronic bronchitis can change and improve the course of the disease by quitting smoking.


Bronchitis was originally named and described by Charles Bedham in 1808. It was introduced by P. Frank in his work "Interpretationes Clinicae" in 1812.

External links

Section Online medical references


  • "Chronic bronchitis." Springhouse Handbook of Diagnostic Tests, 2nd ed. (1999). ISBN 0-87434-982-6
  • "Chronic obstructive pulmonary disease." 2005 Current Medical Diagnosis and Treatment. ISBN 0-07-143692-8
  • Kumar, Vinay, Abul Abbas, and Nelson Fausto. Robbins and Cotran Pathologic Basis of Disease, 7th ed. (2005). ISBN 0-7216-0187-1
  • Skinner, Henry Alan. The Origin of Medical Terms. (1970).
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