Chronic Bronchitis-Types-Causes-Clinical Signs and Symptoms

Chronic Bronchitis:
Chronic bronchitis is a respiratory airway disorder and is defined as a persistent productive cough for at least 3 consecutive months in at least 2 consecutive years.

Causes-Risk factors:
1. Smoking
2. people living in smog-ridden cities are at risk

3. Men are more at risk than females
4. Persistent chronic infections
5. Chronic asthma
6. Emphysema
7. Obstructive tumour
Types of Chronic bronchitis:
1. Simple Chronic Bronchitis:
     It is the most common form. The patients have a productive cough, but airflow is not obstructed.

2. Chronic asthmatic bronchitis:
     Some patients with chronic bronchitis develop hyperresponsive airways, with intermittent bronchospasm and wheezing. This condition is called chronic asthmatic bronchitis.

3. Chronic obstructive bronchitis:
     This is very common in heavy smokers. These patients develop chronic outflow obstruction (difficulty in exhaling air) usually with evidence of associated emphysema.

Pathogenesis:
The chemicals present in cigarette and air pollutants induce hypertrophy of mucous glands of trachea and bronchioles.  This results in a marked increase in mucus secretion, this mucus may plug the airways and result in productive cough, with a large amount of mucus. This intermittent obstruction and a large amount of mucus is a good place for bacterial growth and bacterial infections are more common among such individuals, Moreover, this causes inflammation with infiltration with CD8+ cells, macrophages and neutrophils. T cells cytokines exacerbate the inflammation and IL 13 causes hypersecretion of mucus.

Clinical Signs and Symptoms:
1. Prominent Productive Cough
2. Clear, yellow, greenish or blood-tinged sputum
3. Shortness of breath
4. wheezing in the chronic asthmatic bronchitis
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