Chronic bronchitis


Chronic bronchitis
Chronic bronchitis is a form of bronchitis, according to the WHO is defined as "cough and sputum on most days for at least three months in two consecutive years."

Chronic bronchitis is one of the most common disorders (15-25%). Therefore, it is also gesundheitsökonomischer vision of great relevance. Above all men (3:1 ratio) in the fourth decade of life are affected.

First, the inhalation of tobacco smoke (90% of patients are smokers or ex-smokers), but also environmental factors (air pollution, damp, foggy cold-climate), industrial gases (such as sulphur dioxide) and occupational exposure (dust, irritant gases, extreme heat) with chronic bronchitis associated. Frequent infections of the respiratory tract may also mukoziliäre self-cleaning of the respiratory tract damage. Even a chron. Sinusitis due to a Nasenscheidwandverkrümmung (Deviatio septi nasi; Septumdeviation) may be the cause for a chron. Bronchitis.

Smoking, for example, inhibits the Zilienschlag the bronchial epithelium, for the removal of the throat Bronchialsekretes direction is responsible. After years of tobacco degenerate the cilia and it begins a conversion (metaplasia) to the plate epithelium. The self-cleaning system of the lung is disrupted. Above all night muköser mucus accumulates, the typical morning Abhusten the smoker conditionally, but often only a portion of the produced Schleims eliminate.

Chronic bronchitis katarrhalische
It is the hypertrophy of the mucus glands and the development of a cup cell hyperplasia. The mucus overwhelmed the ziliäre clearance, as the successor to a bacterial settlement. The mucous is ödematös swollen, the Bronchialmuskulatur is occasionally by the frequent coughing thickened.

Chronic bronchitis slimy-purulent
It arises from a katarrhalischen bronchitis by bacterial colonization. It is characterised by a strong granulo and lymphocytic infiltration of the Bronchialwand. The wall thickening leads to wrinkling (hence the synonym hypertrophische bronchitis). The complication can lead to relocation of smaller Bronchialäste (bronchioli).

Chronic bronchitis atrophic
The chronic inflammation of the mucous membrane of the bronchi destroyed. This will change the underlying layers (the mucous becomes thinner, the Submukosa fibrosiert, muscles and cartilage are diluted). The Bronchuswände be flaccid. Therefore, it may be forced to Exspiration the collapse of individual bronchi.

Already in the diagnosis are two symptoms of evidence:

* Cough
* Ejection

Here, these symptoms usually increase when standing up in the morning. The patient must abhusten. After that, he often symptoms for hours. The morning Abhusten is often as disturbing, but not too dangerous felt. If symptoms can be added as night sweats, fever, slight signs of inflammation in the blood, whistling exhalation, shortness of breath under load and increased infections. In advanced cases, the oxygen saturation in the blood decreased, a blue addiction (cyanosis) is detectable.


* COPD with emphysema, Bronchiektasien, Atelektasen
* Bronchopneumonien (pneumonia)
* Stenoses in bronchial
* By increasing resistance in the pulmonary circulation can lead to chronic pulmonary Cor.


* Strict tobacco smoke abstinence
* Breathing exercises (such as breathing lips against brake)
* Klopfmassagen
* Ample fluid intake
* Medikamentös: Beta-2-sympathomimetics, Parasympatholytika, corticosteroids, theophylline, if necessary antibiotics
* Oxygen transfer in respiratory failure

Read also Bronchitis