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Chronic Bronchitis

Chronic bronchitis is an insidious disease in which repeated infections of the bronchi eventually damage the tissue permanently. Symptoms - a persistent cough with sputum and shortness of breath - develop gradually, often over a period of many years, The disease may start at any age, but most commonly between the ages of thirty and sixty, recurring every winter.

People with chronic bronchitis are very susceptible to infection, and every cold or bout of influenza will cause a flare-up, so that the affected person may have several attacks a year. Each repeated infection further damages the lungs, making them more susceptible to yet another infection. The disease can eventually lead to pneumonia, hypertension in the lungs, emphysema or even heart failure.

In industrialized countries the mortality rate for bronchitis in men is between two and four times higher than that for women. The difference may be due to men's higher exposure to pollutants in their jobs, or their greater tobacco consumption. The incidence of bronchitis increases after the age of forty-five, and in the age group fifty-five to sixty. four the death rate is double that for all other ages. Prevention of bronchitis requires the elimination of tobacco smoking, a reduction in atmospheric pollution, and prompt and effective treatment of chest infections in people most at risk.

Symptoms

The amount of sputum and the duration of the cough gradually increases, until it is continuous throughout three months of the year or more. The sputum, at first colourless or grey from the presence of inhaled smoke or soot, evetually becomes frothy, with a thick and sticky consistency. As the disease progresses, breathlessness and wheezing are additional symptoms, and the affected person will notice that he or she can no longer keep pace with other people of the same age and build, or climb stairs without gasping for air. In the severest cases, breathlessness may occur even at rest. The shortness of breath is due to the narrowing of the bronchi and to the inefficient exchange of oxygen and carbon dioxide in the lungs. In the advanced stages, there may be cyanosis (blueness of the skin) due to the lack of oxygen.

The severest form of chronic bronchitis and the most deaths occur among heavy smokers. Many smokers regard the 'smoker's cough' as normal, but it is actually an early symptom of chronic bronchitis. Another factor is air pollution: the disease is more common in urban, industrial areas.

Treatment

To treat bronchitis, there are several possible self-help measures: give up smoking, and avoid smoke-filled rooms and people with colds. If possible, move to a rural area away from the pollution of a town or city. Drugs which help to expel mucus (expectorants) can be helpful, as can drugs which dilate the bronchi, as used for asthma. Antibiotics may be given for a bad attack with signs of infection.

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