What Increases Risk of Chronic Bronchitis in COPD?
Research studies have found that having chronic bronchitis (CB) can increase the chance of death. (1) People with chronic obstructive pulmonary disease (COPD) are more likely to become ill with CB, making it even more difficult to breathe. (2) (3) CB has been found in many research studies to worsen the symptoms of COPD quicker than in COPD patients without CB. (4) (5) (6) A recent study was published in the journal Respiratory Research. It looked at 2703 patients with COPD. About 660 of them had CB and 2040 did not. This study asked them questions about their habits and medical history. (2) They looked to find the risk factors of CB in patients with COPD. Risk factors are behaviors or medical history that make a disease more likely to happen.
There were many risk factors for becoming ill with chronic bronchitis (CB) in patients with COPD. The biggest risk factor for CB was smoking while already diagnosed with COPD. (4) This risk has nothing to do with, or independent of, the severity of COPD. However, smoking was not the only risk factor of CB. Other risks include gastric reflux, allergies causing nose and eye symptoms, “a history of asthma and acute bronchitis,” breathing in dust and other particles in the air at work, and having to receive emergency medical treatment in the past year due to COPD symptoms. (4)
Some of the risk factors can be changed. These are known as behavioral risk factors. Although it may be difficult, patients may prevent becoming ill with chronic bronchitis (CB) if they stop smoking. This can help prevent other diseases as well, like lung cancer and emphysema. Wearing protective masks in areas where breathing in dust and other airborne particles can also help prevent CB.
Some of the risk factors for CB cannot be prevented by changing a behavior so that those risk factors no longer exist. However, perhaps successful treatment of them can help lower the patient’s risk. For example, a patient with gastric reflux can reduce their symptoms by eating foods that do not make gastric reflux worse and medications to treat reflux. Medication to treat allergies and asthma can help to prevent symptoms of those illnesses, which can lower the risk of CB.
Changing certain behaviors or habits can help prevent chronic bronchitis in COPD patients. For risk factors that have medicines to treat symptoms, these risks can be lowered as well. For any COPD patients with any of these discussed risk factors for CB, extra caution should be practiced when the patients have a chronic cough, seeing their doctors for possible treatment.
1. Thirty-year cumulative incidence of chronic bronchitis and COPD in relation to 30-year pulmonary function and 40-year mortality; a follow-up in middle-aged rural men. M, Pelkonen, et al. 2006, Chest, Vol. 130, pp. 1129-1137.
2. Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease. TA, Seemungal, et al. 2000, Vol. 161, pp. 1608-1613.
3. Cough and sputum production are associated with frequent exacerbations and hospitalizations in COPD subjects. PR, Burgel, P, Nesme-Meyer and P, Chane. 2009, Chest, Vol. 135, pp. 975-982.
4. The chronic bronchitic phenotype of COPD: an analysis of the COPDGene study. V, Kim, et al. 2011, Chest, Vol. 140, pp. 626-633.
5. Association of chrnic mucus hypersecretion with FEV1 decline and chronic obstructive pulmonary disease morbidity. Copenhagen City Heart Study Group. J, Vestbo, E, Prescott and P, Lange. 1996, Am J Respir Crit Care Med, Vol. 153, pp. 1530-1535.
6. Longitudinal lung function decline in subjects with respiratory symptoms. CB, Sherman, et al. Dis : s.n., 1992, Am Rev Respir, Vol. 146, pp. 855-859.
7. Clinical and computed tomographic predictors of chronic bronchitis in COPD: a cross sectional analysis of the COPD Gene study. V, Kim, et al. 2014, Respiratory Rsearch, Vol. 15, p. 15. Retrieved from http://respiratory-research.com/content/pdf/1465-9921-15-52.pdf
Laurie M. DeChello, MPH, CPH
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