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BRONCHITIS - CHRONIC IN ACUTE EXACERBATION

Chronic bronchitis is an infection of the trachea and bronchi for at least 3 consecutive months for more than 2 consecutive years.
The patient experiences symptoms of increase in dyspnea, sputum volume and sputum purulence over baseline on most days.

Diagnosis is basically based on clinical presentation.

Patient Education

  • Educate patient about the nature of the chronic bronchitis (the progressive nature and its potential impact on future lifestyle and function)
  • Review with the patient the signs of onset of infection (eg increased purulence, viscosity or volume of secretions) that should be treated early
  • Discuss measures that may limit the spread of viral infections (eg hand washing)
  • Encourage patients to exercise regularly
    • Although not accompanied by measurable improvement in lung function, it will increase exercise tolerance and improve the patient’s sense of well-being

Lifestyle Modification

Smoking Cessation

  • A discussion of smoking behavior and the setting of a specific cessation date should be part of every physician-patient encounter
  • Patients presenting with AECB should be encouraged to stop smoking since it is the most effective way to reduce the risk of future morbidity from chronic bronchitis
  • It can lead to dramatic symptomatic benefits for patients with chronic bronchitis eg stopping cough in 94-100%; when coughing stops, it can occur in as quickly as 4 weeks in 54% of patients

Reduction/Elimination of Irritants

  • Reduction or elimination of any source of irritants that may worsen lower airway inflammation
    • Includes environmental pollutants (eg dust, pollutants and second-hand smoke) and occupational irritants
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