Two closely related lung diseases, both associated with coughing, wheezing and breathlessness.

Causes of Chronic bronchitis and emphysema

Underlying both of these common conditions is the chronic irritation of the lungs. This irritation is most often caused by cigarette smoke and its associated tars; other sources are air pollution, dust from industrial processes and coal mining. These irritating pollutants stimulate the lining of the small airways of the lungs to produce large quantities of mucus. Mucus is the sticky material that traps dust particles; specialized cells then sweep the mucus away from the narrowest parts of the lungs to the larger airways and ultimately the gullet, where the mucus can be swallowed or spat out.

Over time – meaning decades – the irritated lungs produce ever greater quantities of mucus, leading to a persistent cough. In addition, the airways narrow, leading to wheezing and breathlessness. In emphysema a further complication is that the tiny sacs at the ends of the lungs decay into large cavities, These are inefficient for gas exchange and add to the feeling of breathlessness.

Symptoms of Chronic bronchitis and emphysema

The earliest features of bronchitis are persistent cough and the constant bringing up of mucus. The cough gradually lasts longer until the individual is coughing all year round. Colds keep going to the chest, causing increased amounts of mucus and worsening breathlessness. People with emphysema have similar symptoms with, additionally, an over-inflated chest, giving a barrel-chested appearance. However, there is much overlap between bronchitis and emphysema and the exact diagnosis may not be clear without tests of lung efficiency. Eventually sufferers of both diseases can become constantly breathless even when walking a few steps and are effectively housebound. Severe cases also put a strain on the heart.

Treatment of Chronic bronchitis and emphysema

At the earliest signs, it is essential to stop smoking and avoid irritating dusts. Although this will not repair the damage done, it reduces the chances of further deterioration. Medical treatment is with a gas inhaler, of which there arc many types. These contain drugs called bronchodilators, which relax the muscles that otherwise tend to squeeze the already narrow airways even narrower. Those affected need to use these inhalers several times a day, often in combination. Examples of drugs used are terbutaline and salbutamol. Steroids given via inhalers are very helpful in reducing inflammation within the airways; the most commonly used is beclomethasone.

As well as being used in an inhaler, all these drugs can be given via a nebulizer, which produces a cloud of gas easily breathed in from a face mask. During flare-ups it may be necessary to take high doses of steroids by mouth.

Infections have to be treated aggressively with antibiotics because each infection can damage more of the lung. Many patients need to have oxygen available at home or in portable cylinders for when they go out. Very recently there has been interest in performing operations to remove the part of the lung damaged by emphysema, allowing the other parts to expand and so work more efficiently.

Complementary Treatment of Chronic bronchitis and emphysema

A Chinese herbalism remedy would be Quing Qi Hua Tan Wan (clean air and transform phlegm). Acupuncture points for the lungs include bladder 13 on the upper back and Lung 5 on the arm. Nutritional therapy – ensure your diet is rich in vitamin C and other nutrients. Ayurveda offers dietary advice and yoga breathing exercises. Other therapies to try: auricular therapy; Alexander Technique.

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