Understanding Chronic Bronchitis

According to the most recent statistics reported in 2011 by the Centers for Disease Control and Prevention (CDC), nearly 10 million Americans were diagnosed with chronic bronchitis in 2010. Yet, people often mistakenly believe that the condition isn’t life-threatening and ignore the signs until it has advanced to dangerous stages.

Chronic bronchitis develops over time rather than striking suddenly. Because many people who develop chronic bronchitis are smokers, some with the condition assume that they just have “smoker’s cough.” Though early symptoms of bronchitis may seem mild, a persistent cough may belie a more serious problem that requires medical attention and ongoing treatment.

Bronchitis can be either acute or chronic, and is determined by symptom duration. Acute bronchitis is more common, often developing from a cold or other respiratory infection. It generally clears up on its own within a few weeks without lasting effects, though a nagging cough may linger for several weeks after the bronchitis has resolved. Repeated bouts of bronchitis that continue beyond several weeks may indicate chronic bronchitis—a recurring long-term condition that can be managed but not completely cured. 

The American Lung Association (ALA) defines chronic bronchitis as the onset of a mucus-producing cough most days of the month, three months of the year, for two consecutive years without any other underlying condition to explain it. If you have chronic bronchitis, you may also develop emphysema. Together, the two conditions are referred to as chronic obstructive pulmonary disease, or COPD.


While bacterial or viral infections often cause the initial airway irritation that leads to acute bronchitis, the National Institutes of Health (NIH) confirms that cigarette smoking is the most common cause of chronic bronchitis. In fact, 90 percent of those with the disease have a history of smoking, according to Johns Hopkins Medicine. Secondhand smoke can also contribute to chronic bronchitis. Other possible causes include extended exposure to air pollution, industrial or chemical fumes, toxic gases, and dust. Repeated lung infections may also damage the lungs and can worsen symptoms.


Bronchitis is the irritation and inflammation of the lining of the bronchial tubes, or air passages. This irritation and swelling cause excess mucus in your airways that leads to coughing, and makes it difficult for air to move through your lungs. The irritation can also damage cilia, the hair-like structures that help to keep your air passages clear from mucus. In this condition, air passages become a likely breeding ground for infections.

After a long period of airway irritation, chronic bronchitis can result in several hallmark symptoms, including constant production of excess mucus that may appear clear, white, yellow, gray, or green. As airway passages continue to thicken, breathing becomes increasingly difficult, resulting in an irritating, heavy cough that may produce an ounce or more of mucus daily. This may cause scarring in the lungs. Other symptoms may include fatigue, fever, chills, and chest discomfort.

The symptoms of chronic bronchitis may wax and wane over time. Your cough may disappear temporarily, only to be followed by a period of worsened coughing. At times when you experience heightened symptoms, you may have acute bronchitis on top of chronic bronchitis.

Tests and Diagnostics

If you’re uncertain about whether or not your symptoms are those of chronic bronchitis, a number of tests are available to help your doctor make a definitive diagnosis:

  • Chest x-ray: A chest x-ray can help rule out other lung conditions, like pneumonia, that may explain your cough
  • Sputum examination: Culture testing and analysis of cells in sputum can confirm the presence of bacteria and determine if you have whooping cough or another condition that can be treated with antibiotics
  • Pulmonary function test: This test checks lung function and signs of asthma or emphysema by measuring the airflow and volume of air in your lungs
  • High-resolution computed tomography: This scan allows for high-resolution images of your lungs, which can help aid diagnosis

When to Seek Treatment

Failing to receive timely treatment for chronic bronchitis can put you at risk for serious injury to your lungs, including respiratory problems or heart failure. When implemented early, treatments and lifestyle changes can effectively help manage the disease and improve your quality of life. Seek medical assistance if your cough:

  • Lasts longer than three weeks.
  • Prevents you from sleeping.
  • Is accompanied by a high fever (above 100.4°F).
  • Produces discolored mucus or blood.
  • Causes wheezing or shortness of breath.