Bronchitis
Inflammation of lining of bronchial tubes, which carry air to and from the lungs (bronchial tubes) results in cough and mucus.
Bronchitis Types:
- Acute Bronchitis
- Chronic Bronchitis
Acute Bronchitis
- Condition remains for few days to 10 days
- Bacteria or virus that cause common cold or infection.
- Irritants like cigarette smoke, air pollution, dust, vapours or fumes.
Chronic Bronchitis
- Condition remains for months to years.
- Lining of bronchial tube is constantly irritated and inflamed.
- Cough with mucus for at least 3 months in a year.
chronic bronchitis Caused by
- Repeatedly breathing in irritants.
- Smoking major cause.
- Viruses or bacteria easily infect irritated tubes.
- Ongoing and serious
Causes and Risk factors
- Cold and flu season
- Viruses: Influenza Type A or B
- Bacteria: Mycoplasma pneumoniae
- Person inhaling irritants like dust, fumes.
- Gastroesophageal reflux disease (GERD)
- Weak immune system
- Smoking
- Unhealthy environment
Pathophysiology of bronchitis
- Virus, bacteria, smoke or other environment pollutants irritate airways
- Hypersecretion of mucus and inflammation
- Bronchial walls become thickened
- Bronchial lumen narrow, mucus plugged airways
- Alveoli adjacent to bronchioles may become damaged and fibrosis
- Fibrosis of bronchial and airflow limitation
Clinical features of Bronchitis
Acute bronchitis clinical features
- Cough with or without phlegm
- Chest tightness
- Fever
- Mild headache, body aches
- Shortness of breath
- Wheezing sound
Chronic bronchitis clinical features
- Daily, productive cough for at least 3 months of the year, 2 or more years in a row.
Asthma
Asthma is a common chronic inflammatory condition of the lung airways . It has three characteristics:
- Airflow limitationàwhich is usually reversible spontaneously or with treatment
- Airway hyper responsiveness àto a wide range of stimuli
- Inflammation of the bronchi àwith eosinophils, T lymphocytes and mast cells that is associated with plasma exudation, edema, smooth muscle hypertrophy, mucus plugging and epithelial damage.
Epidemiology
- Asthma affects an estimated 300 million individuals worldwide.
- Annually, the World Health Organization (WHO) has estimated that 15 million disability-adjusted life-years are lost and
- 250,000 asthma deaths are reported worldwide.
Predisposing factors
Environmental allergens
- house dust mites;
- animal allergens, especially cat and dog;
- cockroach allergens;
- fungi
- Viral respiratory tract infections
- Exercise, hyperventilation
- sinusitis or rhinitis
- Aspirin and NSAID hypersensitivity
- Use of beta-adrenergic receptor blockers
- Obesity
- Environmental pollutants, tobacco smoke
- Occupational exposure
- Irritants (eg, household sprays, paint fumes)
- Emotional factors or stress
- Perinatal factors (prematurity and increased maternal age; maternal smoking and prenatal exposure to tobacco smoke)
Clinical features
three most common symptoms
- cough,
- dyspnea, and
- wheezing.
In some instances, cough may be the only symptom.
COPD
- Chronic obstructive pulmonary disease (COPD) is lung disease
- characterized by persistent airflow limitation that is usually progressive and
- associated with an enhanced chronic inflammatory response in the airways and the lung in response to noxious particles or gases.
- COPD Include
- Chronic Bronchitis
- Emphysema
- Irreversibale astma
- Bronchetiasia
Emphysema:
- Impaired gas exchange from destruction of the walls of over distended alveoli.
Chronic Bronchitis:
- Excessive accumulation of mucus due to inflammation and cause narrow airway.
Irreversible asthma:
- Inflamed and constricted airways obstruct airflow.
Bronchiectasis:
- Mucus sticks to bronchi leading to obstruction, infection and inflammation.
Epidemiology
- The Global Burden of Disease Study reports a prevalence of 251 million cases of COPD globally in 2016.
- Globally, it is estimated that 3.17 million deaths were caused by the disease in 2015 (that is, 5% of all deaths globally in that year).
- More than 90% of COPD deaths occur in low and middle income countries.
- Nepal have reported the prevalence of COPD ranging from 23% to 43%.
Risk factors and cause of COPD
- Smoking (Active or Passive)
- Indoor and outdoor pollution
- Genetic factors: alpha 1 antitrypsin deficiency
- Socioeconomic status
- Asthma & airway hyper-reactivity
- Emphysema
- Chronic bronchitis
- Infections
- Exposure to smoke
Pathophysiology of COPD
Due to causes and risk factors of COPD
CLINICAL FEATURES
- Chronic coughing (sputum)
- Dyspnea
- Wheezing
- Chest tightness
- Frequent respiratory infection
- Enlarged alveoli
- Weight loss
- Advanced symptoms
- Cyanosis
- Morning headache
- Weight loss
- Haemoptysis
- Swollen feet and ankles