Bronchitis

Bronchitis acute or chronic inflammation of the mucous membrane of the bronchial airways. Acute bronchitis is characterised by fever, cough, tightness of the chest, occasional chest pain, and occasional wheeze in children. It is usually viral in origin, but may be associated with other infective diseases. It usually has a short period of illness and responds well to antibiotics.

In Bangladesh acute bronchitis frequently develops in children during winter months. It also follows influenza, measles, typhoid, or chickenpox. Its prevalence is high in humid, cold, overcrowded areas and in areas of higher air pollution.

Chronic bronchitis is defined symptomatically, where one suffers from productive cough for at least 3 months in two consecutive years. It could be periodic but may be a long lasting disease. smoking is the most important cause of chronic bronchitis, but air pollution, dust, and other environmental factors could be responsible. Sputum coughed up from the respiratory tract is initially scanty and viscid. In some cases the sputum may be streaked with blood.

In Bangladesh chronic bronchitis is more prevalent in rural areas. The main reason for this is Bidi smoking. Chronic bronchitis is almost double in males than in females, and more common in those 40 years or more in age.

The other symptoms of chronic bronchitis include breathlessness, periodic fever, tightness of the chest, and wheeze. It is a crippling disease and may end up in heart failure or respiratory failure. Cold causes aggravation of chronic bronchitis and for this reason it occurs in a milder form in Bangladesh than in the cold countries of the world.

The treatment of chronic bronchitis depends on stopping all forms of smoking, avoidance of cold exposure, avoidance of dust and smoke. The clinical treatment consists of appropriate antibiotics.

Breathlessness may have to be treated with oxygen inhalation. In long standing cases of chronic bronchitis the mucous glands lining the bronchia become hypertrophied and go on secreting mucous.

Bronchitis is largely a preventable disease. Prevention of chronic bronchitis depends on stopping all forms of smoking, and strict regulations to prevent air pollution by automobiles and industrial establishments. [M Serajul Islam and Mir Mesbahuddin]