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However, exacerbations of bronchitis are more common with the main pathogen being bacteria. The acute exacerbations are also severe in patients with chronic bronchitis. Chronic bronchitis affects 15percent to 25 percent of the adults and most of them suffer from acute exacerbations (Schlossberg 197). Chronic bronchitis is included in chronic obstructive pulmonary diseases (COPD). Chronic bronchitis is described as “the presence of a chronic productive cough for more than half of the time over two years” (Rubin and Strayer 564). Major causes of chronic bronchitis include smoking in adults and cystic fibrosis (Goljan 303). Pathological aspects or physiological abnormalities which predispose an individual to bronchitis include bronchial obstruction by abnormal secretions, mucociliary clearnance impairment, bronchial constriction and impaired host defenses (Schlossberg 197). Bronchitis leads to a plethora of manifestations and if not managed promptly can lead to serious consequences.
Chronic bronchitis is caused by hypersecretion of submucosal mucous secreting glands in the trachea and bronchi. This leads to sputum overproduction in chronic bronchitis. In many cases, as mentioned before, neutrophils or acute inflammation is seen superimposed on chronic inflammation. Chronic bronchitis leads to mucus plugs in the respiratory tract lumen hence causing respiratory tract obstruction. This blocks the release of carbon dioxide from the respiratory tract through expiration, hence the arterial PaCO2 will be greater than 45 mmHg in such patients. Chronic bronchitis also leads to goblet cell metaplasia and hypertrophy of mucus secreting glands. Patients suffer from dyspnea late in the disease and also exhibit cyanosi of mucous membranes and skin. This is due to poor oxygen saturation caused by hypoxemia. Thus, these patients are also called “blue bloaters”. The chronic inflammation and fibrosis
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