Chronic Bronchitis
Also known as: Chronic bronchitis, Chronic productive cough, Chronic obstructive pulmonary disease, COPD chronic bronchitis phenotype
Chronic bronchitis is traditionally defined clinically by productive cough on most days for at least three months in each of two consecutive years after other causes have been excluded. It commonly occurs within chronic obstructive pulmonary disease (COPD), although chronic mucus hypersecretion may also occur without fixed airflow obstruction. Tobacco smoke is the leading preventable cause, while occupational dusts, fumes, air pollution, recurrent infection and other airway disorders may contribute. Diagnosis requires medical assessment and usually spirometry when COPD is suspected. Management may include smoking cessation, inhaled medicines, vaccination, pulmonary rehabilitation, physical activity, airway-clearance strategies where indicated and a written exacerbation action plan. In Chinese medicine, chronic bronchitic presentations are commonly differentiated within Ké Sòu (咳嗽), Tán Yǐn (痰饮), Fèi Zhàng (肺胀) and Chuǎn Zhèng (喘证). Frequent mechanisms include Lung Qi deficiency, Spleen Qi deficiency with Phlegm-Damp, Cold-Phlegm obstructing the Lung, Phlegm-Heat congesting the Lung, Lung and Kidney Qi deficiency, or Qi and Yin deficiency. Chinese medicine treatment is adjunctive and must not replace diagnostic spirometry, prescribed inhalers, smoking-cessation care, vaccination, pulmonary rehabilitation or urgent treatment of exacerbations.
Plain-English one-pager you can print or hand to a patient. Free, no sign-in needed.
Lifestyle & Diet
- •Support complete smoking cessation and avoidance of second-hand smoke.
- •Identify and reduce occupational exposure to dusts, fumes, gases and vapours.
- •Use prescribed inhalers exactly as directed and have inhaler technique checked regularly.
- •Participate in pulmonary rehabilitation when eligible.
- •Maintain regular physical activity within an individualised respiratory plan.
- •Keep influenza, COVID-19, pneumococcal and other recommended vaccinations current.
- •Use a written COPD action plan where COPD is diagnosed.
- •Maintain adequate hydration unless medically fluid-restricted.
- •Use airway-clearance techniques only when taught or recommended by an appropriate clinician.
- •Avoid smoke, incense, aerosol irritants and poorly ventilated treatment rooms.
- •Monitor air-quality alerts and reduce strenuous outdoor exposure during smoke or pollution events.
- •Maintain adequate protein and energy intake.
- •Use smaller meals if large meals worsen breathlessness.
- •Seek dietetic assessment for unintentional weight loss, obesity or muscle wasting.
- •Balance activity with pacing rather than prolonged inactivity.
Cautions & Contraindications
- •Acupuncture during severe breathlessness or acute respiratory distress — Risk of deterioration and delay of emergency treatment — Stop treatment and activate emergency care.
- •Supine positioning in a patient with orthopnoea — May worsen ventilation and distress — Use upright or semi-reclined positioning.
- •Moxibustion near oxygen equipment — Major fire and combustion risk — Strictly avoid.
- •Stopping or reducing prescribed inhalers because symptoms improve — May destabilise disease control — Medication changes require the prescribing clinician.
- •Herbal products without interaction review — Potential interactions with bronchodilators, corticosteroids, antibiotics, anticoagulants and cardiovascular medicines — Complete medication reconciliation before prescribing.
- •Claims of curing COPD or reversing fixed airflow obstruction — Misleading and inconsistent with evidence and advertising obligations — Use adjunctive symptom-management language only.
When to reassess or seek care again
- •COPD Assessment Test (CAT)
- •Modified Medical Research Council (mMRC) Dyspnoea Scale
- •Cough and sputum frequency
- •Exacerbation and hospitalisation frequency
- •Exercise tolerance and daily activity
- •Smoking status
- •Patient-reported sleep and quality of life
Explore more diseases
Sources & Further Reading
Clinical guidance, red flags and safety notes on this page draw on the following current sources alongside the classical references above.
Educational reference for licensed practitioners. Not a substitute for individual clinical assessment. Refer to conventional care for any red-flag or undiagnosed presentation.