27 Year old with Chronic Bronchitis

Hi...I am 27 years old...I just went to the pulmonologist a few days ago and had a lung function test done....all the tests were within normal range, but before I had the tests, the pulmonologist said that I have all the classic symptoms of chronic bronchitis....these are the symptoms I have...I have had Shortness of breath for a year and three months now....burning pain in my chest and back...coughing up blood.....Now, I noticed that these get worse when it gets cold outside and the air gets dry...also I have had a bloody stuffed up nose for like a month now...I am on symbicort inhaler, albuterol inhaler, and nasacort...these don't seem to help me that much. If I used a humidifier...would that help me?.....what else do you recommend that I do?...the pulmonologist said that because I am young, and I only smoked for eight years, that there's a chance that this will get better...is this true?.....also...I am scared that I am going to die at a young age....what is the prognosis...please help me..I am worried.....also...there is no lung problems that run in my family...why am I being affected so badly????

[National Jewish Health]

That your lung function measurements were within the normal range is good news.  Whatever may be going on with your lungs, you still apparently have good pulmonary function reserve.  But there is something you should understand.  That is, “normality” of pulmonary function is a range of values, rather than an absolute number.  Thus it is possible that your lung function was at the upper limits of normal and is now at the lower limits of normal; both measures within normal limits after a significant loss of lung function.  Comparison with previous lung function measurements, if available, could clarify this.

The main sign of chronic bronchitis is a productive cough.  Coughing up blood, with the exception of blood streaked sputum during an episode of acute bronchitis, should not be attributed to chronic bronchitis.  You mention a “bloody stuffed-up nose”.  It is possible that the blood you have been raising has been originating in your nose, simple nose bleeds, rather than in your lungs, but that should not be assumed.  The pulmonologist should make this determination with reasonable certainty, because bleeding from one’s lungs is always abnormal.  If he is not certain that the blood has come from your nose and if, as you suggest, the bleeding has been going on recurrently for some length of time, bronchoscopy should be performed, which is an exam of the inside of your lungs.

Worsening with exposure to cold, dry air is consistent with the diagnosis of asthma, chronic bronchitis and even with the diagnosis of chronic obstructive pulmonary disease (COPD).

There is an inherited condition called, alpha-1 antitrypsin deficiency, that significantly increases the risk of a person developing COPD, which is a combination of chronic bronchitis and emphysema, and despite a negative family history, you could have this condition and definitely be tested for it.

Until all this is sorted out, it will be impossible to offer a prognosis.

You may want to consider seeking a second opinion from another pulmonologist and do so in the near future, in behalf of your physical health and your serious concerns.

Good luck.