Chronic Bronchitis?

[steelie13]

Hi there, I have been diagnosed with mild Chronic Bronchitis. Now I have seen that it says that you have a persistent cough. I do not cough at all. I just feel like I have to clear my chest or throat quite a bit. My Fev1 was 82% pre and 88% post. My FEV1/FVC was 66.7%. I have had another Respo say it is asthma. All I know is that sometimes I feel like I have something stuck in my throat lower down or some pressure in my chest. I am 36 and my blood pressure is excellent. I smoked for 3 years total. I am on advair and spiriva.

I am active and run on the treadmill for about 1/2 hour 5 days a week. I seem to feel worse or heavy chested and feel the need to clear my chest a couple of hours after I run.

Anyone have the same kind of experience or advice?

Thanks in advance,

[steelie13]

Hi Doc,

Thanks for getting back to me. I do think I have something going on in my guts because I do get bloated sometimes and I feel pressure on my lungs. I do have alergies and had sinus surgery about 1.5 years ago. My nose does get stuffy a lot. My fef 2575 was low and that is why my doc wanted me to go see the Pulmo. My fef 2575 was around 55%. I have stopped my Advair and only take the Spiriva. I still do feel some heaviness sometimes. I have stopped running to see if it was the cultprit and it has gotten better. I stopped the Advair as well. I will run today to see if the heaviness comes back.

Thanks again,

Mike....

[David Tinkelman, M.D.]

The details you’ve provided suggest that you do indeed have some type of chronic obstructive airway disease.  That is a broad category of respiratory disease that encompasses asthma, chronic bronchitis, cystic fibrosis (CF), bronchiectasis without CF, and a number of other diseases.  It also includes COPD but that is unlikely at age 36 with a minimal smoking history, with one exception, an inherited disease that predisposes one to COPD at an early age, called Alpha-one anti-trypsin (or anti-protease)  disease.  That disease can be confirmed or ruled-out by a simple blood test.

The feeling of having to “clear my chest or throat” is usually associated with excess mucous production, with mucous that can originate in the upper airways (nose and sinuses) or in airways within the lung itself (lower respiratory disease).  That feeling along with the feeling of chest pain or pressure can also be associated with acid reflux (Gastroesophageal reflux), a condition that can contribute to or worsen upper or lower airway disease.

The first step in addressing your problem is for your doctors to determine, with a high degree of certainty, the correct diagnosis.  It may be as simple as your having the most common chronic respiratory disease in persons your age, Asthma, with a component of exercise induced asthma (EIA or EIB), suggested by, “I seem to feel worse or heavy chested and feel the need to clear my chest a couple of hours after I run.”  Or it could be a disease other than asthma.  This determination may require further pulmonary function testing to include an inhalation challenge (Methacholine challenge), blood testing and perhaps even a CT scan of the lungs.

I suggest that you seek a second (pulmonary specialist) opinion at a large academic medical center (Mayo Clinic, Cleveland Clinic or other).  It would be unwise for you to continue with this incompletely characterized disease, not optimally responsive to Advair and Spiriva, without further diagnostic evaluation.

Good luck