Diagnosis of Bronchitis

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The diagnosis is made on the basis of the symptoms, the sputum and the response to treatment.

In chronic bronchitis, there are flare-ups every winter, and often at other times. Cough with sputum production occurs on most days for at least three months of the year. Chronic bronchitis is virtually confined to cigarette smokers.

A stethoscope will reveal added sounds. Superimposed on the breath sounds are wheezes, crackles and musical notes of different pitches indicating spasm of the bronchial tubes.

Peak expiratory flow measurement is a test widely used to assess the degree of any kind of obstruction to the air passages, especially of the kind caused by asthma and chronic bronchitis. The test gives a valuable indication of the severity of the disease and of response to treatment.

Usually an individual who breathes out as forcibly as possible through the mouth, the rate of flow of air rises rapidly to a peak and then declines steadily to zero. Usually there is a peak breathe out rate of up to 8 litres a second, but in certain lung diseases, such as bronchitis, the figure is much lower because the bronchial tubes are narrow or partially blocked.

Provided there is no gross weakness in the respiratory muscles, a lowered peak flow rate indicates probable disease of the air passages. This could be asthma, bronchitis or bronchiectasis, or a lung disorder, such as emphysema or fibrosis that affects the natural recoil of the lungs.