Chronic Obstructive Pulmonary Disease

Chronic Bronchitis – Causes, Symptoms & Treatment

Chronic obstructive pulmonary disease (COPD) is an umbrella term that refers to a number of chronic progressive lung diseases that prevent proper breathing.

The principle COPD’s are chronic bronchitis or emphysema (also, chronic irreversible asthma).  COPD is caused by recurrent injury to the airway, mainly from smoking or exposure to other lung irritants. The narrowing of the airways limits airflow to and from the lungs, causing severe shortness of breath. Unlike asthma, the narrowing of the airways is not reversible and worsens over time.

Chronic bronchitis is characterised by inflammation and irritation of the bronchi and bronchioles, and the subsequent production of thick mucous leading to a chronic cough.

Emphysema is characterised by lung damage and inflammation of the alveoli, causing permanent enlargement of the airways and destruction of the walls of the alveoli. This reduces the surface area available for the exchange of oxygen and carbon dioxide during breathing.

Causes of COPD & Chronic Bronchitis

• Cigarette smoking: the primary cause of COPD; 20-25% of smokers will develop COPD and even ex-smokers remain at risk
• Prolonged exposure to chemical irritants

Signs and symptoms of COPD & Chronic Bronchitis

Chronic bronchitis

• Productive cough that lasts for 3 months or more per year for at least 2 years
• Dyspnea (shortness of breath)
• Frequent upper respiratory tract infections
• Fatigue
• Cyanosis and peripheral edema in advanced stages
• Usually normal weight or overweight

Emphysema

• Dyspnea: the main symptom in emphysema
• Wheezing
• Chest tightness
• Enlargement of the chest (barrel chest)
• Fatigue
• Weight loss and cachexia
• Cyanosis and peripheral oedema in advanced stages

TREATMENT STRATEGY FOR COPD & CHRONIC BRONCHITIS

• Promote healthy lung function
• Reduce inflammation and oxidative damage
• Support immunity / prevent infection
• Support and balance gut pathogens / increase digestion and absorption
• Reduce mucous production and tone mucous membranes
• Reduce bronchoconstriction and airway reactivity
• Optimise oxygen utilisation
• Maintain adequate energy and nutritional intake

Diet plan guidelines for COPD & Chronic Bronchitis

• Ensure balanced macronutrient ratio:

Protein: 20-30% of kilojoules (or 1.2-1.7 g/kg body weight). Protein is essential for immune function and lung and muscle strength

Fat: 30-40% of kilojoules

Carbohydrate: 20-40% of calories

• Emphasise anti-inflammatory foods: in cold-water oily fish, berries, nuts and seeds, turmeric, ginger, green tea, olive oil
• Promote antioxidant-rich foods to support immune function: berries, green tea, turmeric, fruits and vegetables
• Minimise pro-inflammatory foods: sugar, refined carbohydrates, trans fats, vegetable oil, omega-6 fatty acids, caffeine and alcohol
• Emphasise vitamin C and quercetin-rich foods: e.g. berries, cherries, citrus, apples, onions, parsley, black and green tea, kale, broccoli
• Include magnesium-rich foods to promote bronchodilation: whole grains, green leafy vegetables, dark chocolate, nuts and seeds
• Include garlic, onion and horseradish: mucolytic action
• Include raw cacao (e.g. in smoothies, drinks, raw chocolate etc): highest natural source of theophylline, which reduces smooth muscle spasm and inflammation. Theophylline is also found in trace amounts in tea.
• Include pre- and probiotic foods to regulate immune function: high fibre foods, fermented foods

Supplements that support COPD & Chronic Bronchitis

• Vitamin C: anti-inflammatory, supports immune function
• Quercetin: anti-inflammatory, supports immune function
• Bromelain (and other proteolytic enzymes): between meals
• N-acetyl cysteine: mucolytic action, antioxidant
• Omega-3 EFA’s: anti-inflammatory action
• Vitamin A: tone and repair mucous membranes, immune support
• Zinc: tone and repair mucous membranes, immune support
• CoQ10: optimise oxygen utilisation, antioxidant, supports heart and lung function
• Magnesium: reduce bronchospasm and stress response, support energy production
• Vitamin D (depending on status): needed for healthy immune function
• Probiotics: to support immune function

Herbal medicine treatment that supports COPD & Chronic Bronchitis

• Lung tonics / expectorants: hyssop, elecampane, thyme, licorice, horehound, mullein
• Tone / repair mucous membranes: goldenseal
• Reduce mucous production: goldenseal, eyebright, goldenrod
• Reduce inflammation: licorice, turmeric, ginger
• Reduce free radical damage: turmeric, green tea, grapeseed
• Support immune system: echinacea, astragalus, olive leaf

Lifestyle / Physical measures that support COPD & Chronic Bronchitis

• Quit smoking!
• Avoid other airborne irritants e.g. occupational chemicals, cleaning chemicals, second hand tobacco smoke, fumes, food additives etc.
• Castor oil packs to chest – powerful anti-inflammatory. Apply oil directly to chest, cover with a soft clean cloth and plastic wrap; place a heat source (e.g. hot water bottle, heating pad) over the pack and leave for 30 to 60 minutes
• Postural drainage, yogic breathing and pulmonary rehabilitation programs may be useful
• Acupuncture: may help improve lung function and can be helpful for cessation of smoking

FUNCTIONAL MEDICINE TREATMENT of COPD & CHRONIC BRONCHITIS

The above nutritional, herbal and lifestyle factors may help support someone with chronic bronchitis or COPD.  Environmental and lifestyle causative factors will need to be removed to enable healing.

A functional medicine approach will address underlying body systems that may be compromised to assist overall immunity and repair.  Improvement of the gut microbiome, removal of pathogenic gut bacteria and improving intestinal permeability have shown to have a very positive effect of lung conditions.  All treatment approaches should be performed in conjunction with ongoing lung support.  At Advanced Functional Medicine we have have experience with respiratory diseases including chronic bronchitis and COPD. 

If you or a family member are suffering from chronic bronchitis or other respiratory disorder we would love to hear from you, what treatments have worked best for you?  What are your main triggers?  Please write a comment below.

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