COPD GUIDE · CHRONIC BRONCHITIS

Chronic Bronchitis: Symptoms, Treatment and Its Link to COPD

Prof. Dr. Yalçın Karakoca · Last updated: 25 September 2026

SHORT ANSWER

Chronic bronchitis is a long-lasting cough with phlegm. This cough lasts at least three months every year. It comes back for at least two years in a row. It is caused by ongoing inflammation in the airways and increased phlegm. A breathing test may show persistent airflow obstruction. In that case, it is considered the type of COPD in which cough and phlegm predominate. Treatment includes stopping smoking, inhaler medicines and phlegm-loosening medicines. Vaccines, exercise and airway clearance are also part of treatment. In patients with advanced COPD whose symptoms persist despite medicines, balloon treatment may be considered.

What happens in the lungs in chronic bronchitis?

The walls of the airways become inflamed and thickened. The cells and glands that produce phlegm multiply. The tiny hairs that clean the airways weaken, and phlegm cannot be cleared. The small airways narrow and infections keep coming back. You feel these changes as morning phlegm, a cough that does not go away and shortness of breath on exertion. Balloon treatment targets this thickened tissue and the mucus on the inner lining of the airway.

The difference between chronic bronchitis and emphysema

	Chronic bronchitis	Emphysema
Area affected	Airways (bronchi)	Air sacs
What happens?	Inflammation, increased phlegm, narrowing	The walls of the air sacs break down, the lung loses its elasticity, air stays trapped inside
Main symptom	Cough, phlegm	Shortness of breath
Chest CT scan	Thickening of the airway walls	Areas of emphysema, air building up in the lungs
If symptoms persist despite medicines	Balloon treatment	Lung valve

Most people with COPD have both. Treatment is planned according to whichever one predominates.

Treatment

Staying away from cigarettes and smoke (cough and phlegm decrease within months).
Long-acting bronchodilator inhalers are used. In people who have frequent flare-ups, a steroid inhaler, roflumilast or azithromycin may be added at the doctor’s discretion.
Phlegm-loosening medicines (N-acetylcysteine, carbocisteine): these may reduce flare-ups in some patients.
Airway clearance: controlled coughing and plenty of fluids (unless your doctor has advised you to limit them). If needed, devices that help bring up phlegm are also used.
Vaccines and pulmonary rehabilitation.
Severe symptoms that persist despite medicines: Balloon treatment may be considered. This applies to advanced COPD in which cough and phlegm predominate. The treatment is carried out with a tube with a camera at its tip (bronchoscope), which is passed through the mouth. Suitability is determined by a consultation and tests. Other bronchoscopic methods, such as freezing spray, are also being studied for this group of patients.

PRELIMINARY ASSESSMENT

Is it suitable for you?

Book an appointment and bring your breathing test and chest CT scan reports. We decide together at the consultation. If you are coming from outside Istanbul, an online preliminary consultation can be held first.

Please bring: your breathing test, your chest CT scan report and images (CD/USB), your list of medicines and, if you have one, your blood gas test result.

HAVE A QUESTION?

Frequently asked questions

The questions our patients and their relatives ask most often, with answers. We discuss questions about your own situation together at the consultation.

Is there a treatment for chronic bronchitis?

Yes. Treatment with medicines reduces symptoms and flare-ups. In suitable patients, balloon bronchoplasty can also be performed. In chronic bronchitis, the phlegm-producing cells (goblet cells) in the bronchi increase in number. Balloon treatment clears the thickened surface where these cells have multiplied. The more these cells return towards normal levels, the longer the results last.

Is chronic bronchitis fatal?

Chronic bronchitis can become fatal if it has led to severe respiratory failure.

What helps bronchitis that won’t go away?

Stopping smoking, the right inhaler and clearing phlegm. If the cough lasts longer than 8 weeks, you need a breathing test and a consultation with a pulmonologist.

What happens if it progresses?

Airflow obstruction, frequent flare-ups and respiratory failure may develop. Early treatment slows its progression.

Is there a herbal treatment for chronic bronchitis?

No herbal treatment has been shown to work. Details: Herbal treatments: the facts.

Who can have balloon treatment for chronic bronchitis?

Patients with advanced COPD in which cough and phlegm predominate and whose symptoms persist despite medicines. The decision is based on a chest CT scan and a breathing test.

APPOINTMENT

Book an appointment for a preliminary assessment

To find out whether you are suitable, book a preliminary assessment appointment. Bring your breathing test, chest CT scan report and list of medicines with you.

info@yalcinkarakoca.com · Rüzgarlıbahçe Mah. Cumhuriyet Cad. Hasoğlu Plaza Kat:3, Kavacık / Beykoz, İstanbul

REFERENCES

International COPD guideline (GOLD 2026 report); Turkish Thoracic Society COPD Diagnosis and Treatment Consensus Report.

This page is for general information purposes. It does not replace a medical examination or diagnosis. Treatment decisions are made during an examination, on an individual basis. In an emergency, call 112.

Medical content review: Prof. Dr. Yalçın Karakoca, Pulmonologist · Last updated: 25 September 2026

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