Chronic bronchitis is charecterized by an increased secretion of slime (mucus) in the lower parts of the windpipe, of cough to get rid of the mucus, of mucus comming up and of decreased volume in the windpipe making it more difficult to breath. The inflammation also periodically flares up and resides again.

The mucus comming up by cogh is often green or yellowish green and also may be orange or pink, depending on the pathogen causing the inflammation..  Other pcational symptoms are chest pain, fever and malaise.

By ausculation the doctor will find dimmished sounds of breath, wheezing and a longer time to breath out.

Mucosal hypersecretion is caused by a substance released by neutrophils invading the inflamed tissues. Further clogging of the airways is caused by an increase number of goblet cells in the lower airways. Neutrofiles are white blood cells that play a role in the immune defence. Goblet cells are the mucus secreting cells inside the lower respiratory tract.

The diagosis of chronic bronchitis is based on the following methods:

- Pulmonary Function Tests (PFT) (or spirometry) is performes If the test shows a FEV1/FVC ratio below 0.7 that is not fully reversible after bronchodilator therapy indicates the presence of COPD that makes the condition much more severe and indicates more aggresive therapy.

- A chest x-ray may reveal conditions that causes chronic bronchitis. If the chest A chest X-ray shows hyperinflation; collapse and consolidation of lung areas, pneumonitis is a probable diagnose

- A sputum sample showing white blood cells of the type neutrophil granulocytes and culture showing pathogenic microorganisms such as Streptococcus spp.

- A blood test would indicate a raised white blood cell count and increased C-reactive protein,  telling about an inflammation.

- Neutrophils infiltrate the lung tissue, aided by damage to the airways caused by irritation.
Damage caused by irritation of the airways leads to inflammation and leads to neutrophils being present.

- Increased secretion of mucus.

Most cases of chronic bronchitis is caused by tobacco smoking. A long term inhalation of chemical fumes is another cause.

Chronic bronchitis can caused by and viral infection, but may also be caused by a bacteria, like pneumococs, the same bacteria that cause lung infection.

The cause can be multimodular, for example smoking combined with an infection. Often the infection occurs when the bronchitis has been present for some time and worsens the condition.

If a person suffering from acute infectious bronchitis does not allow himself enough rest until the bronchitis has resided, the chance of developing chronic bronchitis gets higher.

However, when the condition gets chronic, there may also be some deficiency in the immune system that allows the infection to remain, or there is some deficiency in the system that tidy up after an infection, so that the germs can hide from the immune system and cause their effect a long time.

Because of these causes, some infection remains after the acute fase, or some residual junk from the infection remains and cause a chronic inflammation. 

THE TREATMENT OF CHRONIC BRONCHITIS

When chronic bronchitis is caused by tobacco smoke, to cease smoking is important to stop the process. Whan there are irritating pollution of chamicals in the environment or at a workplace, the outlet of these substances should be stopped if possible, or other ways to protect the airways from the irritants should be used.

The traditional treatment of chronic bronchitis is usually symptomatic against the secretions and  coughs, enough rest and  long term rehabilitation of daily rutines.

Bronchodilators, substances that make the boncs relax and widen is often used.

When the brochitis acutly worsens, one often uses antibiotics or chorticosteroids.

Althernative treatment has the aim of providing nutrients that strengthen the immune system and the renovation system of the body, so that the body more easily can get rid of the condition.

About the liquorize plant and liquorize  - an ingredient often used in respiratory drugs

The liquorice plant is a flowered plant of legume family that that can be found in Spain, Greece and Turkey. Of the root of the plant can be produced a juice that is used partly to produce licorice or to be used as it is in food, sweets and herbal medicines.

The full botanical classification of the plant is: Kingdom: Plantae, Division: Magnoliophyta, Class: Magnoliopsida, Order: Fabales, Family: Fabaceae, Subfamily: Faboideae, Tribe: Galegeae, Genus: Glycyrrhiza, Species: G. glabra

The liquorice plant is a legume related to beans and peas. It is an herbaceous perennial plant growing to 1 m in height, with pinnate leaves about 7–15 centimetres (3–6 in) long, with 9–17 leaflets.

The flowers are 0.8–1.2 cm (½–⅓ in) long, purple to pale whitish blue, produced in a loose inflorescence.

The fruit is an oblong pod, 2–3 centimetres (1 in) long, containing several seeds.

Liquorize, its composition and the basic effects of the constituents

Liquorize (Glycyrrhiza extractum) is a black or brown, edible substance that is extracted from the root of the licorice plant.

Liquorize is produced by boiling the root and then evaporating most of the water from the extract thus produced.

A working substances in liquorize are glychyrrhizin, glychyrrhizic acid and glycyrrhetinic acid 

Glychyrrhizic acid is a compund with very sweet taste. It is a multicyclic organic compound. Chemically, glycyrrhizin is a triterpenoid saponin glycoside of glycyrrhizic (or glycyrrhizinic) acid.

Several of the good effects and side effects of liquorize originates from these compunds hindering certain enzymes.

These componds are effecting the endocrine system in several ways. For example will these compounds increase the amount of the hormone cortisol in the kidneys by inhibiting an enzyme that degrades cortisol. Cortisol then stimulates higher excretion of calcium that then lower the calcium content in the blood. The compounds also hinder enzymes in the bactrerium Helicobacter pylorii and thus work against the activity of this bacterium. Thus it can help against stomach ulcers.

Other working substances are isoflavones which resamble the female sex hormomes.

Aspects of the flavor originates also from the  compound anethole ("trans"-1-methoxy-4-(prop-1-enyl)benzene), an aromatic, unsaturated ether present also in anise, fennel, and other herbs

Uses of liquorize

Licorize has the following uses:

- Liquorice is used both as a flavor substance, especially in sweets, but also in, for example, smokeless tobacco.

- It mixture is used as an expectorant substance, that is a substance that loosens, in medicines to alleviate symptoms of respiratory diseases.

- Liquorize mixture is used to alleviate irritation, transient cough and catarrhic (inflammatory) symptoms of the upper respiratory tract.

- Liquorize mixture (mixture solvency) can be used to alleviate symptoms of cold.

 - liquorize powder works as a mild laxative.

- Liquorize alleviates spams in the intestines and can be used to treat symptoms of bowel diseases that are associated with spasms.

- Liquorize can help healt stomach ulcers by effects against the bacterium Helicobacter pylorii.

- It can be used to reduce a too high sex drive.

- It can be used to treat hypercalemia.

The name comes from the Greek glykyrrhiza meaning "sweet root".

The full botanical classification of the plant is:

Cladus: Eukaryota, Regnum: Plantae, Cladus: Angiospermae, Cladus:Eudicots, Cladus: core eudicots, Cladus: Asterids, Cladus: Euasterids II, Ordo: Asterales, Familia: Asteraceae, Subfamilia: Asteroideae, Tribus: Heliantheae, Subtribus: Unassigned, Genus: Echinacea, Subgenus: Echinacea subg. Echinacea,

Species: Echinacea anguatifolia, purpurea and others.

The species have large composite flowers blooming through the whole summer. They live in north America and grow in wet and dry prairies.

Echinacea angustifolia and some others are used to make herbal drugs.

The active ingredients in echinachea are phenols, alchylamides and polysaccarides. It is however not known well how each of the ingredient contribute to the action.

Echinacea enhances the action of the immune system against bacteria and vira. The action seems to be general against all germs. It seems however that it enhances the action more when the germ has caused the disease than it enhances the preventive effect of the immune system.

It may also have a direct antibiotical effect.

Experiment on tumor cells indicate that the plant can be useful for anti-tumor use.