Topic overview

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The defining pattern is a productive cough for at least three months per year across two or more consecutive years. Cigarette smoking is a major risk factor; biomass smoke, recurrent respiratory infections and α₁-antitrypsin deficiency are also associated. Mucous-gland enlargement, goblet-cell hyperplasia and airway inflammation contribute to airflow limitation. Common features include chronic cough, purulent sputum and exertional dyspnea. Assessment includes post-bronchodilator spirometry, with chest radiography to exclude alternatives and sputum culture when infections are frequent. Management emphasizes smoking cessation, appropriate bronchodilators and prevention of infective triggers. The source also outlines options for selected patients, acute exacerbation care, monitoring and patient support, alongside cautions about treatments that may impair airway clearance or respiratory drive.