Spastic bronchitis symptoms

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Symptoms of bronchitis

Bronchitis is one of the most common ailments of the lower respiratory system. This disease is an inflammatory process localized on the walls of the bronchi. The disease can be caused by: smoking, microorganisms, respiratory diseases, aggressive gases and dust.

Table of contents:

The disease is completely self-sufficient, which must be treated with special methods. Therefore, you need to know the manifestations of this disease and not confuse bronchitis with a cold or ARVI.

This material will outline the main signs of bronchial inflammation, as well as the reasons why you need to be able to diagnose this disease yourself.

Signs of acute bronchitis may vary depending on the type of primary disease that provoked inflammation of the bronchi. Due to the fact that most often this inflammation is caused by acute respiratory infections, much attention will be paid here to the signs of an acute form of bronchial inflammation that appears against the background of acute respiratory diseases. It is no secret that acute respiratory disease is caused by a variety of groups of pathogenic microflora. Among them there are those that specifically affect the bronchi, for example, MS infection, influenza, measles, causing inflammation in an acute form. In the presence of an active viral infection, the inner surface of the bronchi is an easy target for pathogens, and therefore the disease is complicated by the addition of microbial flora. That is why changes are observed during the course of the disease, which force doctors to change the treatment regimen.

It must be said that it is important to distinguish the acute form of bronchial inflammation from other ailments with similar manifestations, for example, pneumonia, allergic bronchitis, miliary tuberculosis. The differences between these ailments will be outlined below.

Signs of chronic bronchitis

We can talk about chronic bronchitis if the patient has a chronic cough ( cough observed for more than twelve weeks a year ) for two years or longer. So, the main sign of chronic bronchial inflammation is a chronic cough.

With inflammation of the bronchi in a chronic form, the disease either subsides or worsens again. Exacerbations often develop after exposure to the cold, in connection with acute respiratory diseases and are usually confined to autumn and winter. Just like with the acute form, the chronic form should not be confused with other diseases.

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Spastic bronchitis

In the first months of children’s lives, less often in the second year, acute viral respiratory diseases (possibly in combination with a secondary microbial infection) sometimes occur with symptoms of spastic bronchitis (“asthmoid”).

The essence of the disease is swelling of the mucous membrane of the medium-caliber bronchi (with their relative narrowness) in combination with spasm of the bronchial muscles. In recent years, viral epidemic outbreaks accompanied by spastic bronchitis have been described. Most of them were caused by respiratory syncytial virus, which has an affinity for the autonomic nervous system.

Significantly pronounced expiratory shortness of breath appears (characterized by a difficult elongated whistling or sawing exhalation, audible at a distance), sudden sharp pallor, sometimes cyanosis, a frightened facial expression, shallow breathing, despite the extreme tension of the auxiliary muscles, retraction of the compliant areas of the chest.

Physical examination reveals wheezing, emphysematous lungs, and low diaphragm. Attacks can vary in severity from mild to very severe, especially when complicated by bronchiolitis or pneumonia. Sometimes attacks are repeated, bothering the patient for several months, and occasionally (in no more than 20% of cases) they develop into bronchial asthma.

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Bronchitis: symptoms and treatment

Bronchitis - main symptoms:

  • Fever
  • Sore throat
  • Cough
  • Dry cough
  • Increased sweating
  • Moist cough
  • Coughing up blood
  • Cough with phlegm
  • Hard breath
  • Fatigue

Quite often there are cases of people getting bronchitis. This is due to the polluted air that a person inhales. This air contains a large number of viruses and parasitic bacteria, which, when they enter the body, begin to “take root” there and cause painful reflexes. These reflexes are similar in both children and adults, but have varying degrees of severity.

What is bronchitis?

This is a type of disease in which the bronchial mucosa becomes infected with viral bacteria and causes inflammatory processes caused by swelling of the bronchial branches. Through these branches, the air inhaled by a person enters the lungs. At the ends of the branches there are microscopic accumulations through which air enters the blood. When viruses infect the bronchi, a lot of mucous substance is released into them, clogging the lumen of the tubes.

What causes the symptoms?

Inflammatory processes are caused by viral irritants that enter the human body. The causative agents are staphylococci, streptococci, influenza viruses, adenoviruses, and parainfluenza. But there is another type that causes this disease - atypical flora. Actually, it is something between a virus and a bacterium, which are called mycoplasma or chlamydia. In some cases, you can get sick due to a fungal infection that originated on the human body or in the house he inhabits.

The trigger for the manifestation of symptoms of the disease is not the entry of the bacteria into the body, but the weakened immunity of a person who is unable to resist a foreign irritant. A weakened immune system occurs in both adults and children, which is caused by a lack of vitamins. Vitamin C plays a particularly important role.

Types of disease

Bronchitis is divided into two forms, which differ in the symptoms of the disease. So, the forms of bronchitis are divided into chronic and acute.

Acute bronchitis

An acute illness is caused by short-term development, which can last from 2-3 days to two weeks. In the process, a person initially suffers from a dry cough, which then develops into a wet cough with the release of a mucous substance (sputum). Acute bronchitis is divided into obstructive and non-obstructive depending on the obstruction of patency in the mucous membrane.

Chronical bronchitis

Chronic manifests itself in both adults and children, because the cause of such a complicated form of the disease is the long course of the disease, possibly even if the acute disease is not treated. Long-term exposure to irritants on the respiratory organs and bronchial branches causes the development of this form. Irritants are: smoke, dust, gases, chemical emissions, etc., which a person breathes for a long time, for example, at work.

The chronic form has another reason for the development of the disease - genetic. This reason is caused by congenital deficiency of alpha-antitrypsin. With adequate exposure to the body with medications, acute and chronic bronchitis is cured completely, and prolonged and abnormal bronchitis develops into a chronic form.

Symptoms of bronchitis

It is the symptoms of the disease that are the basis for taking decisive action to combat the disease. But first it is necessary to identify the correct disease, which actually begins to be treated.

The main indicator of the presence of a disease in the human body is a cough. Not just a cough, but a long, lingering, deep, strong and annoying one. In the initial stages, it appears dry, and subsequently with expectoration of sputum from the bronchial mucosa. When, at the beginning of the disease, a person develops a dry cough that dries and scratches the throat, people often try to wet their throats with cold water, but this also affects the further development of the disease. Cold water aggravates the situation, as a result of which it becomes the cause of further spread of the cough symptom. Often the cough begins in the evening, and at night it worsens to the maximum. That is, a person simply cannot sleep due to attacks and suffers all night. Only in the morning there may be a slight weakening, but not for long. Therefore, in this situation, it is necessary to immediately visit a doctor to identify the disease and prescribe measures to prevent it.

The moment the pathogen enters the body, the latter begins to fight, but often weakened immunity does not give a chance to overcome it. Therefore, a person immediately feels some symptoms in the throat in the form of soreness, redness or burning in the throat. Bacteria and bronchitis infections cause rhinitis and laryngitis in adults. Already on the second day, the tickling develops into coughing, which does not appear very often, but intensifies over time. Already on the third or fourth day, the cough changes from dry to wet and expectoration of sputum from the bronchi appears, which indicates damage to the mucous membrane by viruses. Sputum is usually white or yellow in color, which increases as the disease progresses. The color of such sputum indicates that, most likely, a bacterial infection has entered the body. Already on the fourth day, if measures are not taken to combat the pathogen, body temperature rises (especially in the evening). With acute, obstructive, chemical and physical symptoms, a person may suffer an increase in temperature of up to 37 degrees, and with adenoviral damage, perhaps an increase of up to 39 degrees. Therefore, temperature control and lowering it are important.

Often a person simply does not understand how serious such a disease is and ignores going to the doctor, justifying this by saying what the doctor will say is new? And such an attitude towards one’s health will simply lead to complications and, as a result, it will take longer to be treated and it will cost more.

Symptoms in adults

So, a week of cough without taking measures to eliminate it leads to the development of a chronic illness in adults caused by the acute form of the disease. The duration of treatment will increase from several weeks to a couple of months, while acute bronchitis could be cured in the first 2-3 days.

The chronic form in adults is caused by the appearance of headaches in the morning and evening, as well as symptoms of weakness, fatigue and lethargy. Even after sleep, you feel tired and unwilling to do anything. Performing physical work with symptoms of illness ends at the beginning, since weakness does not allow doing anything. Distracted attention and uncertainty prevent a person from performing any adequate action. Therefore, in this case, it is better for the patient to remain in bed without physical and mental stress.

Failure to take action even with a chronic disease will not lead to anything good; the patient’s condition will worsen daily. Appetite will disappear for another 2-3 days and the patient will only be able to drink tea and sometimes broth.

What about breathing and voice?

The voice of adults, especially those who have a bad habit of smoking, simply disappears and they can only speak in a whisper. Often, there is simply wheezing in the voice and heaviness of speech, as if talking brings physical fatigue. But in fact it is! At this time, breathing is caused by frequent shortness of breath and heaviness. At night, the patient breathes not through the nose, but through the mouth, while emitting strong snoring.

High sweating when performing minor physical efforts, but at the same time the patient is covered from head to toe with cold and hot sweat; it is especially important to avoid sweating outside when the wind is blowing or in severe frost.

Self-medication for adults

If you find the slightest signs of bronchitis, do not try to cure yourself; it is better to consult a doctor for qualified help, which will give you a chance of recovery in the first days of the disease. Bronchitis is not a disease that can be cured at any stage; the earlier medical measures are taken, the greater the chance of getting rid of its symptoms.

Symptoms in children

Children are more susceptible to the disease than adults due to their weak and immature immunity. Symptoms of bronchitis in children differ slightly from adults.

Symptoms of recurrent bronchitis

Occurs in children periodically 2-4 times throughout the year. Symptoms of bronchitis during an exacerbation are similar to a chronic disease. It occurs on summer spring and autumn days, when the air becomes more dusty, cold weather sets in, or flowers begin to bloom and release pollen.

Symptoms of asthmatic disease

In children it has the following character of manifestation:

  • temperature increase;
  • an increase in histamine and immunoglobulins A and E in the child’s blood;
  • night cough;
  • irritable, lethargic and capricious behavior of the child.

At moments of coughing, attacks of severe suffocation are not observed, which indicates symptoms of an asthmatic nature of the disease.

Symptoms of acute bronchitis

In children, acute bronchitis manifests itself as:

  1. Changes in children's behavior. They become capricious, nervous, irritable.
  2. Heavy breathing and wheezing in the voice, developing into a dry cough.
  3. Body temperature increases. In children it rises to 38-38.5 degrees.
  4. After two or three days, a dry cough develops into a wet cough, and expectoration of sputum begins.

If the disease is detected in children at the developmental stage, treatment of bronchitis will take up to one or two weeks.

Symptoms of chronic bronchitis

The chronic form is more dangerous for children than for adults. Since this form can prevent the onset of bronchial asthma. Therefore, parents should not allow such a phenomenon to occur, but if this happens, then strictly undertake treatment. Follow all doctor's instructions and be treated until complete recovery. The symptoms are the same as for an acute illness, only slightly less pronounced.

Symptoms of obstructive form

It occurs as a result of viral damage to small branches, caused by expansion of the muscular system, swelling of the mucous membrane and a large amount of sputum released from the body. Symptoms of obstructive bronchitis appear in the form of intense coughing attacks. A disease of this kind in children causes special complications, since intense coughing develops into deep attacks of suffocation, which can lead to death. Often, untreated obstructive disease develops into a chronic form.

In children, an obstructive symptom manifests itself in the presence of bronchospasm. The child has difficulty breathing and shortness of breath. It occurs due to blockage of the bronchial branches, which also causes a cough, but without the ability to cough up sputum.

Symptoms of the non-obstructive form

A non-obstructive diagnosis is more gentle and does not cause complications if treatment measures are taken on time. Therefore, people do not consider themselves sick, and the cough that occurs periodically is explained by the body’s protective reaction from dust or cigarette smoke. It is a periodic cough with sputum discharge that is the only sign by which the disease is determined. It often occurs in the morning or before bed, but can also be caused by a cold stream of air that a person inhales.

Diagnosis of bronchitis

The diagnosis of “acute or chronic bronchitis” is made by a qualified doctor after examining the patient. The main indicators are complaints, on their basis the diagnosis is made. The main indicator is the presence of a cough with white and yellow sputum discharge.

It is also important to know that the presence of a cough in a person does not mean that he has bronchitis. Coughing is a consequence of the body's defense reaction, which is intended to clear the airways.

Determination of the disease with maximum efficiency is carried out through the following factors:

  • blood tests determine inflammation;
  • pneumotachometry, by which the doctor determines external respiration;
  • X-ray of the lungs, which gives an explanatory picture of the processes occurring inside.

Identification of the obstructive form is carried out through studies for the presence of:

  • bouts of dry cough;
  • visual examination of the chest and throat;
  • wheezing with long delays;

An additional examination is carried out for signs of wheezing and dry sounds, and a chest X-ray is taken.

Having made a diagnosis, the doctor immediately prescribes medication, which the patient must strictly follow. Treatment is usually carried out at home.

Treatment of bronchitis

The most important factor in how to treat bronchitis is its immediate identification in a hospital. Early treatment of bronchitis will prevent complications and get rid of symptoms in a matter of days. Therapeutic actions to treat the disease include:

  • compliance with bed rest, especially during exacerbations;
  • the patient must be provided with plenty of hot drinks, preferably 1-2 cups of tea per hour;
  • ventilation of the room (without creating drafts) and humidification of the air. In dry air, the disease is more difficult;
  • use of antipyretics.

People are sometimes afraid of hospital walls and do not want to visit a doctor for fear of what he may require for examination and treatment. Therefore, the question of “how to treat bronchitis, in a hospital or not?” is very popular. If the disease is severe and combined with ARVI, then treatment is best carried out in a hospital. It is understood that if you develop acute bronchitis, you will not be able to escape the hospital bed, because you will begin to feel unwell from chronic bronchitis.

Treatment of chronic bronchitis

Treatment involves a number of measures, depending on the stages in which the disease is located. A chronic disease in the acute stages involves the elimination of inflammatory processes occurring in the bronchi. It is also necessary to carry out a number of activities:

  • normalization of salivation;
  • improving airway ventilation and eliminating spasms;
  • maintaining heart function.

At the final stages it is necessary:

  • completely eliminate foci of infection;
  • carry out health improvement at resorts;
  • do breathing exercises.

Antibiotics for bronchitis are used to act directly on areas of pathogen proliferation. The following drugs are used for mucus secretion: Lazolvan, Bromhexine. Bronchospasms are eliminated with a medication called Atrovent, which thins the mucus and removes it from the bronchial branches. You can achieve complete recovery in 1-2 months.

Treatment of acute bronchitis

The acute form of the disease is treated with medical antiviral drugs. And if the treatment does not have an effect, then the doctor has the right to prescribe antibiotics for bronchitis, but after the causative agent has been identified. To enable expectoration of sputum, mucolytics are prescribed to dissolve the sputum and remove it from the body. Treatment also involves the use of herbal remedies, syrups and inhalations both at home and in the clinic.

Effective antibiotics for bronchitis, which are prescribed exclusively by a doctor:

The doctor may prescribe antibiotics for children under and over one year old, if the disease is complicated and requires immediate attention.

Prevention

Carrying out breathing exercises can improve the removal of mucus and improve breathing. Physiotherapeutic treatment of bronchitis is carried out in the last stages, when the symptoms are minor. Follow-up treatment is necessary with electrophoresis, inhalation and UHF therapy.

Important points in the treatment of bronchitis are the immediate adoption of effective measures at the first symptoms of the disease and monitoring the recovery situation. After treatment, the doctor is obliged to conduct an examination and confirm the complete absence of bronchitis pathogens.

If you think that you have Bronchitis and the symptoms characteristic of this disease, then doctors can help you: a therapist, a pediatrician, a pulmonologist.

We also suggest using our online disease diagnostic service, which selects probable diseases based on the entered symptoms.

What is ARVI? Acute respiratory viral infections are contagious diseases of viral etiology that affect the body through the respiratory tract by airborne droplets. Most often, this disease is diagnosed in children aged 3–14 years. As statistics show, ARVI does not develop in infants; only isolated cases have been reported in which a child at that age suffered from the disease.

Hemolytic streptococcus is a gram-positive bacterium with a specific shape. Belongs to the lactobacilli family. Often it simultaneously coexists with Staphylococcus aureus. The bacterium can infect the body of any person - both an adult and a small child.

Aspiration pneumonia is an inflammation in the lung tissues that develops as a result of foreign bodies or substances entering the organ. Aspiration can be carried out both by mechanical objects from the outside and by body fluids, for example, stomach contents or amniotic fluid, which is why aspiration pneumonia develops in newborns. When describing this pathology, one should distinguish between aspiration pneumonia in adults and in children, since the causes and mechanisms of harmful effects in these cases are different.

Allergic bronchitis is a type of inflammation of the bronchial mucosa. A characteristic feature of the disease is that, unlike ordinary bronchitis, which occurs due to exposure to viruses and bacteria, allergic bronchitis is formed due to prolonged contact with various allergens. This disease is often diagnosed in children of preschool and primary school age. It is for this reason that it needs to be cured as quickly as possible. Otherwise, it takes on a chronic course, which can lead to the development of bronchial asthma.

Whooping cough is an acute infectious disease that is transmitted by airborne droplets. Whooping cough, the symptoms of which are characterized by cyclical manifestations, as well as a prolonged cough of a paroxysmal nature, is especially dangerous for children (under two years of age in particular), although people of any age can get sick with it.

With the help of exercise and abstinence, most people can do without medicine.

Symptoms and treatment of human diseases

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Types and signs of bronchitis

Bronchitis is a disease in which the mucous membrane of the bronchi becomes inflamed. Types of bronchitis differ in their etiology and causes.

Various factors can provoke the disease, but the main one is a decrease in immunity. If the body has a weak immune system, even a simple infection can lead to illness.

Some people develop unilateral bronchitis, but generally all bronchi are affected.

Types of bronchitis

According to the development of the disease, bronchitis is of primary and secondary types. The primary form occurs as an independent disease, while the inflammation does not spread further and remains in the bronchi.

The secondary form occurs as an additional manifestation against the background of an already present disease.

Acute and chronic bronchitis

Acute bronchitis can have various causes:

  • viral, bacterial, viral-bacterial infection;
  • non-infectious factors (exposure to the body of chemical and physical substances, allergens);
  • mixed factors (infection entering the body and the effect of physical and chemical substances).

Inflammation can occur in different parts of the bronchi, so bronchitis can be divided into the following forms:

  • tracheobronchitis;
  • broncholitis;
  • bronchitis, which affects the bronchi of medium and small caliber.

Despite the fact that today the disease can be treated without problems, if treatment is incorrectly prescribed or due to self-medication, not only pneumonia, but also chronic bronchitis can occur.

Pollutants—substances contained in the inhaled air—play a major role in the occurrence of the chronic form. They have different chemical structures and have a negative effect that irritates the bronchial mucosa. The first place is occupied by tobacco smoke; it is for this reason that almost every heavy smoker has chronic bronchitis.

Is it possible to treat bronchitis on your own?

Regardless of what type of bronchitis is diagnosed, treatment of the disease must be carried out under the supervision of a doctor, and it is better to do this in a hospital setting, because the disease is fraught with quite serious health problems. Inflammation of the lungs, which can occur as a consequence of untreated bronchitis, is known to result in death or heart complications in some cases.

Many people who self-medicate bronchitis subsequently suffer from chronic bronchial asthma. Therefore, at the first symptoms of the disease, you should consult a doctor. In addition, bronchitis can have different etiologies, which are simply impossible to identify on your own. You need to know which antibiotics you need to choose in order to kill a particular virus or bacteria that provoked bronchitis.

Catarrhal bronchitis

This species is an advanced form of the disease. Almost always this bronchitis ends in a chronic form. It is characterized by abundant mucus secretion, but the absence of lesion processes. One can single out one, but the main reason why the disease occurs is improper treatment, even for a common cold. The disease can also occur in smokers, people living in unsanitary conditions, due to hypothermia, and if a person is in contact with a sick person.

The main symptoms include a strong, deep, piercing cough accompanied by sputum production, high fever, weakness, and sweating. When the disease is at the initial stage, the cough may not be severe, but after 2-3 days it worsens. If the necessary treatment is not carried out within 2 weeks, the disease is modified into a chronic form, which is practically untreatable.

To treat catarrhal bronchitis, doctors use antibiotics and physiotherapy. The key to success is bed rest, drinking plenty of fluids and following all doctor’s orders.

Chlamydial bronchitis

It occurs against the background of microorganisms from the genus Chlamydia (Chlamydia pneumoniae) present in the body. The consequences of this type of disease are obstructive bronchitis and bronchial asthma. In most cases, children suffer from chlamydial bronchitis. It should be noted that this form of the disease can only be detected in laboratory conditions. During the analysis, antibodies to chlamydia (or DNA of microorganisms) are detected in the blood of a sick person.

The main symptoms include the appearance of a recurrent dry cough, which in some cases is accompanied by suffocation, wheezing, and inflamed larynx. Too high a temperature is not typical for this type of bronchitis (37.5-38°C). Long-term untreated bronchitis of the chlamydial type is characterized by paroxysmal and wet cough. If you do not go to the hospital on time, chlamydial pneumonia develops.

To treat these types of bronchitis, doctors use macrolides, fluoroquinolones, and tetracyclines.

Infectious and toxic bronchitis

Its second name is bronchitis obliterans; it is a simple form, proceeds easily and almost always ends with absolute recovery. The risk group is the elderly, as well as those with cardiovascular diseases.

The disease bronchitis obliterans is manifested by a runny nose, fatigue, chills due to increased body temperature, pain in the muscles, inflammation of the nasopharynx, a dry cough (in the first days), which is replaced by a wet one. The sputum may be white, yellow, or green. If the disease is advanced, the airways narrow, resulting in wheezing. If you do not start timely treatment, pneumonia may develop. Most often, the disease occurs in winter due to viruses and pathogenic bacteria.

Depending on what bacteria or viruses are causing infectious bronchitis, a course of antibiotics and physiotherapy is prescribed.

The toxic type of bronchitis is a very common disease that occurs due to damage to the mucous membrane by chemicals and poisons. What the degree of damage will be depends on how deeply the toxic substances have entered the bronchi (root bronchitis may develop). The first symptoms appear immediately after the poison begins to act. This disease is manifested by an unproductive cough, pain and soreness in the larynx, and a burning sensation in the chest area. Distinctive signs are the appearance of lacrimation, photophobia, and cyanosis of the skin. Breathing becomes harsh, a day after the lesion the cough intensifies, a buzzing and wheezing wheezing appears, and after coughing, the person experiences rapid breathing up to 30 breaths per minute. It seems that the patient cannot breathe. In some cases, pathological changes in the cardiovascular system, tachycardia or vegetative-vascular crises may occur. If the intoxication is mild, then recovery occurs in 3-4 weeks.

The peculiarity of toxic inflammation is that quite serious and deep damage to the bronchial tree can occur, causing endobronchitis and peribronchitis to develop. It is for this reason that pneumosclerosis or toxic pneumosclerosis develops.

Sometimes toxic bronchitis can be accompanied by an infection. Such changes in almost all cases lead to bronchitis becoming chronic.

Treatment of toxic bronchitis should begin from the first days of the lesion, so as not to suffer from a chronic form for the rest of your life.

Spastic, congestive and deforming bronchitis

Spastic bronchitis is characteristic of childhood. The fact is that in children the bronchial lumens are narrowed much more than in adults. Therefore, the mucous membrane can swell and process mucus. For this reason, airway obstruction occurs.

The disease appears mainly against the background of viruses that enter the body of children. The patient experiences shortness of breath, wheezing when he exhales air, coughing, the skin becomes pale, and sometimes cyanosis appears. Spastic bronchitis is characterized by increased body temperature, increased heart rate and general weakness.

The most unpleasant thing is when the disease affects the bronchi of infants, because they still cannot talk about their feelings. Therefore, at the first signs, especially if the newborn’s cough is wheezing and severe, you should immediately go to the hospital.

This type of bronchitis is fraught with pulmonary emphysema, which occurs if there is no proper treatment for spastic bronchitis.

Treatment is aimed at relieving spasms and destroying the infection that provoked the inflammatory process as quickly as possible. For this purpose, bronchodilators, antihistamines, and sedatives are used. Bed rest is required. After hospital treatment, a sanatorium stay is recommended.

Congestive bronchitis occurs against the background of heart failure. In this case, the fluid is located not only in the bronchi, but also in the intermediate tissue, the alveoli. The disease can occur without obvious symptoms, or, conversely, with pronounced ones. A person may complain of a cough, but no other pathological changes are observed. In some patients, there is no cough, and when listening, clear dry rales are noted. For some, breathing becomes difficult because swelling of the lung tissue develops. When coughing, sputum with yellowish clots is necessarily released. In sputum with congestive bronchitis, there is a high content of protein molecules. It is on this basis that this type of bronchitis is determined in the laboratory.

Treatment of congestive bronchitis is carried out only in hospital settings, because attacks of acute heart failure can be repeated.

The deforming type of bronchitis (destructive) is diffuse and progressive damage to the bronchi (diffuse bronchitis). The disease does not occur due to allergies. In this case, bronchospasmodic attacks occur. The cough is accompanied by sputum production. This type of bronchitis almost always becomes chronic. Treatment is carried out only under the supervision of a specialist.

This disease can be inherited, so if there have been cases of the disease in the family, then children are at risk. Treatment of deforming bronchitis involves eliminating the inflammatory process and normalizing bronchial patency.

Professional and terry bronchitis

Occupational bronchitis is also called dust bronchitis. This form of aura does not arise due to viruses and bacteria, but as a consequence of the mechanical and chemical effects of substances contained in the air. The occupational type of bronchitis is a chronic disease. Most often, miners, metallurgists, chemists, and hairdressers suffer from this type of bronchitis. This form of the disease is divided into dust and toxic-dust (if the dust contains toxic substances that settle on the epithelium that lines the bronchi).

Symptoms: dry cough, practically not accompanied by sputum, breathing becomes heavy, wheezing and whistling are heard. The disease has several degrees of severity. The disease can occur in attacks and appears several times a year.

Treatment of this type of bronchitis is long-term and is aimed at eliminating the narrowing of the lumens of the bronchi and stopping spasmodic cough.

Terry bronchitis, in addition to coughing, has such symptoms as tingling and itching on the skin, a feeling of tightness in the sternum, and pain in the cardiac region. Then wheezing and pain in the lumbar and abdominal areas appear.

Source: http://respiratoria.ru/bronhit/vidy-bronxita.html

Description of types of bronchitis

The treatment tactics for any disease depend on the accuracy of the diagnosis. Bronchitis is one of the most common diseases of the respiratory system. However, what is it like? Does the severity of symptoms depend on the form of bronchitis?

What is bronchitis?

When foreign particles enter the bronchial mucosa, it becomes inflamed and activates its protective properties. Inflammation of the bronchial mucosa is called bronchitis.

According to the international classification, only two forms of bronchitis are distinguished:

However, among doctors there is a more detailed description of the pathological process. They distinguish the following types of bronchitis:

  1. According to the duration of the course - acute and chronic.
  2. By etiology – viral, bacterial, allergic, toxic.
  3. According to the localization of inflammation - tracheobronchitis, bronchitis, bronchiolitis.
  4. According to the nature of exudative inflammation - catarrhal, mucopurulent, purulent, fibrous, hemorrhagic.
  5. According to the severity of the course - obstructive, spastic, stagnant.

Is bronchitis contagious?

The inflammation itself in the bronchial tree is not contagious. However, it is worth considering the etiology of bronchitis. If the cause is an infection, it can be transmitted through airborne droplets and pose a threat to others. If the inflammation is caused by toxins or an allergen, then contact with the patient is safe.

Features of different forms

What types of bronchitis are described above. How are they different?

  1. Spicy. More often caused by a viral pathogen that penetrates through the nasopharynx and descends lower into the respiratory tract. As a rule, it is mild, the symptoms subside within a week after the onset and then disappear completely.
  2. Chronic. Arises as a complication of the acute form. It is characterized by frequent relapses, a mild course and constant discomfort in the patient’s life (cough, shortness of breath, lack of oxygen). It is also called smoker's chronic bronchitis
  3. Catarrhal. Bronchitis is a mild form of inflammation that affects only the mucous membranes. A distinctive feature is increased secretion of sputum.
  4. Chlamydial. A rare form, infection of which most often occurs through contact from a sick person. Symptoms develop gradually and are mild. The doctor will distinguish this form by special wheezing after listening to the patient.
  5. Infectious. Infectious to others. Inflammation of the bronchi is caused by bacteria or viruses that have entered the body.
  6. Toxic. When inhaling irritating substances (dust, chemicals), the mucous membrane becomes inflamed and swollen.
  7. Spastic. It occurs due to excessive swelling and narrowing of the airways, which leads to oxygen deficiency. It is more often observed in children, since the diameter of their bronchi is much narrower than in adults.
  8. Congestive or “cardiac bronchitis”. Edema of the lungs and bronchi occurs due to heart failure and venous stagnation. There may be no cough, but shortness of breath is a constant concern. This form can be distinguished after listening or laboratory tests.
  9. Deforming bronchitis. It occurs as a result of damage to bronchial tissue, which leads to deterioration in organ function. It is accompanied by a spasmodic cough and almost always has a chronic course.
  10. Professional. Constant contact with irritating factors (dust, medications, chemicals) leads to chronic inflammation of the mucous membrane. The cough is usually dry and comes in paroxysms.
  11. "Terry." A kind of professional, but in a more neglected form. The cough may be accompanied by other symptoms - itchy skin, chest pain, abdominal and lower back spasms.

Symptoms

The main symptom of bronchitis is cough. He can be:

In addition, inflammation can provoke:

  • general weakness;
  • headache;
  • increased temperature (typical of an acute process);
  • symptoms of cyanosis (with obstruction or respiratory failure) or occur without additional complaints (with a chronic form).

Complications and treatment

Untimely treatment often leads to the spread of infection to other organs or the transition to a chronic form. A pediatrician, pulmonologist, and internist can help treat bronchitis. You should contact a specialist at the first symptoms of illness. Proper treatment will help completely get rid of the cause and restore the function of the respiratory tract.

The doctor may prescribe the following medications:

Treatment with folk remedies is also aimed at alleviating symptoms and combating the pathogen. Widely used:

  1. Radish juice with honey.
  2. Warming procedures.
  3. Herbal decoctions.
  4. Inhalations with potatoes or mineral waters.
  5. Propolis products.
  6. Milk and cocoa butter.

Additionally, physiotherapy procedures (massage, UHF, electrophoresis) may be prescribed.

Bronchitis in children and pregnant women must be treated according to the recommendations of a doctor. Mostly natural or plant-based products are used, but the pharmaceutical industry can also offer a sufficient selection of approved products.

Prevention and patient regimen

Preventive measures and care during illness are aimed at restoring the function of the mucous membrane and cleansing the respiratory tract. To do this, you need to follow these recommendations:

  1. Maintain optimal temperature (20 degrees) and humidity (60%) in the room.
  2. Drink at least 2 liters of liquid per day.
  3. Follow all medical recommendations to the end without interrupting the course.
  4. In severe cases, exclude physical activity. During periods of good health, on the contrary, moderate exercise and walks in the fresh air are recommended.

During the peak season of respiratory infections, maintaining a distance (no closer than 2 m from a sick person) or special protective masks will help to avoid infection.

It turns out that there are not so few cases of bronchitis without a cough, which is considered its main symptom. About 5% of inflammatory processes in the bronchi may not cause […]

The simultaneous manifestation of symptoms of tracheitis and bronchitis causes the disease tracheobronchitis, the treatment of which depends on the cause and severity of the inflammation. At the initial stages, folk recipes are quite effective, [...]

Having suffered from acute obstructive bronchitis, many people begin to take more care of their health in order to prevent recurrence of the disease. This type of bronchitis can be quite severe and [...]

The term "eosinophilic bronchitis" and its difference from bronchial asthma was first described in 1989. Now it is distinguished as a separate type of bronchitis, which is characterized by its […]

Not many people are familiar with the term “atrophic bronchitis”. But the symptoms of the disease are so common that the patient may confuse them with another condition. This is why it is important to have an idea [...]

The danger of bronchitis lies not only in the possible development of pneumonia. Symptoms of bronchial inflammation are sometimes severe and can threaten the patient’s life. One of the most dangerous symptoms is shortness of breath, […]

Most respiratory diseases begin with general malaise and fever. It is these symptoms that make the patient wary and seek help from a doctor. However, bronchitis can […]

The modern rhythm of life does not always provide an opportunity for an adult to get sick and receive treatment properly. Many people think that the body will cope with the infection on its own and does not need help. However, […]

Doctors prescribing antibiotics for bronchitis in children often causes disagreement among parents. However, if the disease is caused by bacterial flora, this group of drugs cannot be avoided. How to determine what […]

Doctors call a frequently recurring cough recurrent bronchitis. However, it is not diagnosed in all patients. What causes frequent bronchitis and is there anything that can be done to […]

As a child, I often suffered from bronchitis. The cough was terrible. They made me mustard plasters and radish juice with honey. It helped. Radish juice is an excellent expectorant.

My nephew had been coughing for several months, was diagnosed with protracted bronchitis, and was treated with antibiotics and various other drugs. The cough subsided for a while and returned again. This is a terrible picture when nothing helps with a cough, and the child coughs right to the point of vomiting, but finally one doctor was found who advised screening for bacteria in the oral cavity, and they found streptococcus, which provoked a frequent cough in the child, and as a result and bronchitis. We were treated, and everything is fine, the child is healthy and does not cough! As for radish juice with honey (comment above), it really helps with coughs; I treat my child this way for initial coughs.

Since I have often suffered from colds since childhood, all this developed into chronic bronchitis. And every winter I get sick twice. It cannot be completely cured, it can only be extinguished for a while until the next time.

My son suffered from obstructive bronchitis a year ago; he was in the hospital and drank an antibiotic (suspension) plus nasal drops, since the bronchitis, according to the doctor, was caused by the snot that accumulated on the back wall. And probably the most effective thing is inhalation with ambrobene. But after discharge, the cough returned within a day and we were diagnosed with pneumonia, which resulted in two more antibiotics until the infectious disease specialist found the right antibiotic for us. It was terrible, almost three months from hospital to hospital.

My son had obstructive bronchitis, he was in the hospital, and after discharge he was treated with transfers for two weeks. After that, I started getting sick less often. Pah-pah-pah...And they also say that the drugs from the Siberian Health company help.

As a child, when I was sick with bronchitis, my mother made radish juice, mixed it with honey and gave it to me. She also forced me to breathe in the vapors of salted potato broth; I didn’t really like this procedure, but as a result the illness went away.

Source: http://bronhit.guru/vidy

Bronchitis symptoms

Bronchitis is an inflammatory disease of the bronchi with primary damage to their mucous membrane. The process develops as a result of a viral or bacterial infection - influenza, measles, whooping cough, etc.

In terms of frequency of occurrence, it ranks first among other respiratory diseases. Bronchitis mainly affects children and the elderly. Men get sick more often, which is due to occupational hazards and smoking. Bronchitis is more common in people living in areas and countries with cold and humid climates, in damp stone rooms or working in drafts. See how to treat this disease with folk remedies here.

Bronchitis is generally divided into primary and secondary. Primary bronchitis includes those in which the clinical picture is caused by isolated primary damage to the bronchi or combined damage to the nasopharynx, larynx and trachea. Secondary bronchitis is a complication of other diseases - influenza, whooping cough, measles, tuberculosis, chronic nonspecific lung diseases, heart diseases and others. Inflammation can be primarily localized only in the trachea and large bronchi - tracheobronchitis, in the bronchi of medium and small caliber - bronchitis, in the bronchioles - bronchiolitis, which occurs mainly in infants and young children. However, such isolated local inflammation of the bronchi is observed only at the beginning of the development of the pathological process. Then, as a rule, the inflammatory process from one area of ​​the bronchial tree quickly spreads to neighboring areas.

There are acute and chronic forms of bronchitis.

The acute form is characterized by inflammation of the bronchial mucosa. Most often found in young children and the elderly. The disease is accompanied by a dry and sharp cough that gets worse at night. After a few days, the cough usually softens and is accompanied by sputum production.

Acute bronchitis, as a rule, occurs as a result of infection and occurs against the background of rhinitis, laryngitis, pharyngitis, tracheitis, influenza, catarrh, pneumonia and allergies. Bronchitis can be triggered by weakening of the body due to other diseases, addiction to alcohol and smoking, hypothermia, prolonged exposure to dampness, and high air humidity.

Acute inflammation of the bronchi can occur under the influence of many factors - infectious, chemical, physical or allergic. It occurs especially often in spring and autumn, since at this time hypothermia, colds and other diseases reduce the body's resistance.

Acute bronchitis occurs when an irritant or infection causes the tissue lining the bronchioles to become inflamed and swollen, narrowing the air passages. When the cells lining the air passages are irritated beyond a certain degree, the cilia (sensitive hairs) that normally catch and expel foreign objects stop working. Excessive mucus is then produced, which clogs the air passages and causes the severe cough characteristic of bronchitis. Acute bronchitis is common and symptoms usually go away within a few days.

Acute bronchitis can be either primary or secondary. It occurs mainly with catarrh of the upper respiratory tract and influenza, when the inflammatory process from the nasopharynx, larynx and trachea spreads to the bronchi. Acute bronchitis most often occurs in people who have foci of chronic inflammation in the nasopharynx - chronic tonsillitis, sinusitis, rhinitis, sinusitis, which are a source of constant sensitization of the body, changing its immunological reactions.

• The most common cause of acute bronchitis is viral infections (including the common cold and flu). Bacterial infections can also lead to the development of bronchitis.

• Irritants such as chemical fumes, dust, smoke and other air pollutants can trigger an attack of bronchitis.

• Smoking, asthma, poor diet, cold weather, congestive heart failure and chronic lung disease increase the risk of severe bouts of bronchitis.

In general, acute bronchitis can develop:

• with the activation of saprophytic microbes that are constantly present in the upper respiratory tract (for example, Frenkel pneumococci, Friedlander pneumobacilli, streptococci, staphylococci and others);

• for acute infectious diseases - influenza, whooping cough, diphtheria and other infections;

• due to hypothermia, a sudden sharp change in body temperature or when inhaling cold, moist air through the mouth;

• when inhaling vapors of chemical toxic substances - acids, formaldehyde, xylene, etc.

Most often, acute diffuse bronchitis develops under the influence of provoking factors: cooling of the body, acute infectious diseases of the upper respiratory tract, exposure to exogenous allergens (allergic bronchitis). A decrease in the body’s protective reactions also occurs with overwork and general exhaustion, especially after suffering mental trauma and against the background of serious illnesses.

At the beginning of the development of acute bronchitis, hyperemia (redness, indicating a sharply increased blood supply) and swelling of the bronchial mucosa with pronounced hypersecretion of mucus containing leukocytes and, less often, red blood cells occur. Then, in more severe cases, damage to the bronchial epithelium develops and the formation of erosions and ulcers, and in some places inflammation spreads to the submucosal and muscular layer of the bronchial wall and interstitial tissue (which surrounds the bronchi).

Those who suffer from diseases such as rhinitis, tonsillitis, sinusitis, and sinusitis are more likely to develop acute bronchitis. Bronchitis often occurs during acute infectious diseases (influenza, measles, whooping cough, typhoid fever). With increased sensitivity to the protein substance, acute bronchitis can develop when inhaling dust from animals or plants.

From the first day of the disease, antibiotics and sulfonamides are prescribed. To relieve bronchospasm, aminophylline, ephedrine, isadrine and other bronchodilators are used. Cupping, mustard plasters, and hot foot baths give a good effect, especially in the first days of the disease. Alkaline inhalations, inhaling steam, and frequent drinking of hot tea, hot milk with Borjomi or soda soften the cough.

For a dry, painful cough, stoptussin, codterpine, tusuprex, glaucine should be used (the drugs are used as prescribed by a doctor). If sputum is difficult to cough up, expectorants are given: bromhexine, potassium iodide, Doctor MOM, etc.

To treat acute bronchitis, mustard plasters, hot foot baths with mustard, drinking plenty of fluids, rubbing the chest, and inhalations are used. It is useful to drink marshmallow root syrup and licorice root infusion. Linden tea (sold in pharmacies) is effective.

In chronic bronchitis, changes are observed in all structural elements of the bronchial wall, and lung tissue is also involved in the inflammatory process. The first symptom of chronic bronchitis is a persistent cough that produces a lot of mucus, especially in the morning. As the disease progresses, breathing becomes increasingly difficult, especially during physical activity. Low oxygen levels in the blood cause the skin to appear bluish. If acute bronchitis lasts from several days to several weeks, then chronic bronchitis lasts for months and years. If acute bronchitis is not treated, it can lead to complications - cardiac and respiratory failure, pulmonary emphysema.

Chronic bronchitis can develop as a complication after acute or frequent repetition of acute bronchitis. In chronic bronchitis, not only the mucous membrane becomes inflamed, but also the walls of the bronchi themselves, along with the surrounding lung tissue. Therefore, chronic bronchitis is often accompanied by pneumosclerosis and emphysema. The main symptom of chronic bronchitis is a dry paroxysmal cough, especially often appearing in the morning after a night's sleep, as well as in damp and cold weather. When coughing, purulent greenish sputum is coughed up. Over time, a patient with chronic bronchitis develops shortness of breath and pale skin. Heart failure may develop.

A common cause of chronic bronchitis is prolonged, repeated inhalation of irritating dusts and gases. The causes of chronic bronchitis can also be diseases of the nose, chronic inflammatory processes in the paranasal sinuses. The addition of this infection worsens the course of chronic bronchitis, causing the transition of the inflammatory process from the mucous membrane of the nose and sinuses to the walls of the bronchi and peribronchial tissue. Chronic bronchitis can be a consequence of acute bronchitis.

At the onset of the disease, the main symptom of chronic bronchitis is a cough, which gets worse in cold and damp weather. In most patients, cough is accompanied by sputum production. It occurs in attacks only in the morning or bothers the patient all day and even at night.

Symptoms of bronchitis also include increased fatigue, pain in the muscles of the chest and abdomen (caused by frequent coughing). Body temperature, usually normal, may rise during periods of exacerbation. Increased sensitivity to microflora and protein breakdown products in patients with chronic bronchitis can lead to bronchial asthma.

When treating chronic bronchitis, especially in the early period, it is important to eliminate all factors that irritate the bronchial mucosa: prohibit smoking, change a profession associated with inhalation of dust, gases or vapors. The nose, paranasal sinuses, tonsils, teeth, etc., where there may be foci of infection, should be carefully examined and appropriate treatment should be carried out. It is important to ensure that the patient breathes freely through the nose.

Antibiotics are prescribed during periods of exacerbation of the disease after determining the sensitivity of microbes isolated from sputum to them. The duration of antibiotic treatment varies - from 1 to 3-4 weeks.

Sulfonamides occupy an important place in treatment, especially in cases of intolerance to antibiotics or the development of fungal diseases.

For the treatment of cough syndrome in chronic bronchitis, the following groups of drugs are used: - mucolytics (help thin the sputum) - acetylcysteine, ambroxol, bromhexine, etc.;

— mucokinetics (promote the removal of sputum) — thermopsis, potassium iodide, “Doctor MOM”;

- mucoregulators (have mucokinetic and mucolytic properties) - erispal, flui-fort;

- drugs that suppress the cough reflex. Bronchitis must be treated under the supervision of a doctor, but preparations with mustard can promote a speedy recovery.

Treatment of the disease is carried out only by a doctor. In addition to basic therapy, compresses, rubbing, teas for better mucus separation and inhalation are useful, especially those prepared on the basis of medicinal plants.

According to the severity of inflammation of the bronchi, bronchitis is distinguished as catarrhal, mucopurulent, purulent, fibrous and hemorrhagic; according to the prevalence of inflammation - focal and diffuse.

Symptoms

• Deep, persistent cough producing grey, yellowish or green sputum.

• Shortness of breath or difficulty breathing.

• Chest pain that gets worse with coughing.

Clinical picture. At the onset of the disease, patients note rawness in the throat and chest, hoarseness, cough, pain in the muscles of the back and limbs, weakness, and sweating. The cough at first is dry or with a scant amount of viscous, difficult to separate sputum; it can be rough, sonorous, often “barking” and appears in the form of attacks that are painful for the patient. During coughing attacks, a small amount of viscous, mucous sputum, often “vitreous,” is released with difficulty.

On the second or third day of the disease, during coughing attacks, pain is felt behind the sternum and in the places where the diaphragm is attached to the chest, sputum begins to be released more abundantly, first mucopurulent, sometimes mixed with streaks of scarlet blood, and then purely purulent. Subsequently, the cough gradually decreases and becomes softer, as a result of which the patient feels noticeable relief.

In mild cases of bronchitis, the body temperature is normal or sometimes elevated for several days, but only slightly (low-grade fever). In severe cases of bronchitis, the temperature rises to 38.0-39.5 ° C and can remain this way for several days. The respiratory rate is usually not increased, but in the presence of fever it is increased slightly. Only with diffuse damage to the small bronchi and bronchioles does severe shortness of breath occur: the number of respirations can increase to 30, and sometimes up to 40 per minute, and an increase in heart rate (tachycardia) is often observed.

When percussing (tapping) the chest, the percussion sound is usually not changed, and only with diffuse inflammation of the small bronchi and bronchioles does it acquire a boxy tint. When listening, hard breathing and dry buzzing and (or) wheezing wheezing are detected, which may change (increase or decrease) after coughing.

During the period of “resolution” (subsidence) of the inflammatory process in the bronchi and liquefaction under the influence of proteolytic enzymes of viscous sputum, along with dry wheezing, moist, silent wheezing can be heard. X-ray examination does not reveal significant changes; only sometimes there is an increase in the pulmonary pattern in the hilar zone of the lungs.

Leukocytosis (up to 9000 in 1 μl) and acceleration of ESR can be detected in the blood.

In most cases, by the end of the first week, clinical signs of the disease disappear, and after two weeks, complete recovery occurs. In physically weakened individuals, the disease can last up to 3-4 weeks, and in some cases - with systematic exposure to harmful physical factors (smoking, cooling, etc.) - or the absence of timely and competent treatment - it can take a protracted, chronic course. The most unfavorable option is the development of a complication such as bronchopneumonia.

Diagnostics

• Medical history and physical examination are necessary.

• Chest x-rays and sputum and blood tests may be done to look for other lung diseases.

Treatment

• Take aspirin or ibuprofen to reduce fever and pain.

• Take a cough suppressant if you have a persistent dry cough. However, if you cough up phlegm, suppressing your cough can cause mucus to build up in your lungs and lead to severe complications.

• Stay in a warm room. Breathe in steam, use a humidifier, and take frequent hot showers to loosen mucus.

• Drink at least eight glasses of water a day to help the mucus become less dense and easier to clear.

• If your doctor suspects a bacterial infection, he may prescribe antibiotics.

• Smokers should give up cigarettes.

• Call your doctor if symptoms do not improve after 36 or 48 hours or if bouts of acute bronchitis recur.

• Call your doctor if you have pulmonary disease or congestive heart failure and experience symptoms of acute bronchitis.

• Call your doctor if you cough up blood, have shortness of breath, or have a high fever during a bout of bronchitis.

Prevention

• Don't smoke and try to avoid secondhand smoke.

• People with a predisposition to the disease should avoid being in areas where the air contains irritating particles, such as dust, and avoid physical activity on days when the weather conditions are poor.

Acute bronchitis in children

As we already know, acute bronchitis is one of the manifestations of a viral infection with localization of the process in the bronchi. Due to the fact that acute bronchitis usually does not occur in isolation, but is combined with damage to other parts of the respiratory system, the disease essentially “dissolved” in diagnoses of acute respiratory viral infection or pneumonia. Very approximately, the share of acute bronchitis accounts for 50% of all respiratory diseases in children, especially in the first years of life.

The main pathological factor in the development of acute bronchitis can be almost equally viral and bacterial, as well as mixed infections. However, viruses are of greatest importance, and first of all - parainfluenza, respiratory syncytial and adenoviruses. Rhinoviruses, mycoplasmas and influenza viruses are relatively rare in this regard. It should also be noted that acute bronchitis in children is quite naturally observed with measles and whooping cough, but with rhinovirus or enterovirus infection - it is extremely rare.

Bacteria play the least role. The most common are staphylococcus, streptococcus and pneumococcus. It should be borne in mind that the bacterial flora is activated secondarily against the background of a previous viral infection. Except

In addition, bacterial bronchitis is observed when the integrity of the mucous membrane of the airways is disrupted (for example, by a foreign body). It should also be taken into account that a viral disease of the respiratory tract in the very first days takes on a viral-bacterial character.

Features of the development of the disease in childhood are, in fact, inextricably linked with the anatomical and physiological characteristics of the child’s upper respiratory tract. These, first of all, include: a significantly more abundant blood supply to the mucous membrane compared to adults, as well as age-related looseness under the mucous structures. Against the background of infection, these features ensure the rapid spread of the exudative-proliferative reaction along the continuation of the respiratory tract in depth - the nasopharynx, pharynx, larynx, trachea, bronchi.

As a result of exposure to viral toxins, the motor activity of the ciliated epithelium is suppressed. Infiltration and swelling of the mucous membrane, increased secretion of viscous mucus further slow down the “flickering” of the cilia, thereby turning off the main mechanism of cleansing the bronchi. The consequence of viral intoxication, on the one hand, and the inflammatory reaction, on the other, is a sharp decrease in the drainage function of the bronchi - difficulty in the outflow of sputum from the underlying parts of the respiratory tract. Which ultimately contributes to the further spread of infection, while simultaneously creating conditions for bacterial embolism into bronchi of a smaller diameter.

From the above, it is clear that acute bronchitis in childhood is characterized by a significant extent and depth of damage to the bronchial wall, as well as a pronounced inflammatory reaction.

It is known that the following forms of bronchitis are distinguished by extent:

• limited - the process does not extend beyond the segment or lobe of the lung;

• widespread - changes are observed in segments of two or more lobes of the lung on one or both sides;

• diffuse - bilateral damage to the airways.

Based on the nature of the inflammatory reaction, the following are distinguished:

In childhood, catarrhal, catarrhal-purulent and purulent forms of acute bronchitis are most common. Like any inflammatory process, it is composed of three phases: alterative, exudative and proliferative. A special place among diseases of the respiratory tract is occupied by bronchiolitis (capillary bronchitis) - a bilateral widespread inflammation of the final sections of the bronchial tree. Based on the nature of inflammation, bronchiolitis is divided in the same way as bronchitis. In the most common catarrhal bronchiolitis, swelling and inflammatory infiltration of the walls of the bronchioles are combined with complete or partial blockage of the lumen with mucous or mucopurulent discharge.

Clinical picture. For different variants of infection, the disease picture may have its own specific features. For example, parainfluenza is characterized by the formation of proliferations of the epithelium of small bronchi, and adenoviral bronchitis is characterized by an abundance of mucous deposits, loosening of the epithelium and rejection of cells into the bronchial lumen.

Here it should be emphasized once again that the decisive role in the development of narrowing of the airways in children does not belong to bronchospasm, but to increased secretion of mucus and swelling of the bronchial mucosa. And it should be noted that, despite the widespread prevalence of the disease and its well-known clinical picture, the doctor is often overcome by serious doubts when making a diagnosis due to the variety of symptoms, as well as the often present component of respiratory failure. The latter circumstance can play a decisive role in interpreting the process as pneumonia, which later turns out to be incorrect.

Acute bronchitis is a disease that manifests itself during an acute respiratory viral infection. Therefore, it is characterized by:

• connection with an infectious process;

• evolution of the general condition according to the evolution of the infectious process;

• catarrhal phenomena in the nasopharynx and pharynx, preceding the onset of bronchitis.

The temperature reaction is usually due to an underlying infectious process. Its severity varies in each specific case depending on individual characteristics, and the duration ranges from one day to a week (on average 2-3 days). It should always be remembered that the absence of fever in children does not exclude the presence of an infectious process.

Cough, dry and wet, is the main symptom of bronchitis. In the initial period it is dry and painful. Its duration varies. Usually, at the end of the first week or at the beginning of the second, the cough becomes wet, with sputum, and then gradually disappears. In young children, cough often persists for more than 14 days, although the total period rarely exceeds three weeks. A prolonged dry cough, often accompanied by a feeling of pressure or pain in the chest, indicates involvement of the trachea in the process (tracheitis, tracheobronchitis).

The “barking” tone of a cough indicates damage to the larynx (laryngitis, laryngotracheitis, laryngotracheobronchitis).

During a physical examination, either a clear pulmonary sound or a pulmonary sound with a box-like tint is determined by percussion, which is determined by the presence or absence of bronchial constriction and its degree. During auscultation, all types of wheezing, dry and wet, including fine bubbling, are heard. It should be borne in mind that fine bubbling moist rales indicate only damage to the smallest bronchi. The origin of these wheezes, as well as dry, large- and medium-bubbly wet ones, is exclusively bronchial in nature.

X-ray changes manifest themselves as an intensification of the pattern of the lungs, small shadows are visible - most often in the lower and hilar zones, symmetrically on both sides. The inflammatory process in the mucous membrane of the respiratory tract is accompanied by vascular hyperemia and increased lymph production. As a result, the pattern becomes stronger along the bronchovascular structures, which makes it more and more abundant, the shadows become wider, and the clarity of the contours deteriorates. The increased outflow of lymph, directed towards the regional lymph nodes, creates a picture of a basal strengthening of the pattern, in which blood vessels also take part. The roots of the lungs become more intense, their structure moderately deteriorates, i.e., the clarity of the elements that make up the root pattern. The smaller the bronchial branches involved in the process, the more abundant and indistinct the enhanced pattern appears.

Reactive enhancement of the lung pattern lasts longer than the clinical manifestations of bronchitis (on average 7-14 days). Infiltrative changes in the lungs that cover or blur small elements of the pulmonary pattern are absent in bronchitis.

Changes in the blood during bronchitis in a child are determined by the nature of the infection - predominantly viral or bacterial.

Acute simple bronchitis is one of the manifestations of a respiratory viral infection that occurs sequentially in a descending direction, affecting the nasopharynx, larynx, trachea and occurring in the absence of clinical signs of airway obstruction.

The main complaints are fever, runny nose, cough, and often pain in the throat when swallowing. Characteristic is the evolution of a cough, sometimes accompanied (with tracheobronchitis) by a feeling of pressure or even pain in the chest. Dry, obsessive at the beginning of the disease, this cough becomes wet in the second week and gradually disappears. Its persistence for more than two weeks is observed in young children with certain types of ARVI (acute respiratory viral infection), more often caused by adenoviruses. Longer persistence of a cough should be alarming and serve as a reason for a more in-depth examination of the patient, searching for possible aggravating factors (it should be remembered that the persistence of a cough for 4-6 weeks (without signs of bronchitis or other pathology) is observed after tracheitis.

Acute obstructive bronchitis is a disease characterized by clinically pronounced signs of airway obstruction: noisy breathing with prolonged exhalation, whistling, audible at a distance, wheezing and persistent cough (dry or wet). The terms “spastic bronchitis” or “asthmatic syndrome,” which are sometimes used to denote this form, are narrower, since they associate the development of narrowing of the bronchi only with their spasm, which is, however, not always observed.

The clinic of obstructive bronchitis occupies an intermediate position between simple and bronchiolitis. The complaints are basically the same. Objectively, during an external examination, attention is drawn to the phenomena of moderately severe respiratory failure (shortness of breath, cyanosis, participation of auxiliary muscles in the act of breathing), the degree of which is usually low. The general condition of the child, as a rule, does not suffer.

A boxy tint of the sound is noted by percussion; During auscultation, a prolonged exhalation, sounds on exhalation, dry, large- and medium-bubbly moist rales, mainly also on exhalation, are heard. All the phenomena determined by the course of a viral infection are also present.

Acute bronchiolitis is a type of disease of the terminal sections of the bronchi in young children, accompanied by clinically pronounced signs of airway obstruction.

Typically, the first symptoms of a respiratory disease appear: serous runny nose, sneezing. The deterioration of the condition may develop gradually, but in many cases it occurs suddenly. In this case, as a rule, a cough occurs, which is sometimes paroxysmal in nature. The general condition is disturbed, sleep and appetite worsen, the child becomes irritable. The picture develops more often at a slightly elevated or even normal temperature, but is accompanied by tachycardia and shortness of breath.

Upon examination, the child gives the impression of being seriously ill with clear signs of respiratory failure. The flaring of the wings of the nose during breathing is determined, the participation of auxiliary muscles in the act of breathing is manifested by retraction of the intercostal spaces of the chest. With pronounced degrees of obstruction, an increase in the anteroposterior diameter of the chest is clearly visible.

Percussion reveals a box tone over the lungs, a decrease in the zones of dullness over the liver, heart, and mediastinum. The liver and spleen are usually palpated several centimeters below the costal arch, which is a sign not so much of their enlargement as of displacement as a result of swelling of the lungs. Tachycardia is pronounced, sometimes reaching a high degree. In both lungs, multiple fine rales are heard over the entire surface, both during inhalation (at the end of it) and during exhalation (at the very beginning).

This picture of a “wet lung” can be supplemented by medium- or large-bubbly wet, as well as dry, sometimes wheezing wheezing, changing or disappearing with coughing.

Treatment of bronchitis in children

The so-called etiotropic (that is, directly affecting the pathogenic agent, for example, bacterial) for bronchitis includes the following groups of drugs:

• antiseptics (sulfonamides, nitrofurans);

• biological nonspecific protection factors (interferon).

As mentioned earlier, the advisability of using antibiotics in the treatment of bronchitis, and in particular in children, is disputed by many authors today, but we will not raise this issue here: it is quite specific, and therefore there is no point in discussing it in this book. However, there are very specific indications for prescribing the above remedies for bronchitis in children, which boil down to three main points, namely:

• the possibility or direct threat of developing pneumonia;

• prolonged temperature reaction or high temperature in a child;

• development of general toxicosis,

• finally, the lack of a satisfactory effect from all types of therapy performed previously.

Let's consider the features of antibiotic therapy in childhood, since a child's body reacts to some medications differently than a fully formed adult. Therefore, adequate (in other words, necessary and sufficient) treatment in terms of dosages is especially important, so as not to cause harm and to avoid some complications that are possible with irrational therapy with drugs from the above pharmacological groups.

Antibiotics

Penicillin group drugs

• Benzylpenicillin potassium and sodium salts: children under two years of age ———(maximum, according to special indications) IU/kg body weight per day; from two to five years - ED, from five to ten years - ED and, finally, from 10 to 14 years - ED per day. The frequency of administration is at least 4 times and no more than 8, respectively, every 3-4-6 hours. It must be remembered that if there are indications for intravenous administration, then only the sodium salt of benzylpenicillin can be injected into the vein.

• Methicillin sodium salt - for children up to three months - 50 mg/kg body weight per day, from three months to two years - 100 mg/kg per day, over 12 years - adult dose - (from 4 to 6 g per day). It is administered intramuscularly and intravenously. The frequency of administration is at least two and no more than four times, respectively, every 6-8-12 hours.

• Oxacillin sodium salt - children up to one month - 20-40 mg/kg body weight per day, from one to three months - 60-80 mg/kg, from three months to two years - 1 g per day, from two to six years - 2 g, over six years - 3 g. Administered intramuscularly and intravenously. The frequency of administration is at least twice a day and no more than four times, respectively, every 6-8-12 hours. It is given orally 4-6 times a day 1 hour before meals or 2-3 hours after meals in the following doses: up to five years - 100 mg/kg per day, over five years - 2 g per day.

• Ampicillin sodium salt - up to 1 month of life - 100 mg/kg body weight per day, up to 1 year - 75 mg/kg body weight per day, from one to four years - 50-75 mg/kg, over four years - 50 mg/kg. It is administered intramuscularly and intravenously. The frequency of administration is at least two times and no more than four times a day, respectively, every 6-8 or 12 hours.

• Ampiox - up to one year - 200 mg/kg body weight per day, from one to six years - 100 mg/kg, from 7 to 14 years - 50 mg/kg. It is administered intramuscularly and intravenously. The frequency of administration is at least two and no more than four times a day, respectively, every 6-8-12 hours.

• Dicloxacillin sodium salt - up to 12 years - from 12.5 to 25 mg/kg body weight per day in four divided doses, orally, 1 hour before meals or 1-1.5 hours after meals.

Macrolide drugs

• Erythromycin (at one dose) up to two years - 0.005-0.008 g (5-8 mg) per kilogram of body weight, from three to four years - 0.125 g, from five to six years - 0.15 g, from seven to nine - 0.2 g, from ten to fourteen - 0.25 g. Used orally four times a day 1-1.5 hours before meals.

• Erythromycin ascorbate and phosphate are prescribed at the rate of 20 mg/kg body weight per day. It is administered intravenously slowly after 8-12 hours, 2 or 3 times, respectively.

• Oleandomycin phosphate - up to three years - 0.02 g/kg body weight per day, from three to six years - 0.25-0.5 g, from six to fourteen years - 0.5-1.0 g, older 14 years -1.0-1.5 g per day. Taken orally, 4-6 times a day. Can be administered intramuscularly and intravenously to children under three years of age - 0.03-0.05 g/kg body weight per day, from three to six years - 0.25-0.5 g, from six to ten years - 0.5- 0.75 g, from ten to fourteen years - 0.75-1.0 g per day. It is administered 3-4 times, respectively, every 6-8 hours.

Drugs of the amipoglycoside group

• Gentamicin sulfate - 0.6-2.0 mg/kg body weight per day. It is administered intramuscularly and intravenously 2-3 times a day, respectively, after 8-12 hours.

• Preparations of the chloramphenicol group - chloramphenicol sodium succinate - the daily dose for children under one year of age is 25-30 mg/kg of body weight, for children over one year of age - 50 mg/kg of body weight. It is administered intramuscularly and intravenously twice a day, respectively, after 12 hours. Contraindicated in children with symptoms of hematopoietic suppression and under the age of one year.

• Cephaloridine (synonym - ceporin), kefzol - for newborns the dose is 30 mg/kg body weight per day, after one month of life - an average of 75 mg/kg body weight (from 50 to 100 mg/kg). It is administered intramuscularly and intravenously 2-3 times a day, respectively, after 8-12 hours.

Antibiotics of other groups

• Lincomycin hydrochloride - 15-30-50 mg/kg body weight per day. It is administered intramuscularly and intravenously twice a day every 12 hours.

• Fusidine sodium: prescribed orally in doses: up to 1 year - 60-80 mg/kg body weight per day, from one to three years - 40-60 mg/kg, from four to fourteen years - 20-40 mg/kg .

On average, the course of antibiotic therapy in children with bronchitis is 5-7 days. For gentamicin, chloramphenicol - no more than 7 days, and only for special indications - up to 10-14 days.

In addition, in some cases it may be advisable to use combinations of two or three antibiotics (specially designed tables exist to determine their mutual compatibility and chemical compatibility). Such expediency is determined by the patient’s condition, often severe.

Sulfonamides

The most commonly used are: biseptol-120 (bactrim), sulfadimethoxine, sulfadimezin, norsulfazole.

• Biseptol-120, containing 20 mg of trimethoprim and 100 mg of sulfamethoxazole, is prescribed to children under two years of age at the rate of 6 mg of the first and 30 mg of the second of these drugs per 1 kg of body weight per day. From two to five years - two tablets in the morning and evening, from five to twelve years - four. Bactrim, which is an analogue of Biseptol, is recalculated taking into account the fact that one teaspoon of it corresponds to two tablets of Biseptol No. 120.

• Sulfadimethoxine is prescribed to children under four years of age once: on the first day - 0.025 mg/kg body weight, on subsequent days - 0.0125 g/kg. Children over four years old: on the first day - 1.0 g, on subsequent days - 0.5 g daily. Take 1 time per day.

• Sulfadimezin and norsulfazole. Children under two years of age - 0.1 g/kg body weight on 1 day, then 0.025 g/kg 3-4 times every 6-8 hours. Children over two years old - 0.5 g 3-4 times a day.

• Niftrofurans (furadonin, furazolidone) are used much less frequently. The daily dose of the drug is 5-8 mg/kg body weight for children under two years of age. Take 3-4 times a day.

The general course of sulfonamide or nitrofuran therapy averages 5-7 days and in rare cases can be extended to 10.

Chronic bronchitis

Chronic bronchitis is one of several lung diseases that are collectively called chronic obstructive diseases. Chronic bronchitis is defined as the presence of a cough with mucus that continues for at least three months, two years in a row. This cough occurs when the tissues lining the bronchi (the branches of the trachea through which air is inhaled and exhaled air passes) become irritated and inflamed. Although the onset of the disease is gradual, as it progresses relapses become more frequent and the cough may become persistent as a result. Long-term chronic bronchitis causes the air passages of the lungs to become irreversibly narrow, making breathing very difficult. Chronic bronchitis cannot be completely cured, but treatment nevertheless relieves symptoms and prevents complications from occurring.

Chronic bronchitis is a long-term inflammatory disease of the mucous membrane of the bronchi and bronchioles.

Infection plays an important role in the development and course of the disease. Chronic bronchitis can develop due to acute bronchitis or pneumonia. An important role in its development and maintenance is also played by long-term irritation of the bronchial mucosa by various chemicals and dust particles inhaled in the air, especially in cities with a damp climate and sudden changes in weather, in industries with significant dust or increased saturation of the air with chemical vapors. Autoimmune allergic reactions that occur due to the absorption of protein breakdown products formed in areas of inflammation also play a certain role in the maintenance of chronic bronchitis.

Smoking is no less important in the development of chronic bronchitis: the number of people suffering from bronchitis among smokers is 50-80%, and among non-smokers - only 7-19%.

Causes

• Smoking is the main cause of chronic bronchitis. About 90 percent of patients smoked. Passive smoking also affects the development of chronic bronchitis.

• Lung irritants (gas emissions from industrial or chemical plants) can cause damage to the respiratory tract. Other air pollutants also contribute to the development of the disease.

• Repeated lung infections can damage the lungs and make the disease worse.

Symptoms

• Persistent cough with mucus, especially in the morning.

• Frequent lung infections.

• For patients with chronic bronchitis, vaccination against influenza and the most common form of bacterial pneumonia (pneumococcal pneumonia) is recommended.

Clinical picture. At the very beginning of the disease, the bronchial mucosa is congested, hypertrophied in places, and the mucous glands are in a state of hyperplasia. Subsequently, inflammation spreads to the submucosal and muscular layers, in place of which scar tissue forms; the mucous and cartilaginous plates atrophy. In places where the bronchial wall is thinned, their lumen gradually expands - bronchiectasis is formed.

The process may also involve peribronchial tissue with further development of interstitial pneumonia. The interalveolar septa gradually atrophy and pulmonary emphysema develops.

The clinical picture as a whole is quite characteristic and well studied, however, all manifestations of chronic bronchitis strongly depend on the extent of inflammation throughout the bronchi, as well as on the depth of damage to the bronchial wall. The main symptoms of chronic bronchitis are cough and shortness of breath.

Cough can have a different character and vary depending on the time of year, atmospheric pressure and weather. In summer, especially dry, the cough is insignificant or completely absent. With high air humidity and in rainy weather, the cough often intensifies, and in the autumn-winter period it becomes strong and persistent with the release of viscous mucopurulent or purulent sputum. More often, a cough occurs in the morning, when the patient begins to wash or get dressed. In some cases, the sputum is so thick that it is released in the form of fibrous strands that resemble casts of the lumen of the bronchi.

Dyspnea in chronic bronchitis is caused not only by impaired drainage function of the bronchi, but also by secondary developing pulmonary emphysema. It is often of a mixed nature. At the beginning of the disease, difficulty breathing is observed only during physical activity, climbing stairs or uphill. In the future, with the development of pulmonary emphysema and pneumosclerosis, shortness of breath becomes more pronounced. With diffuse inflammation of the small bronchi, shortness of breath takes on an expiratory nature (predominant difficulty in exhaling).

General symptoms of the disease are also observed - malaise, fatigue, sweating, and body temperature rarely rises. In uncomplicated cases of the disease, palpation and percussion of the chest do not reveal any changes. Auscultation reveals vesicular or harsh breathing, against which dry buzzing and whistling sounds, as well as silent moist rales, are heard. In advanced cases, upon examination, palpation, percussion and auscultation of the chest, changes characteristic of pulmonary emphysema and pneumosclerosis are determined, and signs of respiratory failure appear.

Changes in the blood occur only during exacerbations of the disease: the number of leukocytes increases, the ESR accelerates.

X-ray examination of uncomplicated bronchitis usually does not reveal pathological changes. With the development of pneumosclerosis or emphysema, corresponding radiological signs appear. Bronchoscopy reveals a picture of atrophic or hypertrophic bronchitis (i.e., with thinning or swelling of the bronchial mucosa).

The obstructive nature of chronic bronchitis is confirmed by data from a functional study (in particular, spirography).

Improvement in pulmonary ventilation and respiratory mechanics with the use of bronchodilators indicates bronchospasm and reversibility of bronchial obstruction.

Differential diagnosis of chronic bronchitis is carried out primarily with chronic pneumonia, bronchial asthma, tuberculosis, lung cancer and pneumoconiosis.

Treatment of patients with chronic bronchitis should begin at the earliest possible stage. It is important to eliminate all factors that cause irritation of the bronchial mucosa. It is necessary to sanitize any chronic foci of infection and ensure free breathing through the nose. It is often more appropriate to treat patients with exacerbation of bronchitis in a hospital.

Further course and complications. One of the most unfavorable manifestations of chronic bronchitis, which largely determines its prognosis, is the development of obstructive disorders in the bronchial tree. The causes of this type of pathology can be changes in the mucous and submucous membranes of the bronchi, which develops due to a fairly long-term inflammatory reaction with infiltration of the walls and spasm of not only large bronchi, but also the smallest bronchi and bronchioles, narrowing of the lumen of the entire bronchial tree with a large amount of secretion and sputum. The described disturbances in the bronchial tree lead, in turn, to disturbances in ventilation processes. With an unfavorable development of the process, arterial hypertension of the pulmonary circulation subsequently develops and a picture of the so-called “chronic pulmonary heart” is formed.

Bronchospastic syndrome can occur in any form of chronic bronchitis and is characterized by the development of expiratory shortness of breath, and if bronchospasm occupies the main place in the overall clinical picture of the disease, chronic bronchitis is defined as asthmatic.

Symptoms and clinical picture depend on the caliber of the affected bronchi. The first symptoms of chronic bronchitis: cough with or without sputum, more typical for damage to large bronchi, progressive shortness of breath, more often with damage to small bronchi. The cough may occur paroxysmally only in the morning, or it may bother the patient all day and then at night. More often, the inflammatory process first affects the large bronchi and then spreads to the small ones. Chronic bronchitis begins gradually, and for many years, except for an occasional cough, nothing bothers the patient. Over the years, the cough becomes constant, the amount of sputum produced increases, and it becomes purulent in nature. As the disease progresses, smaller and smaller bronchi become involved in the pathological process, which leads to pronounced disturbances in pulmonary and bronchial ventilation. During periods of exacerbation of chronic bronchitis (mainly in the cold and damp seasons), cough, shortness of breath, fatigue, weakness intensify, the amount of sputum increases, body temperature rises, often slightly, chilliness and sweating appear, especially at night, pain in various muscle groups caused by frequent cough. Exacerbation of obstructive bronchitis is manifested by an increase in shortness of breath (especially during physical exertion and the transition from heat to cold), the release of a small amount of sputum after a paroxysmal painful cough, prolongation of the exit phase and the appearance of wheezing dry rales on exhalation.

The presence of obstruction determines the prognosis of the disease, since it leads to the progression of chronic bronchitis, to emphysema, the development of cor pulmonale, the occurrence of atelectasis (areas of compaction in the lung tissue), and, as a consequence, to pneumonia. In the future, the clinical picture is determined by developing changes in the lungs and heart. Thus, when the disease is complicated by chronic pulmonary heart disease, during an exacerbation the symptoms of heart failure increase, pulmonary emphysema appears, and severe respiratory failure occurs.

At this stage, the development and progression of bronchiectasis is possible; when coughing, a large amount of purulent sputum is released, and hemoptysis is possible. Some patients with asthmatic bronchitis may develop bronchial asthma.

In the acute phase, both weakened vesicular and harsh breathing can be heard, and the number of dry whistling and moist rales over the entire surface of the lungs often increases. Outside of an exacerbation, they may not exist. There may be no changes in the blood even during an exacerbation of the disease. Sometimes moderate leukocytosis, a shift in the leukocyte formula to the left, and a slight increase in ESR are detected. Macroscopic, cytological and biochemical examination of sputum is of great importance. With a severe exacerbation of chronic bronchitis, the sputum is purulent in nature, mostly leukocytes, DNA fibers, etc. are found in it; in case of asthmatic bronchitis, eosinophils, Kurschmann spirals, and Charcot-Leyden crystals, characteristic of bronchial asthma, may be observed in the sputum.

At the same time, radiological symptoms in most patients are not detected for a long time. In some patients, radiographs show uneven enhancement and deformation, as well as changes in the contours of the pulmonary pattern; with emphysema, an increase in the transparency of the pulmonary fields.

During the course of chronic bronchitis, significant variability is observed in different patients. Sometimes people suffer from bronchitis for many years, but functional and morphological disorders are less pronounced. In another group of patients, the disease gradually progresses. It causes exacerbations under the influence of cooling, most often in the cold season, in connection with influenza epidemics, in the presence of unfavorable professional factors, etc. Repeated exacerbations of bronchitis lead to the development of bronchiectasis, pulmonary emphysema, pneumosclerosis, signs of respiratory distress appear, and then - pulmonary heart failure.

Chronic bronchopulmonary respiratory failure is designated by the term “chronic pulmonary failure” and its three degrees are distinguished, depending on the severity of clinical manifestations.

Patients with severe pulmonary insufficiency are characterized by a cough with the release of a significant amount of sputum, constant shortness of breath, signs of heart failure: cyanosis, enlarged liver (on average, usually 2-3 cm), sometimes swelling of the lower extremities. X-ray of the chest reveals significant emphysema in all patients, and the nature of ventilation disorders is of a mixed type.

Diagnostics

• A medical history and physical examination help make the diagnosis of chronic bronchitis.

• To confirm the patient's weakened lung function, the lung function is checked (measurement of the volume of air held).

• X-rays can detect damage to the lungs and help identify other diseases, such as lung cancer.

• An arterial blood test is performed to determine the oxygen and carbon dioxide levels in the blood.

The general condition in simple bronchitis is determined by the reaction to infection (in the absence of toxicosis - satisfactory or moderate), and in obstructive bronchitis it is also determined by the degree of obstruction, and, consequently, the severity of respiratory failure.

The cough with simple bronchitis is usually dry; it becomes wet at the end of the first or beginning of the second week of the disease. With obstructive bronchitis, the cough is dry, persistent, painful in the first week, and deep, moist, rich in overtones in the second. Cough with bronchiolitis is frequent, painful, deep, increasing as it resolves.

Respiratory failure: absent in simple bronchitis; with obstructive respiratory failure, respiratory failure of the first, rarely second degree is possible, and with bronchiolitis it is pronounced, and is more often of the second or third degree.

Character of shortness of breath: absent in simple bronchitis, expiratory in the presence of obstruction.

Percussion: pulmonary sound in case of simple bronchitis, box tone in the presence of obstruction.

Auscultation: breathing is harsh or vesicular in simple bronchitis with the usual ratio of inhalation and exhalation phases. With obstructive bronchitis, bronchiolitis, exhalation is difficult and prolonged. Wheezing in simple bronchitis is scattered, a few dry and mostly large-bubbly - wet, disappearing almost completely after coughing. With obstructive bronchitis - a large number of dry and moist rales (both small and medium bubble), numerous, heard symmetrically throughout the entire length of the lungs. Their quantitative dynamics are almost independent of cough.

It is usually not difficult to distinguish severe bronchiolitis from milder obstructive bronchitis: with bronchitis there are no signs of severe respiratory failure. At the same time, there is an adjacent zone where it can be difficult to differentiate these two forms. In these cases, one should be guided by the presence of abundant fine wheezing, which is typical for bronchiolitis. This is important when differentiating from pneumonia, whereas in patients with obstructive bronchitis without moist rales, the main diagnostic problem is to exclude bronchial asthma.

Treatment

• The progression of the disease may be slowed by stopping smoking. It is also recommended to avoid second-hand smoke and other lung irritants.

• Moderate outdoor exercise can help prevent the development of the disease and generally increase the ability to exercise.

• It is recommended that you take steps to prevent lung infections, including frequent hand washing and vaccinations.

• Drink plenty of fluids and breathe moist air (for example, use a humidifier), which will help make the mucus less dense. Cold, dry air should be avoided.

• A bronchodilator, which dilates the bronchi, may be prescribed to make breathing easier.

• If bronchodilators do not work, an oral or inhaled steroid may be prescribed. Patients taking steroids should be monitored by a doctor to determine whether breathing improves. If there is no response to the medication, steroid therapy may be interrupted.

• Additional oxygen supply helps patients with low oxygen levels in the blood; for them it can help prolong life.

• Antibiotics are prescribed to treat new infections, which help prevent symptoms from getting worse. Chronic antibiotic treatment is not recommended.

• Certain exercises can help clear mucus from the lungs and improve breathing. Your doctor can give you instructions on how to do the exercises.

• For patients with chronic bronchitis, the use of cough suppressants and expectorants is not recommended.

• Call your doctor if you have a persistent cough that produces mucus and the amount of mucus increases, the color darkens, or you notice blood in the mucus.

• Contact your doctor if you have a persistent cough in the morning.

• Call your doctor if you experience shortness of breath or other types of difficulty breathing.

• Seek immediate medical attention if the skin on your face turns bluish or purple.

Treatment of bronchitis should be based on the etiology, pathogenesis and clinical picture of the disease. Depending on the severity of the clinical picture, more or less strict rest is prescribed, and at high temperatures, bed rest. It is necessary to strictly prohibit the patient from smoking and humidify the dry air in the room. Food should be easily digestible and rich in vitamins. At the same time, drinking plenty of fluids is recommended, and diaphoretic infusions (linden blossom, raspberries, black elderberry, and others) are advisable. Mustard plasters or jars at night are useful, especially in the initial stages of the disease.

Interferon is prescribed in the first 2 days (no later) 1-2 drops in both nostrils 4-6 times a day, up to 5 days.

If a painful cough occurs, antitussives are prescribed for 3-4 days. A good drug is glaucine hydrochloride; An infusion of ipecac root (pharmaceutical form) is also prescribed, 1 tablespoon every 3-4 hours for three days.

For bronchospasm, bronchodilators are also used: theophedrine (1/2, 1 tablet 3 times a day), aminophylline (0.15 g 3 times a day) are effective.

In general, we can say that pathogenetic therapy for bronchitis should be aimed at:

• restoration of the drainage function of the bronchi,

• in the presence of obstruction - to restore their patency.

Taking into account the above, drug therapy for bronchitis mainly consists of the following:

• expectorants and sputum thinners (mucolytics);

• means of increasing oxygenation (supplying the body with oxygen).

Expectorants and sputum thinners are administered orally or by inhalation. A separate chapter is devoted to inhalation therapy for bronchitis; here we will focus only on the group of enzyme preparations.

Trypsin is a proteolytic enzyme, 2-5 mg of which is dissolved in 2-4 ml of isotonic sodium chloride solution and used as an aerosol once a day; the course lasts from 7 to 10 days. Chymotrypsin is more persistent than trypsin and inactivates more slowly. Indications for use, method, doses are the same as for crystalline trypsin. Another enzyme preparation is ribonuclease. 10-25 mg of the drug is dissolved in 3-4 mg of isotonic sodium chloride solution or 0.5% novocaine. The course is 7-8 days. Deoxyribonuclease - 2 mg per 1 ml of isotonic sodium chloride solution, 1-3 ml per inhalation for 10-15 minutes 3 times a day. Course 7-8 days.

Experimental and clinical observations have shown that enzyme preparations help reduce the viscosity of tracheobronchial secretions, cleanse the respiratory tract of purulent exudate, mucus, necrotic masses, regeneration and epithelization of the respiratory tract mucosa.

At home, steam inhalation of a 2% solution of sodium bicarbonate or essential oils is effective. In addition, anise oil is taken as an expectorant, 2-3 drops in a spoon of warm water per dose (up to six times a day).

As for internal remedies, mucolytics include well-known prescriptions for complex expectorant mixtures based on marshmallow root or thermopsis herb (respectively: 3.0 per 100.0 ml or 6.0 per 180.0 ml, 0.6 per 180.0 ml or 1.0 per 200.0 ml). To a recipe containing an infusion of marshmallow or thermopsis, add sodium bicarbonate up to 3-5 g, ammonia-anise drops and sodium benzoate 2-3 g each, syrup up to 20 g. The mixture is prescribed one teaspoon, dessert or tablespoon, depending on age .

Breast preparations No. 1 and No. 2 have proven themselves well (standard dosage forms, available in retail pharmacies). Collection No. 1 contains 4 parts of marshmallow root, 4 parts of coltsfoot leaves and 2 parts of oregano herb, and No. 2 contains 4 parts of coltsfoot leaves, 3 parts of plantain leaves, and 3 parts of licorice roots. The infusion is prepared at the rate of one tablespoon of the mixture per glass of boiling water.

In case of difficult to separate sputum (especially in the case of tracheobronchitis), expectorants are prescribed, including mucaltin - in tablets of 0.05, glaucine hydrochloride in tablets of 0.1. The dosage varies depending on the age of the patient and the degree of clinical manifestations. The mucolytic ACC (M-acetyl-1 cysteine ​​(usually in soluble tablets or powders) is also widely used). The drug has the property of destroying the disulfide bonds of sputum mucoproteins and thus reduces their viscosity.

A number of expectorants have bronchodilator, antispastic, anti-inflammatory and sedative effects. Therapy with expectorants is assessed by the dynamics of changes in the amount of sputum per day or secreted in the first hour after waking up.

Taking into account that the inflammatory process can contribute to the development of bronchospasm (secondarily), it is necessary in some cases to use bronchodilators. Preference is given to aminophylline, mainly given its mild and multifaceted effect (improvement of pulmonary, coronary and cerebral circulation, diuretic effect). It is prescribed intravenously in a slow stream alone or in an isotonic solution of sodium chloride; 2.4% solution 10.0 ml (or 2-5 mg/kg per dose). For intramuscular administration, 12% and 24% solutions are used.

Oxygen therapy is carried out with humidified oxygen through a mask for 10-15 minutes every 2-3 hours with initial manifestations of respiratory failure, and through nasal catheters every 1-2 hours for 10-15 minutes with increasing symptoms of respiratory failure.

However, it should be remembered that oxygenation with positive expiratory pressure (according to Martin Boyer or Gregory) is strictly contraindicated for any form of obstructive bronchitis (acute emphysema is possible).

Symptomatic treatment of acute bronchitis is determined by the clinical picture of the underlying disease - acute respiratory viral infection and includes the prescription of antipyretics and sedatives. In children with toxicosis, multidisciplinary infusion therapy is used, but this is a rather specialized issue, and we will not consider it in detail here.

The complex of therapeutic measures for chronic bronchitis is determined by its stage. General therapeutic measures for all forms of chronic bronchitis: absolute prohibition of smoking, elimination of substances that constantly irritate the mucous membrane of the respiratory tract (at home and at work), lifestyle regulation, sanitation of the upper respiratory tract, increasing the body's resistance, therapeutic physical training, physiotherapy, inhalations , expectorants.

For viscous sputum, enzyme preparations (trypsin, chymopsin) are used endobronchially, modern mucolytic agents (acetylcysteine, bromhexine) endobronchially and orally.

Widely known expectorants of plant origin also contribute to the removal of sputum if they are rationally selected and taken.

Expectorant medications make coughing easier, thin mucus, or reduce secretion. They are appointed:

• with retention of secretions or with very abundant secretion, threatening pulmonary edema; in this case it is necessary to induce a cough;

• with a cough that greatly bothers the patient;

• with a dry cough and no sputum; when sputum is produced, the cough should become soft and wet;

• for foul-smelling sputum as a result of decomposition processes in the lungs and bronchi for disinfection, deodorization and reduction of secretions.

It should be borne in mind that there are certain contraindications for prescribing expectorants for chronic bronchitis:

• if the respiratory tract is dry, you should not use medications that reduce secretion;

• in case of threatening pulmonary edema, drugs that suppress cough or increase and dilute secretion should not be prescribed;

• Caution is also necessary when prescribing expectorants to pregnant women.

Medicines of the next group tend to be secreted by the bronchi, causing dilution of bronchial secretion, increasing it and facilitating expectoration, as well as enhancing the resorption capacity of the lungs. They are often used simultaneously with emollients or mild secretomotor agents.

Ammonia and its salts. Ammonia salts taken orally are secreted by most of the bronchial mucosa in the form of carbonates, which have the property of enhancing and diluting bronchial secretion (mucin). The use of these salts is most indicated in the presence of acute and subacute inflammatory processes of the respiratory tract and bronchitis. With the existing abundant and liquid bronchial secretion (in chronic cases), taking them becomes useless. The effect of ammonia preparations is short-lived, so it is necessary to use them every 2-3 hours.

Ammonium chloride. It is secreted by part of the bronchial mucosa in the form of ammonium carbonate, which acts as a base, enhancing the secretion of mucous glands and diluting phlegm, which facilitates the movement of secretions outward. Prescribed mainly for bronchitis with scanty secretion orally - adults 0.2-0.5 g, children 0.1-0.25 g per dose every 2-3 hours (3-5 times a day) at 0.5- 2.5% solution, or in powder form in capsules. The drug should be taken after meals. In large doses, the local action may be accompanied by reflex stimulation of the vomiting center, coming from the gastric mucosa, sometimes accompanied by a feeling of nausea.

Ammonia-anise drops. Ingredients: anise oil 2.81 g, ammonia solution 15 ml, alcohol up to 100 ml. (1 g of drug = 54 drops). Transparent, colorless or slightly yellowish liquid with a strong anise or ammonia odor. 1 g of the drug with 10 ml of water forms a milky-turbid liquid of an alkaline reaction. Used as an expectorant, especially for bronchitis. Prescribe 10-15 drops every 2-3 hours 5-6 times a day on their own (diluted in water, milk, tea); often added to expectorant mixtures: ipecac, thermopsis, primrose, senega. Children: 1 drop per year of life, 4-6 times a day (every 2-3 hours). Incompatible with codeine salts and other alkaloids, sour fruit syrups, iodine salts.

Alkalis and sodium chloride. The main indication for the use of alkaline-salty mineral waters is catarrh of the mucous membranes of the pharynx and respiratory tract. The use of alkalis is based on their ability to dissolve mucin.

Sodium bicarbonate. Resorbing even in small quantities, sodium bicarbonate increases the alkaline reserve of the blood; the secretion of the bronchial mucosa also becomes alkaline, which leads to the dilution of sputum. Prescribed orally 0.5-2 g several times a day in powders, solution, or more often together with sodium chloride (table salt), in a ratio similar to some mineral waters. Sodium bicarbonate reduces the excitability of the respiratory center while increasing the alkaline reserve of the blood. The drug is contraindicated in case of copious liquid sputum.

Iodine salts. Iodine salts, released by the mucous membranes of the respiratory tract, cause hyperemia and increased secretion of sputum. Potassium iodide is used as an expectorant; it irritates the gastric mucosa less than other iodine preparations. The advantage of potassium iodide over other expectorants is its longer action, the disadvantage is its irritating effect on other excretory pathways (nasal mucosa, lacrimal glands). Iodine salts often have a beneficial effect on chronic bronchitis in older people. Prescribed for prolonged chronic bronchitis with viscous, difficult to expectorate sputum, in addition, for dry bronchitis, for catarrh in those suffering from emphysema, and especially for simultaneous asthmatic complaints. There are contraindications: acute inflammatory processes of the lungs and respiratory tract, early stages of pneumonia.

In many cases, emollients such as marshmallow root preparations are effective.

For bronchitis with the release of a large amount of serous sputum, terpinhydrate is used in a daily dose of up to 1.5 g. For putrefactive sputum, terpinhydrate is used in a dose of 0.2 g 3-4 times a day, often together with antibiotics.

With an increased cough reflex and bronchial obstruction, it is advisable to prescribe dosage forms from the herb thyme, which contains a mixture of essential oils, some of which have sedative properties. The combination of a central calming effect with an expectorant and some bactericidal activity makes thyme an effective drug for obstructive bronchitis.

Among the preventive measures for chronic bronchitis to increase the body's resistance, along with respiratory therapeutic exercises and hardening procedures, general tonic agents are of great importance. Pantocrine, Eleutherococcus, Schisandra, and vitamins have adaptive properties. It has a promising effect on allergic reactivity and immunobiological defense mechanisms.

Pantocrine is prescribed 30-40 drops 30 minutes before meals for 2-3 weeks. Eleutherococcus extract is recommended 20-40 drops 3 times a day 30 minutes before meals in courses of 25-30 days. Chinese Schisandra tincture is taken 20-30 drops per dose 2-3 times a day on an empty stomach for 2-3 weeks. Therapy with saparal 0.05 g 2-3 times a day is also indicated for 15-25 days.

For purulent bronchitis, antibacterial therapy is additionally prescribed, and for obstructive bronchitis, antispasmodics and, in some cases, strictly according to indications, glucocorticoids.

Long-acting sulfonamide drugs are also used: sulfapyridazine 12 g/day, sulfadimethoxine 1 g/day. Bactrim is effective (2 tablets 2 times a day). Of the quinoxaline derivatives, quinoxidine is prescribed 0.15 g 3 times a day. Acetylsalicylic acid, calcium chloride and other drugs are prescribed as anti-inflammatory drugs.

In general, for the effective treatment of chronic bronchitis, the identification and treatment of rhinitis, tonsillitis, and inflammation of the paranasal cavities is essential.

It is also necessary to prescribe vitamins: ascorbic acid 300-600 mg/day, vitamin A 3 mg or 9900 IU per day, B vitamins (thiamine, riboflavin, pyridoxine) - 0.03 g per day throughout the course of treatment. Vitamin infusions are shown - from rose hips, black currants, rowan berries, etc.

The advisability of using antibiotics is disputed by many authors. However, when positively deciding the question of indications for their use in bronchitis, it is necessary to be guided by the following general rules: the possibility of pneumonia, a long-lasting increase in temperature or high temperatures, toxicosis, as well as the lack of effect from previously carried out therapy.

On average, the course of antibiotic therapy for bronchitis is 5-7 days. For gentamicin, chloramphenicol - a week, according to indications - 10 days, in severe cases up to two weeks.

In some cases, guided by the patient’s condition, it is advisable to use combinations of two or even three antibiotics, which is determined by existing compatibility tables for this group of drugs.

Sometimes, for antibacterial therapy, a choice may be made in favor of sulfonamides or drugs of the nitrofuran group. The general course of sulfonamide therapy lasts on average, as a rule, from five days to a week, less often it can be extended to ten.

Prevention

• The best way to prevent chronic bronchitis is to quit or not start smoking.

• Avoid contact with lung irritants and areas with polluted air.

Traditional medicine recommends for the treatment of bronchitis:

• drink tea with raspberries as a diaphoretic;

• drink an infusion of coltsfoot leaves (a tablespoon of leaves per glass of boiling water, sip throughout the day), or a mixture of coltsfoot with wild rosemary and nettle in equal parts;

• drink an infusion of pine buds (a teaspoon in a glass of water, boil for 5 minutes, leave for 1.5-2 hours and drink in 3 doses after meals);

• drink onion juice and radish juice as a strong expectorant;

• for the same purpose, drink milk boiled with soda and honey.

The risk of bronchitis can be minimized by regular hardening of the body and frequent cleaning of the house to prevent the accumulation of household dust. Prolonged exposure to air in dry weather is beneficial. Treatment of chronic bronchitis is especially successful on the sea coast, as well as in dry mountainous areas (for example, in the resorts of Kislovodsk).

Source: http://medn.ru/statyi/bronxit-simptomy.html