Otitis

Constructive bronchitis in adults. Obstructive bronchitis: symptoms

Obstructive bronchitis- the presence of problems with bronchial patency, as a result of which the air loses its ability to free access into the lungs.

The bronchi become a site of extensive accumulation thick mucus, which is a good reason for difficulty breathing.

In other words, obstruction develops. Bronchial obstruction is nothing more than an unexpected lightning spasm of the bronchi, the cause of which is numerous factors of different origins (infectious, non-infectious).

A characteristic difference from ordinary bronchitis is the fact that pathological changes affect the entire thickness of the bronchus.

As a result, its significant narrowing is observed and edema occurs. The bronchial tree is completely exposed to damaging effects.

Causes of obstructive bronchitis

The list of infectious factors that are responsible for the occurrence of bronchial obstruction includes:

adenoviruses
mycoplasma
rhinoviruses

Allergies are considered to be the key non-infectious factor. The list of allergens that can trigger the disease is very extensive:

sweets, canned food, semi-finished products, drinks
medicines, dietary supplements
house dust
animal fur

Children under the age of five are most susceptible to acute obstructive bronchitis because they bronchopulmonary system at this age is underdeveloped.

In addition, the habit of children breathing through their mouth plays a significant role.

Unfortunately, some parents ignore the frequent skin rash that occurs after the child has eaten new foods.

There is no proper reaction to seasonal runny nose.

They explain such a superficial attitude towards this problem by the fact that the symptoms of the problem condition are minimal, and, therefore, emergency treatment not required.

In addition to allergies, risk factors include:

systematic
passive smoking - parents should definitely remember this
congenital malformations of the bronchi
extremely weakened immune system
complete absence of moderate sports activity
tendency towards a sedentary lifestyle

The most important thing is to promptly determine the cause of the obstruction and do everything necessary measures to eliminate it as quickly as possible.

When the cause of obstructive bronchitis is a viral infection, treatment should focus on strengthening the immune system. Don’t forget to take it systematically against colds. antiviral drugs, prescribed by an immunologist.

If it is definitely established that the main culprit of the breathing problems that have arisen is an allergy, then it is necessary to immediately create hypoallergenic conditions in the home. In addition, it is recommended to conduct allergy tests.

Signs of obstructive bronchitis

The presence of the following symptoms should cause anxiety:

the occurrence of shortness of breath after the body has experienced slight physical exertion
in particular difficult situations, shortness of breath can occur even in a calm state
when breathing, the exhalation phase is accompanied by a whistling “sound effect”
occurs at the moment of exhalation cough
exhalation is much longer than inhalation
Thick mucus produced in large volumes when coughing
temperature increase, up to 38 degrees

there is no opportunity for deep exhalation
rapid rise in temperature
the use of mucolytics and bronchodilators does not give the desired effect - shortness of breath does not stop
free breathing is possible for the patient only if he is in a standing position
if a person is in a supine position, then while breathing, bubbling sounds are clearly audible
the strongest emerge painful sensations in the head, possible dizziness

Development of the disease

The onset of obstructive bronchitis is identical to acute respiratory infections, without standing out in anything special, and is very similar to a common cold. Probably, and during the first days of the illness, the nature of its manifestation is unobtrusive, the intensity is minimal. There is a runny nose and pain in the throat.

With an increase in the “power” of the cough, an increase in temperature is observed to 38 degrees. As the disease progresses, the cough manifests itself in attacks. There is no relief because the mucus is extremely viscous and difficult to separate.

Maximum problems are experienced at night. It is worth noting that with obstructive bronchitis, the nature of the cough is characterized by a variety of manifestations: dry, whistling, wet.

In such a situation, even without resorting to the help of a phonendoscope, an experienced doctor, based on the patient’s breathing, is able to detect at what moment the bronchial spasm is most pronounced. Wheezing, dyspnea- all these signs are clearly audible.

Toxins actively secreted by pathological bacteria have the ability to spread rapidly. There is effusion and swelling of the mucous membrane. As a result, the bronchial lumen is reduced. Due to the narrowing of the lumen, a significant obstacle has been created, making it difficult for the sputum and mucus accumulated in the bronchi to quickly exit.

Emerging sputum extremely thick, separated with great difficulty.

If you ignore the timely start of treatment, then quickly enough, pathological condition the so-called obstruction occupies the patient’s bronchi for a long time, becoming chronic.

The situation develops much more complicated when the patient is a child, and an allergic reaction is recognized as the main cause of obstructive bronchitis.

In this situation, it is indicative primary symptom is extremely severe cough, which is certainly accompanied by a very characteristic whistle, clearly audible during exhalation.

The child’s activity rapidly decreases, he is overcome by lethargy, and becomes inactive. , general condition is extremely weakened. In addition, pain in the chest can cause significant concern.

Characteristic distinctive feature allergic obstructive bronchitis - a clear relationship between the onset of the disease and the changes or changes occurring around the patient.

For example, a new pet appeared in the house, or some interior item was purchased (carpet, furniture).

There is a fairly high probability that a child will develop shortness of breath, which means breathing problems, under loads of varying severity.

However, it is worth noting that there is a significant difference from cardiac dyspnea. The child does not feel any desire to sleep while sitting. Rather, on the contrary, the most favorable position for sleeping is lying on your stomach, which is due to better discharge of sputum.

Treatment of obstructive bronchitis

Fundamentally, medications that are usually prescribed by a doctor for this disease can be classified into four main groups:

bronchodilators
antispasmodics
antihistamines
expectorants

I note that the list of medications included in each group is very impressive, so the final selection of the drug is the task of your attending physician.

If you have a nebulizer, it becomes possible to cope with mucus through inhalation procedures, using solutions that have bronchodilator and expectorant properties.

Please note that in this situation, the selection of drugs is a purely individual issue, which must be agreed upon with the attending physician.

As for antipyretics, their use is permissible only when the temperature exceeds 38 degrees. The best option is paracetamol. Be careful, some medications in this group are contraindicated for children. You should refrain from taking aspirin and analgin, since such drugs have a wide range of negative side effects.

If the nature of the cough is dry, its manifestations are paroxysmal, then it is permissible to use drugs that have an effective effect on the “cough center”, for example, libexin, or the like.

However, do not forget that such drugs should be taken only in the absence of sputum, since in this case it is extremely difficult to separate.

At acute phase obstructive bronchitis, as a secondary therapeutic measure, is quite acceptable to carry out in a mild form. It is advisable that such a procedure be carried out by a qualified specialist. If such an opportunity is not available, then the massage can be performed by a person close to you, but he must have fundamental principles of this action.

When the disease enters a “quiet” phase, this form of treatment can be supplemented with vibration, acupressure. They are carried out either by a professional massage therapist or people close to you who have the appropriate skills.

Connecting antibiotics to ongoing therapy is permissible if there is a secondary one. Characteristic, clearly evidenced symptoms are expressed:

temperature over 39
constantly feeling lethargic
general weakness of the body is clearly expressed
constant headache
increased white blood cell count

saline solutions
preparations with sea water
products containing silver

For recovery full breathing through the nose, use vasoconstrictor sprays and drops. However, drugs of this group should not be used long time- there is a high probability of hypertrophy, atrophy of the nasal membrane.

Diagnostics

It will not be difficult for a highly qualified therapist to diagnose obstructive bronchitis. In many cases, it will be quite enough to talk about the symptoms that appear and listen to your breathing.

It happens that an x-ray image can show an increase in the pulmonary pattern, although this is not always observed. In addition, it is possible to accelerate the ESR in the general blood test. If the cause of the disease is, then the number of eosinophils in the blood increases.

Nutrition

During obstructive bronchitis, it is recommended to increase fluid intake to 2.5-3 liters. per day. Required condition successful treatment is strict compliance hypoallergenic diet. At the same time, I note that the nutritional diet should be varied, complete, and appropriate to the patient’s age.

The list of products that should be strictly prohibited is quite impressive:

products containing preservatives, dyes
sweets, soda
yoghurts, milk cheeses
sausage products
citrus

Everything fatty and fried is subject to significant restrictions. Red and orange fruits are prohibited; be careful with honey.

In conclusion, one more important point. How similar form Is bronchitis different from asthma?

With bronchitis, in most cases it is noted steady increase temperature, cough, shortness of breath, wheezing. All this is a specific reaction of the body to viruses, so fever occurs as a result of the fight against them.

Classification and development of the disease

In adults, acute primary obstructive bronchitis is quite rare. As a rule, the disease is chronic and has periodic exacerbations.

Acute obstructive bronchitis usually appears in childhood, and with an unfavorable course, this disease is the basis for the occurrence of chronic lung diseases in adulthood.

According to the current classification, chronic obstructive bronchitis is classified as a chronic obstructive pulmonary disease (COPD).

The disease develops throughout life, and clinical symptoms appear by age 40; if a person abuses smoking - earlier.

Inflammation of the small bronchi during obstructive bronchitis is irreversible, permanent, intensifies over time and serves as the basis for persistent obstruction of the tracheobronchial tree.

In case of exacerbation of the disease, reversible phenomena are added to the irreversible component - increased secretion mucus, spasm of the bronchial muscles.

Causes of the disease

The disease is formed as a result of the following factors:

Smoking – both active and passive;
Alcoholism;
Professional activity – inhalation of caustic, toxic fumes, soot, soot, dust, earth;
Advanced age;
Infections.

Manifestations of the disease

Before we talk about the symptoms and whether obstructive bronchitis can be cured, it should be noted that this disease has two categories:

Acute form;
Chronic obstructive bronchitis.

Acute bronchitis with obstruction is a consequence prolonged irritation lungs, which usually occurs after cured colds infectious diseases. This condition is quite difficult to treat, but recovery (usually complete) is sure to occur.

Treatment of chronic obstructive bronchitis is much more complicated, and the most that a patient can count on in many cases is accelerating the approach of remission and prolonging this condition.

The danger of chronic obstructive bronchitis lies not only in the complexity of treatment, but in the fact that it is almost impossible to cure completely. It is dangerous, first of all, due to the difficulty of diagnosis: on the first day the disease can manifest itself as a dry cough, on the second it literally ruptures the lungs with strong coughing and copious sputum production.

Usually, during the first day after the onset of the disease, coughing attacks are not too severe, sometimes they are dry, sometimes wet, and appear at night, closer to the morning or immediately in the morning. After the first day, the cough progresses; after waking up, it turns into an annoying, hysterical, dull, scratching throat.

Additional signs of chronic obstructive bronchitis are:

Difficulties with timely initiation of adequate treatment of chronic obstructive bronchitis in most cases are due to the traditional latency of the disease. Its symptoms can appear one at a time, or affect the patient all at once, or they may be completely absent.

Treatment of the disease

For this disease, treatment is prescribed by a pulmonologist or general practitioner, and only after collecting complaints, passing the appropriate tests and a full examination.

The following methods are used to treat bronchitis:

Inhalations;
Drug treatment;
Physiotherapeutic methods, breathing exercises.

Drug treatment includes the prescription of drugs that eliminate the cause of the disease and eliminate the symptoms of the disease.

An objective indicator of obstructive bronchitis is FEV - expiratory volume per second. In the chronic form of obstructive bronchitis, FEV decreases by 50 ml every year. This value is measured with a flowmeter.

Quantifying the rate of increase in bronchial obstruction allows the doctor to choose how to treat the disease based on its stage.

Irreversible changes increase over time and are eliminated with treatment:

Bronchospasm;
Inflammatory phenomena.

They treat pathology during exacerbations mainly in case of exacerbation bacterial infection take antibiotics; for viscous sputum, mucolytics (Acetylcysteine) are prescribed.

Inhalations

With exacerbation of bronchitis, the following is noted:

Changes in the nature of cough and sputum discharge;
Increased shortness of breath, change in inhalation depth, frequency breathing movements;
Tightness in the chest.

If these signs indicating an exacerbation appear, the doctor prescribes bronchodilators of all 3 groups in inhalation.

The main cause of obstruction in adults is bronchospasm. To eliminate it, they resort to long- and short-acting drugs.

For chronic bronchitis with obstruction, Troventol, Atrovent, Oxythorpium bromide are prescribed. Take 3-4 doses a day, the effect appears after half an hour, lasts up to 6 hours.

If the effectiveness of treatment is low, the following is additionally prescribed:

At acute conditions the attending physician may prescribe inhalations combination drugs, which combine the action of bronchodilators with the action of a hormonal agent.

Antibiotics

Antibiotics are taken during an exacerbation caused by infection. A symptom of exacerbation is an increase in temperature; in the case of chronic obstructive bronchitis, it can rise above 38 degrees.

First-line antibiotics – Azithromycin, Amoxicillin, Amoxicillin + clavulanic acid, Moxifloxacin, Levofloxacin.

If you are allergic to the drug Amoxicillin, Cefixime, Ceftriaxone, Ciprofloxacin are prescribed. They take antibiotic tablets, injections are prescribed when in serious condition patient and diseases of the digestive tract.

Therapy during remission

When absent acute symptoms, preventive measures are carried out.

Prevention includes:

Breathing exercises;
Strengthening immunity;
Rational nutrition;
Refusal of bad habits.

The key condition, the fulfillment of which allows at least to reduce the symptoms of the disease, is quitting smoking.

At the stage of remission, strengthening the body's defenses is possible through the use of traditional medicine. There are effective folk remedies for adults that improve the patient’s condition and eliminate shortness of breath and cough.

One of the forms of inflammation of the respiratory system - in adults - develops under the influence of allergens, polluted air or against the background of viral respiratory diseases.

At the first symptoms, this pathology requires complex, competent treatment under the supervision of a doctor.

Ignoring clinical manifestations diseases can lead to serious complications.

according to the international classification ICD 10 refers to COPD. The disease is a pathological inflammatory process characterized by blockage of the air ducts.

Diffuse inflammation of the bronchi causes a sharp spasm smooth muscles , a change in the quality and composition of sputum secreted by the organ and, as a result, a violation of lung ventilation.

As the disease progresses, mucosal tissue respiratory tract undergo structural changes, their walls thicken, the bronchial lumen narrows to a minimum size.

A person feels a lack of air up to attacks of suffocation. Untimely treatment of the disease leads to the development of persistent respiratory failure.

Classification

Depending on the duration and nature of the course, experts distinguish two forms of the disease:

Acute form. It is typical for children with their imperfect respiratory system, but is sometimes diagnosed in adults. The development of acute obstruction in adult patients is caused by a combination of several predisposing factors. For example, during an acute respiratory viral infection, the patient came into contact with an allergen, or he was in a contaminated environment for a long time. harmful substances indoors. The body's defenses are not able to cope with such a massive attack, and an inflammatory process begins in the bronchial tree.
Chronic form The disease is characterized by slow development. According to statistics, this form is diagnosed in men 3 times more often than in women. The slow course of the disease over ten years narrows the lumen of the bronchial canals. The disease passes through periods of exacerbations and remissions. At the same time, the symptoms during an exacerbation at the initial stage of the chronic form are smoothed out, and the patient takes them for manifestations of a mild cold. Progressive obstruction gradually leads to structural changes in bronchial tissue. The lumen of the airways narrows more and more, and with each period of exacerbation the patient’s condition worsens.

Chronic obstructive bronchitis leads to irreversible processes in the respiratory system. Through narrowing channels, air cannot penetrate into the small bronchi, causing prolapse of the membrane wall. Systematic lack of oxygen causes complications:

emphysema;
pulmonary hypertension;
diseases of the cardiovascular system;
increased blood pressure;
bronchiectasis.

IMPORTANT! After 40-50 years, patients suffering from a chronic form of the disease develop COPD.

Reasons for development

The risk group for the development of obstructive bronchitis is: patients prone to acute respiratory viral infections, smokers and allergy sufferers.

People who get colds often are different weak immunity, since their body is constantly under attack from viruses and bacteria.

Respiratory inflammation of the nasopharynx leads to the penetration of infection into the bronchi. When settling in the respiratory tract, viruses lead to inflammation of the mucous membrane and accumulation of mucus in the bronchi.

Causes no less harm to the mucous membrane of the respiratory tract tobacco smoke, including when passive smoking. It burns the epithelium, settles on the surface, gradually corroding the mucous membrane.

The rate of development of bronchial obstruction in smokers depends on individual characteristics body, but the outcome is inevitable. The gradual narrowing of the lumen of the bronchi leads to the development of respiratory failure.

The cause of the development of obstructive bronchitis in adults there may also be the following factors:

neoplasms in the respiratory tract;
systematic inhalation of polluted air;
hereditary predisposition;
age-related decrease in immunity;
penetration of fungal infection into the bronchi;
living in unsanitary conditions.

Symptoms in adults

Characteristic symptoms of obstructive bronchitis in adults:

chest pain;
unproductive cough;
shortness of breath with minimal physical activity.

Coughing attacks vary in severity and duration in the morning, since it accumulates in the bronchi overnight maximum quantity sputum.

In the chronic form of bronchitis, the cough subsides for a certain period of time, and then resumes with the same force.

Additional clinical signs diseases:

periodic increase in temperature;
general weakness, sweating;
headaches;
sleep disorder;
blue discoloration of the nasolabial triangle and fingers;
loss of appetite.

The intensity of symptoms increases as the disease progresses.

Diagnostics

Diagnosis of bronchial obstruction is based on the following research methods:

radiography chest, revealing an enhanced bronchial pattern with deformation of the roots of the lungs;
bhonchoscopy for collecting biomaterial and assessing the condition of the mucous membrane;
spirometry, determining the parameters of inhalation and exhalation;
tests blood and urine.

For differential diagnosis with tuberculosis, sputum is additionally examined for the presence of Koch's bacillus.

Features of treatment

The first step towards treating obstructive bronchitis is elimination of a factor irritating the respiratory system.

Smokers need to give up this bad habit.

If the cause of bronchitis is air pollution, it is worth changing urban conditions to living in an ecologically clean area.

It is not always possible to fulfill these conditions, but without them it is impossible to get rid of the disease.

IMPORTANT! Quitting smoking in combination with breathing exercises and physiotherapy allows you to cure obstructive bronchitis at the initial stage of development without the use of medications.

The goal of treating obstruction is to relieve bronchospasm, remove sputum and restore the mucous membrane of the airway.

The therapy process is long and is based on the use of a complex of medications, physiotherapeutic procedures and auxiliary folk remedies.

During treatment, the patient must follow the following recommendations:

bed rest;
daily wet cleaning of the room;
drinking plenty of fluids and following a special diet.

Treatment of the disease is carried out in outpatient setting. Hospitalization in a hospital is necessary if there is no effect self-treatment, as well as in the presence of respiratory and heart failure.

Treatment in a hospital is also necessary if bronchitis is accompanied by general intoxication of the body.

Medication

Medications – required element treatment.

The set of medications and the regimen for taking them is determined by the doctor after a diagnostic study.

The therapy complex consists of the following groups medicines:

Bronchodilators:"Ipratorium Bromide" (Atrovent). Medicines in aerosol form quickly stop attacks.
Beta 2 antagonists: “Salbutamol”, “Atrovent”, “Spiriva”, “Berodual”. Designed to relieve symptoms of the disease or as a preventive measure for spasms before active physical activity.
Mucolytics:"Acetylcysteine", "Carbocysteine", "Lazolvan", "Ambroxol".

If a bacterial infection is associated with bronchial inflammation, antibiotics are additionally used:

"Amoxicillin";
"Doxycycline";
"Cefazolin";
"Levofloxacin".

At viral etiology diseases are prescribed instead of antibiotics antiviral drugs:

"Isoprinosine";
"Groprinosin";
"Remantadine";
"Orvirem."

To relieve symptoms of shortness of breath and restore air access to the bronchi use bronchodilators in spray form:

If the disease is caused allergic reaction, the patient is prescribed latest generation antihistamines:

"Loratadine";
"Fenistil";
"Erius";
"Desal";
Zyrtec.

CAREFULLY! Pulmonologists warn that first-generation antiallergic drugs - Suprastin, Diphenhydramine, Diazolin, Tavegil, Diprazine - cannot be taken for obstructive bronchitis.

The active ingredients of these medications thicken mucus, which increases inflammation and causes the risk of developing pneumonia.

At advanced stages of the disease, it is impossible to relieve swelling of the airways with bronchodilators and non-hormonal antihistamines.

Therefore, doctors prescribe glucocorticosteroids:

Sprays:“Budesonide”, “Fluticasone”, “Ingacort”, “Beclazone”;
Tablets and capsules: “Prednisolone”, “Triamcinolone”;
Injection solutions: Dexamethasone, Prednisolone.

Physiotherapy

Physiotherapeutic procedures complement drug treatment, relieve bronchospasm, and stimulate sputum discharge. The number and set of procedures depends on the general condition of the patient’s body and the stage of the disease.

CAREFULLY! Medicinal herbs and honey can cause an allergic reaction and cause additional swelling of the bronchi. Therefore, prepared on their basis medicines It is necessary to test taking a small dose. If you are prone to allergies, it is safer to avoid using traditional methods.

Video: Cough, bronchitis, treatment

How to treat in adults and children: what even many doctors do not know. Dr. Evlakimenko, explains the methods of treating bronchitis. But in any case, consult your doctor.

Prevention

It is almost impossible to cure obstructive bronchitis in adults completely and without complications, so it is worth making every effort to prevent the disease.

balanced diet;
giving up bad habits;
maintaining hygiene in the home;
prevention colds hardening;
maintaining immunity.

Inflammatory process on last stage can completely block breathing, so treatment of the disease is under control qualified specialist should be started when the first symptoms appear.

Obstructive bronchitis is a diffuse inflammation of the bronchial mucosa of various etiologies, which is accompanied by obstruction of the airways due to bronchospasms, i.e. narrowing of the lumen of the bronchioles and the formation of a large amount of poorly discharged exudate.

With obstructive bronchitis, a large amount of poorly separated mucus is formed

Hyperemia of the internal covers of the bronchopulmonary tract impedes the movement of the cilia of the ciliated epithelium, causing metaplasia of ciliated cells. Dead epithelial cells are replaced by goblet cells that produce mucus, resulting in a sharp increase in the amount of sputum, the discharge of which is complicated by bronchospastic reactions on the part of the autonomic nervous system.

At the same time, the composition of bronchial mucus changes: an increase in the viscosity of the secretion is accompanied by a decrease in the concentration of nonspecific immune factors - interferon, lysozyme and lactoferrin. Thus, the products of inflammatory reactions become a breeding ground for representatives of pathogenic and opportunistic microflora. A progressive inflammatory process entails persistent impairment ventilation of the lungs and the development of respiratory failure.

Causes and risk factors

Obstructive bronchitis can have both infectious and non-infectious origin. Most often, the causative agents of the disease are viruses - rhinovirus and adenovirus, as well as herpes, influenza and parainfluenza type III viruses. Against the background of severe suppression of the immune system, a bacterial component may be added to the viral infection. Quite often, obstructive bronchitis develops against the background chronic focus infections in the nasopharynx.

Non-infectious obstructive bronchitis occurs as a result of constant irritation mucous membranes of the respiratory tract. Allergens can have an irritating effect - plant pollen, animal epithelium particles, house dust, bed mites, etc. New growths in the trachea and bronchi usually act as mechanical irritants. Also contribute to the occurrence of the disease traumatic injuries and burns of the mucous membranes of respiratory substances, as well as the damaging effect toxic substances, such as ammonia, ozone, chlorine, acid fumes, sulfur dioxide, suspended fine particles of copper, cadmium, silicon, etc.

Frequent inhalation of toxic substances and fine dust particles in hazardous production conditions is considered one of the main predisposing factors in the development of chronic obstructive bronchitis in representatives of a number of professions. The risk group includes miners, metallurgists, printing workers, railway workers, builders, plasterers, and enterprise employees chemical industry And agriculture, as well as residents of environmentally disadvantaged regions.

Smoking and alcohol abuse also contribute to the development of bronchial obstruction. In pulmonology, there is the concept of “smoker’s bronchitis,” which is applied to patients with a smoking history of more than 10 years who complain of shortness of breath and a severe hacking cough in the morning. Probability of occurrence of this disease with active and passive smoking it is approximately the same.

Living conditions, the environmental situation in the region and the organization of labor protection at enterprises are of great importance for the prevention of obstructive diseases of the respiratory system.

An inadequate approach to the treatment of acute obstructive bronchitis creates the preconditions for the disease to become chronic. Exacerbations of chronic bronchitis are provoked by a number of external and internal factors:

viral, bacterial and fungal infections;
exposure to allergens, dust and toxic chemicals;
heavy physical activity;
uncontrolled diabetes mellitus;
long-term use of certain medications.

Finally, a significant role in the pathogenesis of acute and chronic obstructive bronchitis is played by hereditary predisposition - congenital hyperreactivity of the mucous membranes and genetically determined enzyme deficiency, in particular the deficiency of certain antiproteases.

Forms

Based on the reversibility of bronchial obstruction, in pulmonological practice it is customary to distinguish between acute and chronic forms of obstructive bronchitis. Acute obstructive bronchitis is more common in young children; the chronic form is more typical for adult patients. With chronic bronchial obstruction, irreversible changes in bronchopulmonary tissue are observed, up to disruption of the ventilation-perfusion balance and the development of chronic obstructive pulmonary disease (COPD).

Stages

The initial stage of acute obstructive bronchitis manifests itself catarrh upper respiratory tract. Further, the clinical picture of the disease unfolds as the inflammatory process spreads to the peribronchial tissue, bronchioles and bronchi of small and medium caliber. The disease lasts from 7–10 days to 2–3 weeks.

Depending on efficiency therapeutic activities There are two possible scenarios for the development of events - relief of the inflammatory process or transition of the disease to a chronic form. In case of repetition of three or more episodes per year, a diagnosis of recurrent obstructive bronchitis is made; The chronic form is diagnosed when symptoms persist for two years.

The progressive development of chronic obstructive bronchitis is characterized by a gradual decrease in the volume of forced inspiration in one second (FIV-1), expressed as a percentage of the standard value.

Stage I: OVF-1 from 50% and above. The disease does not cause a significant deterioration in quality of life.
Stage II: CVF-1 decreases to 35–49%, and signs of respiratory failure appear. Systematic observation by a pulmonologist is indicated.
Stage III: OVF-1 is less than 34%. Pathological changes in bronchopulmonary tissue become irreversible, and severe decompensation of respiratory failure occurs. Improving the quality of life is facilitated by supportive treatment in an outpatient setting and day hospital. During exacerbations, hospitalization may be required. When signs of peribronchial fibrosis and emphysema appear, the transition of chronic obstructive bronchitis to COPD can be assumed.

Symptoms of obstructive bronchitis

Acute and chronic forms of bronchial obstruction manifest differently. Initial symptoms acute obstructive bronchitis coincide with the manifestations of catarrh of the upper respiratory tract:

dry hacking cough, worse at night;
difficult sputum separation;
feeling of tightness in the chest;
heavy breathing with whistling;
low-grade fever;
sweating

In some cases, the symptoms of obstructive bronchitis resemble ARVI. In addition to cough, headaches, dyspeptic disorders, myalgia and arthralgia, general depression, apathy and fatigue are observed.

With chronic bronchial obstruction, the cough does not stop even during remission. After prolonged attacks, accompanied by profuse sweating and a feeling of suffocation, the small quantity mucus. As the disease progresses against a background of persistent arterial hypertension, streaks of blood may appear in the sputum.

During exacerbations, the cough intensifies, and purulent exudate is found in the sputum. At the same time, shortness of breath is observed, which initially manifests itself during physical and emotional stress, and in severe and advanced cases, even at rest.

Those at risk for developing obstructive bronchitis include miners, metallurgists, printing workers, railway workers, builders, plasterers, workers in the chemical industry and agriculture, as well as residents of environmentally unfavorable regions.

With progressive obstructive bronchitis, the inhalation period lengthens, causing breathing to be accompanied by wheezing and whistling as you exhale. Not only the respiratory muscles take part in the expansion of the chest, but also the muscles of the back, neck, shoulders and abs; the swelling of the veins in the neck, the swelling of the wings of the nose at the moment of inhalation and the sinking of the compliant areas of the chest - the jugular fossa, intercostal spaces, supraclavicular and subclavian areas - are clearly noticeable.

As the body's compensatory resources are exhausted, signs of respiratory and heart failure appear - blueness of the nails and skin in the area of the nasolabial triangle, on the tip of the nose and on the earlobes. Some patients experience swelling of the lower extremities, increased heart rate and blood pressure, and the nail plates take on a specific “watch glass” shape. Patients are worried about loss of strength, increased fatigue and decreased performance; signs of intoxication are often present.

Features of the disease in children

In children of preschool and primary school age, the acute form of obstructive bronchitis predominates, which is easily curable with adequate and timely therapy. The treatment of obstructive bronchitis in children prone to colds and allergic reactions requires special attention, since there is a possibility of developing allergic bronchitis and bronchial asthma against the background of frequent relapses.

Diagnostics

The diagnosis of acute obstructive bronchitis is usually made on the basis of the clinical picture and the results of a physical examination. On auscultation, moist rales are heard in the lungs, the frequency and tone of which change when coughing. To accurately assess the degree of bronchial damage, identify concomitant diseases and to exclude local and disseminated lung lesions in tuberculosis, pneumonia and oncopathology, chest radiography may be required.

In chronic obstructive bronchitis appears hard breathing, accompanied by a whistling noise during forced exhalation, the mobility of the pulmonary edges decreases, and with percussion over the lungs a box sound is noted. Characteristic sign developed heart failure of pulmonary origin - a pronounced accent of the second sound of the pulmonary artery during auscultation. However, if chronic obstructive bronchitis is suspected, physical methods are not enough. Additionally, endoscopic and functional studies are prescribed to judge the depth and degree of reversibility of pathological processes:

spirometry – measurement of volumetric parameters of breathing with inhalation samples;
pneumotachometry - determination of the volume and speed of air flows during quiet and forced breathing;
peak flowmetry - definition peak speed forced exhalation;
bronchoscopy with biopsy sampling;
bronchography.

Plastic bag laboratory research includes:

general blood and urine tests;
immunological tests;
definition gas composition blood;
microbiological and bacteriological research sputum and lavage fluid.

In doubtful cases of exacerbation of chronic obstructive bronchitis should be differentiated from pneumonia, tuberculosis, bronchial asthma, bronchiectalic disease, pulmonary embolism and lung cancer.

Treatment of obstructive bronchitis

The treatment of acute obstructive bronchitis is based on a comprehensive therapeutic regimen using a wide range of medications selected on an individual basis. The acute form of the disease is usually provoked viral infection. For this reason, antibiotics are prescribed only for bacterial complications; the need for their use is determined by the attending physician. If the disease is caused by an allergic reaction, antihistamines are used.

Symptomatic treatment of obstructive bronchitis involves eliminating bronchospasm and facilitating mucus discharge. To eliminate bronchospasm, anticholinergics, beta-blockers and theophyllines are prescribed, administered parenterally, in inhalation form or using a nebulizer. Parallel use of mucolytics helps to thin the exudate and quickly evacuate sputum. For severe shortness of breath, inhaled bronchodilators are used.

For relaxation pectoral muscles and rapid restoration of respiratory function, percussion massage is recommended, as well as breathing exercises according to Buteyko or Strelnikova. Persistent therapeutic effect They give classes on the Frolov breathing simulator.

In order to prevent intoxication and dehydration, the patient needs plenty of warm drinks - alkaline mineral water, decoction of dried fruits, fruit juices, berry fruit drinks, weak brewed tea.

In the chronic form of the disease, symptomatic treatment predominates. Etiotropic therapy is used only during exacerbations. If there is no positive effect, corticosteroids may be prescribed. The patient's active participation in the therapeutic process is expected: it is necessary to reconsider the lifestyle, diet and diet, daily routine, and give up bad habits.

In the most severe cases, treatment of acute and chronic obstructive bronchitis is carried out in a hospital. Indications for hospitalization:

intractable bacterial complications;
rapidly increasing intoxication;
feverish conditions;
confusion;
acute respiratory and heart failure;
debilitating cough accompanied by vomiting;
the addition of pneumonia.

In pulmonology, there is the concept of “smoker’s bronchitis,” which is applied to patients with a smoking history of more than 10 years who complain of shortness of breath and a severe hacking cough in the morning.

Possible complications and consequences

In the absence of qualified medical care in acute obstructive bronchitis, there is a high probability of the addition of an asthmatic and bacterial component. In children prone to allergies, complications such as asthmatic bronchitis and bronchial asthma are more common; typical development for adults bacterial pneumonia and the transition of bronchial obstruction to a chronic form.

Most probable complications chronic obstructive bronchitis - emphysema, chronic obstructive pulmonary disease (COPD) and heart failure of pulmonary origin - the so-called. "pulmonary heart". Acute infectious processes, pulmonary embolism or spontaneous pneumothorax can cause acute respiratory failure, requiring immediate hospitalization sick. In some patients, frequent attacks of suffocation provoke panic attacks.

Forecast

If carried out in a timely manner adequate therapy The prognosis of acute bronchial obstruction is favorable, the disease responds well to treatment. With chronic obstructive bronchitis, the prognosis is more cautious, however, a properly selected treatment regimen can slow down the progression of the pathology and prevent complications. With a large number of concomitant diseases and in old age, the effectiveness of treatment decreases.

Prevention

Primary prevention of obstructive bronchitis comes down to a healthy lifestyle. It is advisable to give up smoking and drinking alcohol, eat rationally, devote time to hardening and regular walks in the fresh air. It is necessary to promptly and adequately treat acute respiratory infections, and for respiratory disorders of an allergic nature, undergo a course of desensitizing therapy.

Living conditions, the environmental situation in the region and the organization of labor protection at enterprises are of great importance for the prevention of obstructive diseases of the respiratory system. It is necessary to ventilate the premises every day and carry out wet cleaning at least two to three times a week. If the atmosphere is very polluted, you can use humidifiers. To prevent exacerbations of chronic obstructive bronchitis caused by the irritating effect of pesticides, a change of place of residence or profession may be required.

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Obstructive bronchitis is a diffuse inflammation of the bronchi of small and medium caliber, occurring with a sharp bronchial spasm and progressive impairment of pulmonary ventilation.

Next, we will look at what kind of disease this is, what the first signs are in adults, what is prescribed as a diagnosis to identify the obstructive form of bronchitis, as well as what methods of treatment and prevention are most effective.

What is obstructive bronchitis?

Obstructive bronchitis is inflammatory disease bronchial tree, which is characterized by the occurrence of an unproductive cough with the presence of sputum, shortness of breath and, in some cases, broncho-obstructive syndrome, which in its etiology is similar to bronchial asthma.

The word “obstruction” is translated from Latin as “obstacle,” which quite accurately reflects the essence pathological process: narrowing or obstruction of the airways makes it difficult for air to enter the lungs. And the term “” means inflammation of the small respiratory tubes - the bronchi. Obstructive bronchitis is a violation of the patency of the bronchi, which leads to the accumulation of mucus in them and difficulty breathing.

The disease is characterized by the fact that not only inflammation develops in the bronchi, but also damage to the mucous membrane occurs, which causes:

spasm of the bronchial walls;
tissue swelling;
accumulation of mucus in the bronchi.

Also, obstructive bronchitis in adults causes significant thickening of the walls of blood vessels, which leads to a narrowing of the bronchial lumen. In this case, the patient experiences difficulty breathing, difficulties with normal ventilation of the lungs, and a lack of rapid discharge of mucus from the lungs.

Forms of development

There are 2 forms of the disease:

Acute obstructive bronchitis

It is typical for children under four years of age, but sometimes occurs in adults (in which case it is called primary obstructive bronchitis). In order for broncho-obstructive syndrome to develop in adults, it is necessary to inflammatory process one or several predisposing factors have appeared in the respiratory tract. For example, obstructive syndrome can develop against the background of:

banal bronchitis or improper treatment diseases,
contact with an allergen,
being in polluted air conditions.

Chronic obstructive form

The chronic form of the disease is characterized by a long absence of symptoms of obstructive bronchitis. The disease occurs with periods of remission and exacerbations, most often caused by hypothermia and acute respiratory diseases. Clinical symptoms occur during periods of exacerbation of the disease and depend on its stage and the level of damage to the bronchial tree.

Chronic obstructive bronchitis, along with other diseases that occur with progressive obstruction of the respiratory tract (bronchial asthma), is usually classified as chronic obstructive pulmonary disease (COPD).

Reasons

Causes of obstructive bronchitis in adults:

Chronic forms of nasopharyngeal diseases.
Bad environment.
Smoking.
Harmful conditions in the workplace. A person with air inhales particles of substances that contribute to the development of the disease.
Heredity. If someone in the family suffers from obstructive bronchitis, then the pathology may develop in relatives.

Chronic obstructive bronchitis is a disease that most often begins to progress in people who smoke for a long time, work in production with various chemicals. substances and so on.

It is also worth highlighting internal factors, which contribute to the development of obstructive bronchitis in adults and children:

second blood group;
hereditary deficiency of immunoglobulin A;
deficiency of the enzyme alpha1-antitrypsin.

Stages

Symptoms of obstructive bronchitis in adults

Doctors say that obstructive bronchitis in adults can be suspected even at the initial stage. It is best to discuss the symptoms and treatment of the pathology with your doctor. After all, making a diagnosis on your own, let alone selecting therapy, can be very dangerous.

Of course, the main complaint of a patient with obstructive bronchitis is a strong, long, cutting and delivering discomfort cough. However, this does not mean that the victim develops bronchitis. Therefore, it is important for any person to know all the symptoms of the disease in order to catch it in time and visit a doctor.

It is worth noting that acute obstructive bronchitis mainly affects children under five years of age, while in adults symptoms appear only when acute course goes to . But sometimes primary acute obstructive bronchitis can begin to progress. As a rule, this happens in the background.

Symptoms:

increase in temperature;
dry cough. It usually develops in attacks, worsening in the morning or at night;
the respiratory rate per minute increases up to 18 times. For a child this figure will be slightly higher;
During exhalation, wheezing sounds are observed, which can be heard even at a distance.

Please note: if the patient, when symptoms of acute obstructive bronchitis appear, does not begin to carry out therapeutic measures, he may experience shortness of breath. This is due to the accumulation of a large amount of sputum in the bronchi. In addition to shortness of breath, severe course acute form of the disease in question, wheezing during breathing and whistling air can be noted.

If chronic obstructive bronchitis is observed in adults, the symptoms of the pathology are as follows:

constant cough, worse in the morning;
body temperature is mostly normal;
developing shortness of breath, which can only be treated at an early stage.

Over time, patients begin to complain of a daily annoying morning cough. For some, attacks recur in daytime. Their provocateurs are irritating odors, cold drinks, and frosty air.

Sometimes bronchospasms are accompanied by hemoptysis. Blood appears due to rupture of capillaries during strong straining.

In the later stages, the disease resembles asthma in many ways. Patients have difficulty inhaling. They exhale with wheezing and whistling. The duration of their exhalation increases.

The period of remission of the disease is characterized by slight sweating, moderate shortness of breath and the presence of a wet cough only in the morning, after waking up.

There is a special form of the disease - often recurrent obstructive bronchitis, which is characterized by almost constant periods of exacerbation with the presence of short remissions. This form of the disease most often leads to complications.

Diagnostics

Laboratory testing package includes:

general blood and urine tests;
biochemical blood test;
immunological tests;
determination of blood gas composition;
microbiological and bacteriological studies of sputum and lavage fluid.

In doubtful cases, exacerbation of chronic obstructive bronchitis should be differentiated from pneumonia, tuberculosis, bronchial asthma, bronchiectalic disease, pulmonary embolism, etc.

Instrumental examination:

Spirometry is an examination of the volume and velocity parameters of inhalation and exhalation using a device - a spirograph. The main criteria for assessing the severity of the disease are indicators such as:

Vital capacity – vital capacity of the lungs;
FEV1 – forced expiratory volume in 1 second;
Tiffno index – ratio of vital capacity to FEV1;
POS – peak volumetric velocity.

X-ray of the chest organs (chest organs), on which you can see dilated bronchi and a uniform increase in the airiness of the lung fields.

Treatment

When obstructive bronchitis is diagnosed, the identified symptoms and prescribed treatment can quickly put a person back on his feet, but it requires long and careful treatment, which will help prevent another attack, as well as restore bronchi with blockage from phlegm.

For acute obstructive bronchitis the following is prescribed:

rest, drinking plenty of fluids, air humidification, alkaline and medicinal inhalations.
Etiotropic is prescribed antiviral therapy(interferon, ribavirin, etc.).
For severe bronchial obstruction, antispasmodic (papaverine, drotaverine) and mucolytic (acetylcysteine, ambroxol) agents, bronchodilator inhalers (salbutamol, orciprenaline, fenoterol hydrobromide) are used.
To facilitate the discharge of sputum, percussion massage of the chest, vibration massage, massage of the back muscles, and breathing exercises are performed.
Antibacterial therapy is prescribed only when a secondary microbial infection occurs.

	Medicines
Mucolytics	Expectorants and mucolytics are effective, thinning the viscous secretion, which is more easily removed from the bronchi. Medicines in this group do not begin to treat the disease immediately, but after a day or two or even a week. Bromhexine; ACC (Acetylcysteine); Ambroxol (Lazolvan); Bronchicum.
Antibiotics	Amoxicillin; Amoxiclav (Amoxicillin plus clavulanic acid); Levofloxacin or Moxifloxacin; Azithromycin (Sumamed, Hemomycin).
Antihistamines	(Claritin); (Zyrtec); Desloratadine (Erius, Dezal); Dimetinden (Fenistil).
Hormonal drugs	aerosols: Budesonide, Fluticasone, Ingacort, Beclazon Eco; tablets: Prednisolone, Triamcinolone; injection solutions: Prednisol, Dexamethasone.

A patient needs emergency care if there is a danger of complete blockage of the airways - in this case, than longer person will hesitate, the sooner he will need help. What to do if the condition worsens?

The patient should consult a doctor who will prescribe treatment in a hospital, namely:

dropper;
taking mucolytics (Sinekod);
antibiotics (if the pathology is contagious, since bacteria and viruses are transmitted instantly).

How to treat chronic obstructive bronchitis in adults?

Therapeutic tactics for the chronic form of the disease differ significantly from those for acute bronchitis. Only a doctor can select a treatment regimen for a patient, taking into account the stage of the disease, the patient’s age and the presence of concomitant diseases.

The general principles of therapy for the disease in question are as follows:

It is necessary to eliminate the factor that led to the exacerbation of chronic obstructive bronchitis - to cure an acute respiratory viral infection, sore throat.
The doctor should prescribe medications with a bronchodilator effect, for example: Salbutamol, Eufillin, Atrovent and others.
To thin the mucus and ensure its rapid removal, the patient should take mucolytic drugs - for example, Bromhexine or Ambrobene.

To prevent exacerbations of the disease during periods of remission, patients are recommended to perform procedures aimed at strengthening the immune system:

hardening,
exercise,
proper nutrition,
periodic courses of vitamin therapy.

How to treat obstructive bronchitis if home treatment does not help? Most likely, the doctor will recommend hospital treatment. Besides inefficiency outpatient treatment, indications for inpatient treatment are as follows:

acute, sudden onset respiratory failure;
pneumonia;
development of heart failure;
the need for bronchoscopy.

Prevention

With obstructive bronchitis in adults, prevention is of great importance.

Primary prevention involves quitting smoking.
It is also recommended to change working conditions and place of residence to more favorable ones.
You need to eat right. The food should have enough vitamins and nutrients - this activates the body's defenses.
It's worth thinking about hardening.
Important fresh air– daily walks are required.

Secondary prevention measures include timely consultation with a doctor if the condition worsens, and undergoing examinations. Period wellness lasts longer if doctors' orders are strictly followed.

At the first signs of obstructive bronchitis, be sure to see a pulmonologist. Only a doctor can make an accurate diagnosis and prescribe the correct treatment. Be healthy and take care of yourself!