Chronic bronchitis: treatment in adults and children, symptoms, causes
The content of the article:
- Varieties of the disease
- Causes of the disease
- Chronic bronchitis symptoms
- How to treat chronic bronchitis
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FAQ
- Is it possible to get rid of chronic bronchial inflammation forever?
- Do they take into the army with this disease?
- Video
Chronic bronchitis is a long-term inflammation of the bronchial tree without damage to the lung tissue, a characteristic manifestation of which is a cough with phlegm. According to the criteria of the World Health Organization, in order to establish an appropriate diagnosis, a cough must bother a patient for at least 2 years in a row, at least 3 months a year.
The chronic process is characterized by the presence of certain phases of the course of the disease: periods of remission, when the patient's symptoms do not bother, and periods of exacerbations with a detailed clinical picture. The medical history of this disease can be very diverse, since the course of bronchitis is individual for each patient.
The main symptom of bronchitis is a cough with sputum production
This is due to the significant variability of external and internal factors influencing its development:
- the widest range of pathogens and provoking agents (from viruses and bacteria to smoking and occupational hazards);
- different intensity of the inflammatory process;
- the frequency of exacerbations (from episodic to continuously recurrent);
- the nature of the manifestations and the severity of the stages.
Varieties of the disease
The disease in a chronic form can develop as a complication of an already existing inflammation of the respiratory organs, and independently, without a previous disease (primary chronic bronchitis).
Depending on the presence or absence of difficulties in bronchial patency:
- obstructive;
- non-obstructive.
In the first case, against the background of the inflammatory process, the characteristics of sputum change: it becomes thick and difficult to separate, its amount increases significantly. In combination with the deterioration of the ciliated epithelium, which sweeps mucus from the respiratory tract, edema of the mucous membrane and increased tone of smooth muscles contribute to the deterioration of bronchial permeability.
The phlegm clogs up the smallest branches of the bronchial tree, thereby reducing the efficiency of breathing and complicating the course of the disease. Congestion often provokes secondary complications, for example, the addition of a bacterial infection.
In a non-obstructive process, sputum does not have such characteristics and is easily removed from the lumen of the bronchi. There are no congestion and bronchospasm. This form of the disease is much easier tolerated by patients and does not provoke the development of respiratory failure.
Obstructive inflammation is more common in young children, which is due to a number of anatomical features: the narrowness of the bronchi, the ability of the mucous membrane to pronounced edema, failure of innervation, etc.
By the nature of the sputum, the disease is also divided into several forms:
- catarrhal bronchitis;
- purulent;
- mucopurulent;
- hemorrhagic;
- fibrinous.
The last two forms are rare.
According to the International Classification of Diseases 10 revision (ICD-10), the code of chronic bronchitis differs depending on the nature of the inflammation:
- J41 Simple and mucopurulent.
- J42 Unspecified.
- J44 Other chronic obstructive pulmonary disease (this includes asthmatic, emphysematous and obstructive bronchitis).
If bronchitis cannot be identified as acute or chronic, it is assigned a J40 code.
Causes of the disease
The disease develops with the failure of local immune defense. At the same time, pathogenic bacteria or viruses are fixed on the surface of the ciliated epithelium (bronchial mucosa).
Penetrating into the cells, they damage the inner lining of the bronchi and disrupt the mechanisms of local regulation:
- The cells that form the bronchial secretion begin to produce more of it. The mucus becomes thick, loses its protective properties - this is how phlegm appears.
- The mucous membrane, colonized by microorganisms, becomes edematous, full-blooded, loose. At the same time, the lumen of the inflamed bronchi narrows, which explains the violation of sputum excretion.
- Excessive mucus can irritate the cough receptors.
- If bronchitis is complicated by an increase in the tone of the smooth muscles of the bronchi and blockage of their small branches with difficult to separate sputum, bronchial obstruction develops.
Damage to local regulatory mechanisms and weakening of protection in the bronchial tree can occur under the influence of many provoking factors.
There is a chronic bronchitis of a smoker, most of the experienced smokers suffer from it
Main risk factors:
- Accommodation in a region with adverse weather conditions. The combination of low temperatures with high humidity levels is considered particularly aggressive.
- Negative ecological situation. There is a statistically significant high incidence of chronic bronchitis among residents of settlements located near large industrial facilities, mining and processing, metallurgical plants, etc. The damaging effect on the mucous membrane is exerted by microparticles of aggressive substances in the atmosphere.
- Work in hazardous production. The most susceptible to the disease are people who are systematically in contact with petroleum products, paints and varnishes, agricultural pesticides and chemicals, aromatic compounds. Also, work in hot workshops affects the bronchial mucosa extremely aggressively.
- Long-term smoking experience. The developing "smoker's bronchitis" is explained by toxic damage to the ciliated epithelium by products of tobacco smoke.
- Alcohol abuse. In this case, the bronchial mucosa is damaged by the products of ethanol metabolism, which are removed from the body by the respiratory system.
- Some chronic diseases of other systems and organs. For example, in renal insufficiency, the ciliated epithelium is damaged by toxins formed due to the failure of the excretory function.
- Genetically determined weakness of the bronchopulmonary zone (hereditary predisposition).
Chronic bronchitis symptoms
In fact, the clinic of the disease has two main symptoms: cough and sputum production.
The first symptom can be of varying severity: both a very strong cough, paroxysmal and painful, and a slight coughing. The patient is worried usually in the early morning hours after waking up. It is accompanied by the release of sputum.
With a non-obstructive process, the cough is easily tolerated by the patient. It appears during an exacerbation and does not bother during the period of remission. The obstructive form of the disease is characterized, on the contrary, by a hacking, painful paroxysmal cough. Usually it is accompanied by wheezing, hard noisy breathing, difficulty breathing out. After coughing up the sputum, the coughing fits pass.
Sputum can be of a different nature: from the usual mucous membrane in an uncomplicated process to purulent in the case of a bacterial infection or fibrinous one, which forms dense "waxy" structures. With bronchial obstruction, viscous, vitreous sputum leaves poorly, in small portions, sometimes it takes a patient from half an hour to an hour to cough up it.
Simple bronchitis in chronic form in the remission phase occurs without fever and any additional symptoms. With an exacerbation, slight hyperthermia (up to subfebrile numbers), a feeling of congestion in the chest is possible. Often at this time, patients complain of unmotivated weakness, a feeling of weakness, decreased performance, drowsiness, and headache.
Shortness of breath is an additional sign of obstructive disease. It intensifies during exacerbations, with intense physical activity or exposure to irritating substances (for example, tobacco smoke or saturated aromas), under adverse weather conditions (low temperatures, damp, humid air). With an old process, respiratory failure progressively increases: shortness of breath increases, appears not only during exertion, but also at rest.
The frequency of symptoms of any form of bronchitis depends on the intensity of its course: the more often the exacerbation, the more pronounced the clinic.
How to treat chronic bronchitis
In the official evidence-based medicine, several groups of drugs have been identified that are necessarily used in the treatment of chronic bronchial pathology. Drug therapy is carried out during exacerbations:
- Anti-inflammatory treatment to address the underlying cause of a worsening condition. Depends on the pathogen: antibiotic therapy, antiviral drugs and immunostimulants.
- Pathogenetic therapy aimed at restoring normal sputum drainage in the bronchial tree. It is carried out using mucolytics (drugs that thin bronchial mucus), bronchodilators (expanding the lumen of the bronchi) and expectorant drugs.
- Symptomatic treatment, which allows you to eliminate nonspecific manifestations of the disease (antipyretic drugs at high temperatures, vasoconstrictor with nasal congestion, etc.).
The most effective antibacterial drugs for relieving an exacerbation of a chronic process are semisynthetic penicillins, second and third generation cephalosporins, macrolides, fluoroquinolones.
Many patients begin taking these drugs at home on their own, without first consulting a specialist. Why is this approach dangerous? The result of an incorrect choice of an antibacterial drug or a treatment regimen may be the resistance (resistance) of microbes. In this case, during subsequent courses of therapy, the drug simply will not work, its effectiveness will be zero.
The attending physician should diagnose and prescribe treatment, self-medication is unacceptable
Antiviral agents and immunomodulatory drugs, in addition to treatment, can be used to prevent exacerbations in the autumn-spring season. Antibiotics are not used prophylactically.
In severe bronchitis, inhaled glucocorticosteroid hormones can be additionally prescribed. They have powerful anti-inflammatory effects, but they also have many contraindications and limitations. They can only be used after being prescribed by a doctor.
Various folk remedies are widely used in the treatment of chronic bronchitis in adults and children: decoctions of linden flowers, thyme, licorice root, aloe tincture, radish or beet juice. Such remedies are good as adjunctive therapy, but not the main one.
FAQ
Is it possible to get rid of chronic bronchial inflammation forever?
If the changes in the bronchial tree have not become irreversible and the patient is able to eliminate all risk factors that aggravate the course of the disease, there are high chances of a successful cure.
Do they take into the army with this disease?
Temporary exemption from service can be granted in the presence of severe bronchitis with severe symptoms of respiratory failure.
Video
We offer for viewing a video on the topic of the article.
Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
