Bronchitis in adults: symptoms, causes, diagnosis and treatment
The content of the article:
- Disease types
- The reasons
-
Symptoms of bronchitis in adults
- The first sign is cough
- Sputum separation
- Dyspnea
- Increased body temperature
- Diagnostics
- Treatment of bronchitis in adults
- Video
Bronchitis is an inflammation of the bronchial tree without the involvement of lung tissue in the pathological process. The disease can be caused by exposure to various factors: from toxic substances to bacterial and viral agents.
Regardless of the origin, the characteristic features of the disease will be inflammatory changes in the bronchial mucosa and disruption of mucus production. In this case, the amount of bronchial secretion increases, its separation is accompanied by a cough.
Bronchitis - inflammation of the bronchi, while the lungs do not suffer
Disease types
Depending on the intensity of the pathological process:
- acute;
- chronic.
In the first case, the disease arises and resolves quickly, after the completion of the treatment course, the symptoms are completely stopped.
The diagnosis of "chronic bronchitis" is established if for at least two years, three or more months a year, the patient is worried about a cough accompanied by sputum production. It can develop as an independent disease or be a consequence of acute inflammation.
The chronic process can proceed in several variations: latent (latent), with rare or frequent exacerbations, or in the form of a continuously recurrent disease.
By the presence of a violation of bronchial patency:
- non-obstructive (simple);
- obstructive.
Bronchial obstruction is manifested by the obstruction of air passage through the bronchi and their branches. It develops when the phlegm becomes excessively viscous, stringy, and difficult to separate. The condition is aggravated by the inflammatory edema of the mucous membrane and the increased tone of the muscles of the bronchi, narrowing their lumen.
Against the background of obstructive changes, not only the efficiency of breathing is significantly reduced, but favorable conditions are created for the development of bacterial complications (the addition of a secondary infection).
The form with obstruction is more widespread in pediatric practice, among children under 3 years of age. This is due to the age-related narrowness of the bronchi, an inadequate cough reflex, when sputum is not evacuated efficiently enough, a large number of cells secreting mucus, and other factors.
By the form of the inflammatory process:
- catarrhal;
- mucopurulent;
- purulent.
Special, rare, forms are hemorrhagic and fibrinous.
Depending on the causative agent of the inflammatory process or provoking factor:
- viral;
- bacterial;
- allergic;
- toxic; etc.
According to the International Classification of Diseases 10 revision, the disease is classified into several nosological forms, each of which has a specific code according to ICD-10:
- acute bronchitis (J20.0) (including provoked by echovirus (J20.7), Coxsackie virus (J20.3), streptococcus (J20.2), Haemophilus influenzae (J20.1), mycoplasma (J20.0), virus parainfluenza (J20.4), etc., or other unspecified pathogen (J20.8));
- acute bronchiolitis (J21) with related subcategories;
- unspecified acute bronchitis (J40);
- chronic simple and catarrhal-purulent (J41) (including chronic simple (J41.0), mucopurulent (J41.1) and mixed (J41.8));
- unspecified chronic bronchitis (J42).
The reasons
The main cause of bronchial inflammation is a violation of local protection in the bronchial tree. At the same time, the cilia of the ciliated epithelium lining the bronchi from the inside are damaged and immobilized. Bacteria or viruses freely adhere to the mucous membrane, multiplying and damaging its cells. As a result, there is a change and deformation of the structure of the epithelium, which is reflected in dysfunction: increased mucus formation by special cells, changes in the properties of sputum, the development of inflammatory edema, etc.
Risk factors for the disease:
- long experience of smoking (the so-called smoker's bronchitis);
- living in environmentally unfavorable conditions with a polluted atmosphere or harsh climatic characteristics;
- exposure to occupational hazards;
- an acute infectious process of a viral or bacterial nature;
- hereditary, genetically determined, predisposition;
- alcohol abuse;
- long-term chronic diseases (including chronic kidney disease); and some others.
An explanation of the development of chronic obstructive inflammation of the bronchi from the standpoint of psychosomatics has become widespread. What it is? This is a branch of medicine that considers a special psychological background of a person as one of the leading risk factors for the development of a disease.
In the case of chronic inflammation of the bronchi, it is assumed that there is constant dissatisfaction, a kind of territorial conflict. Psychosomatic medicine explains the development of long-term bronchial obstruction with a subconscious message "I am uncomfortable, I am suffocating in the environment."
Symptoms of bronchitis in adults
The manifestations of the disease are quite stable in both acute and chronic course. The simple and obstructive forms of the disease will, however, have significant differences.
The first sign is cough
The cough is quite stable, it bothers the patient throughout the day. It is associated with the daily activity of the ciliated epithelium of the bronchi, which explains some of its strengthening in the morning hours and a weakening during nighttime sleep.
In the acute course, this symptom completely stops after the patient recovers. In chronic, it increases during periods of exacerbation, but it can persist in remission. In the initial stages of the disease, outside of exacerbations, cough appears sporadically, is unobtrusive, but as it progresses, it becomes intense, becomes almost permanent.
the main sign of bronchitis is a persistent cough
The obstructive form is characterized by a hacking painful cough, attacks can last up to an hour, regardless of the time of day. In the morning, after getting up, the patient cannot clear his throat for a long time, this requires some effort.
Coughing attacks are intensified or occur when exposed to cold air, low temperatures, the presence of strong odors in the surrounding air, traces of tobacco smoke, etc.
Sputum separation
Sputum can be both mucous and purulent. The average daily volume usually does not exceed 60-70 ml. In the acute course of the disease, the sputum completely disappears after the resolution of the inflammatory process. With a chronic disease, it continues to persist even during remission.
If inflammation is accompanied by the development of obstruction, the sputum is viscous, stringy, and difficult to separate from the walls of the bronchi. At the same time, its quantity is less, which is due not less to its formation, but the difficulty of excretion.
Dyspnea
It is characteristic of the obstructive process. Arises on exhalation, breathing becomes noisy, sibilant. A decrease in shortness of breath after sputum discharge and coughing up is characteristic.
It intensifies in the same way as a cough, under the influence of low temperatures, strong odors, high humidity and other provoking factors.
Increased body temperature
Either it is absent, or it rises to insignificant, subfebrile, numbers. Severe hyperthermia indicates bacterial or viral intoxication, but not the severity of the disease itself.
The signs of bronchitis in an adult and a child are almost the same, but the pathological process in children is more active.
Diagnostics
To confirm the diagnosis, it is necessary to conduct laboratory and instrumental studies, as well as to assess the patient's condition.
Laboratory research methods:
- General blood analysis. There are no characteristic changes on the basis of which bronchitis can be confirmed or refuted. In this case, general signs of inflammation are recorded, such as an acceleration of the erythrocyte sedimentation rate (ESR) and an increase in the number of leukocytes. With an allergic nature of inflammation, the number of eosinophils may increase.
- Blood chemistry. There are no specific changes. Standard markers of the inflammatory process are registered, by the number of which one can judge the severity and severity of the disease.
- Sputum analysis. Allows you to determine its nature (mucous, mucopurulent or purulent), the type of pathogen, sow on a nutrient medium in order to determine its sensitivity to certain groups of antibacterial drugs.
Instrumental methods:
- X-ray of the lungs (fluoroscopy or -graphic). Without pathology.
- X-ray examination of the bronchial tree. There may be a narrowing of the lumen or, conversely, the expansion of some bronchi, deformation of the contour of the mucous membrane, blockage of the branches with mucus.
- Endoscopic examination of the bronchial tree for visual assessment of the severity of inflammation.
- Study of FVD (function of external respiration). Changes of varying severity will be recorded in the presence of bronchial obstruction. In the simple form of the disease, the effectiveness of breathing usually does not suffer.
- Pulse oximetry (determination of the saturation of arterial blood with oxygen). A decrease in indicators is also recorded in the presence of significant bronchial obstruction; in a non-obstructive process, PO2 does not change.
It is not difficult to recognize signs of a chronic inflammatory process in the bronchi, the medical history in this case is indicative: a cough that bothers the patient for at least three months a year for two or more years; the presence of wheezing on auscultation, hard vesicular breathing, the absence of other diseases that may cause complaints, objectively (bronchoscopically) confirmed changes in the mucous membrane of the bronchial tree.
The correct diagnosis can only be made by a doctor, he must also prescribe treatment
In an acute illness or exacerbation of a chronic one, the patient complains of a sharp decrease in performance, unmotivated weakness, intense cough with phlegm, sweating during a night's sleep. Slight hyperthermia (up to 37.2-37.3 ° C), increased heart rate, laboratory nonspecific signs of the inflammatory process are possible. With the development of obstruction, shortness of breath appears and increases with difficult exhalation, wheezing, noisy breathing can be recorded.
Treatment of bronchitis in adults
Drug therapy for bronchitis is carried out in three main areas:
- etiotropic anti-inflammatory treatment;
- pathogenetic therapy, the purpose of which is to eliminate sputum stagnation, normalize its drainage;
- symptomatic treatment, which allows you to eliminate nonspecific manifestations of the disease (antipyretic drugs are prescribed at high temperatures, vasoconstrictor with nasal congestion, etc.).
Depending on the pathogen, antibacterial drugs (protected penicillins, cephalosporins of 2 or 3 generations or macrolides / azalides, fluoroquinolones), antiviral agents, immunomodulators are prescribed as an etiotropic agent.
It is strictly forbidden to take antibacterial agents for preventive purposes. Such drugs can only be prescribed by a doctor, determining the treatment regimen individually in each case.
Antiviral and immunomodulatory agents in the chronic course of the disease or with a high risk of an acute form can be taken according to the scheme for prophylaxis in the autumn-spring season.
Pathogenetic therapy is carried out using several groups of drugs:
- bronchodilators, expanding the lumen of the bronchi;
- mucolytics that thin phlegm;
- expectorants.
In severe bronchitis, glucocorticosteroid hormones may be prescribed additionally by inhalation.
The named groups of drugs are presented in all price segments: from inexpensive to expensive. Quite often, effective remedies have a low cost, which has nothing to do with the strength of their therapeutic effect.
How to treat bronchitis in adults, what combinations of drugs from the above groups to choose for a speedy recovery - the doctor will tell you. Self-medication, choosing and combining medications, can be not only unhelpful, but also dangerous.
Carrying out treatment at home, it must be remembered that drinking during the treatment with mucolytics and expectorant drugs should be 1.5-2 liters more than in the usual mode. Thanks to this, the maximum liquefaction of bronchial mucus and its speedy evacuation are achieved.
Video
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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".
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