Most smokers who stick with this terrible habit for years face health problems.

Most often it is expressed in a cough. At first, a person only coughs slightly, then the disease progresses, the symptoms intensify, and now, the patient can no longer take a deep breath so as not to provoke an attack - chronic smoker bronchitis develops.

What is this disease? What can lead to? How to deal with smoker's bronchitis? This article will be devoted to the answers to these and other questions.

From the article you will learn

Chronic bronchitis of a smoker- this, as a result of which the inflammatory process of the bronchi begins. This disease is known to many smokers, among whom you may be.

According to the current version of the International Classification of Diseases (ICD-10), chronic bronchitis is coded, depending on the degree of bronchial damage, with symbols J40, J41 and J42. The worst stage of chronic smoker bronchitis is COPD ( J44, chronic obstructive pulmonary disease), the cause of which, according to statistics, in 80% of cases is smoking.

What happens in the body? Under the influence of tobacco smoke toxins epithelial cilia are blocked(moving parts of the bronchi, necessary for the removal of harmful substances). As a result poisons stay inside, which leads to inflammation of the tubular ducts of the bronchi, increased formation of mucus, and, as a result, a decrease in the supply of oxygen to the blood.

Coughing is an attempt by the body to get rid of phlegm, toxins and other "smoker's pleasures".

He cannot cope on his own, toxins continue to accumulate, the disease progresses.

The first step to recovery should be to give up this addiction..

If you do not stop the flow of toxins, resins and soot into the body, healing attempts will be in vain!

Symptoms of chronic bronchitis

The disease develops gradually, at the initial stages without manifesting itself. Over time, a slight cough occurs, especially in the morning, then it intensifies - attacks occur throughout the day.

Chronic is the form of bronchitis, which can not get rid of for 2 years or more. At the same time, a person coughs for at least 3 months a year in total.

Often, folk remedies include recommendations such as bed rest, drinking plenty of fluids and breathing exercises. Let's talk about the latter in more detail.

Breathing exercises at home

This procedure is prescribed not instead of drug treatment, but along with it. Many doctors consider breathing exercises to be the second most important element of recovery after quitting smoking.

Any physical activity (walking, climbing stairs, morning exercises, etc.) can be considered an element of breathing exercises, but there are also special techniques:

1. Diaphragmatic breathing. Belly breathing training - in this case, all respiratory organs are involved and the supply of oxygen to the blood increases.
2. With a deep breath. It is necessary to exhale as deeply as possible. You can accompany him with a score, help with your hands (by pressing on the chest).
3. Rapid inhalation - passive exhalation. A sharp short breath helps to provide the body with oxygen, uncontrolled exhalation - to activate the work of the respiratory system. This is the so-called. "Strelnikova's method", which is used together with physical exercises.

There are other types of gymnastics. It is recommended to do it 15 minutes 3-5 times a day.

RCHD (Republican Center for Health Development of the Ministry of Health of the Republic of Kazakhstan)
Version: Clinical Protocols of the Ministry of Health of the Republic of Kazakhstan - 2013

Acute bronchitis due to other specified agents (J20.8)

Pulmonology

general information

Short description

Approved
minutes of the meeting of the Expert Commission
on Health Development of the Ministry of Health of the Republic of Kazakhstan
No. 18 dated 19.09.2013

Classification

Clinical classification of acute bronchitis
The epidemiology of acute bronchitis is related to the epidemiology of influenza and other respiratory viral diseases. Most often occurs in the autumn-winter period. The main etiological factor of acute bronchitis (80-95%) is a viral infection, which is confirmed by many studies. The most common viral agents are influenza A and B, parainfluenza, rhinosincitial virus, less frequent are coronoviruses, adenoviruses and rhinoviruses. Among bacterial pathogens, a certain role in the etiology of acute bronchitis is assigned to such pathogens as mycoplasma, chlamydia, pneumococcus, Haemophilus influenzae. Special studies on the epidemiology of acute bronchitis in Kazakhstan have not been conducted. According to international data, acute bronchitis is the fifth most common acute disease that debuts with a cough.
Acute bronchitis is classified into non-obstructive and obstructive. In addition, a protracted course of acute bronchitis is distinguished, when the clinic persists for up to 4-6 weeks.

Diagnostics

List of basic and additional diagnostic measures
List of main diagnostic measures:
General blood test according to indications:
cough for more than 3 weeks
age over 75 years

febrile fever over 38.0 C
For the purpose of differential diagnosis

Fluorography according to indications:
cough for more than 3 weeks
age over 75 years
Suspicion of pneumonia
for the purpose of differential diagnosis.

List of additional diagnostic measures:
general sputum analysis (if available)
Sputum microscopy with Gram stain
bacteriological examination of sputum
Sputum microscopy for BC
spirography
x-ray of the chest
electrocardiography
Consultation with a pulmonologist (if necessary, differential diagnosis and treatment failure)

Diagnostic criteria
Complaints and anamnesis:
History risk factors may be:
contact with a patient with a viral respiratory infection,
seasonality (winter-autumn period),
hypothermia,
Presence of bad habits (smoking, drinking alcohol),
· influence of physical and chemical factors (inhalation of vapors of sulfur, hydrogen sulfide, chlorine, bromine and ammonia).
Main complaints:
On a cough, first dry, then with sputum, painful, hacking (feeling of "scratching" behind the sternum and between the shoulder blades), which disappears when sputum appears.
general weakness, malaise,
chills,
pain in the muscles and in the back.

Physical examination:
Body temperature subfebrile or normal
On auscultation - hard breathing, sometimes scattered dry rales.

Laboratory research
In the general analysis of blood, a slight leukocytosis, an acceleration of ESR is possible.

Instrumental Research
In a typical course of acute bronchitis, the appointment of radiation diagnostic methods is not recommended. Fluorography or chest X-ray is indicated for prolonged cough (more than 3 weeks), physical detection of signs of pulmonary infiltrate (local shortening of percussion sound, the appearance of moist rales), patients older than 75 years, t.to. they often have pneumonia with blurred clinical signs.

Indications for expert advice:
pulmonologist (if necessary, differential diagnosis and ineffectiveness of therapy)
Otorhinolaryngologist (to rule out pathology of the upper respiratory tract (URT))
gastroenterologist (to exclude gastroesophageal reflux in patients with gastroduodenal pathology).

Differential Diagnosis

Differential Diagnosis:
Differential diagnosis of acute bronchitis is carried out according to the symptom "Cough".

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Treatment

Treatment goals:
relief of severity and reduction in the duration of cough;
restoration of working capacity;
elimination of symptoms of intoxication, improvement of well-being, normalization of body temperature;
recovery and prevention of complications.

Treatment tactics:
Non-drug treatment
Treatment for uncomplicated acute bronchitis is usually done at home;
To reduce the intoxication syndrome and facilitate sputum secretion - maintaining adequate hydration (drinking plenty of water, up to 2-3 liters of fruit drinks per day);
smoking cessation;
Elimination of exposure to the patient of environmental factors that cause coughing (smoke, dust, pungent odors, cold air).

Medical treatment:
Since the infectious agent in the vast majority of cases is of a viral nature, it is not recommended to prescribe antibiotics routinely. The green color of sputum in the absence of other signs of infection of the lower respiratory tract indicated above is not a reason for prescribing antibacterial drugs.
Empiric antiviral therapy in patients with acute bronchitis is usually not carried out. Only in the first 48 hours from the onset of symptoms of the disease, in an unfavorable epidemiological situation, it is possible to use antiviral drugs (ingavirin, umifenovir) and neuraminidase inhibitors (zanamivir, oseltamivir) (level C).
Antibiotics are indicated for a limited group of patients, but there are no clear data on the allocation of this group. Obviously, this category includes patients with no effect and symptoms of intoxication persisting for more than 6-7 days, as well as persons over 65 years of age with concomitant nosologies.
The choice of antibiotic is based on activity against the most common bacterial pathogens of acute bronchitis (pneumococcus, Haemophilus influenzae, mycoplasma, chlamydia). The drugs of choice are aminopenicillins (amoxicillin), including protected ones (amoxicillin / clavulanate, amoxicillin / sulbactam) or macrolides (spiramycin, azithromycin, clarithromycin, josamycin), an alternative (if it is impossible to prescribe the first ones) are 2-3 generation cephalosporins per os. The approximate average duration of antibiotic therapy is 5-7 days.

Principles of pathogenetic treatment of acute bronchitis:
normalization of the quantity and rheological properties of the tracheobronchial secret (viscosity, elasticity, fluidity);
anti-inflammatory therapy;
elimination of hacking unproductive cough;
Normalization of the tone of the smooth muscles of the bronchi.

If acute bronchitis is caused by the inhalation of a known toxic gas, the existence of its antidotes and the possibility of their use should be investigated. In acute bronchitis caused by acid vapors, inhalations of a 5% solution of sodium bicarbonate are indicated; if after inhalation of alkaline vapors, then inhalation of vapors of a 5% solution of ascorbic acid is indicated.
In the presence of viscous sputum, mucoactive drugs (ambroxol, bizolvon, acetylcysteine, carbocysteine, erdosteine) are indicated; it is possible to prescribe reflex action drugs, expectorants (usually expectorant herbs) inside.
Bronchodilators are indicated for patients with symptoms of bronchial obstruction and airway hyperreactivity. Short-acting beta-2-agonists (salbutamol, fenoterol) and anticholinergics (ipratropium bromide), as well as combination drugs (fenoterol + ipratropium bromide) in inhalation form (including through a nebulizer) have the best effect.
It is possible to use combined preparations containing expectorants, mucolytics, bronchodilators.
If a prolonged cough persists and signs of airway hyperreactivity appear, it is possible to use anti-inflammatory nonsteroidal drugs (fenspiride), if they are ineffective, inhaled glucocorticosteroid drugs (budesonide, beclomethasone, fluticasone, ciclesonide), including through a nebulizer (budesonide suspension). The use of fixed combination inhalation drugs (budesonide/formoterol or fluticasone/salmeterol) is acceptable.
In the absence of sputum against the background of ongoing therapy, an obsessive, dry hacking cough, antitussive drugs (cough suppressants) of peripheral and central action are used: prenoxdiazine hydrochloride, cloperastine, glaucine, butamirate, oxeladin.

Other types of treatment: No

Surgical intervention: No

Further management:
After stopping the general symptoms, further observation and clinical examination is not needed.

Indicators of treatment efficacy and safety of diagnostic and treatment methods:
elimination of clinical manifestations within 3 weeks and return to work.

Hospitalization

Indications for hospitalization:
Acute uncomplicated bronchitis is treated on an outpatient basis.
Indications for hospitalization (emergency) are the appearance of complications:
signs of the spread of a bacterial infection in the respiratory sections of the lungs with the development of pneumonia;
signs of respiratory failure
lack of effect from therapy, the need for differential diagnosis;
Exacerbation of serious concomitant diseases with signs of functional insufficiency (cardiovascular, renal pathology, etc.).

Prevention

Preventive actions:
In order to prevent acute bronchitis, possible risk factors for acute bronchitis should be eliminated (hypothermia, dustiness and gas contamination of working premises, smoking, chronic infection of the upper respiratory tract). Influenza vaccination is recommended, especially for those at increased risk: pregnant women, patients over 65 years of age with concomitant diseases.

Information

Sources and literature

1. Minutes of the meetings of the Expert Commission on Health Development of the Ministry of Health of the Republic of Kazakhstan, 2013
   1. References 1) Wenzel R.P., Flower A.A. Acute bronchitis. //N. English J. Med. - 2006; 355(20): 2125-2130. 2) Braman S.S. Chronic cough due to bronchitis: ACCP evidence-based clinical practice guidelines. //Chest. – 2006; 129:95-103. 3) Irwin R.S. et al. Diagnosis and management of cough. ACCP evidence-based clinical practice guidelines. executive summary. Chest 2006; 129:1S–23S. 4) Ross A.H. Diagnosis and treatment of acute bronchitis. // Am. fam. Physician. - 2010; 82(11): 1345-1350. 5) Worrall G. Acute bronchitis. //Can. fam. Physician. - 2008; 54:238-239. 6) Clinical Microbiology and Infection. Guidelines for the management of adult lower respiratory tract infections. ERS Task Force. // Infect.Dis. – 2011; 17(6): 1-24, E1-E59. 7) Uteshev D.B. Management of patients with acute bronchitis in outpatient practice. // Russian medical journal. – 2010; 18(2): 60–64. 8) Smucny J., Flynn C., Becker L., Glazer R. Beta-2-agonists for acute bronchitis. //Cochrane Database Syst. Rev. – 2004; 1: CD001726. 9) Smith S.M., Fahey T., Smucny J., Becker L.A. Antibiotics for acute bronchitis. // Cochrane Database Syst. Rev. – 2010; 4: CD000245. 10) Sinopalnikov A.I. Community-acquired respiratory tract infections // Health of Ukraine - 2008. - No. 21. - With. 37–38. 11) Johnson AL, Hampson DF, Hampson NB. Sputum color: potential implications for clinical practice. RespirCare. 2008.vol.53. - No. 4. - pp. 450–454. 12) Ladd E. The use of antibiotics for viral upper respiratory tract infections: an analysis of nurse practitioner and physician prescribing practices in ambulatory care, 1997–2001 // J Am Acad Nurse Pract. - 2005. - vol.17. - No. 10. - pp. 416–424. 13) Rutschmann OT, Domino ME. Antibiotics for upper respiratory tract infections in ambulatory practice in the United States, 1997–1999: does physician specialty matter? // J Am Board FamPract. - 2004. - vol.17. – No. 3. – pp.196–200.

Information

List of protocol developers with qualification data:
1) Kozlova I.Yu. - Doctor of Medical Sciences, Head of the Department of Pulmonology and Phthisiology JSC "Astana Medical University"
2) Kalieva M.M. - Candidate of Medical Sciences, Associate Professor of the Department of Clinical Pharmacology, Physical Therapy and Physiotherapy of KazNMU named after Asfendiyarov S.D.
3) Kunanbai K. - Doctor of Medical Sciences, Professor of the Department of Clinical Pharmacology, Physical Therapy and Physiotherapy of KazNMU named after Asfendiyarov S.D.
4) Mubarkshinova D.E. - assistant of the department of clinical pharmacology, exercise therapy and physiotherapy of KazNMU named after Asfendiyarov S.D.

Indication of no conflict of interest: The developers of this protocol confirm that there is no conflict of interest associated with the preferred attitude to one or another group of pharmaceuticals, methods of examination or treatment of patients with acute bronchitis.

Reviewers:
Tokesheva B.Sh. - Professor of the Department of Therapy of KazNMU, MD

Conditions for the revision of the protocol - after 3 years from the date of publication of the protocol or when new evidence appears.

Attached files

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Medical workers are well acquainted with the ICD reference book, that is, the International Classification of Diseases. The document contains complete information about all diseases, their forms, diagnostic features, specific recommendations regarding treatment and prevention.

In 1999, the 10th revision of the handbook data was carried out, and the next one is planned for 2015.

ICD-10 consists of 3 volumes, all information is divided into 21 classes and 1-,2-,3- and 4-digit headings. A certain place in this classification is occupied by chronic bronchitis, which manifests itself in various forms and is accompanied by complications.

According to the ICD, chronic bronchitis differs from acute bronchitis in that the inflammatory process in the bronchial tree is progressive in nature and covers significant areas of the organ. Typically, such irreversible damage occurs after prolonged exposure to adverse factors (smoking, poor environment, infections).

The disease is characterized by a restructuring of the secretory apparatus of the bronchi, which leads to an increase in the volume and density of sputum, a decrease in the protective and cleansing functions of the organ. The patient suffers from a cough that may appear intermittently or be permanent. In accordance with the ICD criteria, the diagnosis of "chronic bronchitis" is made when an excessive productive (wet) cough lasts at least 3 months per year over the past 2 years.

Classification of the chronic form

In the CIS countries, there are two methods of classification, which are based on the absence or presence of bronchial obstruction (the gap between the walls of the bronchi narrows, which leads to a violation of their patency), in addition, the nature of the inflammatory process is taken into account.

In accordance with the data obtained, 4 main forms of the disease are distinguished:

• non-obstructive;
• obstructive;
• purulent;
• purulent-obstructive.

Obstructive bronchitis has a characteristic feature - the appearance of shortness of breath, while the inflammatory process affects large and small bronchi. And for the non-obstructive form, inflammation is localized only in large sections of the bronchi. Purulent chronic bronchitis is accompanied by general intoxication of the body, the presence of purulent sputum. Often, chronic forms turn into more severe diseases (asthma, cor pulmonale, emphysema, etc.).

Both obstructive and non-obstructive bronchitis in chronic form has 2 phases:

• exacerbation;
• remission (easing the symptoms of the disease for a while).

The duration of these periods depends on the patient's lifestyle, timely prevention, and the absence of bad habits.

Chronic lung diseases according to ICD-10

The ICD-10 reference book uses the term chronic obstructive pulmonary disease. The systematization of knowledge on this disease is based on centuries of medical experience and research by modern scientists. According to the document, chronic bronchitis is included under J40-J47.

Each individual form of the disease corresponds to a specific code:

• catarrhal bronchitis with tracheitis is designated as J40. However, this category does not include forms of the disease caused by exposure to chemicals, as well as asthmatic and allergic;
• code J41 is a simple chronic form. It is accompanied by a wet cough with purulent or mucopurulent sputum. Large sections of the bronchi are affected;
• tracheobronchitis, tracheitis, bronchitis, that is, diseases not designated as chronic, are labeled J42;
• Primary pulmonary emphysema is manifested by shortness of breath, not accompanied by cough. This is one of the common complications of COPD in the ICD-10 is listed under the number J43;
• code J44 assigned to other COPDs. Chronic obstructive bronchitis has a pronounced symptom - wheezing, and the patient's condition is sharply aggravated;
• Emphysema has the code J45;
• J46 assigns asthmatic status to the patient;
• J47 - bronchiectasis, which is characterized by an irreversible change in the bronchi with a suppurative process in them.

The ICD Handbook is a guide for the doctor in prescribing adequate therapy. The main goal of therapeutic measures is to prevent further deterioration of the patient's condition, lengthen remission periods and reduce the rate of disease progression. Obstructive and non-obstructive bronchitis require different therapy, but great attention is paid to preventive measures.

When choosing drugs, the attending physician should pay attention to the patient's condition, his age, gender, social living conditions and the causes of the disease.

Many doctors believe that chronic obstructive bronchitis is an irreversible process. But you can live with the disease if you eat right, prevent infectious diseases and harden your body. Such conclusions can be drawn from the analysis of statistical data, which are given in the ICD-10 reference book.

What place among lung diseases does chronic bronchitis take according to ICD 10, what are the features of its course

Chronic bronchitis is assigned to a person if the inflammation of the bronchial mucosa does not go away for a long time. Chronic bronchitis according to ICD 10 is one of the diseases of the lungs, has some differences in the course, which are codes - J40-J42, J44.

These digital designations are designed for specialists, so that the doctor, at first glance at the code, can understand what disease he is dealing with.

Features of the disease

The main manifestation of chronic inflammation of the bronchi is cough.

Chronic bronchitis is diagnosed if a person has been coughing for three months. These episodes are summarized during the year, or if the disease lasts the specified time continuously. A similar picture should be maintained for two years in a row.

If these time intervals do not correspond to the conditions for making a diagnosis, then coughing episodes are classified as either acute or recurrent bronchitis.

Important: if temporal features were not taken into account, then any prolonged cough would be defined as chronic bronchitis, and a huge number of patients had this diagnosis.

Often situations of prolonged coughing are observed in people:

• addicted to smoking;
• who are forced to work under adverse working conditions, with highly polluted air.

How does chronic bronchitis develop?

1. Inflammation exists in the lungs for such a long time that changes and rearrangements occur in the structure of the bronchi.
2. Changes in the bronchi cause violations of air permeability.
3. The discharge of secretions from the bronchi is difficult.
4. Local pulmonary immunity is reduced.
5. When an infection gets in, it becomes extremely difficult for the body to recover completely.
6. The infection continues to develop and the inflammation spreads.
7. If the development of the disease is not prevented by therapeutic measures, then the disease will be transformed into chronic obstructive pulmonary disease (COPD). This disease has more severe manifestations and its main problem is not only cough, but also the development of respiratory failure.

The photos and videos in this article will show how the disease is formed.

Classification

Chronic bronchitis code according to ICD 10 refers to the block of chronic respiratory diseases, among them there are several conditions that differ in clinical manifestations, they also have different codes in this medical reference book.

Table No. 1. Types of pathology and their designations:

Important: it is possible to cure chronic bronchitis, for this, patients must diligently follow the instructions of the attending physician.

Signs of illness

Chronic inflammation in the bronchi has certain signs of a course, they are described below.

Cough

Cough is the main symptom of most lung diseases. It invariably accompanies the disease and is a symptom that determines the disease.

Cough is divided according to its features:

1. Moist cough- in which expectoration of sputum occurs. This is considered a protective element, in which the developed sputum is naturally evacuated from the bronchial tree, due to this, the lumen of the bronchi remains free and the patient's breathing is not difficult. It is very important that at the same time there is no bronchospasm, which does not allow normal coughing up of sputum.
2. Dry cough it is otherwise called not productive, since it does not separate sputum and remove it from the body, since it is simply absent in the bronchi. Dry cough is rated by patients as painful. Often it happens in attacks, it is difficult for the patient to stop, it causes pain in the abdomen and chest. After an attack, the patient still coughs up a meager lump of mucus.

During chronic bronchitis, a wet cough predominates, as sputum is actively produced in the bronchi.

Cough itself is a reflex reaction that occurs in response to the excitation of numerous receptors located in the bronchial and tracheal mucosa. Impulses from the receptor apparatus rush to the brain, to a special cough center. The brain responds to impulses and causes the respiratory muscles to contract - this is how a cough occurs.

In the nature of cough, there is one problem - the uneven location of receptors in the tissues of the bronchi of various sizes:

• a large number of receptors are located in the large bronchi and trachea;
• there are practically no receptors in the small bronchi.

In such a situation, if inflammation occurs in small lung structures, then their complete blockage occurs quite quickly. Cough does not occur, even in the presence of sputum, the lungs do not provide air movement - bronchial obstruction develops.

Important: it is possible to determine that the cause of the problem is small bronchi during forced exhalation, if wheezing wheezes are heard, then their patency is impaired.

Dyspnea

If chronic bronchitis resolves without bronchial obstruction, then shortness of breath does not occur.

It occurs in people in the following cases:

• if an exacerbation occurs, the ICD code 10 is J44, the disease is active and the symptoms are rapidly growing;
• if the inflammatory process takes a very long time, for more than one year, it can be considered a sluggish disease, patients in this case do not even notice the moment when the disease returned to them;
• if a person is a smoker or there is a seasonal reaction to a change in the weather in the form of a cough;
• when a person suffers from an obstructive form of the disease, then shortness of breath is formed from the very beginning;
• it can occur along with a cough during physical exertion, even with ordinary bronchitis at the initial stage, with the further development of the disease, the syndrome increases - the symptoms develop in the patient even with minimal activity;
• in severe cases, shortness of breath begins even at rest.

Sputum department

Important: if a person has difficult working conditions - severe air pollution, then the color of sputum will vary, for miners, sputum may be black.

The amount of sputum may vary depending on the stage of the disease and its type.

Table number 2. How actively sputum is produced in various conditions:

ICD coding for chronic bronchitis

Regardless of the conditions of occurrence, the ICD 10 chronic bronchitis code is always located in the class of diseases of the respiratory system and the heading of chronic pathologies of the lower respiratory tract.

Items in this section also have divisions, in most cases specifying the morphological type of respiratory pathology. The etiological factor in this case matters only in clinical classifications.

Encoding options:

• J40 - an inflammatory process in the bronchi, which for a number of reasons cannot be considered acute, but it is also difficult to attribute it to chronic (allergic obstructive inflammations, pathologies caused by chemicals and asthmatic forms of the disease are excluded from the category);
• J41 - under this code is a simple bronchitis, as well as a disease of a mucous and purulent nature (the category is divided into both types of the pathological process and includes a mixed version of the disease);
• J42 - a form of pathology of an unspecified nature;
• J44 - other types of obstructive pathology of the respiratory organs with a protracted course.

Separately in ICD 10 chronic bronchitis has the code J45.9 in case of asthma. The diagnosis of asthma is made by exclusion in the presence of several attacks of obstruction during the year, which are tied to the same factor and are stopped by bronchial dilating drugs.

Features of the disease

Unlike ordinary acute or obstructive bronchitis, this type of inflammatory process is not always associated with an infectious agent. Risk factors for the disease are bad habits, work in hazardous industries, living in unsatisfactory social conditions.

There are mild, moderate and severe forms of pathology, which is not reflected in the international classification of diseases. The severity of the process is set depending on the violation of breathing and morphological changes in the bronchi and alveoli.

Chronic bronchitis in the ICD 10 is established without an exact indication of the etiological factor, since it affects the treatment to a lesser extent.

The drugs used in all forms are the same, but in the case of a specific cause of inflammation, its effect on the body should be limited as much as possible. For example, quit smoking or change jobs associated with the ingress of small particles of dust, sand and other substances into the bronchi.

CHRONIC LOWER RESPIRATORY DISEASES (J40-J47)

Excludes: cystic fibrosis (E84.-)

Note. Bronchitis not specified as acute or chronic in persons under 15 years of age may be considered acute in nature and should be classified under J20.-.

Included:

• Bronchitis:
  • NOS
  • catarrhal
  • tracheitis NOS
• Tracheobronchitis NOS

Excludes: bronchitis:

• allergic NOS (J45.0)
• asthmatic NOS (J45.9)
• chemical induced (acute) (J68.0)

Excludes: chronic bronchitis:

• NOS (J42)
• obstructive (J44.-)

Included: Chronic:

• bronchitis NOS
• tracheitis
• tracheobronchitis

Excludes: chronic:

• asthmatic bronchitis (J44.-)
• bronchitis:
  • simple and mucopurulent (J41.-)
  • with airway obstruction (J44.-)
• emphysematous bronchitis (J44.-)
• obstructive pulmonary disease NOS (J44.9)

Excluded:

• emphysema:
  • compensatory (J98.3)
  • caused by chemicals, gases, fumes and vapors (J68.4)
  • interstitial (J98.2)
    • newborn (P25.0)
  • mediastinal (J98.2)
  • surgical (subcutaneous) (T81.8)
  • traumatic subcutaneous (T79.7)
  • with chronic (obstructive) bronchitis (J44.-)
• emphysematous (obstructive) bronchitis (J44.-)

Included: chronic:

• bronchitis:
  • asthmatic (obstructive)
  • emphysematous
  • With:
    • blockage of the airways
    • emphysema
• obstructive(th):
  • asthma
  • bronchitis
  • tracheobronchitis

Excluded:

• asthma (J45.-)
• asthmatic bronchitis NOS (J45.9)
• bronchiectasis (J47)
• chronic:
  • tracheitis (J42)
  • tracheobronchitis (J42)
• emphysema (J43.-)

Excluded:

• acute severe asthma (J46)
• chronic asthmatic (obstructive) bronchitis (J44.-)
• chronic obstructive asthma (J44.-)
• eosinophilic asthma (J82)
• lung diseases caused by external agents (J60-J70)
• status asthmaticus (J46)

Acute severe asthma

Excluded:

• congenital bronchiectasis (Q33.4)
• tuberculous bronchiectasis (current disease) (A15-A16)

In Russia International Classification of Diseases 10th revision ( ICD-10) is adopted as a single regulatory document for accounting for morbidity, reasons for the population to apply to medical institutions of all departments, and causes of death.

Chronic bronchitis (CB) is one of the most common pathologies of the respiratory system along with pneumonia, bronchial asthma, COPD and bronchiectasis. According to the statistics of recent years, there is a general trend towards an increase in the number of registered cases of this pathology, which, of course, is largely due to earlier detection during medical examination of the population, improvement of diagnostic methods and their greater availability among different regions of the Russian Federation.

Some readers do not know what the bronchial tree is and what its role is in the process of respiration. So, it consists of bronchi of different calibers (orders), as well as bronchioles. The development of the inflammatory process leads to swelling of the bronchial mucosa, dyskrinia (mucus-sputum accumulates), spasm of smooth muscles, which greatly complicates the patient's breathing. However, all these processes are reversible. With chronic inflammation in the wall of the bronchus, connective tissue grows, replaces it with a typical healthy bronchus, and changes in the structure of the epithelium of the mucous membrane. It is already more difficult to suspend and level these processes.

Most often, HB is recorded in men and the elderly. In the absence of proper treatment, the usual inflammation of the bronchi can take a chronic form and proceed with certain complications:

• irreversible bronchial obstruction;
• respiratory failure;
• bronchial asthma and bronchospasm.

According to medicine, the disease is one of the most common in the world: every third person on the planet has chronic bronchitis. It is not surprising that many of us are interested in questions about how to cure chronic bronchitis, how dangerous this disease is, what are the main signs of pathology, what is its classification, and so on. We will try to answer these and other questions below.

Modern classification of bronchitis

Doctors are well acquainted with the ICD-10, in fact, this is a reference book for every practitioner, since this document is the basis for the classification of diseases in health care. All information in the ICD-10 is periodically reviewed, updated and, if necessary, supplemented. The tenth revision of the ICD was carried out back in 1999, the next one is planned for 2015. MBC-10 provides comprehensive information about all pathologies.

There is no single classification of respiratory diseases today. In the Russian Federation, as well as other CIS countries, doctors use two classifications, which are based on the presence of obstruction and the nature of inflammation. Based on the data obtained, the following classification of bronchitis has been developed:

With the flow:

• spicy;
• protracted;
• recurrent;
• chronic.

Type of inflammation:

• purulent;
• catarrhal;
• catarrhal-purulent;
• hemorrhagic.

By localization:

• distal;
• proximal;
• diffuse (common);
• localized.

By the presence of an obstruction:

• purulent;
• fibrinous;
• obstructive;
• non-obstructive (simple).
• catarrhal;
• purulent-obstructive;

By etiology:

• toxic;
• allergic;
• thermal;
• dust;
• unspecified genesis;
• viral;
• bacterial;
• mixed etiology.

Most often, chronic bronchitis is accompanied by obstruction, which is expressed in varying degrees.

The main sign of bronchial obstruction is difficulty in breathing, which is manifested to a greater extent by difficulty in exhaling, its lengthening, involvement of the auxiliary respiratory muscles, whistling, whistling, dry rales (less often finely bubbling wet), cough. A characteristic feature of non-obstructive bronchitis is that the patient does not have difficulty breathing, and the clinic is dominated by symptoms of intoxication, a prolonged cough with sputum (usually purulent or mucopurulent). In advanced cases, without qualified treatment, chronic bronchitis is complicated by more severe pathologies - pneumonia, bronchiectasis, asthma, pneumosclerosis, hemoptysis, etc.

For obstructive and non-obstructive bronchitis, a phase of exacerbation and remission is characteristic. The duration of these periods depends on many factors.

Diagnosis coding according to ICD-10

According to ICD-10, CB is included in J40-J47. Each pathology has its own unique code.

1. Inflammation of the bronchi, which at the time of examination can not be attributed to either acute or chronic in the ICD-10 is designated as J40. This group of pathologies includes catarrhal bronchitis, tracheobronchitis, tracheitis, without specifying the course. Typically, these difficulties occur in people older than 15 years.
2. Uncomplicated chronic simple bronchitis in the ICD-10 is designated as J41, characterized by a wet cough and the release of purulent and mucopurulent exudate. Both small and large bronchi are involved in inflammatory reactions, while the patient has no symptoms of bronchial obstruction (including according to respiratory function).
3. Code J42 - HB, chronic tracheitis and tracheobronchitis without specification.
4. Emphysema not associated with trauma. This is one of the most common complications of COPD in the ICD-10 is labeled J43.
5. Other COPD in the ICD-10 are labeled under the number J44.
6. Code J45 - asthma.
7. J46 - status asthmaticus.
8. J47 in the international classifier ICD-10 - bronchiectasis. It is characterized by an irreversible change, expansion and deformation of the bronchi with a suppurative process in them.

The etiology of chronic bronchitis is diverse. Many experts are of the opinion that the leading role in the development of the inflammatory process belongs to pollutants (chemical compounds, dust, smoke). Analysis of statistical data shows that in smokers this disease occurs four times more often than in non-smokers. At the same time, HB against the background of smoking, as a rule, is obstructive.

Toxic substances irritate the endothelium of the bronchi, provoke the development of an inflammatory reaction, and activate the formation of mucus. Violation of the secretion of the mucous membrane, mucociliary transport (bronchial cleaning system) leads to easier infection of the bronchial tree, the creation of favorable conditions for the reproduction of opportunistic flora, which normally lives in the oropharynx and nasopharynx. If a diagnosis of "chronic bronchitis" is established, then, perhaps, the etiology of the disease is associated with endogenous factors:

• violation of the metabolism of substances;
• chronic diseases of the cardiovascular and respiratory systems, including developmental anomalies;
• disruption of the endocrine system;
• genetic predisposition;
• pathology of the nasopharynx, including trauma;
• acute respiratory pathologies;
• dysfunction of enzymatic systems;
• alcoholism;
• helminthic invasion.

As a rule, bronchitis worsens in autumn and spring. Risk factors for developing the disease include the following:

• SARS;
• lack of vaccination against pneumococcus and hemophilic infection;
• smoking;
• living in a damp, unfavorable climate;
• overdrying of air in residential premises;
• allergic reactions and predisposition to them.

If in adults the disease, as a rule, develops due to exposure to irritants (dust, chemicals, tobacco smoke), then in children the infection comes to the fore. What is it connected with? The fact is that in childhood the immune system is not yet fully formed. Particularly aggressive respiratory viruses and bacterial infections circulate in preschool and educational institutions.

Signs of chronic bronchitis largely depend on the duration, phase of the disease and the presence of complications. Clinical manifestations of the disease:

• shortness of breath;
• difficulty in breathing according to the expiratory type (in the case of obstructive chronic bronchitis);
• dry and wet rales that change with coughing;
• symptoms of intoxication: weakness, lethargy, loss of appetite;
• subfebrile temperature (may persist for a long time);
• cough with mucopurulent or purulent discharge.

Bronchitis is dangerous for both the health of children and adults. The symptomatology of the manifestation of pathology depends on many factors:

• the duration of the illness;
• the presence of any complications;
• phases of the development of the disease, etc.

In the initial stages of the development of pathology, patients complain of a cough that occurs mainly in the morning. With the progression of the disease, shortness of breath appears, first during physical exertion, and after a few years at rest.

Against the background of bronchial obstruction, cardiopulmonary insufficiency develops.

Symptoms of exacerbation of non-obstructive chronic bronchitis are manifested as follows:

• hyperthermia;
• cough;
• headache;
• malaise;
• expectoration;
• sweating;
• myalgia;
• decrease in work capacity.

In the initial stages of the development of the disease - dry cough. Chronic simple (not obstructive) bronchitis is characterized by seasonality of exacerbations. Mucosal, watery sputum is a typical symptom of catarrhal bronchitis. At the beginning of the disease, the cough does not bother the patient, but with the progression of the pathology, it intensifies and becomes paroxysmal. The main symptom of purulent bronchitis is the release of purulent exudate, the amount of which depends on the prevalence and severity of inflammation in the bronchial wall. The key signs of chronic obstructive bronchitis are:

• dry or unproductive cough, initially predominantly in the morning;
• dyspnea of ​​an expiratory nature (difficulty exhaling) initially during physical exertion, coughing, changing weather, then at rest;
• increase in cough, shortness of breath and an increase in the amount of sputum during exacerbation;
• with percussion, a boxed sound is heard, the auscultatory picture includes a weakening of breathing or it is hard with an extended exhalation, whistling dry rales on exhalation;
• during exacerbation, moist rales may also occur;
• diffuse cyanosis.

If the disease is of an infectious origin, the patient has symptoms of general intoxication of the body;

• digestive dysfunction;
• lack of appetite;
• headache;
• hyperthermia;
• general weakness.

Chronic obstructive bronchitis is dangerous for the patient's health, because without appropriate therapy it is complicated by cor pulmonale, respiratory and heart failure. Asthmatic bronchitis is characterized by bronchial obstruction, which manifests itself mainly in the form of bronchospasm due to bronchial sensitization and hyperreactivity.

The disease progresses in different ways. In some patients, chronic bronchitis is atypical, that is, without pronounced symptoms, in others, the disease progresses and exacerbates under the influence of various endo- and exogenous factors. As a rule, the symptoms of chronic bronchitis appear gradually. The clinic of the disease, as a rule, manifests itself in the form of a cough that occurs in the morning. With the progression of the pathology, patients complain of nocturnal and daytime cough, which is aggravated by the presence of irritants (cold air, tobacco smoke, dust, etc.). The amount of exudate increases, over time it becomes purulent or mucopurulent. In some patients, dyspnea is observed and progresses. In most cases, the presented pathology is complicated by bronchial stenosis and sclerosis of the bronchial wall.

Signs of exacerbation

Humid and cold climate provokes an exacerbation of the disease. Signs of exacerbation - chills, hyperhidrosis (excessive sweating), increased cough. The addition of infectious agents (staphylococci, viruses, mycoplasmas, pneumococci, streptococci) worsens the course of the disease, which leads to a generalization of the inflammatory process to the deeper layers of the bronchial wall. As a result of exposure to bacteria, the secretory epithelium is damaged, as well as the muscle and elastic fibers of the bronchi and bronchioles. Due to the accumulation of purulent exudate in the lumen of the bronchi, coughing intensifies, shortness of breath appears, general malaise, fatigue, night sweats, and sometimes body temperature rises.

Possible Complications

All complications of chronic bronchitis can be classified into two groups:

• due to the evolution of the disease (emphysematous expansion of the lungs, generalized pneumosclerosis, respiratory failure, hemoptysis, "cor pulmonale");
• caused by infection (broncho-obstructive component, bronchiectasis, pneumonia, bronchopneumonia).

Often chronic bronchitis ends with disability.

1. Acute pneumonia

The main symptoms of acute pneumonia include the following symptoms:

• chills;
• hyperfatigue;
• hyperthermia above 38 degrees;
• pain in the chest associated with the act of breathing;
• moist cough;
• fatigue;
• headache;
• myalgia;
• general weakness;
• shortness of breath;
• decreased appetite.

It can be noted that the main signs of bronchopneumonia are cough, hyperthermia, auscultation and percussion data, as well as radiological and laboratory data. In the process of auscultation, crepitus, moist rales, weakening of breathing over the affected area of ​​\u200b\u200bthe lung tissue are detected. Inflammation of the lungs with an acute or fulminant course is accompanied by fever. On radiographs, changes in the tissues of the lungs are quite clearly visible. The presence of inflammatory processes in the lungs can also be identified by the blood picture: leukocytosis (the number of white blood cells increases), neutrophilia with a shift to the left, an increase in ESR.

1. Pulmonary emphysema

The disease is characterized by pathological expansion of the lung parenchyma. Due to the development of pathological processes in the alveoli, they lose their plasticity, which as a result leads to a violation of gas exchange in the lungs. The main signs of pathology include the following symptoms:

• diffuse cyanosis;
• shortness of breath;
• an increase in the volume of the chest.

Lack of O2 disrupts the work of all organs and systems in the patient's body.

1. "Lung Heart"

Sometimes chronic bronchitis is complicated by a pathology called "cor pulmonale". This disease is characterized by an increase in the size of the right heart. These pathological processes increase the pressure in the pulmonary circulation, as a result of which the heart overflows with blood and increases in volume. The main clinical signs of "cor pulmonale":

• hyperhidrosis;
• dyspnea, aggravated by lying down;
• severe headaches;
• swelling of the veins in the neck;
• heart pain that is not relieved by nitroglycerin;
• the presence of edema.

Without appropriate therapy, the disease progresses, myocardial dystrophy develops, which further aggravates heart failure.

Pathogenetic bases

The pathogenesis of chronic bronchitis is associated with a violation of local bronchopulmonary protection (decrease in the production of surfactant, immunoglobulins, lysozyme, a decrease in the activity of α1-antitrypsin, a decrease in the function of the ciliated epithelium, T-killers and T-suppressors).

Activation of the above factors leads to the development of the pathogenetic triad: hypercrinia-discrinia-mucostasis. With hypercrinia, activation of the bronchial glands is observed, as a result of which a huge amount of mucus accumulates in the lumen of the bronchi. With mucostasis, stagnation of thick exudate in the bronchi is observed.

Endoscopic examination reveals hyperemia of the mucous membrane, accumulation of purulent exudate in the bronchi. In the later stages of the development of the disease, atrophic and sclerotic changes are detected in the walls of the bronchi.

Diagnosis of chronic bronchitis is carried out on the basis of anamnestic data, the results of instrumental and laboratory studies. The main auscultatory symptoms of the disease include the following: wheezing, hard breathing (weakened in the later stages) and prolonged exhalation. In the presence of emphysema, a characteristic boxed, percussion sound is tapped. The use of lung radiography makes it possible to differentiate chronic bronchitis from pneumonia, cystic fibrosis, cancer and pulmonary tuberculosis.

Bronchoscopy allows you to determine the architectonics of the bronchial tree, the nature of inflammation and exclude the presence of bronchiectasis.

With the help of organoleptic and microscopic analyzes of sputum, its color, the nature of the exudate and the number of leukocytes are determined. Bacterial examination allows you to see the presence of infectious agents. Spirometry (examination of respiratory function) helps to determine the severity of violations of the function of external respiration.

A laboratory blood test includes determining the amount of total protein, as well as its protein fractions (proteins and proteins), fibrin, seromucoid, immunoglobulins and sialic acids.

Additional diagnostic methods include:

• bronchography (performed to diagnose bronchiectasis);
• computed tomography (helps to determine the severity of COPD, exclude oncology);
• pulse oximetry (determines the oxygen content in the blood);
• targeted biopsy (a piece of the bronchus wall is taken for analysis);
• peak flowmetry (determines the peak expiratory flow rate, allows you to identify bronchial asthma);
• ECG (allows to exclude cardiac genesis of shortness of breath and cough);
• pneumotachometry (performed to assess the speed of air flow during inhalation and exhalation);
• echocardiography.

X-ray diagnostics helps to differentiate CB from other diseases accompanied by prolonged cough and shortness of breath (pulmonary tuberculosis, cystic fibrosis, lung cancer, bronchiectasis). For diagnosing CB of allergic origin, it is necessary to produce allergy tests.

When prescribing adequate, highly effective therapy, doctors are guided by the ICD-10 reference book. If the patient is diagnosed with chronic bronchitis, the treatment should be comprehensive, since it is not so easy to get rid of the symptoms of the above pathology. Therapeutic and preventive measures are aimed at preventing further deterioration of the patient's condition, lengthening the periods of remission and reducing the rate of progression of the pathology.

When choosing a treatment regimen, the doctor pays attention to the patient's condition, gender, age, social living conditions and the causes of the disease. Many experts argue that chronic inflammation of the bronchi with an obstructive component is an irreversible process, but you can live with pathology if you eat rationally, increase the body's immune resistance and prevent infectious diseases. A logical question arises, how to treat chronic bronchitis? Below we will present the main directions of treatment of chronic bronchitis.

Medical therapy

Drug treatment of chronic bronchitis is not an easy task, requiring a long time. Before taking medications, you should consult with an experienced pulmonologist. Drug treatment includes antibiotic therapy, expectorants, vitamin therapy, immunomodulators and bronchodilators. The table shows antibiotic therapy depending on the type of bronchitis.

The therapeutic regimen for non-obstructive bronchitis includes expectorants. The type of cough determines the choice of medication. With a dry cough, antitussive drugs are used (Levopront, Bitiodin, Helicidin, Libeksin) and blocking the cough reflex (Sedotussin, Sinekod, Kodipront, Codeine, Dimemorphan, Ethylmorphine ”, “Tecodin”, “Glauvent”, “Tusuprex”, “Dionin”).

With a productive cough, drugs are prescribed that enhance sputum discharge (Ambroxol, Lazolvan, Thermopsis, Tussin). In the presence of viscous sputum, mucolytics-mucoregulators (ACC, Carbocysteine, Mukosolvin, Erdostein) and proteolytic enzymes (proteases, trypsin, α-chymotrypsin, pepsin, streptokinase, renin) are used.

In the treatment of obstructive bronchitis, bronchodilators (methylxanthines, fenoterol, formoterol, salmeterol, saltos, including in combination with corticosteroids - biasten, symbicort, m-cholinolytics) and expectorants are indicated. When an infectious component is attached to obstructive bronchitis, antimicrobial drugs are added (Cefazolin, Azithromycin, Cefaclor, Amoxicillin, Doxycycline, Levofloxacin, Clarithromycin, Sparfloxacin, Piperacillin).

Antibiotics for chronic bronchitis should be prescribed after sputum examination. After conducting the appropriate tests, the doctor will receive information about the sensitivity of bacteria to a particular medication. Thus, doctors select the most effective medicine for the treatment of bronchitis. In cases where it is impossible to carry out the above studies, doctors prescribe protected drugs (antibiotics) of the penicillin series.

Modern drugs ("Augmentin", "Panklav", "Amoxiclav") are very effective against most gram-negative and gram-positive bacteria. The main advantage of the presented medicines is relatively weak side effects. It should be noted that these drugs are ineffective in combating advanced forms of the disease.

To exit the acute stage, anticholinergics are used (Spiriva, Atrovent, in combination with β-2-antagonists Berodual), glucocorticoids (Pulmicort, Bekotid, Beclomet, Flixotide, Asmanex) ), phosphodiesterase enzyme inhibitors ("Theophylline"). In case of violation of the cardiovascular system, cardiac glycosides, oxygen therapy, diuretic drugs are prescribed.

In the treatment of purulent bronchitis, in addition to drugs that regulate mucociliary clearance, antimicrobials are indicated. Since antimicrobial drugs worsen the rheological properties of sputum, they must be used with mucolytics (Ambroxol, Acetylcysteine, Carbocysteine).

In order to get rid of the negative consequences of chronic bronchitis, immunostimulating drugs have been increasingly prescribed lately. For this purpose, you can use "T-activin" and "Timalin". The immunostimulating effect is shown not only by biogenic preparations of the thymus, but also by ascorbic acid and retinol.

Therapeutic tactics in childhood

In children, chronic bronchitis and its exacerbation are recorded less frequently than in adults. If in adults acute bronchitis, as a rule, has a viral etiology and does not require the use of antibacterial agents, then in children this disease may be associated with a layering of bacterial microflora (chlamydia, pneumococcus, mycoplasma).

To eliminate this disease, antibiotic therapy may be required (Amoxicillin, Sumamed, Azithromycin, Roxithromycin, Clarithromycin, Netilmicin, Amikacin). When treating bronchitis, special attention should be paid to the nutrition of the child. The diet should be rich in water- and fat-soluble vitamins. Additionally, you need to give the child nicotinic (vitamin B5) and ascorbic (vitamin C) acids. Good results are obtained with the appointment of immunomodulators: Polyoxidonium, Methyluracil, Levamisole, aloe extract.

Inhalation of essential oils of rosemary, fir, eucalyptus, camphor, garlic and onion phytoncides has an anti-inflammatory and expectorant effect. Immediately it is worth mentioning that you will not be able to get rid of the symptoms of bronchitis by using only essential oils. Steam inhalation is ineffective, it is better to use a nebulizer. This device provides the maximum dispersion of medicines. To achieve a therapeutic effect, inhalations with anti-inflammatory drugs (Chlorophyllipt, Rotokan) and antiseptics (Dioxidin) are prescribed.

Therapy of chronic bronchitis in children is carried out according to the same principles as in adults, with dose adjustment. Some types of medicines are not shown to children. A good effect is the use of a nebulizer, spa treatment.

Performance criteria

Evaluation of the effectiveness of treatment is carried out according to the following criteria:

• clinical efficacy of therapy (significant reduction or complete disappearance of signs of exacerbation of chronic bronchitis at the end of the course of treatment);
• bacteriological efficacy (eradication of an etiologically significant microorganism).

Side effects

The use of drugs can provoke the development of side effects in the patient's body:

• nausea;
• skin rash;
• headache;
• increased activity of liver enzymes;
• diarrhea;
• jaundice;
• vomit;
• angioedema;
• loss of appetite;
• allergic reactions;
• pain in the joints;
• interstitial nephritis;
• skin itching, urticaria;
• colitis;
• mycotic lesions in the oral cavity (most often observed in the elderly and in immunocompromised patients);
• hematological complications.

If side effects occur, it is necessary to inform the doctor about this, but do not cancel the prescribed treatment on your own.

Preventive actions

Prevention of chronic bronchitis is aimed at preventing recurrence of the disease and eliminating the etiological factor. One of the important points in the prevention of the disease is smoking cessation. It is important to lead a healthy lifestyle - go in for sports (running, walking, swimming, aerobics, cycling, etc.), harden, eat rationally, take vitamins of natural origin. Patients susceptible to the disease should avoid stressful situations and hypothermia.

Annual influenza vaccination reduces the likelihood of SARS in the autumn-spring period and, therefore, can be recommended for the prevention of chronic bronchitis. Adhering to simple recommendations, you will forever forget what bronchitis is.

Prevention of chronic bronchitis in babies should include general strengthening of the body, increasing immune resistance and performing special breathing exercises. Only by following all the recommendations of your doctor can you get rid of this insidious disease forever.

Medicine is constantly looking for new ways to cure various diseases, preventive measures to prevent them, and also tries to do everything possible so that people live long. There are a lot of pathologies in the world, therefore, to facilitate doctors, a special taxonomy was created, which is called the ICD - International Classification of Diseases.

Obstructive bronchitis according to ICD 10 is an inflammation of the respiratory system, which is accompanied by spasm of the bronchi and narrowing of the tubules. Most often, the elderly and young children suffer from pathology, because. they have a reduced immune system and susceptibility to various bacterial diseases.

With normal therapy, the prognosis for life is favorable, however, in some cases, the disease can end in death. To get rid of obstructive bronchitis, doctors prescribe standard treatment, which includes:

• anti-inflammatory drugs;
• antibacterial medicines;
• glucocorticosteroid drugs.

When the disease is still at an early stage, it is possible to start using folk recipes in parallel with medicines. It can be the reception of decoctions, herbs, tinctures.

It is also important to be completely calm, so you need to observe bed rest, diet, drink a lot. Be sure to need walks in the fresh air and regular airing.

Obstructive bronchitis ICD 10 is divided into acute and chronic phases. The acute phase is characterized by the fact that the symptoms are very strong, but recovery occurs quickly - in a month. The chronic type is accompanied by periodic relapses with a deterioration in the patient's health.

Depending on the nature of the pathology, the acute phase is also divided into two types:

• Infectious. It occurs due to the penetration of an infectious source into the human body.
• The chemical type occurs when formaldehyde and acetone vapors enter the respiratory tract.
• The mixed type is accompanied by the appearance in the body of two of the above species at once.

If the pathology appeared as a complication after a disease of the respiratory system, then such a process is secondary and is treated much harder. The nature of inflammation in bronchitis can also be divided into purulent and catarrhal.

The disease can proceed in different ways, therefore, obstructive and non-obstructive types are distinguished. In the second case, the disease is not accompanied by problems with lung ventilation, so the outcome for the patient's life is favorable.

ICD code 10 acute bronchitis

Acute obstructive bronchitis is the ICD code 10 - j 20.0, which contains 10 exact diagnoses that differ in the type of pathogen.

Chronic obstructive bronchitis ICD code 10 – j 44.0, while excluding the appearance of the disease after the flu.

Obstructive bronchitis in children according to the description of ICD 10 occurs rapidly and is very similar in symptoms to a cold.

Nature of occurrence

Obstructive bronchitis can appear under the influence of a variety of factors:

• hypothermia;
• weakening of the immune system;
• bad habits such as smoking and drinking alcohol;
• exposure to toxic and irritating components;
• allergic reaction.

Antigens, viruses and microorganisms, when they penetrate into a person, are perceived by the body as foreign substances that must be disposed of. Therefore, the active production of antibodies begins in the body, designed to identify and destroy foreign bodies that have got there. Lymphocytes and macrophages actively bind to harmful particles, engulf them, digest them, and then produce memory cells so that the immune system remembers them. The whole process is accompanied by inflammation, sometimes even with a rise in temperature.

In order for the immune cells to quickly find the focus of the disease, an increase in blood circulation begins, including to the bronchial mucosa. A large number of biologically active substances begin to be synthesized. From the influx of blood, the mucosa begins to expand and acquires a red tint. There is a secretion of mucous secretion from the tissues that line the internal cavity of the bronchi.

This provokes the appearance of a first dry cough, which eventually begins to turn into a wet one. This is because the amount of mucus secreted increases. If pathogenic bacteria enter the trachea, the disease turns into tracheobronchitis, which has the ICD code j20.

Symptoms

All pathologies of the respiratory system, and acute obstructive bronchitis have a similar set of symptoms:

• lethargy;
• deterioration in general health;
• dizziness or headache;
• cough;
• the appearance of a runny nose;
• wheezing, accompanied by noise and whistling;
• myalgia;
• temperature increase.

When there is poor patency of the bronchi, the following symptoms occur:

• dyspnea;
• breathing problems;
• the appearance of a blue tint on the skin (cyanosis);
• incessant dry cough with periodic expiration;
• fine bubbling rales;
• discharge of sputum or mucus from the nose with a lot of pus;
• whistling breath.

This disease is most active in the autumn-spring period, when all ailments begin to worsen. Newborn children suffer the most from it. At the last stage, the following symptoms appear:

• severe paroxysmal cough that occurs on inspiration;
• pain that occurs behind the sternum, at the site of the diaphragm;
• hard breathing with pronounced wheezing;
• sputum may contain impurities of blood and pus.

Diagnostics

To detect obstructive bronchitis according to ICD 10, the doctor must prescribe a number of diagnostic procedures:

• General inspection. The attending physician should listen to the lungs, feel the throat.
• X-ray. On x-ray, the disease appears as dark spots.
• Biochemical and general blood test.
• Analysis of urine.
• Check for external respiration.
• Bronchoscopy.
• immunological methods.
• Microscopic analysis of sputum, as well as checking it for bacterial flora (bakposev).

If there is a suspicion that the patient begins tracheobronchitis, then a number of additional studies are supplemented:

• Ultrasound examination of the respiratory system.
• Spirometry.

Treatment

Treatment of obstructive bronchitis should be complex and based on the nature of the disease. The conservative path of therapy includes:

• Taking medications. Based on the results of the tests and the type of bacterial pathogen, antibacterial drugs are prescribed.
• Antiviral medicines (if the culprits of the disease are viral particles); antiallergic drugs (if it is allergic); anti-inflammatory, to stop the focus of inflammation; expectorants, for better sputum discharge; mucolytic drugs.
• folk methods.
• Physiotherapy procedures.

Inpatient treatment is indicated if the patient is at risk of developing ancillary disease or complications.

As an aid, folk recipes will come in handy that will help you recover faster. For treatment, you can use:

• Improving blood circulation compresses that are applied to the bronchial area.
• Rubbing with warming and mucus-improving oils and gels. Badger fat, fir oil, turpentine ointment can act as such agents.
• Taking herbal preparations, which can have a variety of effects on the body.
• Useful massage treatments.
• Inhalation with a nebulizer.
• Aeroionotherapy.
• Electrophoresis.
• Gymnastics.

Prevention of obstructive bronchitis ICD 10

• strengthening the immune system;
• develop a proper nutrition system;
• taking multivitamin complexes;
• constant physical activity;
• hardening;
• stop smoking and drinking alcohol.

If you ignore the treatment or do not follow it properly, then the acute phase flows into the chronic. One of the dangerous consequences can be bronchial asthma. The elderly and young children may develop acute renal or respiratory failure. To learn more about acute obstructive bronchitis according to ICD 10: