How to treat obstructive bronchitis and what is it?

Obstructive bronchitis is a disease of the bronchi associated with prolonged inflammation of the mucous membrane, its damage and narrowing of the lumen of the bronchi, which causes difficulties in removing mucus that accumulates in the respiratory tract. The disease is accompanied by periodic spasms of the bronchial tree, which are manifested by difficulty breathing.

Over time, inflammation in the bronchial wall progresses, bronchospasm and shortness of breath intensify, obstructive syndrome and chronic impairment of pulmonary ventilation develop.

What is it?

Obstructive bronchitis is the occurrence of reflex spasms that prevent mucus from coming out. Obstruction may be periodic, especially in the chronic form. The peculiarity of such bronchitis is that it can occur latently.

Reasons for development

The disease in most cases becomes complicated by the continuation of respiratory viral infections, exposure to external factors: smoking, unfavorable environmental conditions, hazardous production, poor living conditions.

Environmental factors:

1. The presence of chemical irritants in the air at work or at home - inorganic and organic dust, acid vapors, ozone, chlorine, ammonia, silicon, cadmium, sulfur dioxide, etc. (see the impact of household chemicals on health).
2. Long-term exposure of the bronchial mucosa to physical irritants in the external environment - allergens, such as pollen of certain plants, house dust, animal hair, etc.

Socio-economic factors:

1. Alcohol abuse;
2. Unfavorable living conditions;
3. Smoking, passive smoking (see video of what cigarettes are made from);
4. Old age.

Medical factors:

1. Tumors of the trachea and bronchi;
2. Airway hyperresponsiveness;
3. Genetic predisposition;
4. Tendency to allergic reactions;
5. Injuries and burns;
6. Poisoning;
7. Infectious and inflammatory diseases of the respiratory system and impaired nasal breathing, foci of infection in the upper respiratory tract - bronchitis, pneumonia;
8. Recurrent viral infections and diseases of the nasopharynx.

Chronic obstructive bronchitis

This is a progressive obstruction of the bronchi in response to various irritants. Impaired bronchial obstruction is conventionally divided into: reversible and irreversible.

Signs with which patients usually consult a doctor:

1. Severe cough, with the release of scanty mucous sputum in the morning
2. Shortness of breath, initially appears only with physical exertion
3. Wheezing, difficulty breathing
4. Sputum can become purulent during the period of addition of other infections and viruses and is regarded as a relapse of obstructive bronchitis.

Over time, with an irreversible chronic process, the disease progresses, and the intervals between relapses become shorter.

Symptoms

The clinical picture of obstructive bronchitis is formed by the following symptoms:

• Cough - in the early stages, dry, without sputum, “wheezing”, mainly in the morning, as well as at night, when the person is in a horizontal position. The symptom intensifies in the cold season. Over time, when coughing, sputum and clots appear; in older people, there may be traces of blood in the secretion;
• Difficulty breathing, or shortness of breath (7-10 years after the onset of cough) - first appears during physical activity, then during rest;
• In case of exacerbation - fever, sweating, fatigue, headaches, muscle pain;
• Acrocyanosis - blueness of the lips, tip of the nose, fingers;
• “Watch glass” syndrome, “Hippocratic nail” - deformation of the nail plates when they become like watch glasses;
• The symptom of “drumsticks” is a characteristic change in the phalanges of the fingers;
• Emphysematous chest - the shoulder blades fit tightly to the chest, the epigastric angle is deployed, its value exceeds 90°, “short neck”, enlarged intercostal spaces.

It is important to remember that obstructive bronchitis does not make itself felt immediately. Typically, signs appear when the disease is already fully dominant in the body. As a rule, most patients seek help late, after the age of 40.

Diagnostics

Typically, the diagnosis is made based on the patient's complaints, concomitant clinical history, auscultation of the lungs and heart rhythm.

The task of differential diagnosis is to exclude the development of such severe pathologies as pulmonary tuberculosis, pneumonia, tumors of the lung tissue, and developing heart failure due to a decrease in cardiac ejection fraction. If a patient experiences a decrease in cardiac ejection fraction, a strong, incessant cough, or suspicion of alveolar edema (pulmonary edema), then the doctors’ actions should be lightning fast.

Obstructive bronchitis is characterized by the following:

• listening to percussion sound over the lungs;
• loss of mobility of the pulmonary edge;
• hard breathing;
• on inspiration, wheezing sounds are auscultated;
• the appearance of moist wheezing during exacerbation of the disease.

If the patient is a smoker, then the doctor needs to find out the total length of the bad habit and calculate the smoking index. When classifying obstructive bronchitis at the development stage, the indicator of forced expiratory volume in 1 minute (in the abbreviation FEV) is used in relation to the vital capacity of the lungs (in the abbreviation VC). The following stages are distinguished:

1. Stage I. FEV = 50% of normal. At this stage, the patient has almost no discomfort, and clinical monitoring is not needed in this situation.
2. Stage II. OFI = 34-40% of the norm. The patient is recommended to visit a pulmonologist due to a marked deterioration in the quality of life.
3. Stage III. FEV<33% от нормы. Этот этап заболевания предполагает стационарное либо амбулаторное лечение.

To exclude pneumonia, pulmonary tuberculosis, and dilation of the heart, a chest x-ray procedure is performed. As additional research methods, laboratory test data (blood, urine, scraping of mucus or sputum) are required. Accurate diagnosis will allow you to quickly identify the underlying disease, relieve the symptoms of obstructive bronchitis, and eliminate its relapses in the future.

Complications

When obstruction develops, the lungs are no longer able to get enough air. Inhalations become heavy, the diaphragm does not open completely. In addition, we inhale more than we exhale.

Some part remains in the lungs and provokes pulmonary emphysema. In severe and chronic forms, pulmonary failure may occur, and this is a cause of mortality. Untreated bronchitis almost always ends in pneumonia, which is much more difficult to treat.

How to treat obstructive bronchitis?

First of all, when treating obstructive bronchitis in adults, it is important to minimize, and if possible completely eliminate, contact with irritating factors, which may be a prerequisite for the progression of the process in the bronchi and its exacerbations.

You need to give up smoking and other bad habits, stop contact with allergens, which in some cases may require quite radical steps: changing your job or place of residence.

The next step should be treatment at home with effective modern means.

Drug treatment

For obstructive bronchitis, which is caused by a viral infection, antiviral drugs are prescribed:

1. Rimantadine (Algirem, Orvirem) has an intense antiviral effect by blocking healthy body cells from viral penetration. The drug is prescribed 100 mg (1 tablet) 1-3 times a day for 3-4 days. Allergic reactions are rare.
2. Inosine pranobex (Isoprinosine, Groprinosine) have an antiviral (stimulate the death of viral cells) and immunomodulatory (strengthen the immune system) effect. The drugs are prescribed 1-2 tablets 3-4 times a day. The course of treatment is 7–10 days, but can be extended by 1 month according to indications. The drug is well tolerated and usually does not cause allergic reactions.

For obstructive bronchitis caused by a bacterial infection, antibacterial drugs are prescribed, with which the disease can be cured within 5–10 days:

1. Macrolides (Clarithromycin, Rovamycin) have a bactericidal effect. Prescribed 500 mg 1 time per day. The course of treatment is 5–7 days. The drug does not cause allergic manifestations;
2. Protected penicillins (Augmentin, Flemoxin-solutab) have a bacteriostatic (reduce the growth and division of bacterial cells) and bactericidal (promote the death of bacteria) effect. The drug is prescribed in tablets of 625 mg 3 times a day or 1000 mg 2 times a day for 7–14 days. This group of drugs is given with caution to patients with frequent allergic reactions;
3. In extremely severe cases of the disease, the drugs of choice are respiratory fluoroquinolones - levofloxacin (Loxof, Leflok) 500 mg once a day or 500-1000 mg in a 100.0 ml bottle intravenously once a day. This medicine may cause acute allergic reactions.

If cough occurs, use mucolytic drugs:

1. Ambroxol (Lazolvan, Abrol) has an expectorant effect and stimulates the movement of ciliated epithelium in the bronchi, which promotes better removal of sputum. Prescribed 30 mg (1 tablet) 3 times a day or 75 ml (1 tablet) 1 time a day. The course of treatment is 10 days. The drug does not provoke allergic effects;
2. Acetylcysteine ​​(ACC) reduces the viscosity of sputum and thereby stimulates its better discharge. Prescribed 400–800 mg 1–2 times a day for 10 days. Allergic reactions in the form of skin rash;
3. Local anti-inflammatory drugs - Erespal, Inspiron eliminate hyperproduction of mucus and reduce swelling of the mucous and submucosal layers of the bronchial tree. Prescribed 1 tablet 2 times a day. The course of treatment is 10 days. Special instructions: causes increased heart rate and interruptions in heart function. Allergic reactions are rare.

At elevated body temperatures, non-steroidal anti-inflammatory drugs are used - Nimesulide, Ibuprofen - they have an antipyretic, decongestant and analgesic effect. Prescribed 200 mg 1-2 times a day.

If shortness of breath occurs, treatment of obstructive bronchitis is supplemented with bronchodilators in aerosols (Salmeterol, Berodual, Ventolin, Salbutamol), which have a bronchodilator effect and promote better clearance of mucus from the bronchi. Prescribed 2 breaths 3-6 times a day.

Inhalations

With exacerbation of obstructive chronic bronchitis, the following is noted:

• increased shortness of breath with changes in the frequency of respiratory movements, depth of inspiration;
• change in the nature of cough, sputum discharge;
• tightness in the chest.

When these symptoms appear, indicating an exacerbation, bronchodilators of all three groups are prescribed by inhalation. You can read about the properties of these drugs in the article Bronchodilators.

The main cause of obstruction in adults is bronchospasm. To eliminate it, they resort to short- and long-acting drugs. The drugs of choice for chronic obstructive bronchitis are Atrovent, Troventol, and oxythorpium bromide. The effect of their use appears after 30 minutes, lasts up to 6 hours, 3-4 doses are taken per day.

If therapy is ineffective, the following is additionally prescribed:

• adrenergic stimulants – Ventolin, Bricanil, Berotek inhalations, Clenbuterol Sopharma tablets, Clenbuterol syrup;
• theophylline tablets – Teopek, Theotard.

In acute conditions, inhalation of combination drugs is prescribed, combining the action of a hormonal agent with a bronchodilator. Read more about inhalations for bronchitis in our article Inhalations for bronchitis with a nebulizer.

Physiotherapy

Physiotherapy will improve the patient's condition. One of its means is massage (percussion, vibration, back muscles). Such manipulations help relax the bronchi and eliminate secretions from the respiratory tract. Modulated currents and electrophoresis are used. Her health has stabilized after sanatorium-resort treatment in the southern resorts of Krasnodar and Primorsky Krai.

Nutrition and diet

The diet during an exacerbation of the disease is aimed at eliminating swelling of the bronchial tree, stimulating the immune system, and replenishing protein reserves. Food should be high in calories, at least 3000 cal/day, with a predominance of proteins.

Useful products:

• fruits with vitamin C: orange, lemon, raspberry, grapefruit;
• dairy products: cheese, milk, cottage cheese;
• products containing magnesium: nuts, bananas, sesame seeds, pumpkin seeds, rye bread, buckwheat, olives, tomatoes;
• products with Omega-3 acids: fish oil, cod liver;
• vitamins A and E: green peas, beans, spinach, peach, avocado, carrots.

During treatment of a relapse, it is necessary to reduce the consumption of sugar and salt, limit the intake of allergenic foods (tea, chocolate, coffee, cocoa). Spicy, spicy, and smoked foods contribute to the development of bronchospasm, so they should also be excluded from the diet or eaten in small quantities.

Prevention

Prevention of obstructive bronchitis also involves:

• giving up the bad habit of smoking;
• reducing dust levels at home through wet cleaning. You can replace feather-filled pillows with hypoallergenic fillings. You can also remove carpets and soft toys, which are the first accumulators of dust particles;
• following a hypoallergenic diet, during which all foods that can intensify coughing attacks are excluded;
• taking vitamins B and C to support immunity. For this purpose, you can use herbal teas, which also help remove mucus from the bronchi;
• During the period of plant dusting, you can organize a stay in a comfortable microclimate, where any allergens are excluded.

Patients with obstructive asthmatic bronchitis first of all need to undergo hardening procedures and perform therapeutic breathing complexes.

Which is accompanied by obstruction is called obstructive bronchitis. In other words, if as a result of inflammation the lumen of the bronchi narrows and a large amount of mucus cannot fully exit. All this can lead to respiratory failure and swelling of the bronchi. This is also one of the most dangerous forms of bronchitis, and most often children suffer from it. But this diagnosis also exists among adults. We will look at what the danger of this disease is, how to correctly recognize and treat it.

Forms of obstructive bronchitis

From the Latin name obstruction is translated as “obstruction” - this is damage to the bronchi as a result of the inflammatory process. This disease manifests itself in the form of a cough with sputum and severe shortness of breath.

Children are more susceptible to this disease and often suffer from it. The most active and severe type is acute obstructive bronchitis. This diagnosis is usually made with a prolonged cough with sputum. But if treatment in children and adults was successful, then this disease does not return.

And if the therapy turns out to be ineffective, then the pathology worsens and becomes chronic. Mainly, this condition is characteristic of the older half of humanity. This disease has its own characteristics. The chronic form of the pathology occurs more globally, affecting the respiratory system. The symptoms of obstructive bronchitis in adults are quite unpleasant.

The alveolar tissue is deeply affected - this is recorded in 90% of cases. Broncho-obstructive syndrome is revealed, which can have both stable and reversible changes in the respiratory tract. Secondary diffuse emphysema develops. Then blood and tissue hypoxia begins due to inadequate ventilation of the lungs.

If bronchitis is caused by a viral infection, it can be contagious. And if it is asthmatic or allergic bronchitis, then it is not contagious.

It is extremely important to know that the disease is most often recorded among populations that live in humid climates. Such weather conditions are favorable for the development of fungi and viruses, which give rise to recurrent obstructive bronchitis.

How is pathology formed? Under the influence of an unfavorable factor, the cells of the ciliary epithelium gradually die out. And then a pathological change in the composition and thickness of the mucus occurs. After such a change, the entire bactericidal barrier is lost, and the bronchi are left without protection. And the remaining number of cilia cannot cope with such a flow of phlegm and therefore completely slow down the movement. This leads to mucus stagnation.

The severity of development depends on specific criteria and comes in three degrees. The main indicator that allows you to determine the patient’s condition is FEV1. This is the volume of strong exhalation that is performed in a second. After the indicator is obtained, one of three stages of the disease is identified:

• First stage. FEV1 exceeds 50%. This is chronic obstructive bronchitis, for which treatment is not prescribed. Such a chronic disease does not create any inconvenience for the patient. And the risk of developing disorders is minimal, but, one way or another, the patient must be under the supervision of a doctor.
• The second stage of obstructive bronchitis. FEV1 is reduced to 35-49%. This stage of the disease greatly worsens the patient’s general well-being, so gentle treatment and examination by a pulmonologist are carried out.
• Third stage. FEV1 is less than 34%. The symptoms are bright, the quality of life is reduced. The patient needs to go to a hospital, in some cases outpatient treatment is possible.

Depending on how the disease progresses and what the body’s protective function is, both reversible and irreversible bronchial changes may be detected.

Reversible changes:

• bronchospasm;
• blocking the lumen of the bronchi;
• extensive swelling.

Irreversible changes:

• changes in bronchial tissue;
• narrowing of the lumen;
• emphysema and impaired air circulation.

Symptoms and treatment of obstructive bronchitis in children are often interrelated.

Causes of pathology

For the most part, regardless of age, the disease develops after pathogenic microorganisms enter the body. But the infection that gets inside does not always get worse. In order for a person to get sick, special conditions are necessary.

Recently, more and more people are becoming ill with obstructive bronchitis due to the influence of the following factors on the body:

• Poorly functioning immune system.
• Poor nutrition.
• Chronic diseases of internal organs or dysbacteriosis.
• Chronic respiratory diseases.
• Conditions of stress. We will consider the symptoms of obstructive bronchitis in adults below.

Allergic predisposition in humans also plays a significant role in the development of the disease. For example, if a child has allergic manifestations from an early age, then the chances of getting obstructive bronchitis increase. There are reasons that can contribute to the development of the disease:

• work in hazardous environments (chemical plant workers, miners, metallurgists);
• penetration of toxic substances into the lungs;
• smoking for many years;
• living in an area with poor ecology.

There are also so-called internal provocateurs of obstructive bronchitis. The formation of the disease is influenced by the second blood group, which is genetically formed in such a way that a deficiency of immunoglobulin A is manifested, as well as enzyme deficiency.

In addition to the main causes, adolescents and children also have several associated factors. Thus, the risk group includes children who:

Symptoms

Symptoms of acute obstructive bronchitis depend on the age of the patient and the functioning of his immune system, as well as on the characteristics of the body. In addition, the disease can manifest itself differently depending on its form: active or chronic.

Manifestations in children

Children suffer the most severely from the symptoms of obstructive bronchitis. At an early age, this acute form of pathology often develops due to the penetration of viruses, such as adenovirus and cytomegalovirus.

This disease in children is especially difficult against the background of a general deterioration in health. The first signs observed in children are the symptoms of a common acute respiratory viral infection: fever and cough.

As already noted, the symptoms and treatment of obstructive bronchitis are closely related.

Later, more specific manifestations are noted:

• The fever does not subside and is difficult to reduce with special antipyretic drugs.
• The cough becomes more severe, and attacks of difficulty breathing occur.
• The sputum becomes yellowish-greenish or absent.
• When exhaling, wheezing is noticeable and shortness of breath is noted. Symptoms of obstructive bronchitis in children are more pronounced than in adults.
• Breathing becomes more rapid.
• The throat becomes inflamed and red.
• Attacks of headaches and increased sweating occur.
• the child swallows air.
• Severe anxiety, crying, drowsiness, refusal to eat with obstructive bronchitis in children.

Very important! This symptomatology may be similar to other diseases, therefore, to fully treat a child, a competent diagnosis is required, which will allow one to distinguish ailments from each other. Treatment of obstructive bronchitis should be carried out under the strict supervision of a physician.

And if the child is misdiagnosed and receives inappropriate therapy, the disease will progress to a more severe stage with characteristic signs:

• the baby cannot take a calm and deep breath;
• the skin takes on a bluish tint;
• fever increases;
• special medications do not relieve shortness of breath;
• bubbling breathing when lying down;
• severe headaches, dizziness and loss of consciousness.

Symptoms of obstructive bronchitis in adults

In adults, this form of the disease occurs rarely, but the symptoms will be similar. Perhaps the intensity is less pronounced.

Usually in adults the chronic form of the disease is immediately recognized. In this case, the patient may have slight shortness of breath, cough and mucus production.

Inflammation may worsen after an acute respiratory viral infection. It is accompanied by the following symptoms:

• The color of the sputum changes, perhaps with an admixture of pus and blood streaks.
• Frequent cough with a characteristic whistling sound.
• Increased shortness of breath, difficulty moving quickly with severe inflammation of the bronchi.
• Due to a lack of oxygen from difficulty breathing, cyanosis (blue discoloration of the nasolabial part) appears on the face.
• High blood pressure, headaches and muscle aches.
• There are panic attacks accompanied by difficulty breathing.

Diagnostics

This disease is quite easy to diagnose. The first indicators are its symptoms. During auscultation (listening to breathing), wheezing and whistling are detected. Next, an x-ray is performed to confirm the diagnosis. An x-ray can easily determine the stage of bronchial lesions. And to obtain a more accurate picture of the disease, additional diagnostic procedures are prescribed:

• Biopsy of bronchial tissue if the causative agent of obstructive bronchitis cannot be identified.
• Spirography. Determination of the volume and speed of inhalation and exhalation using a special apparatus.
• Pneumotachometry. This procedure can calculate the degree of airway obstruction using a method of quantifying the liters of air exhaled in one second.
• General analysis of biological fluids - urine, venous blood, sputum.

Such a comprehensive diagnosis makes it possible to more fully understand the stage of bronchial damage, determine the condition of bronchial tissues, as well as the cause of inflammation.

Therapy

Let's look at how obstructive bronchitis is treated in children and adults. It has its differences.

Treatment of obstructive bronchitis in children always occurs in an inpatient setting; in adults, outpatient treatment may also be allowed. Based on the patient's age, FEV1 degree, blood count and general condition, the patient is given a therapeutic course.

Treatment in adults

Especially if it occurs in a chronic form, it is necessary to identify its provocateur (this could be smoking, unhealthy lifestyle, poor nutrition, etc.), and then it is completely isolated.

If there is no exacerbation, then the patient is prescribed treatment to increase immunity, a properly balanced diet, spending a lot of time in the fresh air and a healthy lifestyle.

And if there is already an exacerbation, in this case the patient needs to take bronchodilators and antibiotics for obstructive bronchitis in adults.

If there is severe discharge of sputum with pus, antibacterial drugs such as Amoxil, Sumamed and Augmentin may be prescribed. In order to make breathing easier, bronchodilators are used - Berotec, Atrovent. Drugs that promote the removal of sputum - Ambroxol, Mukaltin. No less good during illness is a vibration massage, which is aimed at relaxing the muscles of the chest.

Treatment in children

Treatment for children is carried out exclusively in hospitals. It consists of several important points:

An important place here is occupied by a walk in the fresh air, preferably damp. And then the question may arise: is it possible to walk with a child who suffers from such bronchitis? The answer is absolutely yes. But some factors must be taken into account: if the child does not have a high temperature and severe frost outside (it is allowed to go out down to -10 degrees).

Treatment with folk remedies

There are many folk recipes that can effectively combat obstructive bronchitis. They will help relieve bronchial swelling, inflammation and improve sputum discharge. Here are some of them:

• Elecampane decoction. Pour one teaspoon into an enamel bowl, pour in 200 milliliters of boiling water and put on low heat. After 15 minutes, the broth will be ready, and then it should be set aside and allowed to brew for 3-4 hours. Then strain and take 1 tablespoon orally 4 times a day. What else is used in the treatment of obstructive bronchitis in adults and children?
• Radish with honey. Make a hole in the black radish. Place 1 teaspoon of honey in the hole and wait until juice begins to ooze from the radish. You need to take 4 tablespoons per day at intervals of 3 hours.
• Tangerine tincture. Take 25 grams of dry tangerine peel and 500 milliliters of water. Boil on fire. After an hour, add 25 grams of candied tangerine peel and cook for another hour. Then cool and take five tablespoons in the morning and take one less spoon every hour. All this will help get rid of acute obstructive bronchitis.

What can help prevent the disease? Doctors recommend:

• carrying out hardening procedures from an early age;
• avoiding crowded places during seasonal exacerbations of viral infections;
• the child should receive daily vitamins, fresh vegetables and fruits, natural juices;
• walks in the air;
• if there is a possibility of an allergic reaction, then measures must be taken to prevent this;
• carry out ventilation of the room and wet cleaning in the room where the child is staying.

Conclusion

But do not forget that home treatment does not replace professional consultation with a specialist and a properly selected course of treatment. Contact your doctor on time, take care of yourself and your health, and remember that it is impossible to cure chronic obstructive bronchitis on your own. Remember about prevention and lead a healthy lifestyle.

Chronic obstructive bronchitis is a disease of the bronchi and lungs, characterized by a partially irreversible restriction of air flow in the bronchopulmonary system, which is constantly progressing. The main symptoms of this pathology in the lungs are shortness of breath and cough with viscous sputum.

Chronic obstructive bronchitis is common throughout the globe and occurs on average in 250–330 persons per 100,000 population.

The lowest incidence of reported cases is less than 110 per 100,000 and covers countries such as Canada, Alaska, southwestern South America, France, Germany, Bulgaria, the Arabian Peninsula, Asian Russia and Japan.

The average prevalence of the disease is the USA, Argentina, Uruguay, Brazil, Great Britain, Norway, Poland, the Czech Republic, Slovakia, and African countries, where the incidence of cases is 110–550 per 100,000 population.

The highest incidence of chronic obstructive bronchitis occurs in Europe (Ukraine, Belarus, Russia), Asia (China, Mongolia, Tibet, Nepal, India, Indonesia, Iran, Iraq), Australia, Oceania and is 550–1350 or more per 100,000 population.

Middle-aged and elderly people are more often affected; in men, chronic obstructive bronchitis occurs 3–4 times more often than in women.

The prognosis for work capacity and life is unfavorable. As the pathological process progresses in the lungs, efficiency is gradually lost. Adequate, timely treatment only stops the course of the disease for a short time. Death occurs from complications (cor pulmonale, emphysema, etc.).

Chronic obstructive bronchitis in adults occurs due to many negative influences on the lungs, both from the environment and directly from the body, and therefore the causes of the disease are conventionally divided into two groups:

1. External factors:

High-risk professions:

1. mining industry;
2. builders;
3. miners;
4. metallurgists;
5. pulp and paper industry workers;
6. railway workers;
7. pharmaceutical industry workers.

• Frequent ARVI (acute respiratory viral infections);
• Adenoviral infection;
• Chronic vitamin C deficiency;
• Previously suffered mononucleosis.

1. Internal factors:

• Hereditary predisposition, the basis of which is a deficiency of alpha1-antitrypsin - a substance that blocks enzymes that break down protein in the bronchial tree and thereby prevent the destruction of lung tissue;
• Prematurity - the lungs fully develop only by 38–39 weeks of pregnancy (9 months);
• HIV infection (human immunodeficiency virus);
• Bronchial asthma, which is accompanied by an increase in the level of immunoglobulin E;
• Bronchial hyperreactivity is a persistent increase in the formation of mucus in the bronchial tree.

Classification of the disease

Degree of severity depending on symptoms:

• 0 degree – no severity – shortness of breath occurs with intense stress on the body;
• 1st degree – mild severity – shortness of breath occurs when climbing or while walking relatively quickly;
• 2nd degree – moderate severity – shortness of breath forces patients to move at a slower speed compared to healthy people of the same age group;
• 3rd degree – severe – shortness of breath requires patients to stop during normal walking every 100 m;
• Grade 4 – very severe – shortness of breath occurs when eating, changing clothes or turning in bed. Such patients do not leave the room.

Stages of the disease depending on the study of external respiration function using spirometry - measurement of volume and speed parameters of breathing. (This method will be described in detail in the section “Modern methods of examination,” i.e., diagnosing the disease).

Stage I – mild.

• Tiffno index is less than 70%;
• FEV 1 greater than 80%;
• Absence of the main symptoms of the disease - sputum, shortness of breath and cough.

Stage II – middle.

• Tiffno index is less than 70%;
• FEV 1 is less than 80%;
• The presence or absence of the main symptoms of the disease - sputum, shortness of breath and cough.

Stage III – severe.

• Tiffno index is less than 70%;
• FEV 1 is less than 50%;

Stage IV is extremely severe.

• Tiffno index is less than 70%;
• FEV 1 is less than 30%;
• Chronic respiratory failure;
• The presence of the main symptoms of the disease is sputum, shortness of breath and cough.

Symptoms of the disease

Chronic obstructive bronchitis occurs with a constant alternation of 2 phases of the disease - exacerbation and remission, and symptoms vary depending on the phase.

Signs during an exacerbation:

• slight increase in body temperature;
• general weakness;
• headaches;
• dizziness;
• nausea;
• aches, chills, increased sweating;
• decreased ability to work;
• shortness of breath with minimal physical exertion;
• cough with the release of viscous sputum of a purulent nature (yellow).

Symptoms during remission:

• shortness of breath with increased exertion;
• cough, mainly in the morning, sputum is serous (transparent or white).

Concomitant symptoms of damage to other organs from oxygen starvation resulting from damage to the bronchopulmonary system:

• Signs of damage to the cardiovascular system - increased blood pressure, increased heart rate, pain in the heart, palpitations, blueness of the nose, lips, fingertips;
• Signs of damage to the urinary system - pain in the lumbar region, swelling of the lower extremities;
• Signs of damage to the central nervous system - impaired consciousness, shallow breathing, decreased memory and attention, blurred vision, hallucinations;
• Signs of damage to the digestive system are yellowness of the skin, lack of appetite, bloating, and abdominal pain.

Modern examination methods

Adult patients with a disease such as chronic obstructive bronchitis are observed at their place of residence or work by a general practitioner. When visiting a clinic for diagnosis and treatment, they can be observed by local therapists, family doctors or pulmonologists. For inpatient treatment, they should be in specialized pulmonology departments.

Algorithm for examining such patients:

1. Diagnostic survey and collection of complaints;
2. Diagnostic examination of the patient, including percussion (tapping) and auscultation (listening) of the chest.

During percussion, a boxy sound appears, which means increased airiness of the lungs.

On auscultation, harsh breathing and dry, whistling or buzzing rales are observed.

1. Diagnostic laboratory examination:

• A general blood test, which will be characterized by an increase in leukocytes, a shift in the leukocyte formula to the left and an increase in ESR (erythrocyte sedimentation rate);
• A general urine test, in which an increase in squamous epithelial cells and leukocytes in the field of view will be observed, as well as the possible appearance of mucus and traces of protein;
• General sputum analysis, which will be characterized by the presence of a large number of neutrophils and leukocytes.

1. Diagnostic instrumental examination:

The patient is asked to breathe into a tube connected to a computer program that immediately displays a graph of inhalation and exhalation. During the examination, the doctor gives commands to patients, which involve changing the speed and depth of breathing.

The main indicators that can be determined using spirometry:

1. Vital capacity (vital capacity of the lungs) is the total amount of air inhaled and exhaled from the lungs during quiet deep breathing;
2. FVC (forced vital capacity) is the total amount of air inhaled and exhaled from the lungs during deep, rapid breathing;
3. FEV 1 (forced expiratory volume in 1 second) - the volume of air during a sharp exhalation after a calm, deep inhalation;
4. Tiffno index – the ratio of FEV 1 to vital capacity. This parameter is a diagnostic criterion for determining the severity of the disease;
5. PSV (peak volumetric velocity) is the maximum speed of air flow achieved during a sharp exhalation after a deep inhalation.

• X-ray of the chest cavity, which is characterized by the presence of dilated bronchi and increased airiness of the lung tissue.

Main types of treatment

For a disease such as chronic obstructive bronchitis, treatment is prescribed only by qualified specialists in a hospital or outpatient setting. Therapy should be combined, i.e. Drug treatment must necessarily be supplemented by physiotherapeutic treatment, which includes aromatherapy, inhalations, massages, warming and exercise therapy (therapeutic exercises).

Drug treatment

The main goals of treatment are to prevent frequent exacerbations of chronic obstructive bronchitis, relieve symptoms of the disease, improve the body's tolerance to physical activity and reduce mortality.

Bronchodilators are drugs that dilate the bronchi:

• M-cholinergic blockers (ipratropium bromide) - Atrovent, Ipravent have a bronchodilator effect by blocking m-cholinergic receptors in the smooth muscles of the bronchi. The drug is prescribed to adults in the form of an aerosol of 40 mcg (2 puffs) 4–6 times a day;
• Short-acting beta2-agonists (salbutamol) - Salbuvent, Volmas, Ventolin - have a bronchodilator effect by stimulating beta2-adrenergic receptors, which are located in the bronchial wall. For adults, the drug is prescribed by inhalation at 2–4 mg (1–2 puffs) up to 6 times a day;
• Long-acting beta2-agonists (formoterol) - Athymos, Foradil have a pronounced bronchodilator effect. Prescribed for adults: 2 breaths 2 times a day (morning and evening).

Glucocorticosteroids (hormonal drugs):

Combination drugs containing long-acting beta2-agonists and glucocorticosteroids:

Antibacterial drugs act on chronic foci of infection in the bronchi due to the accumulation of copious amounts of sputum, which serves as a breeding ground for them. These drugs are prescribed only during the period of exacerbation of the disease.

• 2nd generation cephalosporins (cefuroxime, cefamandole);
• 3rd generation cephalosporins (cefotaxime, ceftriaxone);
• 2nd generation fluoroquinolones (ciprofloxacin, ofloxacin);
• Respiratory fluoroquinolones (levofloxacin);
• Aminoglycosides (amikacin).

Mucolytic drugs are drugs that stimulate the discharge of sputum from the bronchial tree:

• Bromhexine (Solvin, Bronchostop) has antitussive, mucolytic and expectorant effects. Prescribed in tablets of 8–16 mg 3–4 times a day;
• Ambroxol (Abrol, Ambrotard) stimulates the liquefaction of mucus by reducing viscosity, which promotes its better excretion. Prescribed 30 mg (1 tablet) 3 times a day;
• Acetylcysteine ​​(ACC) has antitussive and mucolytic effects. Prescribed 200–400 mg 2–3 times a day or 800 mg 1 time a day.

Physiotherapeutic treatment

Essential oils used for aromatherapy include:

• pine oil;
• eucalyptus;
• juniper;
• sandalwood;
• tea tree;
• bergamot.

Complications of the disease

• Pulmonary emphysema is increased airiness of the lung tissue, in which the elasticity of the bronchi is completely lost. With this complication, inhalation is easy, but in order to exhale it is necessary to make a significant effort;
• Pulmonary heart - in conditions of oxygen starvation of the body, the myocardium (heart muscle) begins to contract more intensely in order to improve blood supply to the internal organs and deliver the required amount of oxygen. Over time, the myocardium wears out, the chambers of the heart enlarge, the muscle layer becomes thin, which leads to disruption of the heart;
• Pulmonary hypertension - increased pressure in the bronchi and alveoli due to narrowing of blood vessels;
• Lung cancer.

Prevention of disease

• giving up bad habits, especially smoking;
• moving to environmentally friendly areas of cities;
• combating occupational hazards or switching to work that is not related to heavy industry in conditions of increased air dust;
• rational nutrition;
• playing sports;
• timely diagnosis and treatment of respiratory system diseases;
• annual preventive examinations with mandatory FLG (fluorography).

Video: Program “Live Healthy”, topic: “COPD - chronic obstructive pulmonary disease”

Chronic obstructive bronchitis is the undisputed leader in the list of the most common respiratory diseases. Often exacerbating, it can lead to the development of pulmonary insufficiency and loss of ability to work, therefore, at the first suspicion of the disease, it is important to immediately consult a pulmonologist.

What is obstructive bronchitis?

The word “obstruction” is translated from Latin as “obstacle,” which quite accurately reflects the essence of the pathological process: due to narrowing or blocking of the airways, air has difficulty leaking into the lungs. And the term means inflammation of the small respiratory tubes - the bronchi. So it turns out that “obstructive bronchitis” is a violation of the patency of the bronchi, which leads to the accumulation of mucus in them and difficulty breathing. A disease is called chronic if it lasts at least 3 months a year for 2 or more years.

Currently, the concept of “chronic obstructive bronchitis” is increasingly being replaced by another, more generalized one – chronic obstructive pulmonary disease (abbreviated as COPD). This diagnosis more accurately describes the nature of the lesion, because in reality, inflammation affects not only the bronchi. Very quickly it spreads to all elements of the lung tissue - blood vessels, pleura and respiratory muscles.

Causes of the disease

In 9 out of 10 people with this pathology, the cause is smoking.

The European Respiratory Society found that in 90% of cases, the occurrence of obstructive bronchitis is associated with smoking. The fact is that cigarette smoke causes a burn to the mucous membrane of the respiratory tract. The attack on the irritated membranes is completed by the tars and formaldehydes contained in tobacco, which provoke their destruction. The disease can occur with both active and passive smoking.

An important role in the development of bronchitis is played by inhalation of other harmful substances that float in the atmosphere: industrial emissions, exhaust gases. That is why the victims of chronic disease often include residents of large cities and chemical industry workers.

More rare causes of the disease include severe congenital deficiency of α1-antitrypsin, an enzyme produced by liver cells. One of the functions of this compound is to protect lung tissue from aggressive factors.

In addition, the following can contribute to the development of the disease:

• frequent,
• alcohol abuse,
• old age,
• low immunity,
• hereditary predisposition to bronchitis,
• neurological disorders.

Chronic bronchitis worsens when weakened mucous membranes are infected with viruses, pneumococci or mycoplasmas.

Stages of development

The development of the disease begins with irritation of the bronchial mucosa. In response to it, special substances are produced in the walls of the respiratory tubes - inflammatory mediators. They cause swelling of the membranes and increase mucus secretion.

At the same time, the formation of protective factors (interferon, immunoglobulin) that prevent the proliferation of microbes on the mucous membranes is reduced. The surface of the respiratory tract is colonized by all kinds of pathogenic bacteria.

With prolonged inflammation, scar tissue grows around the bronchi, which further compresses them and prevents normal breathing. During this period, a person experiences dry wheezing and whistling sounds when exhaling.

The outcome of the inflammatory process is the “sticking together” of the smallest branches of the bronchi - bronchioles, as a result of which the supply of oxygen to the air sacs of the lungs (alveoli) is disrupted. This is how respiratory failure develops. This is the last stage of obstructive bronchitis, at which it is no longer possible to restore the destroyed bronchi.

Symptoms

The causative factor irritates the bronchial mucosa, which reacts to this with inflammation, secretion of large amounts of mucus and spasm.

The main symptom of chronic bronchitis is cough. At first, it bothers patients only during periods of exacerbations that occur in the cold season. During attacks, a small amount of sputum is released. During illness, the temperature may rise slightly (up to 37.5–37.8 degrees).

Over time, patients begin to complain of a daily annoying morning cough. For some, attacks recur during the 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.

Obstructive bronchitis is an inflammatory disease that affects the bronchi and is complicated by obstruction. This pathological process is accompanied by severe swelling of the respiratory tract, as well as a deterioration in the ventilation capacity of the lungs. Obstruction develops more rarely; doctors diagnose non-obstructive bronchitis several times more often.

This disease is the “prerogative” of young children starting from the age of 3. It is more rare in people of working age.

Reasons

Obstructive bronchitis in children and adults most often begins to progress due to the penetration of infection into the body - viruses or bacteria. But in order for pathology to begin to develop, favorable conditions are also needed. The following factors contribute to the development of obstructive bronchitis in adults and children:

• decrease in the body's immune forces;
• inadequate and irrational nutrition;
• frequent diseases of the upper respiratory tract;
• stressful situations that are repeated repeatedly.

The second reason for the development and progression of the disease is an allergic reaction. If a child is prone to allergies, then the likelihood of developing chronic obstructive bronchitis increases.

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 that 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

The severity of chronic obstructive bronchitis in an adult or child is assessed by FEV1, which stands for the volume of forced expiration produced in one second. There are three degrees of severity of the disease:

• Stage 1. FEV1 is more than 50% of normal values. At this stage, chronic obstructive bronchitis does not worsen the patient’s quality of life. There is also no need to constantly be registered with a pulmonologist;
• Stage 2. FEV1 is reduced to 35–49%. In this case, the pathology affects the patient’s quality of life, so he needs to be systematically monitored by a pulmonologist;
• Stage 3. FEV1 less than 34%. The symptoms of the pathology are very pronounced. Patients should undergo treatment as an inpatient or outpatient in a pulmonary department.

Symptoms

Symptoms of obstructive bronchitis in children and adults are somewhat different. They largely depend on the severity of the pathology, the functioning of the immune system, as well as on the characteristics of the patient’s body.

Symptoms of the disease in adults

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

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.

If the above symptoms persist for three weeks, then doctors say that acute obstructive bronchitis has developed. If this condition recurs more than three times in a year, we will be talking about a recurrent form of the disease. But if the symptoms do not disappear within 2 years, then clinicians talk about the development of chronic obstructive bronchitis. In this case, the main clinical picture is supplemented by the following symptoms:

• headaches. Occur due to hypoxia;
• cough in the morning. Usually during it, sputum of a mucous or purulent nature is released;
• in severe cases of chronic obstructive bronchitis, hemoptysis may be observed;
• dyspnea;
• sweating;
• changes in the appearance of fingers and nails;
• increased fatigue.

Symptoms of the disease in children

Obstructive bronchitis in children usually occurs in an acute form. Risk group: children under 5 years of age. And it is possible that obstructive bronchitis may develop in an infant. There is one peculiarity - in a child, the symptoms of acute obstructive bronchitis are difficult to distinguish from bronchiolitis, so it is very important that the doctor conducts a competent differential diagnosis.

The development of acute obstructive bronchitis in children usually occurs due to the penetration of a viral infection into the body: adenovirus, etc. The pathology in a child is much more severe and complex. At first, you can note symptoms that are more indicative of development: the child is capricious, the temperature rises, and a slight cough appears.

The following symptoms indicate that acute obstructive bronchitis has begun:

• body temperature rises again;
• the cough is not productive and manifests itself in attacks;
• wheezing is observed when exhaling;
• increased breathing rate above the age norm (it is especially important to pay attention to this symptom when obstructive bronchitis develops in an infant);
• several elements of the body take part in the act of breathing at once - intercostal spaces, wings of the nose, jugular fossa, etc.;
• drowsiness or, conversely, constant anxiety;
• weak cry;
• the child refuses to eat.

Diagnostics

Diagnosis of acute and chronic obstructive bronchitis includes physical, endoscopic, laboratory, functional and radiological techniques. The program includes:

• percussion of the lungs;
• auscultation of the lungs;
• X-ray;
• spirometry;
• pneumotachometry;
• peak flowmetry;
• bronchography;
• sputum analysis by PCR;
• immunological tests.

The doctor will be able to tell how to treat obstructive bronchitis only after he has assessed the test results and identified the cause of the development of the pathology, as well as the severity of its course.

Treatment

Treatment of obstructive bronchitis requires a very long period of time and should only be carried out in a hospital setting. Therapy for an adult and a child is somewhat different. When drawing up a treatment plan for obstructive bronchitis, everything is taken into account - the characteristics of the pathology, the degree of FEV1, the general condition of the patient’s body, and age.

Treatment in adults

In order for the treatment of obstructive bronchitis in adults to be as effective as possible, it is necessary:

• eliminate the harmful factor that contributed to the progression of the disease - this could be an unfavorable place of work or smoking;
• stick to a diet;
• During the period of exacerbation, antibacterial drugs are added to the treatment plan for obstructive bronchitis. This is especially true in the case of purulent sputum. The drugs of choice are Sumamed, Amoxil;
• take bronchodilators;
• medications are prescribed that help thin sputum and remove it;
• vibration massage is indicated.

Treatment in children

Treatment of obstructive bronchitis in a child is carried out strictly in a hospital setting. Especially when it comes to babies. The treatment plan for a child’s illness includes the following activities:

• carrying out inhalations using a nebulizer. As a rule, a saline solution with the addition of Ventolin, Berodual and other drops is used;
• It is important to drink enough liquid per day;
• Only a doctor prescribes antibiotics to treat a child. Self-medication is unacceptable, as it can only worsen the course of the pathology;
• during the period of bronchial blockage, it is strictly forbidden to give expectorants;
• in more severe clinical situations, they resort to placing a dropper in the child with saline solution and the addition of active substances.

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Pneumonia (officially pneumonia) is an inflammatory process in one or both respiratory organs, which is usually of an infectious nature and is caused by various viruses, bacteria and fungi. In ancient times, this disease was considered one of the most dangerous, and although modern treatments make it possible to get rid of the infection quickly and without consequences, the disease has not lost its relevance. According to official data, in our country every year about a million people suffer from pneumonia in one form or another.