Chronic obstructive bronchitis of the lungs symptoms. Chronic obstructive bronchitis

- diffuse inflammation of the bronchi of small and medium caliber, proceeding with a sharp bronchial spasm and progressive impairment of pulmonary ventilation. Obstructive bronchitis is manifested by cough with sputum, expiratory dyspnea, wheezing, respiratory failure. Diagnosis of obstructive bronchitis is based on auscultatory, x-ray data, the results of a study of the function of external respiration. Therapy for obstructive bronchitis includes the appointment of antispasmodics, bronchodilators, mucolytics, antibiotics, inhaled corticosteroid drugs, breathing exercises, and massage.

ICD-10

J44.8 Other specified chronic obstructive pulmonary disease

General information

The reasons

Acute obstructive bronchitis is etiologically associated with respiratory syncytial viruses, influenza viruses, type 3 parainfluenza virus, adenoviruses and rhinoviruses, viral-bacterial associations. In the study of bronchial flushing in patients with recurrent obstructive bronchitis, DNA of persistent infectious agents - herpesvirus, mycoplasma, chlamydia - is often isolated. Acute obstructive bronchitis occurs predominantly in young children. The most susceptible to the development of acute obstructive bronchitis are children who often suffer from acute respiratory viral infections, who have a weakened immune system and an increased allergic background, and a genetic predisposition.

The main factors contributing to the development of chronic obstructive bronchitis are smoking (passive and active), occupational risks (contact with silicon, cadmium), air pollution (mainly sulfur dioxide), deficiency of antiproteases (alpha1-antitrypsin), etc. The risk for the development of chronic obstructive bronchitis includes miners, construction workers, metallurgical and agricultural industries, railway workers, office workers associated with printing on laser printers, etc. Men are more likely to develop chronic obstructive bronchitis.

Pathogenesis

The summation of genetic predisposition and environmental factors leads to the development of an inflammatory process, which involves the bronchi of small and medium caliber and peribronchial tissue. This causes a violation of the movement of the cilia of the ciliated epithelium, and then its metaplasia, the loss of ciliated cells and an increase in the number of goblet cells. Following the morphological transformation of the mucosa, a change in the composition of the bronchial secretion occurs with the development of mucostasis and blockade of the small bronchi, which leads to a violation of the ventilation-perfusion balance.

In the secret of the bronchi, the content of nonspecific factors of local immunity, which provide antiviral and antimicrobial protection, decreases: lactoferin, interferon and lysozyme. Thick and viscous bronchial secretion with reduced bactericidal properties is a good breeding ground for various pathogens (viruses, bacteria, fungi). In the pathogenesis of bronchial obstruction, an essential role belongs to the activation of cholinergic factors of the autonomic nervous system, which cause the development of bronchospastic reactions.

The complex of these mechanisms leads to swelling of the bronchial mucosa, hypersecretion of mucus and spasm of smooth muscles, i.e., the development of obstructive bronchitis. If the component of bronchial obstruction is irreversible, one should think about COPD - the addition of emphysema and peribronchial fibrosis.

Symptoms of acute obstructive bronchitis

As a rule, acute obstructive bronchitis develops in children of the first 3 years of life. The disease has an acute onset and proceeds with symptoms of infectious toxicosis and bronchial obstruction.

Infectious-toxic manifestations are characterized by subfebrile body temperature, headache, dyspeptic disorders, and weakness. Leading in the clinic of obstructive bronchitis are respiratory disorders. Children are worried about a dry or wet obsessive cough that does not bring relief and worsens at night, shortness of breath. Pays attention to the swelling of the wings of the nose on inspiration, participation in the act of breathing of the auxiliary muscles (muscles of the neck, shoulder girdle, abdominals), retraction of the compliant parts of the chest during breathing (intercostal spaces, jugular fossa, supraclavicular and subclavian region). For obstructive bronchitis, an elongated whistling exhalation and dry (“musical”) rales, audible at a distance, are typical.

The duration of acute obstructive bronchitis is from 7-10 days to 2-3 weeks. In case of recurrence of episodes of acute obstructive bronchitis three or more times a year, they speak of recurrent obstructive bronchitis; if symptoms persist for two years, a diagnosis of chronic obstructive bronchitis is established.

Symptoms of chronic obstructive bronchitis

The basis of the clinical picture of chronic obstructive bronchitis is cough and shortness of breath. When coughing, a small amount of mucous sputum is usually separated; during periods of exacerbation, the amount of sputum increases, and its character becomes mucopurulent or purulent. The cough is persistent and accompanied by wheezing. Against the background of arterial hypertension, episodes of hemoptysis may occur.

Diagnostics

The program of examination of persons with obstructive bronchitis includes physical, laboratory, radiological, functional, endoscopic studies. The nature of physical data depends on the form and stage of obstructive bronchitis. As the disease progresses, voice trembling weakens, a boxed percussion sound appears over the lungs, and the mobility of the lung edges decreases; auscultatory revealed hard breathing, wheezing with forced exhalation, with exacerbation - wet rales. The tone or number of wheezing changes after coughing.

A necessary criterion for the diagnosis of obstructive bronchitis is the study of the function of external respiration. The data of spirometry (including with inhalation tests), peak flowmetry, pneumotachometry are of the greatest importance. Based on the data obtained, the presence, degree and reversibility of bronchial obstruction, pulmonary ventilation disorders, and the stage of chronic obstructive bronchitis are determined.

In the complex of laboratory diagnostics, general blood and urine tests, blood biochemical parameters (total protein and protein fractions, fibrinogen, sialic acids, bilirubin, aminotransferases, glucose, creatinine, etc.) are examined. In immunological tests, the subpopulation functional ability of T-lymphocytes, immunoglobulins, CEC is determined. Determination of CBS and blood gases allows you to objectively assess the degree of respiratory failure in obstructive bronchitis.

Microscopic and bacteriological examination of sputum and lavage fluid is carried out, and in order to exclude pulmonary tuberculosis, sputum analysis by PCR and AFB is performed. Exacerbation of chronic obstructive bronchitis should be differentiated from bronchiectasis, bronchial asthma, pneumonia, tuberculosis and lung cancer, pulmonary embolism.

Treatment of obstructive bronchitis

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

The goal of the treatment of chronic obstructive bronchitis is to slow down the progression of the disease, reduce the frequency and duration of exacerbations, and improve the quality of life. The basis of pharmacotherapy of chronic obstructive bronchitis is basic and symptomatic therapy. Smoking cessation is a must.

Basic therapy includes the use of bronchodilators: anticholinergics (ipratropium bromide), b2-agonists (fenoterol, salbutamol), xanthines (theophylline). In the absence of the effect of the treatment of chronic obstructive bronchitis, corticosteroid drugs are used. Mucolytic drugs (ambroxol, acetylcysteine, bromhexine) are used to improve bronchial patency. The drugs can be administered orally, in the form of aerosol inhalations, nebulizer therapy or parenterally.

When layering the bacterial component during periods of exacerbation of chronic obstructive bronchitis, macrolides, fluoroquinolones, tetracyclines, b-lactams, cephalosporins are prescribed in a course of 7-14 days. With hypercapnia and hypoxemia, an obligatory component of the treatment of obstructive bronchitis is oxygen therapy.

Forecast and prevention of obstructive bronchitis

Acute obstructive bronchitis responds well to treatment. In children with an allergic predisposition, obstructive bronchitis may recur, leading to the development of asthmatic bronchitis or bronchial asthma. The transition of obstructive bronchitis to a chronic form is prognostically less favorable.

Adequate therapy helps to delay the progression of obstructive syndrome and respiratory failure. Unfavorable factors that aggravate the prognosis are the elderly age of patients, comorbidities, frequent exacerbations, continued smoking, poor response to therapy, and cor pulmonale.

Measures for the primary prevention of obstructive bronchitis include maintaining a healthy lifestyle, increasing overall resistance to infections, improving working conditions and the environment. The principles of secondary prevention of obstructive bronchitis involve the prevention and adequate treatment of exacerbations to slow down the progression of the disease.

According to the ICD, this term is characterized by diffuse inflammatory processes that occur in the bronchi. Chronic obstructive bronchitis can cause serious changes in the structure and functioning of the lungs. Therefore, it is extremely important to detect the disease in time and begin its treatment.

Causes of bronchial obstruction

Chronic obstructive bronchitis can occur as a result of exposure to the following factors:

• Respiratory hazard working conditions. These include working with varnishes and paints, building mixtures, chemicals and other toxic materials. The risk group includes miners, office workers, construction workers, workers in metallurgical plants and people living in large cities.
• Smoking. This bad habit provokes the deposition in the bronchi of a large amount of nicotine, tar and other combustion products.
• Upper respiratory tract infections. The resistance of the lungs and bronchi decreases under the influence of the virus.
• The predisposition is in the genetic code. This cause is characterized by a hereditary deficiency of the alpha1-antitrypsin protein, which performs protective functions in the lungs.

Symptoms of obstructive bronchitis

The main signs of chronic obstructive bronchitis:

• Cough. At the initial stages of the disease, it is dry, accompanied by a whistle. As the disease progresses, sputum develops. There may be traces of blood.
• Dyspnea. At first, this sign appears only during physical exertion, then shortness of breath is also noted in a calm state.
• fatigue. The patient feels tired very quickly, even if his load is minimal.
• Temperature. It does not rise because the reaction of the immune system does not work.

emphysematous type

An emphysematous type of the disease is found in the elderly. It is characterized by the appearance and progression of shortness of breath, which does not cause blue skin. It occurs under stress. Manifestations of the development of this type of chronic bronchitis is a small wet non-allergic cough, there is a decrease in body weight. In the later stages, pulmonary hypertension, hypoxemia, and left ventricular failure may occur. When diagnosing, specialists detect signs of emphysema on the lung.

Bronchitis type

A mild degree of shortness of breath suggests a bronchitis type of disease. At the same time, edema and cyanosis are observed in patients. This type of disease is characterized by a productive cough, wheezing or whistling sounds are found on examination. Chronic obstructive pulmonary disease of this type manifests itself at an early age, contributes to the development of hypoxia. On x-rays, patients can detect signs of fibrosis and an increase in the outlines of the lung pattern.

How to Diagnose Bronchitis

In the initial stages, the clinical picture of an obstructive type of disease does not have specific signs, so research will be aimed at excluding other diseases. To establish a diagnosis, the following procedures are carried out:

• sputum examination for bacterial content;
• inhalation procedures with beta2-adrenergic agonist to exclude asthmatic syndrome;
• radiography;
• examination of the respiratory function of the lungs;
• calculating a smoker's index;
• blood tests;
• bronchoscopy.

Carrying out FVD

The study of the function of external respiration is used to establish pathologies in the lungs and bronchi in case of suspected obstructive bronchitis. It is carried out on an empty stomach, and after the last meal, at least 2 hours should pass. Smoking patients are advised not to resort to a bad habit during the day before the respiratory tract. In addition, you can not drink coffee and strong tea, drink alcoholic beverages. 30 minutes before the start of the study, you need to calm down, exclude physical activity. The FVD rules require the patient to wear something light.

During the procedure, the person should sit in a chair with their hands on the armrests. A special clamp is put on his nose, the patient breathes through his mouth into a special device - a spirometer. This device measures the volume of air that is released during inhalation and exhalation. First you need to take a deep breath. Then, gradually exhale all the air into the machine. The next action is similar, but is not performed calmly, but abruptly. At the last stage, you need to inhale as much as possible and exhale quickly. A decrease in indicators means the presence of obstructive bronchitis.

Chest x-ray and fluorography

No changes in the lungs on x-rays with obstructive disease in the initial stage will be detected. Fluorography is done to determine the progression of the disease, which is expressed in complications. In this case, the following indicators may be reflected in the images:

• greater severity of the lung pattern;
• changes in the roots of the lungs;
• signs of emphysema;
• hardening and thickening of smooth muscle.

Treatment of chronic obstructive bronchitis in adults

Various types of treatment are used to stop the symptoms and eliminate the causes of obstructive bronchitis. The basis of therapy is effective medicines that should clear the airways of sputum and microbes. In addition to pills, patients with obstructive bronchitis rely on physiotherapy and special exercises, the implementation of which will help restore proper breathing.

Therapy with bronchodilators

To treat COPD, 2 types of bronchodilators are used:

• Bronchodilator drugs. These medications are mandatory. Among them are:

• Ipratropium bromide. The drug is used in the form of inhalations, which can be carried out using a spray can or nebulizer. Berodual combines this substance with beta2-agonists. Such funds are allowed for long-term use.
• Fenoterol (salbutamol, terbutaline) are used during an exacerbation of a chronic illness.
• Salmeterol (formoterol) - inhalations that have a prolonged action. They are prescribed for severe symptoms of obstructive disease.
• Doctors prescribe complex therapy with these drugs in case of a severe course of the disease, accompanied by inflammatory processes.
• Glucocorticoids. Medicines of this group are prescribed in the most serious cases of chronic bronchitis, if the drugs of the first type do not work. Inside it is prescribed to take a dose equal to 30 mg per day. The course of treatment is 1-1.5 weeks. If low efficiency is found, inhalations are prescribed.

The use of mucolytics

Expectorants are an important part of the treatment of chronic bronchitis. Their components reduce the viscosity of sputum, restore the ability of mucosal cells to regenerate. In addition, drugs help improve the effectiveness of other drugs. The most popular medicines of the group:

• Lazolvan;
• Bromhexine;
• Carbocysteine;
• Fluimucin.

Correction of respiratory failure

Treatment of chronic obstructive bronchitis in adults is carried out with the use of special breathing exercises and oxygen therapy. The latter type of recovery can be used both in a hospital and at home. Exercises for gymnastics with obstructive bronchitis are selected by the doctor individually for each patient. For home oxygen therapy procedures, non-invasive ventilation devices and oxygen concentrators are suitable.

Antibiotics

Indications for the use of antibiotics for the treatment of obstructive chronic bronchitis:

• secondary microbial infection;
• elderly age;
• severe course of the disease during an exacerbation;
• the appearance of pus among the sputum secreted when coughing;
• if the cause of the disease is a violation in the immune system.

The choice of an anti-inflammatory antimicrobial drug for chronic bronchitis should be carried out by a doctor, based on the testimony of tests and studies, individual characteristics of the body. If these measures have not been taken, broad-spectrum antibiotics are prescribed. These drugs include:

• Augmentin;
• Levofloxacin;
• Amoxiclav;
• Erythromycin.

Video

Obstructive bronchitis is an inflammatory disease of the bronchi, in which the airway is blocked. There are acute and chronic forms of the disease. Acute obstructive bronchitis most often occurs in childhood. The main causes of the disease in this case are viral infections (, parainfluenza, adenoviruses, rhinoviruses, respiratory syncytial virus). The disease usually develops in adults.

There are many factors that increase the risk of developing chronic obstructive bronchitis:

• smoking;
• hereditary genetic pathology, in which α1-antitrypsin deficiency is detected in patients;
• adverse environmental conditions (air pollution, high humidity);
• occupational hazards (work with silicon, cadmium, cement, in coal mines, metallurgy, etc.).

Symptoms of obstructive bronchitis

Signs of the acute form of the disease almost always develop against the background of SARS. In patients, body temperature rises, weakness, chills appear. The main symptom of bronchitis is that at the beginning of the disease it is dry and intrusive, and then it becomes wet, a large amount of sputum is discharged. , which occurs in severe cases, is due to the accumulation of secretions in the bronchi, as well as swelling of their mucous membrane. Sometimes at a distance when the patient breathes, wheezing is heard, the so-called whistling exhalation.

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

The first visit to the doctor is usually associated with the appearance of shortness of breath and cough, which is sometimes accompanied by sputum production. These symptoms are most pronounced in the morning. Since the disease progresses slowly, in most cases, shortness of breath, which initially occurs only during physical exertion, appears on average 7–10 years later than cough.

Exacerbations of chronic obstructive bronchitis are usually associated with acute respiratory diseases, so a cough with purulent sputum and increased shortness of breath are often not regarded as signs of this particular disease. Over time, exacerbations of the disease begin to occur more often, and periods of remission are significantly reduced.

As bronchitis progresses, "whistling" breathing joins the cough, and shortness of breath can vary from a feeling of lack of air during habitual physical exertion to severe respiratory failure.

Treatment of acute obstructive bronchitis

In the acute form of obstructive bronchitis, therapy is aimed at, as well as eliminating the violation of bronchial patency. to free the airways, it is recommended to suck out accumulated mucus and secretions with a rubber spray or electric suction. Contribute to the improvement of sputum discharge vibration massage and postural (positional) drainage.

Distraction therapy - hot foot baths - will help to somewhat alleviate the patient's condition, and if you feel satisfactory, you can take a shared bathroom. Warm (not hot) plentiful drink, expectorant mixtures (infusions based on marshmallow root, ipecac, thermopsis) contribute to liquefaction of sputum and facilitate its release. To relieve swelling of the bronchial mucosa and thin the sputum, aerosol inhalations are recommended.

In the case of a bacterial infection, when the sputum becomes purulent, the doctor may prescribe broad-spectrum antibiotics. It should be noted that in order to prevent infectious complications, antibacterial drugs should never be used. To strengthen the body's defenses, vitamin therapy is prescribed (Biomax, Vitrum, Complivit, ascorbic acid).

Treatment of chronic obstructive bronchitis

Therapeutic tactics in the chronic form of the disease is significantly different from that in acute bronchitis. Only a doctor can choose a treatment regimen for a patient, taking into account the stage of the disease, the age of the patient and the presence of concomitant diseases.

1. First of all, it is necessary to eliminate the factor that caused the development of the disease. This is an important and mandatory stage of treatment, without which it is impossible to achieve a positive result of treatment.
2. Bronchodilatory therapy is necessary for patients suffering from chronic obstructive bronchitis, since impaired airway patency, in this case, is the main link in the pathogenesis of the disease. The drug that has a bronchodilator effect includes m-anticholinergics (Atrovent, Spiriva), β2-agonists (Salbutamol, Fenoterol) and methylxanthines (Eufillin).
3. Mucolytics (Ambrobene, Bromhexine) contribute to liquefaction, and therefore, facilitate the discharge of sputum from the bronchi. Herbal preparations can also be used as expectorants.
4. Antibacterial therapy is prescribed only in case of pus in the sputum.

To prevent exacerbations of the disease during periods of remission, patients are recommended to perform procedures aimed at strengthening immunity (hardening, exercise, proper nutrition, periodic courses).

Which doctor to contact

When the initial symptoms of inflammation of the bronchi (cough) appear, you can consult a pediatrician or therapist and undergo an initial examination, which should include an assessment of the function of external respiration and a test with bronchodilators. In the future, patients with bronchial obstruction are treated by a pulmonologist.

Unfortunately, many people now suffer from a disease such as bronchitis. We are all sure that it occurs only as a complication after SARS. However, those who are faced with the chronic form have a completely different idea of ​​getting rid of this problem. The treatment and symptoms of chronic obstructive bronchitis are slightly different from the acute form. With this degree of the disease, there is a strong obstruction of the respiratory tract. In this form of the disease, the treatment has two components: irreversible and reversible.

If you do not take measures to cure thoroughly, then the reversible degree will gradually turn into an irreversible one over time. COB should not be taken as a mild illness. In fact, this is a very serious problem, which can be accompanied by severe complications. With progression, not only inflammation occurs, the disease can also affect the bronchial mucosa. At the same time, their correct ventilation is also violated, such a complication does not allow sputum to leave, and often causes asthma attacks.

The program "Live healthy" perfectly describes the features of chronic obstructive bronchitis:

Poor ecology directly affects the development of bronchitis, both in adults and in children. However, there are many other factors that can cause chronic obstructive bronchitis. Physicians conditionally divide them into several groups:

External provocateurs

• Bad habits are one of the most common causes of chronic obstructive bronchitis. It accounts for approximately 95% of cases;
• professional - people who work in organizations with a lot of dust and toxic substances are exposed to this factor. They have a bad effect on the condition of the human lungs. Especially harmful are cadmium and silicon. These toxic substances are commonly found in chemical and metallurgical plants;
• persistent colds - influenza, SARS, etc.;
• adenovirus infection;
• mononucleosis;
• vitamin C deficiency.

Internal provocateurs

• in the first place is hereditary predisposition;
• premature birth - the lungs are able to fully work only at the 39th week of pregnancy;
• AIDS virus;
• bronchial asthma;
• bronchial hyperactivity.

Signs of illness

Symptoms of chronic obstructive bronchitis are slightly different from the acute form. The main difference is that the cough does not stop even during remission.

1. After strong bouts of coughing, which is also accompanied by intense sweating, and suffocation, only a small amount of sputum is released.
2. Sometimes blood streaks also appear in the mucus.
3. When an exacerbation of bronchitis occurs, and coughing attacks become more frequent, intensify, pus is observed in the mucus.
4. In this case, the patient is accompanied by constant shortness of breath, which initially occurs only during physical exertion, and eventually even at moments of rest.
5. Breathing in COPD is quite heavy, there are characteristic whistles and wheezing.
6. The inhale becomes much longer than the exhale. And all because the expansion of the chest contribute to the muscles of the neck, back and even the press.
7. In severe cases, there is even an increase in the veins in the neck, the wings of the nose swell when inhaled, and the areas on the chest sink.
8. When the body gets tired of fighting the disease, symptoms of respiratory and heart failure begin to accompany the person. A characteristic blue appears on the nails, in the region of the nasolabial triangle and on the skin. In some patients, swelling of the lower extremities can also be seen.
9. The patient begins to complain of constant fatigue, lack of energy and desire for vigorous activity.
10. Some patients even have symptoms of intoxication.

The nature of chronic bronchitis in children

Often, babies are struck by an acute form of bronchitis, which is quite easy to cure with timely treatment. However, it is worth paying special attention to the exacerbation of obstructive bronchitis in children who are often exposed to SARS and allergy attacks. And all because there is a risk of developing an allergic form of the disease and bronchial asthma. The appearance of these diseases provoke frequent relapses.

This is important: It is necessary to carefully monitor the well-being of the child, and in the event of a high subfebrile temperature, asthma attacks, constant coughing without mucus discharge, you should urgently call a doctor. The best way out is the therapy of chronic obstructive bronchitis in the acute stage in a hospital, in a hospital.

Diagnostics

As soon as the first signs of bronchitis appear, it is urgent to seek professional medical help. At the first examination, the doctor will be able to accurately diagnose. Since this disease is accompanied by a pronounced clinical picture. Symptoms in adults , and children are always pronounced.

The diagnosis is confirmed by auscultation of the lungs, which show wheezing, which changes in frequency as the person coughs. In order to rule out pneumonia, tuberculosis, or an oncological neoplasm, the doctor recommends undergoing an x-ray of the lungs. In the results, which will be seen that COPD is characterized by a tightening of breathing with wheezing and wheezing during rapid exhalation. And the number of lung edges becomes smaller, and a box sound is observed during percussion. A particularly symptom of emerging heart failure of pulmonary origin is a strong accent of the second tone of the pulmonary artery when listening.

However, many doctors argue that in order to establish an accurate diagnosis of chronic bronchitis, one listening and x-ray is not enough. To do this, it is necessary to undergo an endoscopic examination, which will accurately indicate the depth and level of reversibility of the inflammatory process.

Types of endoscopic examinations

• spirometry;
• pneumotachometry;
• peak flowmetry;
• bronchoscopy;
• bronchography.

Also important are the results of other laboratory studies, which include:

• blood and urine analysis (general);
• blood biochemistry;
• immunoassays;
• gas composition of blood;
• sputum examination.

You also need to know how to distinguish COB from asthma:

Treatment of chronic obstructive bronchitis

The main thing in the treatment of obstructive bronchitis is to reduce the progress of the disease. This means that you must first remove the very cause of the disease, which led to a relapse.

Those who smoke should quit this habit. And if you have a harmful profession, then it is advisable to choose another, more suitable one. In order to remove the main signs of the disease, a whole complex of treatment is prescribed. It includes:

• bronchodilator drugs - it is best to carry out inhalation, and when cases are started, the drug is administered intravenously. To relieve spasm, the doctor will prescribe Eufillin, Berotek, etc.;
• mucolytic drugs are prescribed to reduce the viscosity of mucus and its amount. To improve the output, you can take ACC or Lazolvan, etc.;
• anti-inflammatory drugs will quickly remove the inflammation. And in some cases, even Prednisolone is prescribed.
• antibacterial drugs are prescribed only when the cause of bronchitis is bacteria.

The course of therapy can last from one week to two. And when chronic obstructive bronchitis subsides, some medications still have to be taken, they make it easier to expectorate. You can also do special breathing exercises. And it is best to take a course of vitamin therapy.

Forecasts

If adequate treatment of chronic obstructive bronchitis was carried out with modern means , the prognosis is quite favorable. Seizures can be prevented and reduced, and complications avoided. But, this is only on condition that the therapy regimen was correct and timely. Unfortunately, in old age and when there are many other chronic diseases, the fight against chronic bronchitis becomes more difficult. However, this is not a sentence, and yet you need to be careful and take care of yourself.

Prevention

As strange as it may sound, chronic bronchitis can be easily dealt with. To do this, you must follow a few simple rules:

1. The main prevention of diseases is maintaining a healthy lifestyle.
2. Refusal of bad habits (smoking, drinking alcohol).
3. Proper and rational nutrition.
4. Constant walks in the fresh air.

It is also necessary to carry out timely therapy of acute respiratory diseases. And when allergic reactions torment, it is necessary to undergo antihistamine therapy.

This is important: Pay attention to the environment and living conditions. Every day you need to ventilate the room, do wet cleaning at least three to four times a week. It is best to install humidifiers, as the humidity in the room should not be less than 60%. If COB appeared as a result of toxic substances that are in the environment, it is recommended to change the place of residence or profession.

In conclusion, I would like to say that any disease can be defeated only with the right treatment. And, most importantly, never self-medicate! Coordinate all your actions with your doctor!

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

Next, we will look at what kind of disease it is, what are the first signs in adults, what is prescribed as a diagnosis for detecting an obstructive form of bronchitis, and what methods of treatment and prevention are most effective.

What is obstructive bronchitis?

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

The word "obstruction" is translated from Latin as "obstruction", which quite accurately reflects the essence of the pathological process: due to the narrowing or blocking of the airway lumen, air hardly seeps into the lungs. And the term "" means inflammation of the small respiratory tubes - the bronchi. Obstructive bronchitis is a violation of the patency of the bronchi, which leads to the accumulation of mucus in them and difficulty breathing.

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

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

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

Forms of development

There are 2 forms of the disease:

Acute obstructive bronchitis

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

• banal bronchitis or with improper treatment of the disease,
• contact with an allergen
• exposure to polluted air.

Chronic obstructive form

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

Chronic obstructive bronchitis, along with other diseases that occur with progressive airway obstruction (bronchial asthma), is commonly referred to as chronic obstructive pulmonary disease (COPD).

The reasons

Causes of obstructive bronchitis in adults:

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

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

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

• second blood group;
• hereditary deficiency of immunoglobulin A;
• alpha1 antitrypsin deficiency.

stages

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

Symptoms of obstructive bronchitis in adults

Doctors say that even at the initial stage, obstructive bronchitis in adults can be suspected. Symptoms and treatment of pathology are best discussed with a doctor. After all, making a diagnosis on your own, and even more so choosing a therapy, can be very dangerous.

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

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

Symptoms:

• temperature rise;
• dry cough. It usually develops in attacks, intensifying in the morning or at night;
• the frequency of respiratory movements per minute increases up to 18 times. In a child, this figure will be slightly higher;
• during exhalation, wheezing wheezing is noted, which is audible even at a distance.

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

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

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

Over time, patients begin to complain of a daily hacking morning cough. For some, attacks are repeated in the daytime. Annoying smells, cold drinks, frosty air become their provocateurs.

Sometimes bronchospasm is accompanied by hemoptysis. Blood appears due to rupture of capillaries with strong straining.

In the later stages, the disease is much like asthma. Patients have difficulty breathing. Exhale with wheezing and whistling. The duration of their exhalation increases.

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

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

Diagnostics

The diagnosis of acute obstructive bronchitis is usually made on the basis of a pronounced clinical picture and the results of a physical examination. During auscultation, moist rales are heard in the lungs, the frequency and tone of which change with coughing.

The laboratory research package includes:

• general blood and urine tests;
• blood chemistry;
• immunological tests;
• determination of the gas composition of the blood;
• microbiological and bacteriological studies of sputum and lavage fluid.

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

Instrumental examination:

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

• VC - vital capacity of the lungs;
• FEV1 - forced expiratory volume in 1 second;
• Tiffno index - the ratio of VC to FEV1;
• POS - peak space velocity.

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

Treatment

When diagnosed with obstructive bronchitis, the symptoms identified and the prescribed treatment allow you to quickly put a person on his feet, but it requires a long and thorough treatment that will help prevent another attack, as well as restore bronchi with blockage from sputum.

In acute obstructive bronchitis is prescribed:

1. rest, drink plenty of water, humidify the air, alkaline and medicinal inhalations.
2. Etiotropic antiviral therapy is prescribed (interferon, ribavirin, etc.).
3. With severe broncho-obstruction, spasmolytic (papaverine, drotaverine) and mucolytic (acetylcysteine, ambroxol) agents, bronchodilator inhalers (salbutamol, orciprenaline, fenoterol hydrobromide) are used.
4. To facilitate the discharge of sputum, percussion massage of the chest, vibration massage, massage of the back muscles, and breathing exercises are performed.
5. Antibacterial therapy is prescribed only when a secondary microbial infection is attached.

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

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

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

How to treat chronic obstructive bronchitis in adults?

Therapeutic tactics in the chronic form of the disease is significantly different from that in acute bronchitis. Only a doctor can choose a treatment regimen for a patient, taking into account the stage of the disease, the age of the patient and the presence of concomitant diseases.

The general principles of therapy for the disease under consideration are as follows:

1. It is necessary to eliminate the factor that led to the exacerbation of chronic obstructive bronchitis - to cure an acute respiratory viral infection, tonsillitis.
2. The doctor should prescribe drugs with a bronchodilatory effect, for example: Salbutamol, Eufillin, Atrovent and others.
3. To thin the sputum and ensure its rapid withdrawal, the patient should take mucolytic drugs - for example, Bromhexine or Ambrobene.

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

• hardening,
• physical exercises,
• proper nutrition,
• periodic courses of vitamin therapy.

How to treat obstructive bronchitis if home treatment does not help? Most likely, the doctor will recommend treatment in a hospital. In addition to the ineffectiveness of outpatient treatment, indications for inpatient treatment are as follows:

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

Prevention

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

1. Primary prevention involves quitting smoking.
2. It is also recommended to change working conditions, place of residence to more favorable ones.
3. You need to eat right. There should be enough vitamins and nutrients in food - this activates the body's defenses.
4. It is worth thinking about hardening.
5. Fresh air is important - daily walks are a must.

Measures of secondary prevention imply a timely visit to the doctor if the condition worsens, passing examinations. The period of well-being lasts longer if the prescriptions of doctors are strictly followed.

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