Bronchitis is acute. Bronchitis chronic - Causes, symptoms and treatment. MF.
Bronchitis is an infectious disease accompanied by diffuse inflammation of the bronchi. The main symptom of the disease is cough.
If the disease lasts less than three weeks, they talk about acute bronchitis. If the symptoms of bronchitis occur at least three months during the year for two years or more, you can safely diagnose chronic bronchitis.
If the onset of the disease is accompanied by shortness of breath, then they speak of obstructive bronchitis.
Causes of bronchitis
Bronchitis is an infectious disease. The cause of bronchitis can be a bacterial, viral or atypical flora.
The main bacterial pathogens of bronchitis : staphylococci, pneumococci, streptococci.
Pathogens of the viral nature of : influenza virus, respiratory syncytial infection, adenovirus, parainfluenza, etc.
Atypical pathogens of bronchitis : chlamydia( Chlamydia pneumonia), mycoplasmas( Mycoplasma pneumonia).Atypical they are named in connection with the fact that in their biological characteristics they occupy an intermediate position between bacteria and viruses. They spend most of their life cycle like viruses inside the cell, but the characteristics of the cells are much like bacteria.
Very rarely, the cause of bronchitis is a fungal infection.
There is often a combination of different pathogens. For example, the disease begins as a viral infection, and then the causative agents of a bacterial nature join. In this case, viruses, as it were, open the gate for bacteria, create favorable conditions for their reproduction. This variant of the current is the most common, which is confirmed by a sharp rise in the incidence in the autumn and winter season, when there is a seasonal spread of viral infections.
A prerequisite for the development of bronchitis is a decrease in the activity of the patient's immune system, which normally provides immunity to infectious diseases.
Risk factors for infection are age over 50, smoking, working in conditions of harmful production, frequent hypothermia, alcoholism, chronic diseases of internal organs in the stage of decompensation.
Symptoms of bronchitis
The main symptom of bronchitis is cough .Cough can be dry( without sputum) or wet( with sputum discharge).Separation of sputum, especially with a green tinge, is a reliable criterion for bacterial inflammation. Dry cough can be observed with a viral or atypical infection. The evolution of a cough from dry to wet is most often noted. In acute illness, cough is paroxysmal.while coughing attacks can be so severe that they are accompanied by a headache.
Symptoms of acute bronchitis
Acute bronchitis is accompanied by a rise in temperature to 38-39 degrees, chills, increased sweating. There is general weakness, rapid fatigue and a significant decrease in efficiency. The severity of symptoms can range from moderate to very severe.
During the examination of the patient, scattered rales, heard at auscultation and hard breathing, are taken care of. With an average severity or severe course of the patient's disease, shortness of breath and chest pain begin to ache.
The average duration of acute bronchitis is 10-14 days. Exacerbation of chronic bronchitis, especially in the absence of adequate treatment can last for weeks.
Symptoms of chronic bronchitis
In chronic bronchitis, coughing with sparse sputum, shortness of breath during physical exertion can be permanent symptoms accompanying the patient throughout life. In this case, exacerbation of bronchitis is said, if there is a significant increase in the above symptoms: increased cough, increased volume of sputum, increased dyspnoea, temperature, etc.
Bronchitis, especially acute, rarely occurs in isolation. Most often it is combined with the phenomena of rhinitis( cold), tracheitis. This certainly affects the overall clinical picture.
What tests will have to take if you suspect bronchitis
In any case, with symptoms of bronchitis will have to take a clinical blood test. If you suspect a pneumonia, you will be forced to take an X-ray, but most often do without it.
It is compulsory to submit sputum analysis( if it is, of course) to microscopy with Gram staining. Conduct a cytological examination of sputum with mandatory counting of cellular elements. In case of prolonged disease, chronic or often recurrent bronchitis, it is necessary to make sputum culture on the microflora with mandatory determination of sensitivity to antibiotics.
Also make a smear from the pharynx to the microflora and fungi.
Frequent bronchitis is an indication for the blood test for antibodies( immunoglobulins of classes M and G) of for atypical infections of ( Chlamydia pneumonia and Mycoplasma pneumonia).
In obstructive bronchitis, spirography( examination of the function of external respiration) is required. With pronounced decreases in bronchial patency, spirography is supplemented by a breakdown with a bronchodilator( salbutamyl, ventolin, berodual, etc.).The purpose of such a study is to determine the reversibility of pathological changes and exclude possible concomitant diseases, for example, bronchial asthma.
Frequent exacerbations of bronchitis or chronic bronchitis are an indication for bronchoscopy .The goal is to identify concomitant lung diseases that can cause symptoms similar to bronchitis.
Recurrent bronchitis requires mandatory radiographic examination. First of all do FLG( fluorography) or radiography. The most informative method of X-ray examination is computer tomography.
Treatment of bronchitis
Bronchitis is a serious enough disease, it is the doctor who should treat bronchitis. He determines the optimal drugs for the treatment of bronchitis, their dosage and combination. Under the guise of bronchitis can occur a number of diseases, untimely diagnosis and improper treatment of which can have very unfortunate consequences.
Treatment for bronchitis bed or half-bed."Heroes" who try to transfer the disease on their feet, have every chance to earn complications on the heart or make acute bronchitis chronic.
At the heart of the treatment of bronchitis is the use of anti-infectious agents.
Antibacterial drugs are on the first place, in importance. The first line includes penicillin derivatives( preparations: flemoclave, flemoxin, augmentin, etc.) and macrolides( preparations: macropen, fromilide, azithromycin, hemomycin, rovamycin, vilprafen).Second-line drugs include cephalosporins( preparations: suprax, cefixime, cefazolin, cephalexin, cloforan, cefataxime, fortum, ceftazidime, cefepime, ceftriaxone, rocefin), respiratory fluoroquinolones( sparfloxacin, levofloxacin, moxifloxacin).With mild and moderate severity of the disease, it is preferable to use oral dosage forms( tablets, suspension, syrups, etc.), in severe form - the only possible way of injecting the drug. Sometimes they combine both methods of drug administration.
If you suspect a viral etiology( the cause of development) of bronchitis - it is necessary to supplement the treatment with antiviral drugs. The most widely available broad-spectrum drugs are viferon, geneferon, kipferon. Dosages depend on the patient's age. Duration of application not less than 10 days.
Mandatory treatment of bronchitis is the appointment of expectorant drugs. Currently, pharmacies are represented by a huge number of drugs of this pharmacological group: ATSTS, fluimutsil, lazolvan, mukaltin, ambroksol, libeksin-muko, fluditik, bromhexine, etc. Forms of release: tablets for ingestion, syrups, effervescent tablets, powders. Dosages depend on the age and weight of the patient.
Separately I would like to single out the preparation of erespal( fenspiride).It has both expectorant and anti-inflammatory action. It is produced in tablet form and in the form of syrup. Treatment for at least 10 days. Can be appointed even for children under 1 year.
The presence of dyspnoea with bronchitis is a direct indication for the use of bronchodilators. They are produced in tableted( euphyllin, teopek, theotard) and inhalation forms( aerosol for inhalation: berodual, berotek, salbutamol).
It is possible to use combined preparations for the treatment of bronchitis. For example, aspirate syrup combines the properties of expectorant and bronchodilator drugs.
Popular home remedies, such as staging cans, mustard plasters, with bronchitis are not effective.
It is possible to use a complex of multivitamin complexes.
Features of nutrition and lifestyle in bronchitis
On the background of exacerbation of bronchitis, traditionally recommended a plentiful drink. For an adult person - the daily volume of consumed liquid should be at least 3 - 3.5 liters. Usually alkaline milk, hot milk with Borjomi in a ratio of 1: 1 is well tolerated.
Daily food intake should contain a sufficient number of proteins and vitamins. Against the backdrop of high temperature and general intoxication, one can get hungry a little( if the body of this, of course, requires), but in general, any restricting diets to such patients are contraindicated.
High efficiency shows the use of inhalations with a nebulizer. As a solution for inhalation, mineral water, Ringer's solution or usual saline solution can be used. The procedures are carried out 2-3 times a day for 5-10 days. These manipulations contribute to the removal of the moctroty, facilitate the drainage of the bronchial tree, reduce inflammation.
A lifestyle correction is necessary to eliminate the risk factors for the development of upper respiratory tract infections. First of all, this concerns smoking and various kinds of occupational hazards( dusty production, work with paints, frequent hypothermia, etc.).
An excellent effect in chronic lung diseases is the use of respiratory gymnastics, for example, according to the Strelnikova method. This also applies to chronic bronchitis.
Outside of exacerbation of bronchitis, it is possible to carry out hardening measures.
Treatment of bronchitis with folk remedies
A very popular folk remedy for bronchitis - steam inhalation .For this, it is recommended to breathe the steam generated during the cooking of potatoes, etc. Some of this method with accurate use, of course, helps, but more often its use causes a burn of mucous membranes and subsequent aggravation of the course of bronchitis.
treatment of bronchitis with herbal remedies is possible. Most often, the following herbs and their combination are used for the treatment of bronchitis: thyme, licorice, oregano, lime, coltsfoot, plantain. To prepare the broth 1 tablespoon of the mixture pour ½ liter of boiling water and leave for 2 hours. Take 1/3 cup 3 times a day. The course of treatment is 7-10 days. The method is really effective in complex treatment of chronic bronchitis .
Use of koumiss or goat milk in the treatment of acute and chronic bronchitis : recommend consuming at least 1 cup of milk 3-4 times a day - long. I did not see reliable data on the effectiveness of this method.
Drink mixture onion with honey in the ratio 1: 1, passed through a meat grinder according to the scheme: 1 tablespoon - 2 times a day for 10-14 days. Sometimes instead of onions it is recommended to use garlic. A number of patients did have an effect, most of them had an exacerbation of diseases of the gastrointestinal tract. Perhaps the side effects of the method can be avoided if the onion content of the mixture is reduced.
Bronchitis in children
In children, bronchitis has the same symptoms as in adults. The main symptom of bronchitis in a child is a cough. Symptoms of intoxication with bronchitis in children are usually very pronounced. If possible, it is worthwhile to refrain from excessive use of antibacterial agents.
When a baby has shortness of breath, it is always necessary to carry out differential diagnostics with bronchial asthma. Three or four episodes of obstructive bronchitis for a year - a clear indication for the consultation of an allergist and allergy diagnostics.
When treatment of bronchitis in children, preference should be given to inhalation therapy. Children are given inhalations with mineral water, expectorants( lazolvan, fluimucil) and bronchodilators( berodual, atrovent) drugs. If necessary, antibacterial agents( tobramycin solution, dioxidine 0.5% solution, furacilin 0.02% solution) can be used for inhalations. This method of treatment can effectively combat the symptoms and cause of bronchitis and has a minimum of side effects.
Bronchitis in pregnancy
Symptoms of bronchitis in pregnant women do not differ from the symptoms of bronchitis in other categories of patients. The main sign of bronchitis is also cough.
But in the treatment there are a number of features, since many drugs are prohibited for use during this period of life because of their potential negative effects on the fetus. For example, tetracycline derivatives, streptomycin, and levomycetin are prohibited. With caution apply eufillin.
Of the permitted antibacterial drugs I want to mention vilprafen. A drug with a high safety profile and sufficient antibacterial activity.
In the treatment of bronchitis in pregnant women, emphasis is placed on inhalation therapy.
Possible complications of bronchitis and prognosis
The course of an acute illness is usually favorable and ends with a complete cure. Sometimes bronchitis can be complicated by pneumonia, the development of bronchiectasis.
Chronic bronchitis in the absence of appropriate treatment can lead to respiratory or heart failure.
Prevention of bronchitis
Several approaches to the prevention of this infectious disease can be identified.
1) Reception of immuno-fortifying preparations in a season of possible exacerbation( autumn-winter).This method is most suitable for patients with chronic bronchitis or with frequent exacerbations of acute bronchitis.
A good effect in this respect was shown by preparations of bronchomunal, ribomunil, IRS-19, etc. Diagrams and dosages are determined by the doctor.
The variants of nonspecific immunocorrection can also include regular reception of multivitamin complexes.
2) Vaccination of patients.
Given the high prevalence of pneumococcal infection and its huge contribution to the onset of this disease, most experts recommend patients at risk to be vaccinated with the PNEVO-23 vaccine, which provides immune protection from this type of pathogen. The effect of vaccination is enough for 5 years.
Also taking into account the fact that it is viral infections that are most often triggered by the development of bronchitis, an annual vaccination of people belonging to the group from the influenza virus is recommended.
Who can be classified as a risk group? First of all, they are people over 50 years old, patients suffering from chronic diseases of the internal organs( heart, lungs, kidneys, etc.).Traditionally, women who plan pregnancy and people whose professional activities are associated with people( medical workers, teachers, salesmen, etc.) are vaccinated. Vaccination is mandatory for people who receive long-acting anti-relieving drugs( acetylsalicylic acid, warfarin, etc.).
3) Observance of the basic rules of personal hygiene, for example, frequent washing of hands, use of disposable handkerchiefs - a simple way of preventing infectious diseases.
Answers to frequently asked questions on the topic of acute and chronic bronchitis:
How effective is respiratory gymnastics in bronchitis?
Respiratory exercises, for example, according to the Strelnikova or Buteyko method, are the most important component of treatment, especially in chronic bronchitis.
I suspect that I have allergic bronchitis. Is this possible?
There is no such diagnosis as allergic bronchitis. Perhaps the development of an infectious disease on the background of bronchial asthma. In this case, allergic inflammation and the infection process seem to "support" each other. In any case, it is necessary to consult an allergist and conduct a complete allergological examination( staging skin tests, passing a blood test to identify specific antibodies to allergens, etc.).
With what diseases can you mix up chronic bronchitis?
The list of diseases accompanied by a protracted cough is quite large. First of all, differential diagnosis is carried out between tuberculosis, chronic obstructive pulmonary disease( COPD), bronchiectasis, asthma, and oncological diseases.
the doctor the pulmonologist, the allergist-immunologist, km. Mayorov RV