Allergic bronchitis: symptoms, diagnosis and treatment

Symptoms

One of the main signs of allergic bronchitis is difficulty breathing, which usually gets worse over time. If you have allergic bronchitis, you will experience shortness of breath during exercise or other activities. As the disease progresses, you may experience shortness of breath while resting, in which case it may also indicate chronic obstructive pulmonary disease (COPD) or emphysema.

Cough

The main symptom of allergic bronchitis is a cough that continues daily for at least three months. The intensity of the cough may vary from person to person. Coughing may produce some phlegm, but not always. If you smoke, this cough is often called "smoker's cough." This dry cough often worsens at night and often leads to insomnia due to the frequency of coughing attacks.

Grunting sounds

Another common symptom of allergic bronchitis is difficulty breathing and a high-pitched sound when inhaling and exhaling, resulting from narrowing of the airways (bronchi).

Other possible symptoms of allergic bronchitis include:

• prostration
• chest pain
• a sore throat
• swelling of lips
• headache
• blue-gray skin color

The most striking symptom of bronchitis in adults is a severe cough. It occurs especially often at night. In this case, the patient feels a deterioration in his general condition. When the allergen is concentrated nearby, no treatment will have a positive effect. Temperatures do not fluctuate, but sometimes can reach 37.5 degrees. A runny nose may also occur, which prevents a person from breathing normally.

As the allergic reaction progresses, the cough becomes variable. At first it is unproductive, painful and tearing. But then sputum appears, which makes the condition easier. The atypical form of bronchitis is characterized by a mild manifestation of the clinical picture if there is no direct contact with the allergen. The cough can become permanent, but it does not affect the quality of life.

Thus, the patient experiences sneezing and nasal discharge. During an exacerbation, breathing is disrupted, as a result of which the patient begins to hum and breathe through his mouth. The throat and trachea can be involved in the pathological process. In adult patients, the larynx still suffers, which indicates a complication of the allergic reaction.

In some cases, the clinical picture of the pathology is accompanied by the following signs:

• episodic lacrimation;
• occasional sneezing;
• partial nasal congestion;
• persistent cough.

You can suspect something is wrong with repeated attacks of dry cough. Such attacks occur mainly at night (this is due to the horizontal position of the body). Body temperature may increase slightly.

If at the beginning of the disease the cough is dry, then later it becomes wet, breathing becomes difficult, and shortness of breath appears.

When listening to the bronchi, dry, moist or wheezing sounds are heard. A characteristic feature of wheezing, when compared with bronchial asthma, is its appearance during inhalation (with bronchial asthma, wheezing is heard during exhalation).

Inflammation affects only large and medium bronchi. They can be recognized by swelling of the bronchial mucosa and narrowing of their mouths.

The result is the absence of asthma attacks, as with asthma.

In parallel with wheezing, discharge from the nasal cavity may appear, as the mucous membrane of the paranasal sinuses changes its structure due to exposure to allergens. When complications occur, inflammation affects the mucous membranes of the larynx (laryngitis).

Children experience similar symptoms. The child coughs mainly at night, and the body temperature rises insignificantly. Such symptoms make themselves felt approximately once every two weeks and last from several days (chronic stage) to two weeks (exacerbation period).

If the allergic reaction is complicated by inflammation of the bronchial mucosa, doctors may diagnose obstructive bronchitis.

Its distinctive feature is blockage (obstruction) of the airways by mucus accumulated on the bronchi. causes (blockage). In this case, difficulty breathing occurs not only during inhalation, but also during exhalation.

As mucus accumulates, it thickens and forms mucus plugs. In this case, the permeability of blood vessels decreases, air movement becomes difficult, and wheezing is heard in adults.

Allergic bronchitis is chronic in nature with alternating periods of exacerbations and remissions. An exacerbation of the disease begins with a coughing attack, which is provoked by crying, laughter or physical activity. Often this attack is preceded by warning symptoms, which include mild malaise, sore throat, serous rhinitis, and nasal congestion.

Allergic bronchitis begins with a coughing attack, which is provoked by laughter, crying, physical activity.
During exacerbation of allergic bronchitis, the body temperature in most patients remains within the normal range, but sometimes it increases to subfebrile values ​​(not higher than 38 ° C). In the first hours of the disease, the cough is dry, then it becomes wet.

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Other symptoms of allergic bronchitis include:

• whistling forced noisy exhalation;
• expiratory shortness of breath;
• labored breathing.

At the end of the attack, the patient loses sputum, followed by significant relief.

An exacerbation of allergic bronchitis lasts from several hours to several weeks. If the disease is based on an allergy to non-infectious agents, then eliminating contact with them (change of place of residence, change of season, change in diet) leads to a rapid cessation of coughing attacks.

Allergic bronchitis is often combined with other manifestations of allergies (neurodermatitis, atopic dermatitis, hay fever, allergic rhinitis). With a long course of the disease, some patients experience autonomic and neurological disorders (excessive sweating, lethargy, irritability).

Symptoms of allergic bronchitis fall into one of four classes. If we are talking about an immediate reaction to an allergen with clearly expressed signs visible during bronchoscopy, then the disease is classified as atopic bronchitis. A slow reaction with barely noticeable symptoms indicates that the patient has an infectious-allergic form of bronchitis.

1. Breathing is difficult and accompanied by whistling and noise.
2. Sputum is coughed up.
3. There is shortness of breath.
4. The skin may be affected by a rash (urticaria, eczema, atopic dermatitis, etc.).
5. Signs of colds: sweating, weakness, cough and runny nose.
6. Conjunctivitis.

Unlike ordinary bronchitis, in this case, as a rule, there is no increase in body temperature.

Treatment

Compared to infectious bronchitis, the clinical picture of allergic bronchitis cannot be alleviated with the help of mucolytic, antibacterial, and expectorant drugs. The main treatment is based on eliminating the identified allergen. To do this, immunological blood tests and skin tests are performed, which help determine the group of substances or substances that cause the symptoms of allergic bronchitis.

Each patient needs the right approach. Therapy is carried out depending on how allergic bronchitis progresses. Effective treatment of the disease is possible only by identifying the allergen. Allergic bronchitis can be eliminated by doing the following:

• Treatment with antihistamines. An allergist may prescribe inhaled or oral medications, as well as prescribe a combination treatment, depending on the severity of the clinical picture. The duration of treatment is from 5 to 7 days. If a concomitant allergic reaction occurs with bronchitis (conjunctivitis, dermatitis, rhinitis), ointments and drops are prescribed that will help get rid of the adverse reaction of the disease.
• Assistive therapy. For more effective results, doctors recommend physiotherapy and homeopathy. Such treatment is necessary to normalize immunity and reduce relapses. Therapy alone will not be effective without primary treatment.
• Preventing contact with allergens. After laboratory tests have identified the pathogen causing the allergic reaction, it is necessary to stop contacting the substance and minimize exposure to it.
• Strengthening the immune system. To increase the body's resistance, it is necessary to harden it, eat right and reduce physical activity. This will help reduce attacks and improve your well-being.

If coughing attacks occur from food, you need not only to exclude the allergen from the menu, but also to follow a hypoallergenic diet for several months. It is necessary to restore immunity. Also, the patient should not consume highly allergenic foods, even if attacks of the disease do not occur. The immune system may react to a new ingredient in the daily menu.

Causes and risk factors

Allergic bronchitis is caused by various environmental and genetic factors, such as:

• tobacco smoke
• dust
• air pollution
• mold
• chemical substances
• animal dander
• poor diet
• heredity

Allergens that provoke the development of allergic bronchitis can be both infectious (germs, viruses, fungi) and non-infectious agents that enter the patient’s body through the respiratory system or through the gastrointestinal tract.

The most common non-infectious allergens are:

• food ingredients, especially stabilizers and preservatives;
• animal hair and dander;
• fluff;
• plant pollen;
• house dust;
• industrial animal feed.

Allergens that provoke the development of bronchitis are usually infectious and non-infectious agents.
In children, allergic bronchitis can develop as a result of vaccine or drug allergies.

Often the cause of the disease is polyvalent sensitization (increased sensitivity of the body to several substances at once).

Familial cases of allergic bronchitis are often identified, which indicates the presence of a hereditary predisposition to the disease.

The infectious factor that provokes the development of allergic bronchitis in most cases is staphylococcus. It is this microorganism that is most often cultured from sputum, and antibodies to this microorganism are also found in the blood of patients suffering from this pathology.

In many cases, allergic bronchitis develops after acute bronchitis, tracheitis, laryngitis, measles, whooping cough, pneumonia, ARVI, and influenza. In some patients, the disease develops against the background of gastroesophageal reflux disease.

In the pathological mechanism of development of allergic bronchitis, the main role belongs to the increased reactivity (sensitivity) of the bronchial mucosa to the effects of certain allergens. The sites of the reaction between the allergen and antibodies are the large and medium-sized bronchi. Bronchioles are not involved in the pathological process, which is why with allergic bronchitis there are no pronounced attacks of suffocation.

The main causes of this disease are two factors: allergies and infections. The combination of these reasons results in the patient being diagnosed with bronchitis with an asthmatic component.

A strong body with a strong immune system is able to fight off the disease, but if there are many predisposing factors in a person’s life, the development of the disease becomes only a matter of time.

What causes influence the appearance of bronchitis with an asthmatic component in adults:

• improper lifestyle of a pregnant woman who is carrying a fetus, smoking and drinking alcohol during pregnancy;
• illiterate approach to child vaccination;
• eating poor quality food;
• passive and active smoking, alcohol consumption;
• living in an apartment with unfavorable conditions (dust, dirt, wool, mold);
• indiscriminate use of medications;
• frequent relapses of respiratory diseases;
• lack of treatment for allergic diseases;
• living in a house with a large number of animals;
• passive lifestyle;
• sleeping on bedding made from natural materials (down);
• living in unfavorable areas with polluted air;
• work with industrial hazards (livestock farming, chemical industry, furniture manufacturing, contact with paints and other volatile materials).

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The body can fight allergies at one level for a long time, but at some point all the reasons converge at one point and the person develops a serious illness, the consequences of which can be eliminated for many years.

And others.

Symptoms of pathology

If we are talking about the symptoms and treatment of allergic bronchitis in adults or children, then it is worth paying attention to the fact that in young patients the disease manifests itself more actively. The main sign of a developing pathology is a cough. To distinguish it from viral diseases, you need to pay attention to its features.

First of all, a person experiences an attack, which is a reflex spasm of the respiratory tract. As a rule, patients suffer most from coughing at night, but attacks can also occur during the day. At the very beginning of the development of pathology, mucus is not expectorated during coughing. At a later stage in the development of bronchitis, a person develops sputum.

Also, another distinctive feature of this pathology is that attacks can be easily provoked by stress, physical exertion or overexcitement.

Mechanism of disease development

Bronchitis (except for the name allergic

atopic or atypical bronchitis also occurs) develops against the background of an allergic reaction. A provocateur can be a seasonal or year-round allergy to pollen, pet hair, dust, or household chemicals.

By and large, allergic bronchitis is a protective reaction of the bronchi. On the surface of the mucous membrane of the latter there is a layer of microscopic villi-cilia. Their function can be compared to windshield wipers on a car, the only difference being that the windshield wipers work only when it rains, while the eyelashes work constantly. in constant mode.

Only with this mode of operation is the mucous membrane regularly cleansed of foreign objects - potential allergens: dust, sand, wool.

If any of these objects gets on the mucous membrane, and the cilia for some reason do not cope with their task, allergic bronchitis begins. Bronchial allergies are designed to rid the body of harmful objects.

Depending on the type of immunopathological reaction underlying the development of the disease, infectious-allergic, atopic and mixed forms of allergic bronchitis are distinguished.

The atopic form of the disease is based on an allergic reaction of type I (IgE-mediated allergic reaction, immediate hypersensitivity). The infectious-allergic form develops as a result of delayed-type hypersensitivity (type IV allergic reaction, cell-mediated reaction). Allergic reactions of types I and IV take part in the pathological mechanism of the formation of the mixed form of allergic bronchitis.

To avoid severe forms of allergic bronchitis, symptoms and treatment in adults should be under the close supervision of a pulmonologist. Regular monitoring of such a patient is simply necessary, since asthma is a lifelong disease.

What are the signs of bronchitis with an asthmatic component:

• Nonproductive cough. It can be barking, tickling, chesty or superficial. Sputum does not come out well, in some cases it does not come out at all. The patient cannot cough, as this symptom is caused by swelling of the mucous membrane.
• Expiratory dyspnea. A person is unable to exhale fully, which almost always tells a specialist that the disease is allergic in nature. In the initial stages, shortness of breath does not appear.
• Temperature. An increase in body temperature is observed when there is an infection in the body, to which it reacts in this way. But often the disease occurs without elevated marks on the thermometer.

Sometimes there is a general deterioration in the condition, the development of swelling of the nasopharyngeal mucosa, but these signs may not be present. Without eliminating the main allergen, human health does not improve, and if this happens, the disease quickly returns again.

Features of the course of the disease

As a rule, allergic bronchitis is distinguished by several important factors that help diagnose this disease. First of all, you should pay attention to when exactly the coughing attacks stop. If this happens as soon as a person stops contacting the irritant, then this is a clear symptom of this particular pathology.

This type of bronchitis also differs from the standard one in that in this case the patient does not experience an increase in body temperature. It is also worth paying attention to other symptoms.

Diagnosis of allergic bronchitis

Diagnosis of allergic bronchitis is quite complex and requires analysis of medical history, results of physical and a number of instrumental examinations of the patient, and allergy diagnostics. If allergic bronchitis is suspected, the patient should be consulted by an allergist-immunologist and pulmonologist.

On examination, the chest is of normal volume. A box sound is detected over the lungs during percussion. The auscultatory picture during exacerbation of allergic bronchitis is characterized by the presence of whistling dry and moist rales of various sizes.

On radiographs of the lungs, an increase in the root pattern is noted, a thickening of the pulmonary pattern in the medial and rarefaction in the lateral sections. These changes are assessed as hidden emphysema.

During bronchoscopy, the observed picture is determined by the presence or absence of an infectious-inflammatory component in the pathological mechanism of development of the disease and can vary widely, ranging from a practically unchanged mucous membrane to endoscopic signs of purulent endobronchitis.

Blood tests in patients with allergic bronchitis reveal eosinophilia, decreased complement titer, increased levels of histamine, immunoglobulins class A and E.

To determine the cause of allergic bronchitis, skin prick tests are performed and bacterial culture of sputum or bronchial lavage is performed.

An important step in the diagnosis of allergic bronchitis is skin testing to determine the allergen.

In order to assess the course of allergic bronchitis, it is necessary to examine the function of external respiration (spirometry, pneumotachography, plethysmography, gas analytical study of external respiration, peak flowmetry).

If your doctor suspects that you may have chronic bronchitis, he will refer you to a pulmonologist, a doctor who specializes in treating diseases of the lungs and bronchopulmonary system. A pulmonologist will perform several diagnostic procedures, including a chest x-ray, a computed tomography (CT) scan of your lungs and bronchi, and a pulmonary function test.

Clinical picture

According to statistics, allergic bronchitis can occur in children and adults at any age. This disease is characterized by relapses. As a rule, exacerbation occurs several times a month (lasting 1-2 days).

In addition to the typical symptoms of allergic bronchitis in adults and children, patients often complain of a sore throat. Sometimes the pathology is preceded by rhinitis or nasal congestion. If we are talking about children, then sometimes this pathology occurs together with other allergic diseases (for example, skin diathesis or neurodermatitis). If we are talking about infants, then very often the symptoms of the pathology are supplemented by increased lethargy, heavy sweating and irritability.

Prevention

To prevent the development of allergic bronchitis and its exacerbations, it is necessary:

• adhere to a hypoallergenic diet. Foods that provoke the development of allergies (citrus fruits, chocolate, honey, smoked meats, milk, etc.) are excluded from the diet;
• fight house dust, one of the most powerful allergens. To this end, you should: carry out wet cleaning of the room daily, replace feather and down pillows and mattresses with hypoallergenic ones, get rid of carpets, soft toys, heavy curtains and other items on which dust is deposited in large quantities;
• maintain water regime. Drinking plenty of fluids helps thin mucus and facilitates its removal from the bronchi. It is best to drink herbal teas, alkaline mineral waters;
• quit smoking. Tobacco itself is not an allergen, but tobacco smoke has an irritating effect on the mucous membrane of the respiratory tract, increasing its sensitivity to the effects of other aggressive agents.

When seasonal allergies worsen, the patient is advised to go outside as little as possible. In the room, you should keep the windows closed and carry out wet cleaning daily. When using an air conditioner, it is necessary to equip it with a special filter that captures and retains dust particles and other allergens.

There are several things you can do to help prevent an allergic bronchitis flare-up.

• Wash bedding weekly using hypoallergenic detergents.
• Buy a good vacuum cleaner with HEPA filtration and use it to clean your home frequently.
• Shampoo your pets every week to keep dander to a minimum, and keep pets out of your bedroom.
• Stay away from smoking areas.

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Bronchitis and its types

People who have a predisposition to pulmonary diseases most often suffer from all of this. It is they who in most cases are exposed to a disease such as bronchitis.

The disease especially has a habit of manifesting itself during periods of sudden changes in weather conditions and season changes. During this period, a person develops a slight cold, immunity decreases, and against the background of all the symptoms, a cough appears, turning into severe attacks.

With bronchitis, an inflammatory process develops in the area of ​​the bronchi, which are presented in the form of an extensive network of tubes of different diameters. The air entering the body enters the larynx and then into the lungs.

Bronchitis causes a disruption in the circulation of air that enters the lungs through swelling of the bronchi themselves as a result of the separation of viscous mucus. In some cases, the disease affects the trachea, larynx and nasopharynx.

Depending on the course of the disease, symptoms manifest differently. First of all, a dry, rather obsessive cough appears, and over time, the release of viscous sputum is observed.

At the same time, the patient’s body temperature rises, weakness, and headaches. Basically, the main cause of bronchitis is a bacterial or viral infection.

Bronchitis happens:

• The acute type, which develops very quickly, can last even several weeks, while the cough can be hacking, dry or wet, with sputum and radiating into the chest.
• Obstructive type, when the inflammatory process covers and clogs all bronchi. The volume of sputum increases, swelling of the mucous membrane appears. The patient experiences frequent coughing attacks accompanied by whistling sounds. Such a cough is very dangerous for young children, since it causes spasm of the bronchi and makes breathing very difficult, as a result of which the lungs cannot cope with high tension and suffocation occurs.
• The chronic type, which develops against the background of acute bronchitis through the negative impact of irritating non-infectious factors (dust).

People whose work involves a polluted environment and high humidity are at risk of developing chronic bronchitis. Bad habits, including smoking, play an important role in the development of the disease.

Signs of chronic bronchitis largely depend on the change of season, the presence of various irritants, dust, and other external factors, as well as on the condition of the patient and his immune system. The progression of the disease is accompanied by a cough of a paroxysmal, persistent, exhausting and unproductive nature.

If during a coughing attack the sputum produced changes color, then traces of blood appear in it, the patient experiences general weakness and increased sweating.

In this case, you must urgently consult a doctor for qualified help, who will prescribe an in-depth diagnosis. This must be done in order to exclude or detect the presence of other pulmonary diseases.