Obstructive bronchitis as a disease

Spasmodic cough, deterioration of health, shortness of breath and high temperature are often mistaken by patients for the onset of influenza and ARVI. In some cases, such symptoms may also occur against the background of a mild cold, as its complication - obstructive bronchitis. It can occur as an independent disease, or it can also become a serious complication of a viral infection. Bronchitis is characterized by severe inflammation of the lumens of the bronchi, spasm of the muscle structure, swelling, and accumulation of mucous components in the bronchi. When the bronchial tree becomes inflamed, its walls swell, causing a narrowing of the lumen. Pathological changes lead to serious structural and morphological transformation of tissues, reduce the ventilated volume of the lungs, and prevent normal removal of sputum. With a complicated course of the disease, patients often experience a marked decrease in respiratory function.

There are two main forms of obstructive bronchitis:

• acute process;
• chronic course.

The acute form is more often diagnosed in young children, while the chronic form is diagnosed in adults. Chronic bronchial obstruction is observed if a cough with sputum is observed for more than a month or with frequent relapses over 1.5-2 years.

Chronic obstructive bronchitis is fundamentally different from chronic bronchitis in a number of ways:

• extensive inflammation of the lung tissue and small bronchodilator network;
• the appearance of acute spasmodic bronchial obstruction;
• the formation of diffuse emphysema with pronounced dilatation of alveolar tissues;
• inhibition of contractility of the pulmonary muscles:
• disruption of natural gas exchange in lung cells;
• violation of pulmonary ventilation.

In the obstructive form of bronchitis, the inflammatory process in the small bronchi is irreversible and only intensifies over time. Bronchoobstruction is the main cause of damage to the tissues of the bronchial tree and tracheal lumens. Such phenomena as spasm and an increase in the volume of the mucous component are considered reversible and are eliminated in the process of adequate treatment.

Symptoms of obstructive bronchitis in children

In children, the symptoms of the disease can be quite specific, thanks to which the disease can be quickly diagnosed and timely treatment prescribed. With every minute the baby's condition can worsen even more. The signs of this disease include several symptoms:

• Deterioration in general well-being at night, especially when the baby behaved as usual;
• A sick child becomes very restless. Up to one year old, small children cry all the time, and older children cannot sleep at night and rush around all the time.
• The baby has bubbling breathing inside;
• Shortness of breath occurs, which is accompanied by auxiliary muscles during breathing. This is manifested clinically by abdominal movement and retraction of the intercostal spaces during breathing;
• During breathing, wheezing sounds occur that can be heard from the side.
• With the onset of obstruction, the child develops an obsessive and dry cough that occurs suddenly. Unfortunately, the little guy’s cough does not bring relief. The cough usually gets worse as evening approaches.
• When the baby inhales, the wings of the nose swell. This symptom most often occurs in young children, since the muscles of the neck and shoulder girdle are involved during breathing.

If the first symptoms occur, you should immediately seek help from specialists, even if the child’s well-being has not worsened. With obstructive bronchitis, body temperature does not increase in the first few days. If there is a sharp deterioration in your child’s general condition, you should immediately call emergency help.

Etiological factors of obstructive bronchitis

The main feature of the disease is the obstruction of the airways of varying intensity. Due to the narrowing of the bronchial lumens, normal expectoration of sputum is impossible, so mucus, along with pathogenic microflora, enters the lung cavity. The etiology of the disease is often secondary as a consequence of an advanced infectious disease.

The main reasons for the appearance include:

• Systematic diseases of acute respiratory infections, acute respiratory viral infections, influenza. Chronic colds and other conditions negatively affect the body's immune defense, gradually reducing it. Weakened immunity usually becomes the ideal foundation for the formation of chronic obstructive bronchitis.
• Diseases of ENT organs. Diseases of the upper respiratory tract of the nasopharynx can provoke the occurrence of bronchitis due to the movement of mucus in a downward flow to the bronchi.
• Tobacco smoking. The poison and tar of tobacco products literally corrode lung tissue, causing the formation of scar tissue. Cigarette smoke reduces immunity and suppresses the body's protective functions.
• Ecology, natural factors, working conditions. Poor ecology is now observed not only in large cities, but also in small agglomerations. Exhaust gases and emissions of nuclear processing products into the atmosphere contribute to the pollution of inhaled air. For residents of mining villages, joiners, carpenters, and asphalt pavers, damage to the bronchi or trachea can become an occupational disease due to the constant absorption of harmful particles.
• Genetic predisposition. If obstructive bronchitis is observed in parents, then there is a high probability of their children having bronchial obstruction.

Other reasons include alcoholism, old age, burdened clinical history, and the presence of severe diseases of organs and systems. Usually the reasons indicating the occurrence of obstructive bronchitis are indirect.

Causes of pathology

The main feature of such a disease as obstructive bronchitis is poor airway patency. The narrowing of the lumen causes difficulties with the passage of mucus, and inflammation spreads to the lung tissue.

The following reasons are identified that can cause the development of pathology:

1. Frequent colds. After suffering an acute respiratory infection or acute respiratory viral infection, a person is often quickly diagnosed with acute obstructive bronchitis . Its development can be caused by the fact that constant colds weaken the lungs and their susceptibility to any adverse factors increases.
2. Pathologies of the nasopharynx and influenza. Various chronic nasopharyngeal diseases and influenza have a negative impact on the respiratory system of an adult. Such diseases increase the risk of bronchitis with obstruction and severe complications.
3. Living in unfavorable environmental conditions. In recent years, obstructive forms of bronchitis have been increasingly detected in people living in large cities. The fact is that polluted air is one of the factors that causes the development of pathology in an adult.
4. Harmful working conditions. Various forms of bronchitis are often detected in those who work in difficult working conditions. Most often, this disease is diagnosed in those people who constantly breathe coal dust. In addition, employees of those institutions that are constantly in contact with harmful substances are susceptible to obstructive bronchitis.
5. Genetic factor. Not the least role in the appearance of obstructive bronchitis in a patient belongs to genetics. This means that the tendency to such a disease can be inherited . When obstructive bronchitis is detected in parents, it will certainly appear in their children. Moreover, in such situations, it is the chronic form of the disease that is predominantly diagnosed.
6. Smoking. Constantly inhaling harmful smoke leads to damage to the lining of the lungs. Over time, scars form in the burn area, which serve as a favorable environment for the active activity of pathogenic microbes. In addition, smoke contains a large amount of harmful substances that negatively affect the immune system. The combination of such unfavorable factors ends in acute bronchitis, which requires mandatory treatment.

In adults, obstructive bronchitis often develops as an independent pathology, but can occur as complications after previous nasopharyngeal diseases.

Signs and manifestations of the disease

The insidiousness of the disease lies in the long incubation period. If we are talking about the chronic form of obstructive bronchitis, then the exacerbation can develop over a long period of time and become a rapid process. When obstructive bronchitis occurs against the background of chronic pathologies of the ENT organs, as well as various infectious diseases, then the exacerbation of the disease may coincide with the onset of the provoking illness.

The clinical picture is characterized by the following signs:

• Coughing. At first, the cough does not produce sputum, but is dry and whistling. Cough most often occurs in the morning and at night, when the patient is in a lying position. As the disease develops, phlegm begins to come out when coughing, and the main symptoms intensify in cold weather.
• Shortness of breath and difficulty breathing. Shortness of breath can occur against the background of chronic obstructive bronchitis during sports or at rest.
• Signs of acrocyanosis. During coughing attacks, the skin around the nasolabial triangle and on the extremities turns blue.
• Temperature increase. Bronchitis is usually accompanied by high fever.
• Muscle pain, headaches.
• Fatigue, heavy sweating.
• Chest of emphysematous type. The scapular region fits tightly to the upper edge of the chest, and the epigastric angle is turned out, approximately 90 degrees. The intercostal spaces are greatly enlarged.

Obstructive bronchitis is always quite severe, especially if caused by any factor.

In some situations, the doctor may suspect problems with the heart or blood vessels, especially when the severity of bronchitis does not correspond to the severity of the patient's condition due to the similarity of some symptoms.

Differential diagnostic methods

Typically, the diagnosis of “obstructive bronchitis” 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:

• Stage I. FEV = 50% of normal. At this stage, the patient experiences almost no discomfort, and clinical monitoring is not needed in this situation.
• 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.
• Stage III. FEV <33% of normal. This stage of the disease involves inpatient or outpatient treatment.

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.

Treatment tactics for obstructive bronchitis

Bronchoobstruction requires contacting a doctor to prescribe the correct treatment. Sometimes the patient needs to be hospitalized in a specialized department. In the absence of proper treatment, obstructive bronchitis transforms into a chronic form, and complications arise in the form of pneumonia and asthma attacks. Treatment is prescribed in accordance with diagnostic data confirming the development of obstructive bronchitis. At the very beginning of treatment, the patient needs rest and bed rest.

The following factors are important for successful treatment:

• smoking cessation;
• exclusion of harmful factors (dust, cosmetics, dirty air, etc.);
• therapeutic diet without aggressive foods (salt, fatty foods, fried foods, sugar, hot spices).

Initial therapy is aimed at relieving unpleasant symptoms and preventing progression of the disease.

Conservative treatment involves prescribing the following groups of drugs:

• adrenergic receptors (Terbutaline, Salbutamol) to expand the bronchial lumens;
• expectorants, mucolytic drugs (Ambroxol, Mucaltin, ACC) for sputum discharge;
• antibiotics (Erythromycin, Azithromycin, Amoxicillin) with the rapid development of the disease.

The drugs can be used intramuscularly, orally or parenterally. Many active medicinal substances have an excellent effect on the bronchial tree in the form of inhalations. Inhalations are considered an integral part of conservative treatment. The nebulizer can be filled with not only medicinal solutions, but also herbal infusions and essential oils. Adequate therapy eliminates bronchitis within 7-14 days.

Dosages and medications should be prescribed by your doctor.

Classification of the disease in pediatrics

Obstructive inflammation in children is distinguished by origin. Primary – the infection affects the bronchial tree, secondary – the result of complications of other inflammatory processes. Taking into account the etiology, the disease is:

• irritation (caused by the action of chemicals, toxins);
• bacterial;
• fungal;
• allergic;
• asthmatic;
• viral;
• mixed (impact of several factors).

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Bronchitis of the obstructive type can be acute, chronic and recurrent in nature, limited in duration, diffusion (widespread). Type of disease according to the type of inflammatory process in tissues:

• fibrous;
• catarrhal;
• purulent;
• bronchiolitis;
• necrotic;
• ulcerative;
• catarrhal-purulent;
• hemorrhagic.

Folk recipes

Traditional methods of treatment are used in combination with conservative therapy and nothing else. Obstructive bronchitis is not a common cold. With inadequate treatment, symptoms can increase in intensity and lead to disastrous consequences. Traditional recipes help patients undergo a course of recovery and maintenance therapy against the background of chronic forms of obstructive bronchitis.

Among the main ones are:

• inhalations with decoctions of herbs and ethers (eucalyptus, tea tree, licorice);
• herbal decoctions inside (chamomile, thyme, lemon balm);
• compresses from camphor, eucalyptus ointment;
• gargling, warm drinks.

Drinking plenty of warm drinks (fruit drinks, herbal teas, clean water) will help remove phlegm and infection from the body. To improve sputum discharge, physical exercise can be an ideal assistant. Special exercises allow you to target the respiratory system and remove mucus from the lungs. The basics of breathing exercises for obstructive bronchitis can be found in various sources or checked with a doctor.

How to treat bronchitis in a child

If the disease is mild, it is recommended:

• semi-bed rest;
• hypoallergenic diet;
• wet cleaning, room ventilation;
• frequent warm drinks;
• room humidification;
• taking medications prescribed by a doctor;
• inhalation;
• hot foot baths;
• breathing exercises;
• vibration massage.

Severe acute obstructive bronchitis in children and the disease in newborns require hospitalization. For treatment use:

• oxygen therapy;
• removal of sputum with an electric suction;
• alkaline inhalations;
• antibiotics – Amoxiclav, Flemoxin Solutab ;
• antiviral – Grippferon, Arbidol ;
• mucolytics – Ambroxol, Bronchobos ;
• means that dilate the bronchi - Pulmicort, Berodual ;
• expectorants - Bronchicum, Herbion .

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Treatment tactics in young children

Oxygen therapy is used to eliminate oxygen deficiency in infants. Medicines are given to children in the form of a suspension or by inhalation; they are prescribed:

• antibiotics – Augmentin, Suprax ;
• antiviral – Grippferon Genferon suppositories ;
• antipyretic suppositories - Paracetamol ;
• mucolytics (thin sputum) - Lazolvan, Bromhexine ;
• breathing exercises;
• rinsing the nose with saline;
• vibration massage.

Treatment of bronchitis in children over 3 years of age

The goal of treating obstructive bronchitis in children is to eliminate the cause of inflammation, relieve coughing, and breathing. A child over three years old is prescribed:

• antiviral drugs - Orviem Kagocel tablets ;
• antibiotics – Macropen, Cephalexin ;
• mucolytics – Mukosol, Ambrobene ;
• expectorants - Dr. Theiss, Bronchicum ;
• to relieve bronchospasm - Salbutamol, Troventol .

The treatment regimen for obstructive bronchitis involves the use of:

• inhalations with saline solution, Borjomi mineral water;
• bronchial drainage;
• antipyretics – Efferalgan Viburkol suppositories ;
• antihistamines - Suprastin, Claritin .

Prevention and prognosis

Bronchoobstruction during bronchitis requires medical relief due to the rapid development of the acute form into the chronic form. If the therapy was correct, then the development of obstruction can be excluded. The prognosis for bronchitis, only subject to adequate therapeutic tactics, is usually favorable. Patients at risk are elderly people, people with weakened immune systems, congenital anomalies and pathologies of internal organs and systems, as well as chronic otolaryngological diseases.

Subject to a protective regime, a healthy lifestyle, and full treatment of concomitant diseases, obstructive bronchitis has virtually no chance of worsening the quality of life of a potential patient.

Prevention

First of all, the prevention of obstructive bronchitis in children consists of strengthening the immune system: maintaining breastfeeding for at least a year, more walks in the fresh air, a varied and healthy diet, taking vitamins, and hardening.

In addition, it is very important to treat colds promptly and correctly, preventing the development of complications. Self-medication is the first enemy of health. Although the consequences may not appear immediately. This misleads parents about the harm of their actions.