All causes of frequent bronchitis in a child. Bronchitis in children: acute, obstructive bronchitis, symptoms, treatment Constructive bronchitis in children

A child's constant cough will put any parent in a state of constant anxiety. You can assume that this is just a typical child's cough, and give the child some medicinal syrup. After a few days, it is clear that the child is not getting better, mothers and fathers take him to the pediatrician, who reports that the child has obstructive bronchitis. Often parents begin to panic and fuss because they do not know anything about bronchitis. We will talk about childhood bronchitis with obstruction, its symptoms, causes and treatment.

Pediatrician, gastroenterologist

For pediatricians, patients with bronchitis are part of their daily work. Respiratory system infections are most common in children. Almost all infants and primary schoolchildren develop bronchitis more than once a year. Usually, as soon as kindergarten begins, there is a sharp accumulation of pathogens, and many parents have the feeling that their child is constantly sick.

Obstructive bronchitis in children occurs much more often in winter than in summer, as everyone knows from personal experience. Cold air outside and dry heated air indoors increase the vulnerability of the bronchial mucosa to pathogens.

Whether the clinical course of bronchitis is uncomplicated or associated with bronchial obstruction is partly determined by the genetic predisposition of the child. Depending on family history and allergies, the risk can be increased many times over.

The health damage caused by exposure to tobacco smoke is a major point that should not be underestimated.

The bronchi carry air from the trachea (breathing tube) to the lungs. When these pathways become inflamed, mucus production increases. This condition is called bronchitis.

Bronchitis can be associated with bronchial obstruction. The risk of obstruction depends on the lumen of the inflamed bronchus: the smaller the lumen, the more likely clinically significant bronchial obstruction is. This condition is called “obstructive bronchitis”.

Broncho-obstructive symptoms can be caused by the following pathophysiological changes.

The smooth muscles of the bronchus contract, which leads to acute shortness of breath.
The mucous membrane of the respiratory epithelium swells due to inflammation, which narrows the bronchial lumen.
Increased mucus production also clogs the lumen.

In addition, due to inflammation in the respiratory epithelium, ciliary function is reduced and mucus cannot be transported adequately. Auscultation of the lung reveals wheezing.

Reasons

In 90% of cases, acute obstructive bronchitis in children occurs due to viruses, and the remaining 10% are bacterial infections. A child may have chronic bronchitis with obstruction if he has repeated attacks of acute bronchitis that remain undiagnosed and untreated. Other causes of chronic obstructive bronchitis include living in a region with persistent industrial pollution and passive inhalation of cigarette smoke.

Viral infections that are responsible for the development of obstructive bronchitis include:

flu;
parainfluenza;
adenovirus;
rhinovirus;
respiratory syncytial virus;
herpes simplex virus;
human bocavirus.

The child may develop a secondary bacterial infection, leading to bronchitis with obstruction. However, it is rare in children who do not have immunodeficiency or cystic fibrosis.

A child develops a bacterial infection due to the following bacteria:

mycoplasma;
chlamydia;
hemophilus influenzae;
Moraxella catharalis;
pneumococcus.

Even air pollutants can lead to obstructive bronchitis in children. One of the main air pollutants that can cause bronchitis is cigarette smoke. Research shows that if a pregnant woman is exposed to cigarette smoke or if there is cigarette smoke in the home after birth, it causes a recurrence of obstructive bronchitis in children.

Other causes of bronchitis with obstruction in children:

fungal infection;
chronic aspiration;
gastroesophageal reflux;
allergies.

Is obstructive bronchitis contagious?

Most children with obstructive bronchitis are contagious if the cause is an infectious agent such as a virus or bacteria. The infectious period for bacteria and viruses usually lasts as long as the patient has symptoms, although some viruses will be contagious for several days before symptoms appear. Contagious viruses that cause obstructive bronchitis are listed in the causes section.

Contagiousness subsides when symptoms subside. But bronchitis caused by exposure to pollutants, cigarette smoke, or other environmental substances is not contagious.

Symptoms of obstructive bronchitis in children

Cough

The main manifestation of obstructive bronchitis is cough. It tends to be dry and unproductive in the beginning. As secretion production increases, mucus becomes less viscous, making the cough more wet. Some babies have such severe coughing spells that they may vomit. After regression of obstructive bronchitis, an unpleasant dry cough may still remain for several days or weeks. This is due to transient hyperresponsiveness of the bronchial system due to inflammation caused by infection.

Shortness of breath and wheezing

Shortness of breath gradually increases with the severity of the disease. As a rule, children with obstructive bronchitis cannot breathe as usual when active and begin to cough. Shortness of breath at rest usually signals that COPD (chronic obstructive pulmonary disease) or emphysema has developed. A loud whistling sound is heard when exhaling, but in severe cases it can be heard when inhaling. This is caused by inflammation of the bronchi and narrowing of the respiratory tract.

Other symptoms

Sensation of rattling in the chest.
Moderate.
Runny nose.
Poor sleep due to cough.
Chest tightness and pain.
A tickling sensation in the back of the throat, which makes swallowing painful.
General feeling of malaise.

Obstructive bronchitis in children under one year of age is manifested by blueness of the tips of the ears and nose, nails and lips

The above symptoms are especially dangerous for children under one year of age, since the body is not yet strong and the immune system has not been formed. This causes rapid progression of bronchitis with obstruction.

Diagnostics

Obstructive bronchitis may be suspected in patients with acute respiratory infection with cough. However, because many more serious lower respiratory tract diseases cause cough, obstructive bronchitis should be considered a diagnosis of exclusion.

Cytological examination of sputum in the diagnosis of obstructive bronchitis will be useful for persistent cough. The mucus that the child coughs up will be analyzed for the presence of infections and other pathological components.
A chest X-ray helps the doctor rule out pneumonia or another lung infection. If anyone in the family smokes, this test is done to rule out lung problems due to exposure to secondhand smoke.
Bronchoscopy may be required to rule out foreign body aspiration, tuberculosis, tumors and other chronic diseases of the tracheobronchial tree and lungs.
A pulmonary function test is a breathing test that uses a device known as a spirometer. The doctor will ask the child to blow into a device to measure the amount of air his lungs can hold and determine how quickly the child can exhale. This helps the doctor identify obstruction in children.
Sometimes children with obstructive bronchitis may suffer from cyanosis. In this condition, there is not enough oxygen in the blood, which gives the skin a bluish tint. If your doctor observes a bluish tint to your skin, they will perform a test called pulse oximetry. It helps measure the amount of oxygen in the baby's blood. This is a painless, non-invasive test that involves attaching a small sensor to your child's finger or nose.

How and how to treat obstructive bronchitis in children

In general, bronchitis can be treated symptomatically because most cases are caused by a viral infection for which there is no specific treatment.

To achieve this goal, your doctor will prescribe a combination of medications that open up the bronchial airways and soften the mucus so it's easier to cough up. Bed rest is recommended.

The most effective way to control cough and sputum production in patients with chronic obstructive bronchitis is to avoid environmental irritants, especially cigarette smoke.

Treatment of obstructive bronchitis in children includes taking a number of medications.

Bronchodilators

Bronchitis with obstruction makes it difficult for a child to breathe due to narrowing of the respiratory tract. Therefore, the doctor will prescribe bronchodilators.

They widen inflamed airways and reduce swelling. This allows the child to breathe more freely, without pain or discomfort.

Research (although limited) has shown benefit from bronchodilators and possible superiority to antibiotics for relief.

Albuterol and Metaproterenol relax the smooth muscles of the bronchi, having little effect on the contractility of the heart.

Theophylline and Ipratropium are used to control symptoms such as chronic cough, shortness of breath, and bronchospasm in stable patients with chronic obstructive bronchitis.

Systemic corticosteroids

These are Prednisolone, Prednisone, Dexamethasone.

For children with exacerbation of chronic obstructive bronchitis, a short course of systemic corticosteroid therapy is possible to relieve wheezing and inflammation.

Inhaled corticosteroids

Corticosteroids are the most powerful anti-inflammatory drugs. Inhalation forms are locally active and practically do not penetrate into the systemic circulation. In children who are stable with chronic obstructive bronchitis, treatment with a long-acting bronchodilator combined with an inhaled corticosteroid may help relieve chronic cough.

Beclomethasone causes direct smooth muscle relaxation and may reduce the activity and number of inflammatory cells, which reduces respiratory hyperresponsiveness.

Fluticasone has extremely strong vasoconstrictor and anti-inflammatory activity.

Budesonide reduces inflammation in the respiratory tract by inhibiting multiple types of inflammatory cells and reducing the production of mediators that are involved in the asthmatic response.

Mucolytics

Mucolytic drugs thin the bronchial mucus (phlegm) to make it easier to cough up. Among the mucolytics, the most famous are Acetylcysteine and Ambroxol.

Acetylcysteine has an anti-inflammatory effect.
Bromhexine activates enzymes that break down mucus molecules and stimulate glandular cells to increase mucus production, reducing its viscosity.
Ambroxol is the result of the breakdown of bromhexine. In addition to its effects, it stimulates the production of surfactant (the substance that lines the inside of the alveoli of the lungs). This helps the lungs absorb and metabolize oxygen.

Some herbal substances, such as ivy, are also considered mucolytics. As a general rule, the therapeutic value of all these so-called cough syrups should not be overestimated. It is much more important that children drink enough and take inhalations.

Antibiotics

Antibiotics for obstructive bronchitis in children are prescribed in case of bacterial infection. The choice of the appropriate antibiotic depends on the age of the child, because different age groups have their own predominant pathogenic group.

After obtaining an antibiticogram, antibiotic therapy can be determined according to the sensitivity and resistance of the bacteria. Bacterial spectra also differ between community-acquired and nosocomial infections. Sometimes it is impossible to distinguish between viral and bacterial infections, since the clinical picture and blood parameters can be very similar. In this situation, the child will be treated with an antibiotic, although it is just a viral infection with a high fever.

Amoxicillin and Clavulanate (Augmentin)

This is a semi-synthetic antibiotic with a wide spectrum of bactericidal activity, covering both gram-negative and gram-positive microorganisms. It works by stopping the growth of bacteria.

This is a good alternative antibiotic for children with allergies or intolerances to the macrolide category. It is generally well tolerated and provides good coverage of most infectious pathogens, but is ineffective against Mycoplasma and Legionella species. The half-life of an oral dose is 1-1.3 hours. Penetrates well into tissues, but does not penetrate the blood-brain barrier, which makes it useless in the fight against neuroinfection.

Erythromycin

Erythromycin belongs to the group of macrolides. Macrolide antibiotics inhibit the growth or kill sensitive bacteria by reducing the production of important proteins that bacteria need to survive. It is prescribed for streptococcal, staphylococcal, mycoplasma and chlamydial infections.

Azithromycin

Used to treat some mild or moderate bacterial infections (including sinusitis, pneumonia). This is a macrolide antibiotic that works by stopping the growth of bacteria.

Do not give this medicine to a child younger than 6 months.

Tetracycline

Tetracycline acts on gram-positive and gram-negative organisms, as well as mycoplasma and chlamydial infections.

In certain cases, tetracycline is used if penicillin or another antibiotic cannot be used to treat severe infections such as clostridium, listeria, and others.

It is less effective than Erythromycin.

Tetracycline works best when taken on an empty stomach one hour before or 2 hours after a meal. Take each dose with a full glass of water (240 milliliters). It is not recommended to lie down for 10 minutes after taking this medicine. For this reason, you should not take your dose right before bed.

Tetracycline may make your skin more sensitive to sunlight. Use sunscreen and dress your child in protective clothing when you must be in the sun.

Children under 8 years of age should not take tetracycline. Tetracycline can cause permanent tooth discoloration and may also affect a child's growth.

Cefditoren

This drug belongs to a class of drugs known as cephalosporin antibiotics.

Prescribed for exacerbation of chronic bronchitis, which is caused by sensitive strains of S pyogenes.

Cefditoren works best when taken with food.

Trimethoprim-sulfamethoxazole

Used to treat a certain type of pneumonia (Pneumocystis pneumonia) in immunocompromised patients. This drug is a combination of 2 antibiotics: sulfamethoxazole and trimethoprim. Like tetracycline, it has activity against whooping cough but has no effect against mycoplasma infections.

You should drink plenty of fluids while taking this drug to reduce your risk of developing kidney stones.

Do not give this medication to a child younger than 2 months old.

Amoxicillin

This drug is a penicillin-type antibiotic.

Derived from ampicillin, it has a similar antibacterial spectrum (some gram-positive and gram-negative organisms). It has a bactericidal effect similar to penicillin, acting on susceptible bacteria during the multiplication stage, it has excellent bioavailability and resistance to stomach acid, a wider spectrum of activity than penicillin.

Amoxicillin is less active than penicillin against Streptococcus pneumococcus; penicillin-resistant strains are also resistant to amoxicillin, but higher doses may be effective. The drug is more effective against gram-negative organisms (eg, N meningitidis, H influenzae) than penicillin.

Clarithromycin

Semi-synthetic macrolide antibiotic. It is also used to prevent certain bacterial infections.

Doxycycline

It is a synthetic broad-spectrum bacteriostatic antibiotic in the tetracycline class.

Children under 8 years of age should use Doxycycline only for severe or life-threatening conditions. This medication may cause permanent yellowing or discoloration of children's teeth.

Antibiotics work best if the amount of drug in the body is kept at a constant level. Therefore, antibacterial drugs should be taken at the same time every day.

Analgesics/antipyretics

Analgesics and antipyretics are often useful in relieving the lethargy, malaise, and fever associated with the disease.

Ibuprofen. Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). It reduces the production of substances that cause inflammation and pain in the body. Ibuprofen is used to reduce fever and treat inflammation or pain.
. Paracetamol is a pain reliever and antipyretic. Children under 12 years of age should not take more than 5 doses in 24 hours. Use only the recommended amount of milligrams for the child's age and weight.

Do not give these drugs to a child under 2 years of age without consulting a specialist.

Nasal drops

Saline nasal drops are used to moisten and cleanse the lining of the nose. Vasoconstrictor nasal drops should be given if the eustachian tube swells in response to an upper respiratory tract infection to ensure ventilation of the middle ear. These drops should not be given for more than 7 days, otherwise they may cause irreversible damage to the mucosa.

Oxygen therapy

In the case of severe bronchial obstruction with spasms of the bronchial muscles, swelling of the bronchial mucosa and the formation of viscous secretions, ventilation in the respiratory tract and diffusion in the alveoli may be impaired. This causes partial or systemic oxygen deficiency. If a pulse oximetry test reveals that the oxygen saturation of the blood is too low, supplemental oxygen is needed.

This therapy is carried out to provide the body with additional oxygen, so that tissues and cells receive enough oxygen through the blood.

Oxygen is usually given through nasal cannulas. If young children cannot tolerate nasal cannulas, a mask may be used, especially during sleep.

Treatment for chronic bronchitis helps minimize all symptoms, but you must realize that the symptoms will never go away. They will keep coming back and your child will need regular, long-term treatment.

Why is obstructive bronchitis dangerous in children?

A child is at high risk of complications due to obstructive bronchitis if:

he has had a cough for more than three weeks;
he coughs so much that he cannot sleep well;
the child wheezes;
he has difficulty breathing;
the baby has a fever of 38 degrees or higher;
he coughs up bloody mucus.

Children with undiagnosed and uncontrolled obstructive bronchitis are at risk of developing pneumonia, and chronic bronchitis with obstruction can lead to chronic obstructive pulmonary disease (COPD).

Pneumonia

Statistics show that out of every 20 cases of obstructive bronchitis, 1 pneumonia develops. This is a secondary bacterial infection of the lung caused by bronchitis. The bacteria infect the tiny air sacs (alveoli) in the lungs. Infants and children have a higher chance of developing pneumonia because their immune system is not strong enough to fight the infection.

If a child also has asthma or another condition that has weakened their immune system, they are at risk of developing pneumonia.

Symptoms of pneumonia:

high fever;
shortness of breath, even at rest;
rapid pulse;
lack of appetite;
chest pain;
cough;
sweating and chills;
lethargy.

When a child develops mild pneumonia, doctors will prescribe antibiotics, bed rest, and adequate fluid intake. This treatment takes place at home. However, if the infection is more severe, the child will need hospitalization to prevent respiratory failure.

Chronic obstructive pulmonary disease

Chronic obstructive bronchitis in children can develop into chronic obstructive pulmonary disease (COPD). This disease reduces the lungs' ability to function optimally and causes. It also makes the child more susceptible to other lung infections.

COPD is a progressive disease and symptoms get worse over time. Because the lungs suffer irreversible damage, treatment and lifestyle changes are the only way to slow the progression of the disease and allow your child to lead an active life.

Prevention of obstructive bronchitis in children

Bronchitis is not contagious. But the virus or bacteria that causes bronchitis is infectious. Therefore, the best way to prevent the disease is to make sure that the child does not become infected with a bacteria or virus.

Teach your child to wash their hands thoroughly with soap and water before eating.
Provide your child with a healthy and nutritious diet to ensure that their immunity is strong enough to fight off infectious pathogens.
Keep your child away from family members who have the flu or cold
Do not allow family members to smoke indoors, as passive inhalation of cigarette smoke can cause chronic bronchitis with obstruction.
If you live in a very polluted area, make your child wear a face mask.
Clean your baby's nose and sinuses with a nasal spray to remove allergens and pathogens from the nasal cilia.
Supplement your child's diet with vitamin C to strengthen his immunity.

Treatment of obstructive bronchitis in children with folk remedies

You can use home remedies to treat obstructive bronchitis to relieve the symptoms of the infection. However, consult your doctor before using these methods. This is especially necessary if the child is receiving medication for an infection. Certain home remedies may interact with the medication, resulting in adverse side effects.

Increase your fluid intake.

Cough and fever can dehydrate a child. So let him drink plenty of fluids. He should drink eight to ten glasses of water every day. It also helps thin mucus, making it easier for the body to eliminate it.

Humidifier.

When your child has trouble breathing while sleeping or playing, use a cool mist humidifier to add moisture to the air in the room. This will help him breathe easier. However, clean your humidifier periodically to prevent the spread of germs.

Cranberry juice.

Cranberry juice is high in vitamin C, which is an immunostimulant. This helps the baby's immune system fight infection.

Honey.

Honey has anti-inflammatory and antibacterial properties. It can alleviate the phenomenon of inflammation of the respiratory mucosa, thereby minimizing cough. You can add honey to warm water and give it to your baby as a drink.

Thyme.

Thyme will help clear mucus from your airways and also strengthen your lungs. Boil some dried thymes in a cup of water. Let it sit for 10 minutes. Strain. Mix the mixture with honey and give it to your child to drink.

Turmeric.

Turmeric has been used for centuries to fight infections. Its antiseptic and anti-inflammatory properties help the child with a cold. Mix a teaspoon of turmeric powder and a small amount of warm milk. Stir the turmeric well until it dissolves in the milk. Have your child drink the formula in the morning on an empty stomach for best results.

Magnesium sulfate.

Magnesium sulfate baths can relieve constriction of the bronchi and also cleanse the body of toxins. Add two cups of magnesium sulfate to your baby's bath water and let him sit in it for 30 minutes. Encourage him to inhale the steam for optimal results.

Do not give your child any home remedy that suppresses cough. It is important for your child to cough up mucus as this will help them recover. If you want to soothe his throat, honey should be enough.

Conclusion

Children's obstructive bronchitis ranges from mild to severe with symptoms of respiratory failure. Don't ignore your child's cough; take him to the doctor. The last thing you want is for the infection to worsen and lead to complications such as pneumonia and COPD. With early diagnosis and proper treatment, bronchitis should not be a cause for concern.

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Obstructive bronchitis, the main symptom of which is narrowing (obstruction) of the bronchi and the resulting difficulty in exhalation, is a very common variant of damage to the lower respiratory tract among children, especially young children. The prerequisites for the development of obstruction in children, even against the background of relatively mild ones, are created by the physiologically narrow lumen of the bronchi in children under 3 years of age.

In addition to the anatomical and physiological characteristics, predisposing factors to the formation of obstructive bronchitis are:

allergies and tendency to allergic reactions;
smoking – both passive and active.

Despite its high prevalence, obstructive bronchitis has a very clear clinical picture, often frightening for parents, which leads to the child being treated with potent and not always necessary medications.

Main symptoms of obstructive bronchitis

Loud whistling or hoarse breathing that can be heard from a distance;
swelling of the chest and retraction of the intercostal spaces during breathing;
paroxysmal painful cough, sometimes to the point of vomiting.

Why is obstructive bronchitis dangerous?

Bronchitis is usually mild and responds well. However, the addition of obstruction aggravates the child’s condition, and in some cases can pose a serious threat to his life.

When emergency hospitalization is required

Severe intoxication syndrome in obstructive bronchitis is an indication for hospitalization.

Obstruction in a child under 1 year of age.
Against the background of obstruction, symptoms of intoxication are expressed (high temperature, weakness, lethargy, a sharp decrease in appetite, nausea).
Symptoms of respiratory failure appear: and acrocyanosis. Dyspnea is an increase in the frequency of respiratory movements by 10% or more compared to the age norm. It should be borne in mind that the respiratory rate in children is very variable and increases greatly with anxiety, crying, and during play. Therefore, it is best to count while you sleep. For young children (1–3 years) with uncomplicated bronchitis, the breathing rate during sleep should not exceed 40 per minute. Acrocyanosis is the appearance of blueness of the nails and nasolabial triangle, indicating a lack of oxygen.

But even in cases where a child receives treatment at home, this should not mean a lack of medical advice. Even if your baby is prone to frequent obstructions and you are very familiar with the treatment regimen, you should not neglect a doctor’s examination. The doctor will determine the child’s need for certain medications and adjust their dosage depending on the severity of the condition. In addition, do not forget that obstructive bronchitis can hide under the mask, and frequently recurring obstructions often lead to the formation.

Treatment of obstructive bronchitis

Mode

Bed rest is indicated for a child only against a background of fever. In its absence, the regime is relatively free, but it is advisable to monitor the child’s physical activity: most children subjectively tolerate obstruction well and can run and play until severe shortness of breath appears.

Walking in the fresh air is not only allowed, but even recommended - you can walk twice a day for 1–1.5 hours. You should take your child for walks every day, dressing him according to the time of year and weather conditions (walks are excluded in strong winds and frost). Places for walking should be chosen adhering to the following rules:

away from dusty roads and highways;
away from playgrounds and other concentrations of children, so as not to provoke the child into active games.

Diet

During the period of fever, it is indicated in warm form, liquid and semi-liquid consistency (soups, purees). For the entire period of the disease, it is recommended to drink plenty of fluids to help relieve intoxication and dilute sputum: compotes and fruit drinks from fresh berries, decoctions of dried fruits, freshly squeezed juices (not from citrus fruits), weak tea, alkaline mineral water. Honey, chocolate, citrus fruits (except for tea with lemon), and spices are highly allergenic foods that can cause bronchospasm.

Home hygiene and other features of caring for a sick child

Be sure to ventilate the room daily, especially before bedtime (in the absence of the child). It is advisable to carry out wet cleaning daily, at least partially, but without the use of detergents and disinfectants, especially those containing chlorine. Control air humidity: in summer and winter in well-heated rooms, use humidifiers or replace them with improvised means (spray window screens and curtains with a spray bottle, place a container of water in the room, etc.). Excessively dry air aggravates and prolongs the disease and contributes to exacerbations.

Avoid your child's contact with synthetic detergents and protect him from passive smoking.

Drug treatment

Antibiotics and antivirals

For older children, metered-dose aerosol inhalers (Salbutamol, Berodual, etc.) can be used.

Theophylline tablets (Eufillin, Teopek) are still prescribed, especially for the treatment of children with. However, compared to inhalation forms, they are more toxic and cause more unwanted side effects.

Fenspiride (Erespal)

Erespal is a modern drug that has anti-inflammatory activity, reduces excess mucus production and helps relieve bronchial obstruction. Its administration from the first days of illness reduces the likelihood of complications and speeds up the treatment process.

Antiallergic drugs

Antihistamines are indicated for children with allergic manifestations and a tendency to. In children older than 6 months, second generation drugs are used (Zyrtec, Claritin). In case of abundant liquid sputum, antihistamines from the first generation (Suprastin, Tavegil) can be prescribed for “drying”.

Hormones

Hormonal drugs can quickly relieve inflammation and bronchial obstruction. They are indicated for severe and moderate obstructive bronchitis and are usually prescribed by inhalation (via a nebulizer). Pulmicort is most often used.

Other drugs

Against the background of high temperature, the use of antipyretics is mandatory. At the end of treatment (when the number of drugs taken simultaneously does not exceed 3-4), multivitamins are recommended. Sometimes the use of homeopathic medicines gives a good effect.

Physiotherapy and warming procedures

In the acute period, physiotherapy is ineffective. For prolonged cough after relief of obstruction, electrophoresis, UHF, and laser are recommended. At home, you can perform neutral heat compresses, heating with salt, buckwheat, and potatoes. The use of mustard plasters, ointments and balms on a plant basis, inhalations with essential oils and other products with a strong odor for the treatment of obstructive bronchitis is strictly prohibited, especially in children under 3 years of age - they often provoke bronchospasm.

Massage and therapeutic exercises

To improve mucus discharge, massage, gymnastics and special body positions (postural drainage) are used. The massage is performed using vibration: tapping the child’s back with palms cupped. Older children are asked to take a deep breath, exhale smoothly, and tap while exhaling. The babies are placed with a pillow under their tummy (head down) and massaged, quickly tapping with their fingertips.

Postural drainage is carried out as follows: in the morning, without getting out of bed, the child hangs his head and torso from the bed, resting his palms or forearms on the floor, and remains in this position for 15–20 minutes.

Gymnastics should be carried out while simultaneously performing breathing exercises for enhanced exhalation. Blowing out candles and inflating balloons are suitable as separate breathing exercises.

What else do you need to know?

It is important to remember that obstructive bronchitis can be caused by a combination of infectious and non-infectious factors, or only by non-infectious causes. In young children, obstruction by a foreign body may develop, in adolescents - bronchitis due to smoking, and obstructive bronchitis of allergic origin is common.

Distinctive signs of foreign body obstruction:

Someone around saw the child swallow or inhale a small object.
Cough and shortness of breath occurred suddenly while playing or eating. Before this, the child was absolutely healthy.

In such situations, immediate hospitalization is necessary with consultation with an ENT doctor, X-ray examination, and, if necessary, bronchoscopy and other procedures.

Obstructive bronchitis due to smoking can be suspected when the child’s condition is relatively satisfactory, but the cough is strong, whistling, especially in the morning, for a long time.

Obstruction due to allergies is a common occurrence. Bronchitis in children prone to allergies occurs both due to infection and without it, when obstruction is caused by provoking factors or contact with an allergen. Obstructive bronchitis is prolonged, recurring, and there is a high risk of formation.

Prevention of obstructive bronchitis

With frequent episodes of obstructive bronchitis, the allergic nature of the disease should be excluded.

With repeated episodes of obstructive bronchitis, measures must be taken to prevent its development. For children with allergies, maximum restrictions are required from contact with allergens and provoking factors, which may include tobacco smoke; excessively dry indoor air; pungent odors from new toys, furniture, renovations, etc.

Obstruction syndrome is an obstruction of the airways caused by the accumulation of large amounts of thick mucous contents. The respiratory system of a small child is imperfect, so even a minor inflammatory process can provoke the development of complications. How to normalize the breathing of a small patient and protect him from subsequent attacks? Today we are studying obstructive bronchitis in children, having considered all the details of this complex disease.

Causes of the disease

Most often, obstructive bronchitis does not occur suddenly, but develops against the background of an existing inflammatory process. The period of spread of infection is approximately 3-4 days, after which obvious symptoms of bronchial blockage begin to be observed. So, the main causes of obstructive bronchitis:

Children under the age of one year, as well as older children with low immunity and existing diseases of various organs, are most susceptible to the disease.

Symptoms of the disease

Obstructive bronchitis in a child is a disease that has an acute and chronic course. The only difference between these two forms is the frequency of obstruction attacks. And often the first episode of the disease is repeated many times over the next few years. The main signs of the development of the disease:

Unproductive obsessive cough. Attacks occur at any time of the day, intensifying even more before bedtime and in the morning. In infants, attacks often provoke vomiting.
Increased body temperature and other signs of intoxication. Lethargy, drowsiness, moodiness - all these are symptoms of poor health caused by the onset of the inflammatory process.
Runny nose and red throat. This symptom is characteristic of the viral etiology of the disease. With allergic bronchitis, the mucous membrane of the throat is usually not hyperemic or there is a slight manifestation of redness.
Breathing disorders and shortness of breath are the leading clinical symptoms of obstructive bronchitis. A large amount of viscous secretion accumulates in the bronchi, which cannot be removed by normal coughing due to spasm and swelling. Breathing becomes shallow, intermittent and wheezing.

Symptoms of obstructive bronchitis are most dangerous for infants. Impaired respiratory function leads to frequent bouts of vomiting and lack of oxygen. Progressive pathology can threaten heart rhythm disturbances and changes in brain cells.

When is hospitalization needed?

Despite the fact that obstructive bronchitis can be treated at home, sometimes urgent hospitalization may be required. You need to call an ambulance in the following situations:

obstruction syndrome develops in a child under one year of age;
severe intoxication of the body (the baby completely refuses to eat, the temperature reaches high levels, nausea and vomiting appear);
severe shortness of breath;
cyanosis of the nasolabial triangle and nails, indicating a lack of oxygen.

If we are talking about a repeated episode of obstructive bronchitis, then parents probably already know how to treat the disease and how to help the child restore breathing. But this does not negate consultation with a pediatrician, since a similar clinical picture can be observed with pneumonia.

Drug treatment of obstructive bronchitis

For acute obstructive bronchitis in children, symptoms and treatment are something that should be left to a professional. First of all, the pediatrician must assess the child’s condition and the severity of the disease.. Appropriate drug therapy and treatment regimen are prescribed based on the cause of the pathology and clinical picture. There is no one magic pill that can cure a serious illness. Therefore, treatment of obstructive bronchitis in children at home is possible, but only after confirmation of the diagnosis and selection of a set of drugs. If the effectiveness of the prescribed treatment is low or there is a noticeable deterioration in the child’s health, the diagnosis and list of medications are reviewed.

Antiviral and antibacterial agents

Since bronchitis is most often caused by viral infections, at the initial stage of the disease children are prescribed antiviral drugs. With a diagnosis of obstructive bronchitis in children under one year of age, the use of drugs in the form of suppositories or drops is indicated. The most popular of them are Genferon, Grippferon or Orvirem. From one to three years, drops and syrups with antiviral effects are selected. Among them are Immunoflazid and Amizonchik. For children over three years old, it is possible to prescribe medications in tablet form, for example, Anaferon or Arbidol.

Obstructive bronchitis in a child is not a direct indication for antibiotic therapy. Antibiotics are prescribed in case of urgent need, if the disease was initially caused by bacterial microflora or deterioration in the condition of a small patient is observed. The following signs may indicate a bacterial infection:

persistent increase in temperature for three days;
severe symptoms of body intoxication;
increased levels of leukocytes in subsequent clinical blood tests;
separation of purulent sputum, as evidenced by the characteristic yellow color of expectorated mucus;
the appearance of moist rales, indicating the possible development of pneumonia.

If it is necessary to take antibiotics, a small patient is prescribed drugs of the latest generation that have a minimum of side effects. Among them are Cefazolin or Augmentin.

Cough preparations

Obstructive bronchitis in a child is a dry cough without or with little sputum production. This does not indicate the absence of mucus in the bronchi, but only indicates the high viscosity of the mucous contents, which the child is not able to independently remove by coughing. That's why first of all, mucolytic agents are prescribed, the action of which is aimed at diluting this sputum. The most popular drugs are Ambroxol, Lazolvan, Ambrobene.

If the cough becomes wet, but problems with sputum discharge continue to occur, mucolytics are replaced with drugs with an expectorant effect. In pediatrics, preference is given to herbal products, including Bronchosan, Gedelix, Herbion, Doctor Mom or Prospan.

It is prohibited to treat obstructive bronchitis in children with antitussives. By suppressing the activity of cough receptors, they provoke an even greater accumulation of sputum, making it difficult for the child to breathe. This applies to all types of medications, including those based on codeine and butamirate.

Drugs for relief of obstructive syndrome

To relieve spasm from the bronchi and restore breathing, drugs that stop the attack are prescribed. For children over 6 years of age, inhalations with Berodual solution up to three times a day are recommended. In total, inhalations using a nebulizer are carried out 5-6 times a day, alternating the drug with mineral water, such as “Essentuki” or “Borjomi”.

As an alternative to nebulizers, bronchodilators such as Clenbuterol, Erespal or Ascoril can be used. Clenbuterol is prescribed to children under 12 years of age in the form of syrup in accordance with the age dosage. Ascoril syrup is indicated for children aged two years and older. In case of urgent need, it is possible to use the tablet form in the treatment of children over 6 years of age. Erespal for obstructive bronchitis, like the previous drug, is contraindicated in children under two years of age.

At the discretion of the doctor, Teopek or Eufillin may be prescribed. Indications for their use may include frequent obstructive bronchitis and the threat of bronchial asthma.

All of these remedies have serious limitations and side effects. Therefore, treatment of children under 6 years of age is recommended in a hospital setting under the constant supervision of the attending physician.

Medicines of other groups

When drawing up a treatment regimen, all provoking factors and symptoms of the disease are taken into account, and if necessary, other medications are added. So, with the allergic nature of obstructive bronchitis, a small patient is advised to take antihistamines, such as Cetrin, Zyrtec, Zilola and others. If there is a wet cough with copious sputum, other antiallergic drugs are used, for example, Suprastin or Tavegil.

For moderate or severe obstruction, the use of hormonal corticosteroids is indicated. If the condition of a small patient is more or less satisfactory, you can get by with an inhalation solution, for example, Pulmicort. If the syndrome needs to be stopped quickly, the child is prescribed Dexamethasone injections. Glucocorticosteroid injections may also be needed if there are clear signs of an allergic reaction (including skin rashes).

Traditional medicine

Obstructive bronchitis in a child does not tolerate experimentation, and at the first symptoms of shortness of breath you should consult a doctor. Any amateur activity can lead to the development of complications, so it is better to postpone grandma’s recipes until a doctor’s visit. After making a diagnosis, you can add a couple of effective traditional medicine recipes to the treatment plan, but all of them should be discussed with the pediatrician. In addition, the doctor must monitor the dynamics, regularly monitoring the child’s health.

Since treatment with folk remedies is based on the preparation of herbal infusions and honey mixtures, the use of these methods for allergic obstructive bronchitis is dangerous for the child’s life.

The following compounds have a pronounced expectorant effect:

black radish or onion juice with honey;
sage decoction with milk;
carrots infused with honey;
viburnum with honey;
infusion of tangerine zest or buckwheat flowers.

It is important to remember that folk remedies help get rid of the symptom of the disease, but will not eliminate its cause. So they are not suitable as an independent treatment method and can only be prescribed in combination with drug therapy.

Additional conditions for recovery

Mild obstructive bronchitis in children is not an indication for hospitalization. Therefore, if a child is prescribed home treatment, the parents’ task is to organize comfortable conditions for a speedy recovery. Basic recommendations:

If your child does not have a fever, do not force him to lie in bed. But outdoor games are also contraindicated for the baby, as they can increase bronchospasm, causing a deterioration in the condition.
Be sure to ventilate your child’s room and wet clean it without using disinfectants and other household chemicals.
We monitor the level of air humidity. In a dry and hot room, recovery occurs much more slowly.
If the child's general condition is satisfactory, you can go outside with the baby. Fresh air will be useful for recovery. But, as at home, monitor the child’s activity, preventing the emergence of a new attack of shortness of breath.
Do not allow your child to inhale tobacco smoke.

Particular attention should be paid to the nutrition of the young patient. For infants, feeding on demand remains. At 4 months, many babies become acquainted with their first fruits and juices, but it is better to postpone the introduction of complementary foods until complete recovery. Older children need to cook light foods rich in vitamins. These can be chicken broths, mashed potatoes, steamed vegetables, fresh salads and fruits. If your child does not agree to eat your healthy culinary delights, use your imagination and turn mealtime into fun. To do this, it is enough to serve the portion in an original and fun way, making a funny face or some character out of the finished products.

Also don't forget to drink. To liquefy mucus, it is necessary to provide the body with a sufficient amount of fluid. It can be fruit juice, natural juice, compotes or just mineral water.

To prevent recurrent bronchospasm, you should exclude all foods with a high level of allergenicity from your diet. These include citrus fruits, strawberries, chocolate. It’s also better not to experiment with store-bought sweets.

Prevention

A slight cough in a child after obstructive bronchitis may persist for some time. Coughing may not be strong, but at the same time the remaining sputum comes out. The main thing here is to monitor your breathing and not neglect the need to be examined by a pediatrician even after all the symptoms disappear. Prevention of relapse is very simple:

healthy sleep;
strong immunity (proper food, vitamins);
limiting contact with allergens and other provoking factors;
daily wet cleaning of the apartment;
walks in the fresh air away from roads;
annual trips to the sea.

Complications

If you notice that your child has started coughing, you should immediately sound the alarm. Otherwise, complications cannot be avoided. The most dangerous consequences:

pneumonia;
pleurisy;
lung abscess;
bronchial asthma;
emphysema;
cardiac and respiratory failure (with the possibility of death);

The task of parents is to prevent sad developments. To do this, it is enough to consult a pediatrician at the first symptoms of the disease and strictly follow all his recommendations.

Obstructive bronchitis occurs in children of different ages. It is considered as an inflammation that affects the mucous membranes of the bronchi. The disease got its name from the word “obstruction”, which means “spasm”, “constriction”. Doctors register pathology in every fourth child aged 2 years - at an early age, the child’s body is most susceptible to diseases of the respiratory system.

Why does bronchospasm happen?

Often the inflammatory process starts due to infection of different parts of the respiratory tract. Its causative agents are adenoviruses, rhinoviruses and influenza virus. Some children suffer from mycoplasma lesions of the bronchi. In recent years, children are increasingly getting sick due to the influence of food and household irritants. Their effect on the body is dangerous due to the transformation of allergic bronchitis into bronchial asthma or a chronic form of the disease.

Seasonal rhinitis and skin rashes after eating certain foods increase the body's sensitivity to the intake of certain substances. Subsequently, the slightest dose of the irritant causes unpredictable reactions. As the number of allergens increases, the severity of reactions increases. The interaction of the body with an irritating substance leads to problems with the bronchi.

Obstructive bronchitis can develop due to such abnormalities as:

How does the disease manifest itself?

As a rule, obstructive bronchitis develops in an infected organism. Parents notice the first symptoms 2–3 days after the onset of the illness or hypothermia of the baby. In children with weakened immunity, pathologies of the kidneys, liver, and digestive system, bronchitis may show its symptoms within 24 hours. Traditionally, children complain of general malaise, nausea, runny nose, and discomfort in the throat. These symptoms in children 3 years of age include vomiting, defecation disorder, and fever.

As the pathology progresses, the manifestations of bronchospasm increase. If at first children have difficulty exhaling air, then after a few days they complain of problems with inhalation. The respiratory rate and duration of exhalation lengthen, and noise and whistling erupt from the patient’s respiratory tract, which are not difficult to hear from a distance.

A characteristic symptom of bronchospasm is a dry cough with a small amount of sputum. Viscous mucous contents are difficult to separate. A nonproductive cough is especially annoying at night. In this case, the pathology can occur in a child without fever.

In infants in the 1st half of life, the clinical picture of acute obstructive bronchitis is expressed by the following changes:

runny nose;
hoarse cry;
bloating of the chest;
debilitating cough to the point of vomiting;
retraction of intercostal tissues during exhalation;
noisy breathing with whistling and hoarseness;
elevated temperature – with bronchitis of this type it stays at 38 – 39°C.

At an older age, the listed signs of the disease in children are supplemented by pain in the area of the back between the shoulder blades and yellowish sputum. The wheezing becomes so loud that it can be heard from the next room. It is possible that a sore throat or cervical lymphadenitis may occur.

Inflammation of the bronchial mucosa is diagnosed by a pediatrician and pulmonologist. If the disease is associated with the influence of irritants, consultation with an allergist-immunologist is required. Children are referred to an otolaryngologist to rule out sinusitis. After listening to complaints, external examination and listening to breathing sounds, young patients are given directions for a number of tests:

X-ray;
blood test;
sputum culture;
spirometry. The examination requires the child to inhale and exhale forcefully, which allows the specialist to assess the fullness of the lungs. Children over 5 years of age are referred for spirometry.

The danger of inflamed bronchi

Delayed treatment of the bronchial mucosa is fraught with asthma. Sometimes the pathology occurs with the same symptoms as obstructive bronchitis, but in its clinic attacks of suffocation predominate. To prevent the development of complications, parents of children suffering from bronchitis for more than 3 years. per year, should consult a doctor and undergo additional examination. Advanced asthma with respiratory failure is fatal.

Inflammation of the bronchial mucous membranes can be successfully managed at home if the disease does not worsen the child’s condition. But there are a number of unfavorable changes that require immediate hospitalization of the patient:

dyspnea;
clear signs of intoxication;
cyanosis of nails and nasolabial triangle.

Infants should not be treated at home either. Before reaching 1 year of age, they must be placed in a hospital.

Caring for a sick child

If a child is diagnosed with obstructive bronchitis, Dr. Komarovsky draws the parents’ attention to the living conditions. The patient's room must be ventilated daily. When carrying out wet cleaning, you cannot use detergents and disinfectants.

Since insufficient air humidity leads to drying out of the nasal mucosa and oropharynx, it is necessary to place a humidifier or container of water in the nursery. You can simply spray the liquid from a spray bottle periodically.

Drug therapy for obstruction

In the early stages of development of pathology, children should be treated with antiviral drugs. For babies up to one year old, Genferon suppositories are prescribed for rectal administration. Grippferon is dripped into their nose. Orvirem syrup is given orally. From the age of 3, children are given Arbidol or Kagocel tablets.

Antibiotic drugs are prescribed according to indications. The doctor makes the choice from Cefazolin, Macropen, Augmentin. Prescribing medications is justified in cases of severe intoxication, inflammation confirmed by a blood test, signs of pneumonia, and discharge of a purulent mucous mass of a yellow-green hue.

In addition to eliminating harmful viruses and bacteria, proper treatment of bronchitis includes a course of taking medications to thin and accelerate mucus rejection. For this purpose, children are usually given Lazolvan, Ambroxol, Mucosol, Fluditek, etc. For better expectoration, patients should be treated with syrups with phytocomponents (Gerbion, Bronchosan, Doctor Theiss, Bronchipret).

Doctors suggest treating babies older than 6 months who are prone to allergies with Claritin and Zyrtec. To expel liquefied sputum, Tavegil and Suprastin are prescribed.

To relieve obstruction, treatment is supplemented with inhalations. The procedures are performed using a nebulizer filled with a mixture of Berodual and saline solution. The patient should inhale the vapors 2 - 3 times. per day. It is also recommended to use ultrasonic inhalers that are powered from the mains.

If you do not have the equipment, you can use special devices with pocket inhalers. Salbutamol, Flixotide, Ventolin are suitable mixtures for them. The effectiveness of therapy is evident immediately. For severe recurrent bronchitis and moderate obstruction, Pulmicort is prescribed by inhalation.

Home Therapy Options

Compresses and rubbing help ease the child’s condition at home - under the influence of heat, the bronchial muscles relax and obstructive bronchitis recedes. Compresses with warm vegetable oil can quickly get rid of a cough. A towel is soaked in the refined product and placed on the baby’s chest. The compress is covered with cellophane on top and the baby is dressed in warm pajamas. Positive results of therapy appear after 3 wraps.

If, due to frequent bronchitis, the baby does not have time to get rid of the cough completely, an oil-honey compress will help warm up his insides. The mixture is prepared from an equal amount of butter and beekeeping product. The components are melted over low heat and cooled. The composition is applied to the chest and back of the child, the body is wrapped in a cotton towel and polyethylene. The baby should stay in the “wrapper” until the morning. A week-long course of daily compresses will bring long-awaited relief.

In some cases, obstruction is treated with massage. Properly performed manipulation strengthens the walls of the bronchi and facilitates coughing up mucus. At home, the baby’s collar area, chest area and back muscles lying along the spine are kneaded. Postural massage is carried out by tapping with palms folded into a boat along the back. The patient, whose head hangs from the bed, is placed under the stomach with a pillow and a 15-minute postural session is arranged.

Children with obstruction are recommended to perform breathing exercises. Your doctor will teach you exercises to stimulate mucus production during your consultation. The simplest options are blowing out candles and inflating balloons with your mouth. Sound gymnastics is performed by pronouncing sounds and combining them in a special way. The created vibrations go to the bronchi and relieve spasms.

Diseases in which breathing is impaired are the most common in pediatric practice. The leading symptom of such diseases is cough. A pronounced narrowing in the bronchi can lead to it.

What is it?

With obstructive bronchitis, severe narrowing of the bronchi occurs - obstruction. This condition is caused by numerous causes and provoking factors. As a result of obstruction, breathing is impaired. A few days after the onset of the disease, all symptoms begin to progress, which leads to a deterioration in the baby’s condition.

The bronchial tree is covered with microscopic cilia. They are found on the surface of the cells that form the bronchi. After exposure to provoking factors, the movements of the cilia are disrupted, which also contributes to impaired sputum discharge and increases obstruction.

Causes

Any bronchitis develops only after exposure to various provoking factors on the child’s body. There are quite a large number of them. They are especially dangerous for newborns and infants.

The immunity of children of the first year has not yet fully formed. Any agent foreign to the child’s body can cause severe inflammation in the bronchi. This immediately leads to bronchial obstruction.

Reasons that can cause the disease include:

Viral infections. The most common culprits of the disease: influenza and parainfluenza viruses, MS virus, adenoviruses. They easily penetrate the baby's upper respiratory tract and quickly spread through the bloodstream, reaching the bronchi and lungs. Viral infections are the leading cause of bronchial obstruction in babies in the first months of life.

Bacteria. Streptococci, staphylococci and moraxella are the most common causes that can cause bacterial forms of the disease. These microorganisms contribute to the development of severe inflammation, which leads to a pronounced narrowing of the lumen of the bronchi. The disease caused by bacterial flora has a more severe course and requires intensive care.

Allergies. When an allergen enters the body, the immune system is activated. This contributes to a large release of various biologically active substances into the blood, which strongly constrict the bronchi. Against the background of allergies, breathing is significantly impaired and shortness of breath increases.

Inhalation of polluted air. Living near large industrial enterprises or factories, the baby has a higher risk of bronchial obstruction. This occurs as a result of the constant entry of tiny toxic substances into the small bronchi. Industrial emissions quickly lead to the development of breathing problems.

Prematurity. In the third trimester of pregnancy, the final formation of the respiratory organs of the unborn baby occurs. This process occurs almost until the days of birth. If for some reason the child is born earlier, then the risk of underdevelopment of the respiratory organs increases several times. Such an anatomical defect often leads to impaired respiratory function.

Quick cessation of breastfeeding. Children who have been breastfed for a very short time have a higher risk of developing bronchitis. To fight various infections you need a good level of immunity. During breastfeeding, babies receive a large amount of immunoglobulin G. These protective antibodies help them not get sick during seasonal colds and protect them from the development of diseases of the bronchopulmonary system.

How does it arise?

The influencing provoking factor leads to the development of severe inflammation. Most viruses and bacteria enter the body through the upper respiratory tract. Settling on the epithelial cells lining the respiratory organs, they begin to have a strong toxic effect.

The incubation period varies and depends on the characteristics of the specific microorganism that causes the disease. On average, it is 7-10 days. At this time, the child does not make any complaints. There are no specific signs of the disease during the incubation period. Only weakened children may feel a little tired and drowsy.

After the end of the incubation period, the first specific symptoms characteristic of this disease appear. An active inflammatory process occurring in the bronchial tree contributes to disruption of the discharge of mucus and sputum.

Babies who have anatomical defects in the structure of the bronchi have a very narrow lumen of the bronchi. Bronchial obstruction in such children develops much more often and is much more severe.

Species

The course of diseases accompanied by bronchial obstruction may be different. This depends on the initial state of the baby’s immunity, the characteristics of the anatomical structure of the respiratory system, as well as the cause that caused the disease.

According to the frequency of occurrence, all obstructive bronchitis can be divided:

Spicy. These variants of the disease are appearing for the first time. They last, on average, 1-2 weeks. After the therapy, the baby is completely cured.

Chronic. May be recurrent. They occur with periods of exacerbations and remissions. If the treatment is not well-carried out or the baby has concomitant diseases, acute forms become chronic.

By severity:

Lungs. Occurs with minimally expressed symptoms. They are treated well. After the therapy, the babies fully recover. There are no long-term consequences of the disease.

Average. The cough is more severe, annoying. Body temperature with moderately severe obstructive bronchitis rises to 38 degrees. Shortness of breath may increase. The child's general condition suffers greatly. In some cases, hospitalization and more intensive therapy are required.

Heavy. They occur with a pronounced disturbance in the general condition and well-being of the baby. Body temperature rises to 38.5-39.5 degrees, severe shortness of breath, accompanied by signs of respiratory failure. Treatment is carried out only in a children's hospital, and if cardiopulmonary failure develops, in the intensive care unit.

Symptoms

Narrowing of the bronchial lumen and impaired sputum discharge lead to the child developing specific signs of the disease:

Cough. Appears 2-3 days after the end of the incubation period. A hacking cough bothers the baby more during the daytime. May be paroxysmal.

Dyspnea. Occurs in moderate to severe disease. With shortness of breath, the number of respiratory movements per minute increases. Babies breathe more often. This symptom can be seen from the outside, paying attention to the movements of the chest during breathing.

Pain in the chest when coughing up. With bronchial obstruction, the sputum becomes very dense and thick. All attempts at coughing lead to increased pain in the chest area.

Increased body temperature. It increases to 37-39.5 degrees. Bacterial forms of the disease are accompanied by a higher temperature.

Blue discoloration of the nasolabial triangle. The skin in this area of the face is very thin and sensitive. A pronounced decrease in the level of oxygen in the blood leads to the development of acrocyanosis (blue discoloration) of this area. Against the background of a pale face, the nasolabial triangle contrasts strongly.

Poor nasal breathing and redness of the pharynx. These secondary signs occur with viral and bacterial infections and often appear in a child with obstructive bronchitis.

Severe drowsiness and poor health. Sick children refuse to eat and begin to act up. Little children are more willing to be held. Prolonged coughing attacks lead to the baby starting to cry.

Thirst. It appears during severe intoxication of the body. The more severe the disease, the more clearly this symptom manifests itself in the baby.

Active movements of the ribs during breathing. Breathing movements have a large amplitude and become visible from the side.

Loud breathing. During breathing movements, bubbling sounds are heard. They arise as a result of the passage of air through tightly closed bronchi.

Diagnostics

At the first appearance of signs of bronchial obstruction, the child should be shown to a pediatrician. The doctor will conduct a clinical examination and recommend additional examinations. Such tests are needed to determine the severity and cause of the disease.

To diagnose obstructive bronchitis, use:

General blood test. An increase in the number of leukocytes and an accelerated ESR indicate the presence of an inflammatory process. Changes and shifts in the leukocyte formula make it possible to clarify the viral or bacterial nature of the disease.

Biochemistry of blood. Allows you to identify the presence of complications that develop with respiratory pathology. Also used for differential diagnosis.

X-ray of the chest organs. This method is used in children older than one year. This study allows you to determine the degree of narrowing of the bronchi, as well as identify concomitant lung diseases.

Spirometry. Helps assess functional impairment. Indications of forced inhalation and exhalation allow doctors to draw a conclusion about the presence and severity of bronchial obstruction.

Specific laboratory tests to identify allergens. Necessary to establish the cause of bronchial obstruction in children with an allergic form of the disease.

Differential diagnosis

Narrowing of the lumen of the bronchi occurs not only with obstructive bronchitis. Bronchial obstruction syndrome can occur in various diseases. In order to correctly establish a diagnosis, differential diagnosis is required.

Most often, obstructive bronchitis can be confused with:

Stenosing laryngotracheitis. Most often caused by viruses. It usually occurs 3-4 days after the onset of a viral infection. Characterized by the appearance of a barking cough and severe shortness of breath.

Obliterating alveolitis. With this disease, the inner epithelial layer of the bronchi grows, which leads to the appearance and accumulation of foamy sputum. Usually the cough is paroxysmal. Often the disease leads to various complications.

Acute bronchitis. The symptoms are similar. Only spirometry can accurately establish the correct diagnosis.

Cystic fibrosis. This disease is congenital. Typically, children develop poorly and lag behind their peers in physical development. During an exacerbation, a severe cough appears with difficult to clear and very viscous sputum. The course of the disease is quite severe. The disease requires systemic treatment.

Consequences and complications

Frequent obstructive bronchitis can lead to the development of persistent breathing problems in children. With reduced immunity, the baby experiences new exacerbations over a relatively short period of time.

Poorly performed treatment or untimely diagnosis of the disease contribute to the development of complications in the future. Persistent bronchial obstruction can lead to the development of bronchial asthma, especially if the cause of the narrowing of the lumen of the bronchi is an allergy.

Prolonged and persistent cough contributes to the formation of bronchiectasis. With this pathology, the distal sections of the bronchi expand with the formation of additional cavities. Bronchiectasis contributes to the appearance of shortness of breath with increasing respiratory failure. Surgery is performed to eliminate this condition.

During an exacerbation of obstructive bronchitis caused by a bacterial infection, the inflammatory process may spread to the lungs.

In this case, pneumonia or abscesses appear. They, in turn, lead to a deterioration in the baby’s well-being. Intensive antibiotic therapy is required to eliminate purulent formations.

Treatment

To eliminate the unfavorable symptoms of the disease, various methods of therapy are used. After examining the child and establishing a diagnosis, the pediatrician will recommend a specific treatment regimen, which is provided for in the clinical guidelines. These medical developments contain the necessary algorithm for doctors’ actions when identifying a specific pathology.

Obstructive bronchitis should be treated from the first days after symptoms appear. Early prescription of medications helps to cope with all the adverse manifestations of the disease and prevent chronicity. Medicines that eliminate bronchial obstruction and promote better mucus discharge are prescribed by the attending physician.

For the treatment of obstructive bronchitis use:

Agents with mucolytic effects. They help thin thick mucus and facilitate its easier passage through the bronchopulmonary tree. Preparations based on ambroxol are widely used in pediatric practice. "Ambrobene", "Lazolvan", "Flavamed" help eliminate even a severe cough. Prescribed according to age, 2-3 times a day for 7-10 days.
Antipyretic. Prescribed when the temperature rises above 38 degrees. In children, various paracetamol-based products are used. Not prescribed for long-term use. May cause allergic reactions and side effects.
Bronchodilators. P Designed to eliminate blockage in the bronchi and improve breathing. They are usually prescribed in the form of aerosols or inhalations. The effect is achieved in 10-15 minutes. Short-acting bronchodilators based on salbutamol act within 5 minutes.
Combined drugs containing bronchodilators and anticholinergic drugs. To improve bronchial conduction in children, “Berodual” is used. Prescribed by inhalation. The dosage and frequency of inhalations is carried out taking into account the age of the child. Usually the drug is prescribed 3-4 times a day.
Antihistamines. Helps cope with adverse symptoms of allergic forms of the disease. In children, drugs based on loratadine, Claritin, and Suprastin are used. Prescribed 1-2 times a day, usually in the first half of the day. Discharged for 7-10 days. For more severe cases - for 2-3 weeks.
Vitamin complexes enriched with selenium. These substances are needed to combat intoxication. The biologically active components that are present in the vitamin complex help the baby fight infection and improve the functioning of the immune system. Selenium is needed for the active functioning of the immune system.
Glucocorticosteroids. Used for severe and long-term illness. Pulmicort inhalations are usually prescribed. The drug is prescribed for long-term use. Apply 1-2 times a day until a lasting good result is achieved. May cause side effects with long-term use.
Leukotriene receptor blockers. Helps quickly eliminate bronchospasm. They have a lasting effect. The drug "Singulair" begins to have an effect within 2 hours after administration. Apply once a day.

Treatment at home

You can help your child cope with the disease not only with the help of medicines and pills. The use of medicines prepared at home also helps to eliminate a persistent cough and improve the child’s well-being.

Methods that are safe and effective for self-use include:

Warm, plenty of drink. Alkaline mineral waters heated to a temperature of 40-45 degrees are perfect. They are prescribed 20 minutes before or an hour after meals, 3-4 times a day. The course of treatment is 7-10 days. You can use “Essentuki” or “Borjomi”.

Licorice root. This wonderful remedy improves mucus discharge and promotes better expectoration. It should be used with caution, keeping in mind possible allergic reactions. Works great even with a strong cough.

Breast fees. The composition of such pharmaceutical preparations includes several medicinal plants that have expectorant and anti-inflammatory effects. Licorice, coltsfoot, and sage help relieve coughs and improve bronchial conduction.

Radish juice. To prepare such a homemade medicine, ordinary black radish is suitable. To prepare 250 ml of drink, you only need 1 teaspoon of juice. Before use, add honey to taste.

Breathing exercises

It is used after the acute process has subsided. Typically, such gymnastics is carried out 5-6 days after the onset of the disease. The correct sequence of breathing movements helps normalize the functioning of the respiratory system and cope with adverse symptoms.

In order to improve the outflow of mucus, when performing breathing exercises, a sharp and short breath is taken. Exhale – quite slow and smooth. While exhaling, you should count to 5. Each set of exercises consists of 3-4 repetitions. It is recommended to practice every day. Even during the period of remission, breathing exercises will be very useful.

See the video below for more details on how to do breathing exercises.

Nutrition

The diet of a baby suffering from bronchial obstruction must be complete and contain all the necessary nutrients and vitamins.

Breastfeeding should not be canceled during the acute period of illness. Together with mother's milk, the baby receives all the necessary protective antibodies that help him fight the infection that causes bronchitis.

Older children should eat small meals, at least 5-6 times a day. A child's diet should include a variety of protein foods. It is better that your baby receives some source of protein with each meal. Veal, rabbit, chicken or fish are perfect.

Try to choose leaner varieties. Fatty foods take longer to be absorbed by a weakened child's body. You can supplement proteins with cereals and vegetables. Fresh fermented milk products are also good as protein dishes. They make a great afternoon snack or second dinner.

All dishes are best steamed, baked or stewed. They should have a more liquid consistency. Fruit and vegetable purees are great for younger children. It is not necessary to give your child foods from jars. Homemade cauliflower or potato purees are a good choice.

The baby must drink enough liquid. As drinks you can use compotes, various fruit drinks and juices made from fruits and berries. Frozen fruits are also suitable for preparing healthy decoctions. Try to give your child more boiled water. This will help eliminate the adverse symptoms of intoxication.

Prevention

To prevent your baby from getting obstructive bronchitis, use the following recommendations:

Visit the dentist regularly with your child. Often the presence of carious and untreated teeth leads to the development of various infectious pathologies. Make sure your child brushes his teeth regularly.

Avoid catching colds. Any frequent respiratory diseases, which mainly occur in the cold season, lead to disruption of the respiratory system and reduce immunity. The risk of bronchial obstruction in frequently ill children increases several times.

Strengthen your immune system. Active walks in the fresh air, good nutrition and a proper daily routine contribute to the normal functioning of the immune system.

Treat inflammatory diseases of the upper respiratory tract in a timely manner. Children suffering from chronic otitis media or sinusitis are more likely to develop obstructive bronchitis in the future. To prevent this, regularly visit an otolaryngologist with your child.

Use special room humidifiers. Too dry air contributes to breathing problems. Room humidifiers help create a comfortable and physiologically favorable microclimate in any room.

After the complex of treatment, the children feel much better. Their breathing normalizes and shortness of breath goes away. With properly selected therapy, the transition from acute to chronic does not occur. Compliance with preventive recommendations helps prevent the occurrence of new exacerbations in the future.

Dr. Komarovsky will tell you more about obstructive bronchitis in the video below.