Bronchitis is acute and chronic. How to identify symptoms and how to treat acute bronchitis in an adult

Acute bronchitis is a disease characterized by an acute inflammatory process of the bronchial mucosa. The main symptom by which the disease can be identified is cough. People most often fall ill after hypothermia, damage to the body by various infections, abuse of nicotine, and decreased immunity.

According to ICD 10, acute bronchitis has code J20. Depending on the type of acute form, the disease is assigned different numbers in the international classification of diseases. These forms of the disease are considered developmental types.

An acute attack of bronchitis is provoked by viruses, bacteria and, very rarely, fungi. The disease begins to progress with a common cold, during which the patient develops unpleasant sensations and discomfort, and is overcome by weakness and characteristic symptoms. After which an acute form of bronchial damage can form in the human body in a short period of time.

Acute bronchitis in adults and children can manifest itself not only in the bronchial mucosa, but also affect other tissues, submucosal and muscular layers. Such deviations from the norm are manifested in swelling, hyperemia of the membrane, strong infiltration of the submucosal layer, an increased number of goblet cells, degeneration and deterioration of the protective function of the ciliary epithelium.

Etiology

Often, the reasons for the development of the acute form of the disease lie in viral or bacterial origin. In addition to the infectious manifestation of the disease, clinicians also identify another etiology:

• physical factors - excessively cold, hot or dry air flow;
• chemical;
• allergic.

The etiological factors that provoke the appearance of the disease are directly related to the age category of patients. The above-mentioned reasons for the progression of the disease develop faster due to several factors that help reduce the body's resistance:

• climate and weather;
• working conditions;
• nicotine;
• alcoholic drinks;
• infection of the nasopharynx;
• change in nasal breathing;
• disorders in the lungs from.

If a person begins to experience an exacerbation, then this process often occurs with severe clinical symptoms.

Classification

Understanding the concept of what acute bronchitis is and how it manifests itself, it is imperative to determine what types of illness there are. Clinicians have identified several criteria by which the types of disease are determined. According to the mechanism of occurrence of the inflammatory process, the following forms have been identified:

• primary – damage to the bronchi without concomitant diseases;
• secondary – subsequently the development of another pathology.

The primary type of the disease is rarely diagnosed by doctors; the disease often develops as a complication of an infectious lesion.

Based on the level and localization of exposure, doctors have identified the following forms:

• bronchitis of the lower respiratory tract – , ;
• bronchitis affecting the medium-sized bronchi;
• extensive in nature;
• segmental.

Sputum is considered one of the manifestations of bronchitis, so another classification criterion is devoted specifically to this symptom. The disease has the following types of discharge:

• mucous membranes;
• purulent;
• catarrhal;
• mixed.

If we talk about the functional features of the disease, then it can develop in a non-obstructive form.

In ICD 10, doctors gave a more extensive classification of the disease according to infectious etiology. Thus, bronchitis in an adult can be triggered by the following indicators:

• virus;
• respiratory syncytial virus;
• rhinovirus;
• other infectious agents;
• unspecified.

Symptoms

The clinical picture of the pathology is manifested in specific signs. If the doctor has correctly diagnosed it, then it will not be difficult for a specialist to establish a diagnosis based on symptoms.

Symptoms of acute bronchitis are manifested in the following indicators:

• – formed at the onset of the disease, the duration of the symptom is based on various reasons;
• – characteristic of the second stage. The patient produces specific clear mucus or yellowish-green sputum;
• fever no more than 38 degrees;
• weakness, increased sweating, malaise;
• shortness of breath and decreased activity;
• wheezing in the lungs - at the beginning of the development of the disease, they are dry and rough based on hard breathing. During the period of expectoration, wheezing passes into the stage of moist large- or medium-bubbly wheezing.

Treatment of acute bronchitis in children and adults is prescribed according to the etiology of the disease. Often, the first thing the patient is recommended to do is take certain medications:

• antipyretics;
• antiviral;
• antibacterial;
• dilating bronchi;
• thinning phlegm;
• decongestants;
• vitamins.

Acute bronchitis with purulent sputum in children or adults requires the use of antibiotics, which are prescribed by the attending physician.

In case of obstructive form, it is advisable for the patient to use means to dilate the bronchi. During the protracted manifestation of the disease, inhalations are prescribed, which are based on sea and mineral water. The patient is also recommended physiotherapeutic procedures, namely electrophoresis.

Since bronchitis quite often occurs in smokers, the use of nicotine during therapy should be eliminated, or even better, all negative habits should be completely eliminated from life. The room where the patient lives must be regularly ventilated. In case of pain, warm compresses, mustard plasters, cups, and foot baths are applied to the patient’s chest.

If acute bronchitis in children and adults passes without complications and drug treatment quickly helps, then the patient begins to clinically recover. The therapy process may take 2–3 weeks. After recovery, the patient gradually restores the functions of external respiration and bronchial patency. A protracted form of the disease takes a little longer to treat. Full recovery in a person occurs only after 1–2 months.

Complications

If the patient does not ask himself in time how to treat the pathology and in what time frame, then very soon he may develop the following complications:

• obliterative;
• acute respiratory or heart failure.

Frequent manifestations of bronchitis gradually turn into a chronic form, which can provoke the following consequences - COPD, bronchial asthma, emphysema.

Prevention

• eliminate negative habits;
• maintain the correct daily routine;
• correctly allocate time for both work and rest;
• balance nutrition;
• take vitamins;
• strengthen immunity;
• do not succumb to hypothermia;
• to harden;
• maintain an active lifestyle;
• exercise regularly.

Acute bronchitis is not a death sentence, but the disease takes a long time and is difficult to treat. Therefore, both adults and children should follow the doctor’s recommendations in the treatment and prevention of the disease.

Is everything in the article correct from a medical point of view?

Answer only if you have proven medical knowledge

If dry and then wet are added to the snotty nose and red throat, it means the patient has acute bronchitis, i.e. irritation and swelling of the bronchial mucosa. This article will tell you what needs to be done for bronchitis to become acute (about 2 weeks), and not, and what is required to treat acute bronchitis at home.

Are antibiotics needed to treat bronchitis?

If the bacterial nature of acute bronchitis is confirmed, the patient cannot do without taking an antibiotic.

Since in most cases the causative agents of bronchitis are viruses, there is no point in taking antibiotics. However, if within 5 days the temperature does not decrease, severe weakness, fatigue persists, appears, sputum becomes green and abundant, and a blood test reveals signs of a bacterial infection, then their prescription cannot be avoided. Entrust the choice of drug to your doctor - most likely it will be an antibiotic from the group of macrolides (Macropen, Sumamed, Clarithromycin) or penicillins (Amoxicillin, Augmentin).

Are antiviral drugs needed to treat bronchitis?

If they are already prescribed for a respiratory infection, continue taking them. If more than 2 days have passed since the onset of the disease, there is no point in starting to take them; there is no need to expect any effect.

Do you need anti-inflammatory drugs for bronchitis?

Paracetamol, ibuprofen and other drugs from the class of non-steroidal anti-inflammatory drugs not only help reduce fever and intoxication, but also reduce swelling and spasm of the bronchi, and improve sputum discharge. However, side effects limit their use. Today, fenspiride (Erespal) is considered the safest anti-inflammatory drug recommended for the treatment of acute bronchitis.

What regimen should you follow for bronchitis?

• At high temperatures - bed rest. But as soon as the thermometer shows normal, walking in the fresh air becomes a therapeutic remedy (of course, not in 30-degree frost).
• But even before this, you need to ventilate the room and maintain a sufficient level of humidity in the room. Air humidifiers and simply throwing a wet towel on the radiator will do - the main thing is not to forget to wet it as it dries.
• It is better to eliminate all irritating factors (dust, tobacco smoke, strong odors). For this purpose, daily wet cleaning of the patient’s apartment is recommended. It is better to send smokers outside to smoke, and if the patient himself smokes a cigarette, acute bronchitis is an excellent reason to quit smoking.
• Drinking plenty of teas - including herbal teas (linden, mint, thyme), fruit drinks, juices, warm alkaline mineral water - will help not only reduce intoxication, but also make sputum less viscous and make it easier to pass.

Do inhalations help with bronchitis?

Steam inhalations themselves are ineffective for bronchitis. But inhaling phytoncides - essential oils of garlic, eucalyptus, camphor, pine, mint and rosemary - reduce coughing and make coughing easier. You can use either an inhaler or an aroma lamp, or simply apply a few drops of essential oil to your clothes.

How to treat cough with bronchitis?

In the first days, when the cough is painful, dry and debilitating. These are codeine-containing tablets (Codterpine, Codelac) and non-narcotic Libexin, Tusuprex, Glaucin, Levopront. In folk medicine, marshmallow, broom and stepmother, thermopsis and licorice are successfully used to treat dry cough.

As soon as sputum begins to leave, and this usually happens on days 3-4, antitussive drugs should be stopped and switched to drugs that thin sputum (mucolytics), improve coughing (expectorants), and facilitate its movement (mucokinetics).

The first include acetylcysteine ​​and carbocysteine. The second includes reflex-action drugs: marshmallow, plantain, thyme, ammonia-anise drops.

Mucokinetic agents bromhexine, ambroxol (Lazolvan) are also called mucoregulators: they affect the functioning of the ciliated epithelium lining the walls of the bronchi, making sputum less viscous, facilitating its elimination.

Suprima-Broncho, Prospan (aka Gedelix), Bronchipret, Bronchikum - all these are drugs based on plants that have long been used in medical practice to treat bronchitis. You can also find herbal teas at the pharmacy. Chest mixtures No. 1 and 2 are more suitable for the treatment of dry cough, No. 3, 4 and chest elixir - wet.

Probably, everyone in the family has their own proven cough remedies - radish or turnip with honey or sugar, onion decoction with milk and honey, eggnog, birch sap - all these remedies can be used if there are no allergies and the stomach allows it.

Are drugs that dilate the bronchi needed for acute bronchitis?

Unfortunately, with , there are often situations when, against the background of inflammation, acute bronchial obstruction syndrome develops - bronchospasm. This is manifested by shortness of breath with difficulty in exhaling and bouts of painful coughing, at the peak of which scanty light sputum is released. In such cases, the attending physician may advise adding bronchodilators to the treatment - salbutamol or berodual. They come in the form of inhalers, and their use requires some skill: you need to press the dispenser and inhale the medicine at the same time.

Salbutamol is part of the cough medicine Ascoril - along with the mucokinetic agents bromhexine, guaifenesin and menthol. In this form it is more convenient to use, but not always more effective.

What else can you do to get better faster?

An important role in the treatment of acute bronchitis is played by good nutrition and a positive attitude of the patient towards recovery.

Chest massage, breathing exercises, tasty food rich in vitamins, an optimistic attitude - and recovery will come quickly.

Which doctor should I contact?

If acute bronchitis develops, you should consult a physician/pediatrician. if the disease has become protracted, it is necessary to consult a pulmonologist. Additionally, it is useful to undergo examination by an infectious disease specialist to more accurately identify the pathogen and by an immunologist to determine the state of immunity and the need to use immunomodulatory therapy. A physiotherapist also takes part in the treatment of bronchitis.

Dr. Komarovsky on the treatment of bronchitis and acute bronchitis in children:

Bronchitis is an inflammatory lesion of the bronchial mucosa, as a result of which the drainage function of the bronchial tree is disrupted.

If not properly treated, it becomes chronic and can be complicated by pneumonia, so it is important to know the causes of its occurrence, the first symptoms and the basics of treating bronchitis at home in adults.

Damage and inflammation of the bronchial tree can occur as an independent, isolated process (primary bronchitis) or develop as a complication against the background of existing chronic diseases and previous infections (secondary bronchitis).

Damage to the mucous epithelium of the bronchi disrupts the production of secretions, the motor activity of the cilia and the process of cleansing the bronchi. There are acute and chronic bronchitis, which differ in etiology, pathogenesis and treatment.

Reasons

The most popular among them are:

1. Viral, bacterial and fungal diseases of the respiratory system (parainfluenza,).
2. Damage to the bronchi from toxins, for example from smoking or working with chemicals.
3. Dust pollution of the bronchi (most often found among miners).
4. Exposure to allergens contained in the inhaled air (for example, pollen and others).

The main mechanism for the development of bronchitis caused by infectious pathogens is the spread of the pathogen with air or sputum deep into the respiratory system. Infectious diseases most often cause an acute form of bronchitis.

Acute and chronic

Acute bronchitis is an inflammatory process of the bronchial mucosa that occurs due to a variety of reasons. These include infectious agents, viruses, chemical, physical or allergic factors. With bronchitis, the tissues along the walls of the airways swell and produce large amounts of mucus.

This is a progressive inflammation of the bronchi, manifested by a cough. It is customary to speak of the chronic nature of the process if the cough continues for at least 3 months. per year for 2 years in a row. Chronic bronchitis is the most common form of chronic nonspecific lung diseases, which tends to become more frequent.

Signs

The most important sign of bronchitis in adults has always been and remains a cough. In addition, there are other symptoms:

• temperature increase: significant or insignificant;
• throat spasms, painful sensations;
• wheezing, difficulty breathing.

If these signs are detected, you need to decide how to treat bronchitis so that it does not cause complications.

Symptoms of bronchitis

When bronchitis occurs, cough is the main symptom. It is important to understand that coughing is actually a protective function of the body. In essence, this is an increased exhalation, with the help of which the body tries to get rid of pathogenic agents that have entered the respiratory tract (in this case, viruses, bacteria).

In addition, an adult feels general malaise, loss of appetite, fatigue, and fever. All these are manifestations of general intoxication of the body caused by inflammation of the bronchi. The temperature usually reaches high values ​​- 38 -39⁰С. But sometimes it can be lower, it depends on the individual reactivity of the body.

As a rule, initially, but after a few days it becomes productive (wet), at which sputum is separated. The expectorated mucus when coughing may be clear or have a yellowish-gray or greenish tint.

With significant damage to the respiratory tract, small vessels of the lungs may be damaged, as a result of which blood may be present in the sputum. The period of acute symptoms for bronchitis usually lasts 3-4 days. Severe pain behind the chest is also possible. This is especially true during coughing periods. Patients often complain of increased sweating. When the first symptoms appear, it is important to think about how to treat bronchitis and what medications to use.

Symptoms of chronic bronchitis

In chronic bronchitis, cough with scanty sputum, shortness of breath during exercise can be constant symptoms that accompany the patient throughout life.

In this case, an exacerbation of bronchitis is said to occur if there is a significant increase in the above symptoms: increased cough, increased volume of sputum, increased shortness of breath, the appearance of fever, etc.

Bronchitis in adults, especially acute, rarely occurs in isolation. Most often it is combined with symptoms (runny nose). This certainly has an impact on the overall clinical picture.

Symptoms of obstructive bronchitis

It is characterized by prolonged exhalation, accompanied by whistling, dry rales and the need to use auxiliary muscles during breathing. Periodically, an intense cough gives way to a weak one. Body temperature values ​​may fluctuate.

Obstructive bronchitis in adults is especially physically tiring, since the act of breathing involves auxiliary muscles, there is constant tension in the muscles of the chest, back, neck, etc.

Treatment of bronchitis in adults

First of all, this is bed rest and drinking plenty of fluids. Acute bronchitis is well treated by maintaining sufficient humidity (60%) and temperature (18-20˚C) in the room where the patient is, regularly drinking warm drinks (up to 4 liters per day), and preventing changes in the temperature of inhaled air.

How and with what to treat bronchitis in adults is a very serious question, because the outcome and prevention of complications depend on the effectiveness of treatment.

1. Initially, you need to quit smoking, get rid of bad habits, and stop being in conditions with harmful environmental factors. All this will maximize the effectiveness of treatment.
2. At the second stage, medications are prescribed that dilate the bronchi, stimulating the receptors: “Salbutamol”, “Bromide”, “Ipratropium Bromide”, “Terbutaline”, “Fenoterol” or others. This stage is primarily intended to solve breathing problems and acute states. If necessary, use (ibuprofen, paracetamol).
3. The third stage is the prescription of mucolytics and expectorants, which help make the sputum less thick and viscous. These drugs help to quickly clear it from the respiratory tract. Preparations of plant origin can be used - Thermopsis, Doctor Mom, marshmallow root, licorice, etc., or synthetic - Lazolvan, Ambrobene, Bromhexine, Acetylcysteine, etc.
4. At the fourth stage The only treatment left is antibiotics. They become necessary in the event of a bacterial infection of the bronchi or the development of complications.

Treatment of acute bronchitis should be started as soon as the diagnosis is made. The earlier treatment measures are taken, the less chance of complications developing. To cure bronchitis, you should consult a specialist. The choice of appropriate drugs depends on the severity of the process and the duration of the disease.

How to treat bronchitis at home

Inhalations for bronchitis at home are a good and effective way to treat the disease and alleviate its symptoms, especially when it is not possible to constantly visit a physiotherapy room.

1. Steam inhalation- This is a very affordable treatment method at home. To carry it out, you need to take a container, put suitable herbs on the bottom, for example, raspberries, linden and coltsfoot, fill everything with water and bring to a boil. You need to breathe through a funnel made of thick paper.
2. Inhalations with propolis– bring the water in the pan to a boil, add 3-5 ml of alcohol tincture with propolis and breathe over the steam for 5-15 minutes. You can do inhalation with pure propolis - to do this, you need to heat water in a large container, put a metal bowl with carefully crushed propolis in it - a small piece, 50 grams - and breathe over the steam.
3. For severe pain in the chest area and dry cough, it is very useful to do inhalation based on sea salt, 1 tablespoon of which should be dissolved in 1 liter of water. If salt is not available, you can replace it with an artificial analogue, which is prepared from 1 teaspoon of table salt, the same amount of soda and 4-5 drops of iodine per 1 liter of water.
4. Collection of herbs for inhalation. 50 g each of chamomile herb, sage, eucalyptus leaf, licorice, calendula. pour a liter of boiling water over the string, leave in a thermos for 2 hours, strain.

For inhalation, special devices (inhalers) and devices (nebulizers) are often used, which have a special nozzle through which, in fact, medicinal vapors and aerosols are inhaled. But in the absence of such special equipment, at home you can use improvised kitchen utensils - a kettle, a saucepan or any other container and a towel.

Antibiotics

The question of feasibility is still debatable. Many indicate that these drugs destroy the intestinal microflora and suppress the immune system. But in the absence of antibacterial therapy, the infection from the bronchi will spread to the lung tissue and pleura with the development of pneumonia and pleurisy. Prolonged fever - 3 days or more, accompanied by cough, shortness of breath, requires antibiotics.

For the treatment of bronchitis in adults, antibiotics of choice are:

• penicillins (Amoxicillin, Flemoxin, Augmentin),
• cephalosporins (Cefixime, Cefazolin, Claforan, Cefuroxime, Cefaclor),
• macrolides (Vilpramen, Clarithromycin, Azithromycin, Erythromycin, Macropen, Rovamycin),
• fluoroquinolones (Levofloxacin, Sparfloxacin, Moxifloxacin), etc.

You can use a drug with antibiotics for local use - Bioparox. Antibiotics can be administered orally, parenterally, or by inhalation, such as a nebulizer.

Please note that antibacterial agents are not prescribed in all cases. Therefore, the selection of a specific drug must be approached carefully, based on the spectrum of action and the doctor’s recommendations.

Breathing disorders occur in children at almost any age. Even newborn babies can get sick. Timely diagnosis and timely treatment lead to complete recovery.

What is it?

Inflammation of the bronchial mucosa, provoked by any reason, is called acute bronchitis. There are many reasons that contribute to the development of the disease. The peculiarity of the structure of the bronchial tree contributes to the appearance of this disease in children.

The greatest number of cases of the disease is usually recorded during the cold season. There is also an increase in the incidence of acute bronchitis during influenza epidemics or infectious colds. Boys get sick just as often as girls. The peak incidence occurs between the ages of 4 and 10 years.

Reasons

Every child can get bronchitis. This is due to many reasons that cause this disease. In some cases, there are even several different provoking factors acting simultaneously and causing the disease.

General weakness. Kids become lethargic and less active. They eat poorly and are sleepy. A constant cough makes the baby very anxious and easily excitable.

Chest pain when breathing. Frequent and prolonged hacking cough leads to pain during breathing.

Increased sweating. It is a manifestation of severe intoxication.

Diagnostics

When the first symptoms of the disease appear, be sure to show your baby to the pediatrician. Using a phonendoscope, the doctor will be able to listen to the specific wheezing that appears with bronchitis. After examining the child, the doctor will prescribe the entire necessary treatment package.

Usually, to establish the cause of the disease and correct diagnosis, the following is prescribed:

General blood test. An increased number of leukocytes with accelerated ESR indicates the presence of an infectious process. Changing the parameters in the leukocyte formula helps to establish the probable cause of the disease: viral or bacterial.

Biochemistry. It is carried out to clarify associated complications. Helps determine if there is damage to the kidneys or other internal organs during severe illness.

Radiography. It is performed on children over one year of age. The images allow you to clarify the nature of the damage, as well as carry out a differential diagnosis with other diseases.

Sputum analysis to identify the pathogen. It is usually carried out in the first days of the disease. Helps determine the exact cause of the disease.

Sputum culture with determination of sensitivity to antibiotics. The disadvantage of the study is the long period of analysis. Usually the result is ready only after 7-10 days. Allows you to accurately identify the pathogen and establish its sensitivity to various antibacterial drugs.

Determination of blood gases. Measurement of blood oxygen saturation indicators is carried out in severe cases of the disease.

Computer or magnetic resonance imaging. These methods are used only in complex cases when the diagnosis can be very difficult to make. These studies are highly informative and allow you to accurately obtain the result. They are carried out in older children who are able to remain motionless during the entire examination.

Complications and consequences

Mild forms of the disease usually proceed calmly. After adequate treatment, the baby may forget for a long time that he once suffered from bronchitis. However, in severe cases complications may arise. In some cases they can be quite dangerous.

The most common complication of viral or bacterial bronchitis is development of pneumonia. It usually occurs in weakened and often sick children. A low level of immunity leads to the rapid spread of the inflammatory process into the lungs. Pneumonia can develop quickly. This significantly disrupts the baby’s condition and worsens the course of the disease.

Another, no less dangerous complication is abscess formation- a cavity in the lung that is filled with pus. They usually form due to incorrectly selected antibacterial treatment, as well as due to severe depletion of the child’s body during the period of illness. Treatment of this complication is carried out only in a hospital setting.

With incorrectly selected therapy, acute bronchitis can become chronic. This option occurs when there is insufficient follow-up treatment. After prescribing medications, the baby begins to feel much better already on the 3-4th day of illness.

Some mothers stop giving their child antibiotics or antitussives at this time, or independently reduce their dosage. This leads to a chronic process and the development of possible exacerbations in the future.

Acute bronchiolitis can also become chronic. This form of the disease is most dangerous due to the development of persistent breathing problems. As a result of the disease, a strong and constant narrowing of the lumen of the bronchi occurs. Air with oxygen dissolved in it practically cannot enter the lungs. This leads to development of respiratory failure. Treatment is carried out in a surgical department.

Treatment

For the treatment of acute bronchitis the following is prescribed:

Antitussives and expectorants. They help make sputum more liquid and improve its discharge. “Ambroxol”, “Lazolvan”, “Flavamed”, “Sinekod”, “Gidelix” will help eliminate cough and normalize breathing. They are usually prescribed for 7-10 days, 2-3 times a day. The dosage and frequency are chosen by the attending physician, taking into account the age and condition of the child.

Antipyretics. They are used when the temperature reaches above 38 degrees. Medicines based on paracetamol are prescribed. Long-term use may cause side effects.

Antiviral. They can be prescribed in the form of suppositories, nasal drops or tablets. Interferon is used to activate local immunity. The drug is available in the form of nasal drops or aerosol.

Antibiotics. Broad-spectrum drugs are usually used. It is most effective to prescribe antibiotics only after sputum culture to determine sensitivity to them. The most commonly used are: “Suprax”, cephalosporin preparations, “Sumamed”, “Flemoxin Solutab” and others. The course dose and duration of administration are chosen by the attending physician, taking into account the severity of the disease.

Bronchodilators. They are used for obstructive acute bronchitis to relieve obstruction. Preparations based on salbutamol quickly relieve bronchial spasm and improve breathing. The combined remedy "Berodual" helps to cope with even the most severe obstruction.

Hormones. They are used only for allergic bronchitis. They are usually prescribed by inhalation. Systemic use may cause side effects. When prescribing hormonal therapy, it is recommended to regularly perform spirometry to assess respiratory function.

Warm, plenty of drink. Promotes faster removal of toxins from the body. Fruit and berry compotes, as well as fruit drinks and decoctions are perfect drinks. The baby should receive at least a liter of fluid per day. It is recommended to supplement breastfeeding with boiled water.

Percussion massage. Light tapping and vibration movements on the chest improve mucus discharge and improve breathing. You can perform the massage while the child is lying on the bed with his head bowed. This position promotes better expectoration of mucus and reduced coughing.

Breathing exercises. Improves breathing and helps reduce bronchial obstruction. Recommended for daily use. The duration of the exercises is 10-15 minutes.

– a form of diffuse inflammation of the bronchial tree, characterized by increased bronchial secretion and impaired bronchial patency. Acute bronchitis is characterized by a sharp onset, respiratory symptoms (runny nose, sore throat, paroxysmal cough with sputum, chest pain, shortness of breath, bronchospasm) and symptoms of intoxication (fever, headache, weakness). In the diagnosis of acute bronchitis, physical examination data, chest radiography, laboratory tests, functional tests, ECG, and bronchoscopy help. Treatment of acute bronchitis is complex and conservative; includes antiviral, antibacterial, antipyretic, antihistamine, mucolytic, expectorant and antispasmodic drugs, NSAIDs, glucocorticoids, physiotherapy.

ICD-10

J20

General information

Acute bronchitis is a widespread respiratory disease; can develop as an independent process when inflammation is limited to the bronchi (primary bronchitis), or complicate another existing pathology (secondary bronchitis). According to the level of damage to the lower respiratory tract, acute bronchitis is divided into: tracheobronchitis, bronchitis with predominant damage to the medium-sized bronchi, bronchiolitis. Almost all acute bronchitis refers to inflammatory processes of a diffuse nature; less often they are segmental (usually as a component of another acute local inflammatory process).

Based on the nature of the inflammatory exudate, catarrhal, mucous, and purulent acute bronchitis are distinguished. Most acute bronchitis is catarrhal in nature; purulent forms of the disease are rare, usually with a combination of viral and streptococcal infections.

In acute bronchitis, the inflammatory process can affect only the bronchial mucosa, but in the case of severe bronchitis, it can affect deeper tissues: the submucosal and muscular layers. Pathological changes in the bronchial wall in acute bronchitis are characterized by swelling and hyperemia of the mucous membrane, pronounced infiltration of the submucosal layer with hypertrophy of the mucous-protein glands, an increase in the number of goblet cells, degeneration and a decrease in the barrier function of the ciliary epithelium. Serous, mucous or mucopurulent exudate is noted on the inner surface of the bronchi. Increased secretion of mucus in acute bronchitis leads to disruption of the patency of small bronchi and bronchioles.

Reasons

Depending on the etiological factor, acute bronchitis is divided into infectious, non-infectious, mixed and unknown origin. The leading mechanism for the development of acute bronchitis is infection: the causative agents are viruses (ARVI, influenza and parainfluenza, measles, rubella), less often bacteria (pneumococcus, staphylococcus, mycoplasma, chlamydia, representatives of the typhoid paratyphoid group). Infectious agents can enter the bronchi through the air, hematogenous and lymphogenous routes.

A significant role in the etiology of acute bronchitis is played by respiratory syncytial viral infection, which in most cases is accompanied by damage to the bronchial tree. Primary acute bacterial bronchitis occurs infrequently; a secondary bacterial infection usually overlaps with a viral one due to the activation of opportunistic microflora of the upper respiratory tract.

Non-infectious acute bronchitis is caused by physical and chemical factors (dust, smoke, cold or hot dry air, chlorine, ammonia, hydrogen sulfide, acid and alkali vapors). In addition, acute bronchitis can develop with a combination of infection and the action of physical and chemical irritants. Acute allergic bronchitis occurs, as a rule, in patients genetically predisposed to allergic reactions.

Factors that reduce the general and local resistance of the body and contribute to the occurrence of acute bronchitis are frequent hypothermia, harmful working conditions, smoking and alcoholism, foci of chronic infection in the nasopharynx and impaired nasal breathing, congestion in the pulmonary circulation, severe illnesses, and poor nutrition. Acute bronchitis is more often observed in childhood and old age.

The inflammatory process in acute bronchitis of viral etiology usually begins in the upper respiratory tract: nasopharynx, tonsils, gradually spreading to the larynx, trachea, and then to the bronchi. Activation of opportunistic microflora aggravates catarrhal and infiltrative changes in the bronchial mucosa, causing a protracted course or complications of acute bronchitis.

Symptoms of acute bronchitis

Features of the clinical picture of acute bronchitis depend on the causative factor, the nature, prevalence and severity of pathological changes, the level of damage to the bronchial tree, and the severity of the inflammatory process.

The disease is characterized by an acute onset with signs of damage to the upper and lower respiratory tract and intoxication. Acute bronchitis of infectious etiology is preceded by symptoms of ARVI - nasal congestion, runny nose, sore and sore throat, hoarseness. The development of general intoxication in acute bronchitis is manifested by chills, increased body temperature to subfebrile levels, weakness, fatigue, headache, sweating, pain in the muscles of the back and limbs. With a mild course of acute bronchitis, there may be no temperature reaction. Acute bronchitis caused by measles, rubella and whooping cough is accompanied by symptoms characteristic of the underlying disease.

The leading symptom of acute bronchitis is a dry, painful cough that appears from the very beginning and lasts throughout the disease. The cough is paroxysmal, rough and sonorous, sometimes “barking”, increasing the feeling of rawness and burning behind the sternum. Due to overstrain of the pectoral muscles and spastic contraction of the diaphragm during forced coughing, pain appears in the lower chest and abdominal wall. The cough is accompanied by the release of scanty and viscous sputum at first, then the nature of the sputum gradually changes: it becomes less viscous and comes off easier, and may have a mucopurulent character.

A severe and protracted course of acute bronchitis is observed during the transition of the inflammatory process from the bronchi to the bronchioles, when a sharp narrowing or even closure of the bronchiolar lumen leads to the development of severe obstructive syndrome, impaired gas exchange and blood circulation. When bronchiolitis is added to acute bronchitis, the patient’s condition suddenly worsens: fever, pale skin, cyanosis, severe shortness of breath (40 or more breaths per minute), painful cough with scanty mucous sputum, first excitement and anxiety, then symptoms of hypercapnia (lethargy, drowsiness) are noted. ) and cardiovascular failure (low blood pressure and tachycardia).

Acute allergic bronchitis is characterized by a connection between the disease and exposure to an allergen, a pronounced obstructive syndrome with paroxysmal cough, and the release of light, glassy sputum. The development of acute bronchitis, caused by inhalation of toxic gases, is accompanied by chest tightness, laryngospasm, suffocation and painful cough.

Diagnosis of acute bronchitis

The diagnosis of acute bronchitis is made by a therapist or pulmonologist based on clinical manifestations, as well as data from laboratory and instrumental studies. When examining a patient, it is necessary to take into account that acute bronchitis can be a manifestation of various infectious diseases (measles, whooping cough, etc.).

Auscultatory data in acute bronchitis are characterized by hard breathing of an obstructive type, scattered dry rales. When liquid secretions accumulate in the bronchi, moist, fine-bubble wheezing may be heard, disappearing after vigorous coughing up of sputum. In acute allergic bronchitis, there is an absence of mucopurulent and purulent sputum, and a history of tendency to allergic reactions.

In order to diagnose acute bronchitis, general, biochemical and immunological blood tests, a general urinalysis, chest X-ray, bronchoscopy, pulmonary function testing (spirometry, peak flowmetry), ECG and echocardiography, and sputum culture for microflora are performed. Functional parameters of external respiration in acute bronchitis show a violation of pulmonary ventilation of the obstructive type. Changes in the blood picture include neutrophilic leukocytosis, acceleration of ESR; and in the case of allergic genesis of the disease - an increase in the number of eosinophils.

An X-ray examination in the case of acute bronchitis of viral etiology reveals a moderate expansion and blurred pattern of the roots of the lungs; in the case of a protracted course, it helps to detect the addition of complications (bronchiolitis, pneumonia). Differential diagnosis of acute bronchitis is carried out with bronchopneumonia, miliary pulmonary tuberculosis.

Treatment of acute bronchitis

In most cases, treatment of acute bronchitis is carried out on an outpatient basis; only in severe cases of the disease (for example, with severe obstructive syndrome or complicated by pneumonia) is hospitalization in the pulmonology department necessary.

In case of acute bronchitis, accompanied by fever or low-grade fever, bed rest is indicated, with a diet and plenty of drinking (warmed alkaline mineral waters, herbal infusions), and a ban on smoking. The room where a patient with acute bronchitis is located should be frequently and well ventilated, maintaining high air humidity. For pain in the chest, you should use warm compresses, mustard plasters, cups on the sternum, interscapular area, mustard foot baths.

In the treatment of acute bronchitis against the background of ARVI, antiviral therapy (interferon, rimantadine), antipyretics, painkillers, and NSAIDs are used. Antibiotics or sulfonamides are prescribed only for secondary bacterial infections, for prolonged acute bronchitis, and for a pronounced inflammatory reaction.

In the case of a dry, painful cough in acute bronchitis, in the first days of the disease, take codeine, dionine, libexin, which suppress the cough reflex. With an increase in sputum secretion, mucolytic and expectorant agents are indicated to thin it and improve drainage function: infusion of thermopsis herb, marshmallow, bromhexine, ambroxol, alkaline steam inhalations. It is recommended to take vitamins and immunomodulators. In case of obstruction, adrenolytics (ephedrine), antispasmodics (euffiline, papaverine) are used to relieve bronchospasm, and, if indicated, steroid hormones (prednisolone). If necessary, intensive therapy for acute cardiac and respiratory failure is carried out.

In acute bronchitis, physiotherapeutic methods (Ural irradiation, inductothermy of the interscapular region, chest diathermy, UHF), exercise therapy, and vibration massage are widely used. In the treatment of acute allergic bronchitis, antihistamines (clemastine, chloropyramine, mebhydrolin), sodium cromoglycate, ketotifen are used; in severe cases, glucocorticoids are indicated.

Uncomplicated acute bronchitis, as a rule, ends with clinical recovery within 2–3 weeks, while restoration of functional indicators (external respiration function and bronchial patency) occurs within a month. With a protracted course of acute bronchitis, clinical recovery occurs more slowly, approximately 1-1.5 months from the onset of the disease.

Complications of acute bronchitis

Complications of acute bronchitis include bronchiolitis obliterans, bronchopneumonia, asthmatic bronchitis, and in severe cases in elderly and weakened patients, acute respiratory and heart failure is possible. Regularly recurring acute bronchitis contributes to the transition of the disease to a chronic form, with the progression of which the development of COPD, bronchial asthma, and pulmonary emphysema is possible.

Forecast and prevention of acute bronchitis

In acute catarrhal bronchitis, the prognosis is favorable; the disease usually ends with complete restoration of the structure of the bronchial mucosa and absolute recovery. In the case of acute purulent bronchitis or the development of bronchiolitis, the prognosis worsens due to residual fibrous thickening of the bronchial wall and narrowing of the bronchial lumen. Violation of the drainage function and deformation of the bronchial tree in acute bronchitis contribute to the protracted course of the disease and its chronicity.

Prevention of acute bronchitis should consist of eliminating the possible cause of the disease (compliance with sanitary and hygienic standards at work, eliminating dust and gas pollution, quitting smoking and alcohol abuse, timely treatment of chronic infections and respiratory diseases, preventing ARVI, hypothermia), increasing the body's resistance.