Acute bronchitis with obstruction. How to treat acute obstructive bronchitis and what are its causes. Antibiotics for exacerbations

One of the forms of inflammation of the respiratory system - in adults - develops under the influence of allergens, polluted air or against the background of viral respiratory diseases.

At the first symptoms, this pathology requires complex, competent treatment under the supervision of a doctor.

Ignoring the clinical manifestations of the disease can lead to serious complications.

according to the international classification ICD 10 refers to COPD. The disease is a pathological inflammatory process characterized by blockage of the air ducts.

Diffuse inflammation of the bronchi causes a sharp spasm of smooth muscles, a change in the quality and composition of sputum secreted by the organ and, as a result, a violation of lung ventilation.

As the disease progresses, the tissues of the mucous membrane of the respiratory tract undergo structural changes, their walls thicken, and the bronchial lumen narrows to a minimum size.

A person feels a lack of air up to attacks of suffocation. Untimely treatment of the disease leads to the development of persistent respiratory failure.

Classification

Depending on the duration and nature of the course, experts distinguish two forms of the disease:

• Acute form. It is typical for children with their imperfect respiratory system, but is sometimes diagnosed in adults. The development of acute obstruction in adult patients is caused by a combination of several predisposing factors. For example, during an acute respiratory viral infection, the patient came into contact with an allergen, or he spent a long time in a room contaminated with harmful substances. The body's defenses are not able to cope with such a massive attack, and an inflammatory process begins in the bronchial tree.
• Chronic form The disease is characterized by slow development. According to statistics, this form is diagnosed in men 3 times more often than in women. The slow course of the disease over ten years narrows the lumen of the bronchial canals. The disease passes through periods of exacerbations and remissions. At the same time, the symptoms during an exacerbation at the initial stage of the chronic form are smoothed out, and the patient takes them for manifestations of a mild cold. Progressive obstruction gradually leads to structural changes in bronchial tissue. The lumen of the airways narrows more and more, and with each period of exacerbation the patient’s condition worsens.

Chronic obstructive bronchitis leads to irreversible processes in the respiratory system. Through narrowing channels, air cannot penetrate into the small bronchi, causing prolapse of the membrane wall. Systematic lack of oxygen causes complications:

• emphysema;
• pulmonary hypertension;
• diseases of the cardiovascular system;
• increased blood pressure;
• bronchiectasis.

IMPORTANT! After 40-50 years, patients suffering from a chronic form of the disease develop COPD.

Reasons for development

The risk group for the development of obstructive bronchitis is: patients prone to acute respiratory viral infections, smokers and allergy sufferers.

People who often catch colds have weak immunity, since their body is constantly under attack by viruses and bacteria.

Respiratory inflammation of the nasopharynx leads to the penetration of infection into the bronchi. When settling in the respiratory tract, viruses lead to inflammation of the mucous membrane and accumulation of mucus in the bronchi.

Tobacco smoke, including passive smoking, causes no less harm to the mucous membrane of the respiratory tract. It burns the epithelium, settles on the surface, gradually corroding the mucous membrane.

The rate of development of bronchial obstruction in smokers depends on the individual characteristics of the body, but the outcome is inevitable. The gradual narrowing of the lumen of the bronchi leads to the development of respiratory failure.

The cause of the development of obstructive bronchitis in adults there may also be the following factors:

• neoplasms in the respiratory tract;
• systematic inhalation of polluted air;
• hereditary predisposition;
• age-related decrease in immunity;
• penetration of fungal infection into the bronchi;
• living in unsanitary conditions.

Symptoms in adults

Characteristic symptoms of obstructive bronchitis in adults:

• chest pain;
• unproductive cough;
• shortness of breath with minimal physical activity.

Coughing attacks vary in severity and duration in the morning, since the maximum amount of sputum accumulates in the bronchi during the night.

In the chronic form of bronchitis, the cough subsides for a certain period of time, and then resumes with the same force.

Additional clinical signs of the disease:

• periodic increase in temperature;
• general weakness, sweating;
• headache;
• sleep disorder;
• blue discoloration of the nasolabial triangle and fingers;
• loss of appetite.

The intensity of symptoms increases as the disease progresses.

Diagnostics

Diagnosis of bronchial obstruction is based on the following research methods:

• radiography chest, revealing an enhanced bronchial pattern with deformation of the roots of the lungs;
• bhonchoscopy for collecting biomaterial and assessing the condition of the mucous membrane;
• spirometry, determining the parameters of inhalation and exhalation;
• tests blood and urine.

For differential diagnosis with tuberculosis, sputum is additionally examined for the presence of Koch's bacillus.

Features of treatment

The first step towards treating obstructive bronchitis is elimination of a factor irritating the respiratory system.

Smokers need to give up their bad habit.

If the cause of bronchitis is air pollution, it is worth changing urban conditions to living in an ecologically clean area.

It is not always possible to fulfill these conditions, but without them it is impossible to get rid of the disease.

IMPORTANT! Quitting smoking in combination with breathing exercises and physiotherapy allows you to cure obstructive bronchitis at the initial stage of development without the use of medications.

The goal of treating obstruction is to relieve bronchospasm, remove mucus and restore the mucous membrane of the airway.

The therapy process is long and is based on the use of a complex of medications, physiotherapeutic procedures and auxiliary folk remedies.

During treatment, the patient must follow the following recommendations:

• bed rest;
• daily wet cleaning of the room;
• drinking plenty of fluids and following a special diet.

Treatment of the disease is carried out on an outpatient basis. Hospitalization in a hospital is necessary in the absence of the effect of independent treatment, as well as in the presence of respiratory and heart failure.

Treatment in a hospital is also necessary if bronchitis is accompanied by general intoxication of the body.

Medication

Medications are a mandatory element of treatment.

The set of medications and the regimen for taking them is determined by the doctor after a diagnostic study.

The therapy complex consists of the following groups of drugs:

1. Bronchodilators:"Ipratorium Bromide" (Atrovent). Medicines in aerosol form quickly stop attacks.
2. Beta 2 antagonists: “Salbutamol”, “Atrovent”, “Spiriva”, “Berodual”. Designed to relieve symptoms of the disease or as a preventive measure for spasms before active physical activity.
3. Mucolytics:"Acetylcysteine", "Carbocysteine", "Lazolvan", "Ambroxol".

If a bacterial infection is associated with bronchial inflammation, antibiotics are additionally used:

• "Amoxicillin";
• "Doxycycline";
• "Cefazolin";
• "Levofloxacin".

In case of viral etiology of the disease, instead of antibiotics, antiviral drugs:

• "Isoprinosine";
• "Groprinosin";
• "Remantadine";
• "Orvirem."

To relieve symptoms of shortness of breath and restore air access to the bronchi use bronchodilators in spray form:

If the disease is caused by an allergic reaction, the patient is prescribed latest generation antihistamines:

• "Loratadine";
• "Fenistil";
• "Erius";
• "Desal";
• Zyrtec.

CAREFULLY! Pulmonologists warn that first-generation antiallergic drugs - Suprastin, Diphenhydramine, Diazolin, Tavegil, Diprazine - cannot be taken for obstructive bronchitis.

The active ingredients of these medications thicken mucus, which increases inflammation and causes the risk of developing pneumonia.

At advanced stages of the disease, it is impossible to relieve swelling of the airways with bronchodilators and non-hormonal antihistamines.

Therefore, doctors prescribe glucocorticosteroids:

1. Sprays:“Budesonide”, “Fluticasone”, “Ingacort”, “Beclazone”;
2. Tablets and capsules: “Prednisolone”, “Triamcinolone”;
3. Injection solutions: Dexamethasone, Prednisolone.

Physiotherapy

Physiotherapeutic procedures complement drug treatment, relieve bronchospasm, and stimulate sputum discharge. The number and set of procedures depends on the general condition of the patient’s body and the stage of the disease.

CAREFULLY! Medicinal herbs and honey can cause an allergic reaction and cause additional swelling of the bronchi. Therefore, drugs prepared on their basis must be tested by taking a small dose. If you are prone to allergies, it is safer to avoid using traditional methods.

Video: Cough, bronchitis, treatment

How to treat in adults and children: what even many doctors do not know. Dr. Evlakimenko, explains the methods of treating bronchitis. But in any case, consult your doctor.

Prevention

It is almost impossible to cure obstructive bronchitis in adults completely and without complications, so it is worth making every effort to prevent the disease.

• balanced diet;
• rejection of bad habits;
• maintaining hygiene in the home;
• prevention of colds by hardening;
• maintaining immunity.

The inflammatory process at the last stage can completely block breathing, so treatment of the disease under the supervision of a qualified specialist must begin when the first symptoms appear.

– inflammation of the bronchial tree, accompanied by bronchial obstruction syndrome, mainly of small and medium caliber. The main symptom of acute obstructive bronchitis is expiratory shortness of breath, which occurs against the background of coughing, asthma attacks, fever, whistling or moist rales. In addition to the clinical picture data, spirometry, pneumotachography, and lung x-ray are used in diagnosis. Modern treatment algorithms for acute obstructive bronchitis include the use of bronchodilators, mucolytics, expectorants, inhaled glucocorticosteroids, and massage.

General information

Symptoms of acute obstructive bronchitis

The initial clinical picture is determined by the symptoms of the respiratory infection that gave impetus to the development of acute obstructive bronchitis. Difficulty breathing appears already on the first or second (sometimes on the third or fifth) days. The respiratory rate increases to 25 or more per minute; exhalation becomes elongated, noisy, whistling, audible at a distance (distant wheezing). The younger the child, the more pronounced the signs of respiratory failure (tachypnea, restlessness, perioral cyanosis, desire to take a forced position).

Patients with acute obstructive bronchitis are bothered by an unproductive, paroxysmal cough that gets worse at night. The participation of auxiliary muscles in breathing is indicated by retraction of the intercostal spaces and supraclavicular fossae, and flaring of the wings of the nose. Body temperature may be normal or low-grade. The course of the infectious process is indicated by signs of a disturbance in general well-being: weakness, asthenia, headache, decreased appetite, increased sweating.

Symptoms of acute obstructive bronchitis last from one to two to three weeks. If episodes of the disease are repeated 2-3 times or more within a year, a diagnosis of “recurrent obstructive bronchitis” is made. Acute and recurrent broncho-obstructive syndrome can be complicated by the addition of bacterial inflammation, the formation of chronic obstructive bronchitis, deforming bronchitis, and bronchial asthma.

Diagnosis of acute obstructive bronchitis

Usually, examination and analysis of physical data are sufficient to confirm the diagnosis. Acute obstructive bronchitis is supported by its connection with a viral disease, the presence of tachypnea and prolonged expiration. The chest is enlarged in anteroposterior size; tympanitis is determined by percussion over the lungs. On auscultation, harsh breathing with multiple whistling, buzzing rales is heard.

Treatment of acute obstructive bronchitis

Treatment of acute obstructive bronchitis is carried out on an outpatient basis. Young children with moderate and severe forms of bronchial obstruction require hospitalization. A gentle regime is prescribed, contact with irritants (perfumes, dust, household chemicals, cigarette smoke, etc.) is excluded. In order to dilute sputum and facilitate its evacuation from the respiratory tract, sufficient water regime, humidification of the air in the room, percussion massage of the chest, and positional drainage are recommended.

Rational pathogenetic therapy avoids the development of severe forms of acute obstructive bronchitis and its chronicity. Therefore, the main role in treatment is given to anti-inflammatory, bronchodilator and mucolytic drugs. Among bronchodilators, aminophylline and theophylline are usually used; It is advisable to prescribe beta-2 adrenergic agonists (salbutamol, terbutaline) by inhalation or through a nebulizer. Bromhexine and ambroxol (in the form of syrup, tablets, inhalations) have a mucolytic and expectorant effect. The regimen and dosage are selected by a pediatrician or pulmonologist in accordance with the patient’s age. The use of fenspiride and inhaled glucocorticosteroids is recommended as anti-inflammatory therapy. The prescription of centrally acting antitussives for acute obstructive bronchitis is undesirable.

Distractive procedures (cupping massage, hot foot and hand baths), physiotherapy (UHF, laser, electrophoresis) are effective. Severe forms of bronchial obstruction require oxygen therapy. To combat pathogens of respiratory infections, recombinant interferon preparations are used; Antibiotic therapy is justified only if acute pneumonia is suspected.

Prognosis and prevention of acute obstructive bronchitis

In approximately 30-50% of children who have suffered acute obstructive bronchitis, episodes of bronchial obstruction recur within a year against the background of a new viral infection. In most cases, the obstructive component disappears after the age of 3-4 years. The presence of an allergic predisposition significantly increases the likelihood of chronic obstructive bronchitis. To reduce the risk of morbidity, hardening, limiting contact with infectious and allergic agents, and sanitizing chronic infectious foci are recommended. For recurrent obstructive bronchitis, consultation with an allergist-immunologist and pulmonologist is indicated.

Obstructive bronchitis is the most common disease that affects the respiratory system. Today, bronchitis with obstruction is diagnosed in every 4 patients suffering from this disease. Both children and adults suffer from bronchial pathology. One of the most dangerous forms for health is acute obstructive bronchitis, which brings the patient a lot of discomfort and anxiety, since if the disease becomes chronic, it will be very, very difficult to cure it. In addition, during an advanced form, a person will have to take medications for the rest of his life. That is why, if a patient is suspected of acute obstructive bronchitis, it is important to immediately carry out treatment, because otherwise the patient will face unpleasant health consequences.

Doctors classify chronic or acute obstructive bronchitis as an obstructive pathology of the respiratory tract.

The disease is characterized by the fact that not only inflammation develops in the bronchi, but also damage to the mucous membrane occurs, which causes:

• spasm of the bronchial walls;
• tissue swelling;
• accumulation of mucus in the bronchi.

Also, obstructive bronchitis in adults causes significant thickening of the walls of blood vessels, which leads to a narrowing of the bronchial lumen. In this case, the patient experiences difficulty breathing, difficulties with normal ventilation of the lungs, and a lack of rapid discharge of sputum from the lungs. If acute obstructive bronchitis is not treated promptly, a person may develop respiratory failure.

It is important to note that treatment of obstructive bronchitis in adults should not be carried out until the doctor determines the type of disease - acute or chronic.

In fact, these forms differ significantly from each other, namely:

• in the acute form, the alveolar tissue and small bronchi are not able to become inflamed;
• the chronic form leads to irreversible consequences as a result of the development of serious broncho-obstructive syndrome;
• in the acute form, emphysema does not form (the alveoli of the pulmonary cavity are stretched, as a result of which they lose the ability to contract normally - this causes a disturbance in gas exchange in the respiratory organs);
• during chronic bronchitis, impaired air flow causes hypoxemia or hypercapnia (a decrease or increase in carbon dioxide in the bloodstream).

It is worth noting that recurrent obstructive bronchitis mainly develops in children, as the chronic form of the disease is increasingly being diagnosed in adults. It is indicated by a strong cough with sputum production, which has troubled an adult for more than one year.

Why is obstructive bronchitis dangerous? Basically, the disease carries its danger when the respiratory organs are affected, as a result of which inflammation develops in them. There are no known cases of mortality from this disease, since recurrent obstructive bronchitis, in general, responds well to treatment and is diagnosed on time.

Is obstructive bronchitis contagious or not, and should a person be afraid if he has another attack? In this case, the contagiousness of the disease depends on the cause of the disease - if inflammation in the bronchi develops due to damage to the respiratory organ by viruses or bacteria, the pathology will be considered contagious.

That is why patients with obstructive bronchitis need to closely monitor their health and immediately begin treatment when the first symptoms of the disease are detected. Obstructive bronchitis, the symptoms of which are known to many people, is expressed quite clearly, so only a minimal number of people can fail to notice inflammation of the bronchi.

Quiz: How susceptible are you to bronchitis?

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• You lead a healthy lifestyle and you are not at risk of bronchitis

  You are a fairly active person who cares and thinks about your respiratory system and health in general, continue to play sports, lead a healthy lifestyle, and your body will delight you throughout your life, and no bronchitis will bother you. But do not forget to undergo examinations on time, maintain your immunity, this is very important, do not overcool, avoid severe physical and strong emotional overload.

• It's time to think about what you are doing wrong...

  You are at risk, you should think about your lifestyle and start taking care of yourself. Physical education is required, or even better, start playing sports, choose the sport that you like most and turn it into a hobby (dancing, cycling, gym, or just try to walk more). Do not forget to treat colds and flu promptly, they can lead to complications in the lungs. Be sure to work on your immunity, strengthen yourself, and be in nature and fresh air as often as possible. Do not forget to undergo scheduled annual examinations; it is much easier to treat lung diseases in the initial stages than in advanced stages. Avoid emotional and physical overload; if possible, eliminate or minimize smoking or contact with smokers.

• It's time to sound the alarm! In your case, the likelihood of getting bronchitis is huge!

  You are completely irresponsible about your health, thereby destroying the functioning of your lungs and bronchi, have pity on them! If you want to live a long time, you need to radically change your entire attitude towards your body. First of all, get examined by specialists such as a therapist and a pulmonologist; you need to take radical measures, otherwise everything may end badly for you. Follow all the doctors’ recommendations, radically change your life, perhaps you should change your job or even your place of residence, completely eliminate smoking and alcohol from your life, and reduce contact with people who have such bad habits to a minimum, toughen up, strengthen your immunity as much as possible spend more time in the fresh air. Avoid emotional and physical overload. Completely eliminate all aggressive products from everyday use and replace them with natural, natural remedies. Do not forget to do wet cleaning and ventilation of the room at home.

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   How often do you undergo a lung examination (eg fluorogram)?

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   Do you treat acute respiratory infections, acute respiratory viral infections, influenza and other inflammatory or infectious diseases?

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   Do you take care of your immunity?

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   Have any relatives or family members suffered from serious lung diseases (tuberculosis, asthma, pneumonia)?

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   Do you live or work in an unfavorable environment (gas, smoke, chemical emissions from enterprises)?

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   Do you have heart disease?

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    Do you often get sick with acute respiratory infections or acute respiratory viral infections?

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The mechanism of development of the disease in the victim is as follows - under the negative influence of pathogenic factors on the bronchial cavity, the condition and performance of the cilia deteriorate. As a result, their cells quickly die, which leads to an increase in the number of goblet cells.

Also, with bronchitis, there is a significant change in the density and composition of the secretion located in the respiratory organ - this leads to the fact that the activity of the cilia is significantly worsened, and the movement becomes slower. If treatment of acute obstructive bronchitis was not carried out on time, the victim develops stagnation of sputum in the bronchial cavity, which causes blockage of the small airways.

As a result of the loss of normal viscosity, the bronchial secretion loses its protective qualities, which allow it to protect the respiratory system from dangerous bacteria, viruses and other microorganisms.

In addition, if a person constantly has an exacerbation of the disease and the attack lasts several days, this indicates a decrease in the concentration of the following substances in the bronchial cavity:

• lactoferrin;
• interferon;
• lysozyme

How to treat obstructive bronchitis? To do this, it is necessary to understand exactly what mechanism of the disease develops in a person - reversible or irreversible.

The reversible mechanism includes:

• bronchial swelling;
• bronchospasms;
• obstruction of the respiratory system resulting from poor coughing.

Irreversible mechanisms are:

• tissue changes;
• reduction of bronchial lumen;
• prolapse on the walls of the bronchi;
• lack of intake of large amounts of air due to the course of emphysema.

Obstructive bronchitis, which is important to treat immediately after signs of the disease are detected, can cause a variety of complications.

These include:

• development of emphysema of the pulmonary cavity;
• the appearance of cor pulmonale - expansion of some parts of the heart resulting from increased circulatory pressure;
• respiratory failure of acute or chronic type, which often causes an attack of illness;
• pulmonary hypertension;
• bronchiectasis.

Bronchitis with obstructive syndrome causes complications only if a person does not begin treatment for the disease for a long time. How long does obstructive bronchitis last?

If the pathology is properly combated, the disease can be completely cured in 3-6 months. However, for this it is important to strictly follow the doctor’s treatment, as well as perform all procedures, then acute bronchitis will quickly recede and will not cause complications.

Before answering the question of whether obstructive bronchitis is contagious, it is necessary to identify the causes that cause the development of the disease.

Today, doctors identify several main causes of bronchitis, which include:

1. Smoking. This addiction is responsible for the development of the disease in 90% of cases. To get rid of obstructive bronchitis caused by smoking, you should stop smoking so that nicotine, tar, and combustion substances from cigarettes do not irritate the mucous membranes and aggravate an attack of bronchitis.
2. Unfavorable working conditions for health and respiratory organs. Dirty air can also develop recurrent bronchitis. Miners, builders, office workers, residents of large cities, metallurgists, and so on are especially susceptible to the disease. How long does it take to treat obstructive bronchitis in the case of constant negative effects of dirty air on the lungs? In this case, treatment can be carried out throughout your life, maintaining your own condition with medications and procedures. To completely cure the disease, the victim will have to change the area and try to visit the sea, mountains or coniferous areas more often, where the air will help avoid attacks of the disease, as well as quickly get rid of it.
3. Frequent flu, nasopharyngeal diseases and colds. In this case, acute bronchitis develops due to the fact that the lungs are weakened by the influence of viruses, bacteria and other dangerous microorganisms. Obstructive bronchitis can be cured only with complete restoration of the respiratory system and nasopharynx.
4. Heredity. The symptom of obstructive bronchitis often affects a healthy person as a result of unfavorable heredity. This happens due to the fact that there is an insufficient amount of antitrypsin protein in the body, which constantly protects the lungs from harmful bacteria. Unfortunately, this disease cannot be cured; the patient will have to constantly take maintenance medications. Is it possible to get infected with this type of bronchitis? No, the hereditary form is not contagious, so the patient cannot harm anyone. If the patient’s condition worsens, the patient must receive emergency care, since the consequences of the hereditary form can be disastrous.

The causes of the pathology may be other, but they are observed in the patient quite rarely.

It is important to remember that the signs of obstructive bronchitis do not make themselves known immediately - usually with obstructive bronchitis in adults and children, they appear only when the disease has already developed and is fully affecting the bronchial cavity.

Of course, the main complaint of a patient with obstructive bronchitis is a strong, long, cutting and unpleasant cough. However, this does not mean that the victim develops bronchitis. Therefore, it is important for any person to know all the symptoms of the disease in order to catch it in time and visit a doctor.

Signs of the disease include:

1. Cough. With the development of pathology, it is dry, sparse, sometimes whistling, without sputum production. It mainly attacks the patient at night, when the person is lying down, because at this time bronchial secretions fill the airways and cause their blockage. The cough can intensify in cold weather - in this case, the body will take a long time to survive. After a few days, the person begins to gradually cough up mucus and clots of secretion. In older people, blood can be found in it.
2. Heat. How long does the patient have a fever? On average, it goes away within 3-6 days after the start of treatment. If the temperature persisted and then disappeared, this indicates that a person’s bronchitis occurs in a non-contagious form. Bronchitis without fever means that the disease appeared as a result of smoking or frequent exposure to acute respiratory viral infections or colds. If a patient develops a viral or bacterial infection, it will certainly be accompanied by a high fever.
3. Difficulty breathing. When the bronchial lumen is narrowed, a person cannot inhale a portion of air normally and without straining the body. This is especially noticeable during the infectious course of the disease, which is quite easy to become infected. If the deterioration of breathing is constantly repeated, the patient is prescribed special medications for obstructive bronchitis, which will help relieve inflammation and swelling, as well as normalize the unhindered penetration of air into the body.
4. Dyspnea. It usually appears 10 minutes after the end of a long and strong cough. If obstructive bronchitis in an adult, the symptoms and treatment of which have not been fully studied by a doctor, is characterized by shortness of breath during exercise, this is not a chronic course of the disease. But if shortness of breath affects the patient even at rest, this indicates the development of an advanced form, which needs to be treated as the diagnosis is carried out.
5. Acrocyanosis. This is a blue discoloration of the fingers, nose and lips. If the patient still has a fever, the obstruction will only be relieved after 2-4 months of treatment. In this case, this symptom may constantly disappear and appear again.

Additional symptoms of the disease include:

• muscle pain;
• sweating;
• frequent fatigue;
• change in the appearance of the fingers;
• bronchitis without fever, but with a feeling of heat;
• layering of nails and changes in their appearance.

To prevent this from happening, any person needs prevention of obstructive bronchitis, which will help to forget about the disease forever. However, if a person again discovers the main symptom of the pathology, it is necessary to treat it with full responsibility.

How to cure obstructive bronchitis? To do this, it is important to identify signs of the disease in time, with the help of which the doctor can quickly assess the state of health and prescribe the correct and effective treatment to the patient. With repeated manifestations of relapses of the disease, the obstruction will no longer be considered acute, which means that the patient will need complex treatment.

When obstructive bronchitis is diagnosed, the identified symptoms and prescribed treatment can quickly put a person back on his feet, but it requires long and careful treatment, which will help prevent another attack, as well as restore bronchi with blockage from phlegm.

When contacting a doctor, he must first determine whether bronchitis is contagious or not, as well as how the patient can get rid of airway obstruction forever. After the doctor conducts a diagnosis, which includes bronchoscopy, examination of the bronchi, and radiography, he will prescribe therapeutic measures that are aimed at reducing the rate of development of the disease.

During the course of the disease, the victim must be prescribed bed rest. After 3-6 days, the patient is allowed to go out into the fresh air, especially at a time when it is quite humid.

In order to permanently overcome bronchitis as a very dangerous disease for health, the patient will need to take certain medications.

So, how to treat the disease in order to recover faster from obstructive bronchitis:

• adrenergic receptors (Terbutaline, Salbutamol) - these drugs increase the bronchial lumen and also allow you to relieve unpleasant symptoms of the disease (you need to take such medications for more than one day to achieve a quick treatment result);
• bronchodilators (Eufillin, Teofedrine) – if a person experiences bronchospasm, this group of drugs quickly treats the disease (the duration of such treatment is prescribed by a doctor);
• mucolytics (Lazolvan, Bromhexine, Sinekod, Ambroxol) - these drugs get rid of sputum, since they dilute it well and remove it;
• anticholinergics (Bekotide, Ingacort) – these medications restore the body, reduce swelling and inflammation.

During treatment, patients must follow all the recommendations of the attending physician so that bronchitis does not become chronic. If the disease can be transmitted to a healthy person, treatment should be carried out at home.

A patient needs emergency help if there is a danger of complete blockage of the airways - in this case, the longer a person hesitates, the sooner he will need help. What to do if the condition worsens?

The patient should consult a doctor who will prescribe treatment in a hospital, namely:

• dropper;
• taking mucolytics (Sinekod);
• antibiotics (if the pathology is contagious, since bacteria and viruses are transmitted instantly).

How is the disease transmitted? Bronchitis spreads quickly from person to person through airborne droplets, and the time of such spread of the pathogen is instantaneous.

Today, cases of infection of the disease from a sick person to a healthy person continue - and 1 patient is capable of infecting not one or two people, but everyone who is close to him. That is why sometimes treatment and prevention of obstructive bronchitis takes place in an isolated room or at home.

In addition to taking medications, obstruction is also treated with other methods:

• you can get rid of the disease using steam inhalations or healing infusions (there are no negative consequences from this method of treatment);
• obstruction is treated by performing physiotherapeutic procedures, which are often used as emergency first aid (for this, the doctor must know everything about the etiology of the disease);
• treatment with folk remedies - many are interested in the question of whether it is possible to get rid of bronchitis using folk methods and what consequences such treatment entails: in fact, this method of treatment is considered one of the most effective and efficient.

If signs of bronchitis reappear, you should immediately seek help from a doctor, because the disease can quickly spread to healthy people, since its development requires very little - the bronchi of a healthy person.

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• Congratulations! You are completely healthy!

  Your health is fine now. Don’t forget to take good care of your body, and you won’t be afraid of any diseases.

• There is reason to think.

  The symptoms that are bothering you are quite extensive, and are observed in a large number of diseases, but we can say with confidence that something is wrong with your health. We recommend that you consult a specialist and undergo a medical examination to avoid complications. We also recommend that you read the article on detection and treatment of bronchitis.

• You are sick with bronchitis!

  In your case, there are clear symptoms of bronchitis! However, there is a possibility that it could be another disease. You need to urgently contact a qualified specialist; only a doctor can make an accurate diagnosis and prescribe treatment. We also recommend that you read the article on detection and treatment of acute bronchitis.

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Obstructive bronchitis is a diffuse inflammation of the bronchi of small and medium caliber, occurring with a sharp bronchial spasm and progressive impairment of pulmonary ventilation.

Next, we will look at what kind of disease this is, what the first signs are in adults, what is prescribed as a diagnosis to identify the obstructive form of bronchitis, as well as what methods of treatment and prevention are most effective.

What is obstructive bronchitis?

Obstructive bronchitis is an inflammatory disease of the bronchial tree, which is characterized by the occurrence of an unproductive cough with the presence of sputum, shortness of breath and, in some cases, broncho-obstructive syndrome, which in its etiology is similar to bronchial asthma.

The word “obstruction” is translated from Latin as “obstacle,” which quite accurately reflects the essence of the pathological process: due to narrowing or blocking of the airways, air has difficulty leaking into the lungs. And the term “” means inflammation of the small respiratory tubes - the bronchi. Obstructive bronchitis is a violation of the patency of the bronchi, which leads to the accumulation of mucus in them and difficulty breathing.

The disease is characterized by the fact that not only inflammation develops in the bronchi, but also damage to the mucous membrane occurs, which causes:

• spasm of the bronchial walls;
• tissue swelling;
• accumulation of mucus in the bronchi.

Also, obstructive bronchitis in adults causes significant thickening of the walls of blood vessels, which leads to a narrowing of the bronchial lumen. In this case, the patient experiences difficulty breathing, difficulties with normal ventilation of the lungs, and a lack of rapid discharge of sputum from the lungs.

Forms of development

There are 2 forms of the disease:

Acute obstructive bronchitis

It is typical for children under four years of age, but sometimes occurs in adults (in which case it is called primary obstructive bronchitis). In order for broncho-obstructive syndrome to develop in adults, it is necessary that one or several predisposing factors simultaneously join the inflammatory process in the respiratory tract. For example, obstructive syndrome can develop against the background of:

• banal bronchitis or due to improper treatment of the disease,
• contact with an allergen,
• being in polluted air conditions.

Chronic obstructive form

The chronic form of the disease is characterized by a long absence of symptoms of obstructive bronchitis. The disease occurs with periods of remission and exacerbations, most often caused by hypothermia and acute respiratory diseases. Clinical symptoms occur during periods of exacerbation of the disease and depend on its stage and the level of damage to the bronchial tree.

Chronic obstructive bronchitis, along with other diseases that occur with progressive obstruction of the respiratory tract (bronchial asthma), is usually classified as chronic obstructive pulmonary disease (COPD).

Causes

Causes of obstructive bronchitis in adults:

• Chronic forms of nasopharyngeal diseases.
• Bad ecology.
• Smoking.
• Harmful conditions in the workplace. A person with air inhales particles of substances that contribute to the development of the disease.
• Heredity. If someone in the family suffers from obstructive bronchitis, then the pathology may develop in relatives.

Chronic obstructive bronchitis is a disease that most often begins to progress in people who smoke for a long time, work in production with various chemicals. substances and so on.

It is also worth highlighting internal factors that contribute to the development of obstructive bronchitis in adults and children:

• second blood group;
• hereditary deficiency of immunoglobulin A;
• deficiency of the enzyme alpha1-antitrypsin.

Stages

The progressive development of chronic obstructive bronchitis is characterized by a gradual decrease in the volume of forced inspiration in one second (FIV-1), expressed as a percentage of the standard value.

Symptoms of obstructive bronchitis in adults

Doctors say that obstructive bronchitis in adults can be suspected even at the initial stage. It is best to discuss the symptoms and treatment of the pathology with your doctor. After all, making a diagnosis on your own, let alone selecting therapy, can be very dangerous.

Of course, the main complaint of a patient with obstructive bronchitis is a strong, long, cutting and unpleasant cough. However, this does not mean that the victim develops bronchitis. Therefore, it is important for any person to know all the symptoms of the disease in order to catch it in time and visit a doctor.

It is worth noting that acute obstructive bronchitis mainly affects children under five years of age, while in adults, symptoms appear only when the acute course progresses to. But sometimes primary acute obstructive bronchitis can begin to progress. As a rule, this happens in the background.

Symptoms:

• temperature increase;
• dry cough. It usually develops in attacks, worsening in the morning or at night;
• the respiratory rate per minute increases up to 18 times. For a child this figure will be slightly higher;
• During exhalation, wheezing sounds are observed, which can be heard even at a distance.

Note: If the patient, when symptoms of acute obstructive bronchitis appear, does not begin to carry out therapeutic measures, then he may experience shortness of breath. This is due to the accumulation of a large amount of sputum in the bronchi. In addition to shortness of breath, in severe cases of the acute form of the disease in question, wheezing during breathing and whistling air can be noted.

If chronic obstructive bronchitis is observed in adults, the symptoms of the pathology are as follows:

• constant cough, worse in the morning;
• body temperature is mostly normal;
• developing shortness of breath, which can only be treated at an early stage.

Over time, patients begin to complain of a daily annoying morning cough. For some, attacks recur during the daytime. Their provocateurs are irritating odors, cold drinks, and frosty air.

Sometimes bronchospasms are accompanied by hemoptysis. Blood appears due to rupture of capillaries during strong straining.

In the later stages, the disease resembles asthma in many ways. Patients have difficulty inhaling. They exhale with wheezing and whistling. The duration of their exhalation increases.

The period of remission of the disease is characterized by slight sweating, moderate shortness of breath and the presence of a wet cough only in the morning, after waking up.

There is a special form of the disease - often recurrent obstructive bronchitis, which is characterized by almost constant periods of exacerbation with the presence of short remissions. This form of the disease most often leads to complications.

Diagnostics

The diagnosis of acute obstructive bronchitis is usually made on the basis of the clinical picture and the results of a physical examination. On auscultation, moist rales are heard in the lungs, the frequency and tone of which change when coughing.

Laboratory testing package includes:

• general blood and urine tests;
• blood chemistry;
• immunological tests;
• determination of blood gas composition;
• microbiological and bacteriological studies of sputum and lavage fluid.

In doubtful cases, exacerbation of chronic obstructive bronchitis should be differentiated from pneumonia, tuberculosis, bronchial asthma, bronchiectalic disease, pulmonary embolism, etc.

Instrumental examination:

Spirometry is an examination of the volume and velocity parameters of inhalation and exhalation using a device - a spirograph. The main criteria for assessing the severity of the disease are indicators such as:

• VC – vital capacity of the lungs;
• FEV1 – forced expiratory volume in 1 second;
• Tiffno index – ratio of vital capacity to FEV1;
• POS – peak volumetric velocity.

X-ray of the chest organs (chest organs), on which you can see dilated bronchi and a uniform increase in the airiness of the lung fields.

Treatment

When obstructive bronchitis is diagnosed, the identified symptoms and prescribed treatment can quickly put a person back on his feet, but it requires long and careful treatment, which will help prevent another attack, as well as restore bronchi with blockage from phlegm.

For acute obstructive bronchitis the following is prescribed:

1. rest, drinking plenty of fluids, air humidification, alkaline and medicinal inhalations.
2. Etiotropic antiviral therapy (interferon, ribavirin, etc.) is prescribed.
3. For severe bronchial obstruction, antispasmodic (papaverine, drotaverine) and mucolytic (acetylcysteine, ambroxol) agents, bronchodilator inhalers (salbutamol, orciprenaline, fenoterol hydrobromide) are used.
4. To facilitate the discharge of sputum, percussion massage of the chest, vibration massage, massage of the back muscles, and breathing exercises are performed.
5. Antibacterial therapy is prescribed only when a secondary microbial infection occurs.

	Medications
Mucolytics	Expectorants and mucolytics are effective, thinning the viscous secretion, which is more easily removed from the bronchi. Medicines in this group do not begin to treat the disease immediately, but after a day or two or even a week. Bromhexine; ACC (Acetylcysteine); Ambroxol (Lazolvan); Bronchicum.
Antibiotics	Amoxicillin; Amoxiclav (Amoxicillin plus clavulanic acid); Levofloxacin or Moxifloxacin; Azithromycin (Sumamed, Hemomycin).
Antihistamines	(Claritin); (Zyrtec); Desloratadine (Erius, Dezal); Dimetinden (Fenistil).
Hormonal drugs	aerosols: Budesonide, Fluticasone, Ingacort, Beclazon Eco; tablets: Prednisolone, Triamcinolone; injection solutions: Prednisol, Dexamethasone.

A patient needs emergency help if there is a danger of complete blockage of the airways - in this case, the longer a person hesitates, the sooner he will need help. What to do if the condition worsens?

The patient should consult a doctor who will prescribe treatment in a hospital, namely:

• dropper;
• taking mucolytics (Sinekod);
• antibiotics (if the pathology is contagious, since bacteria and viruses are transmitted instantly).

How to treat chronic obstructive bronchitis in adults?

Therapeutic tactics for the chronic form of the disease differ significantly from those for acute bronchitis. Only a doctor can select a treatment regimen for a patient, taking into account the stage of the disease, the patient’s age and the presence of concomitant diseases.

The general principles of therapy for the disease in question are as follows:

1. It is necessary to eliminate the factor that led to the exacerbation of chronic obstructive bronchitis - to cure an acute respiratory viral infection, sore throat.
2. The doctor should prescribe medications with a bronchodilator effect, for example: Salbutamol, Eufillin, Atrovent and others.
3. To thin the mucus and ensure its rapid removal, the patient should take mucolytic drugs - for example, Bromhexine or Ambrobene.

To prevent exacerbations of the disease during periods of remission, patients are recommended to perform procedures aimed at strengthening the immune system:

• hardening,
• physical exercise,
• proper nutrition,
• periodic courses of vitamin therapy.

How to treat obstructive bronchitis if home treatment does not help? Most likely, the doctor will recommend hospital treatment. In addition to the ineffectiveness of outpatient treatment, indications for inpatient treatment are as follows:

• acute, sudden onset respiratory failure;
• pneumonia;
• development of heart failure;
• the need for bronchoscopy.

Prevention

With obstructive bronchitis in adults, prevention is of great importance.

1. Primary prevention involves quitting smoking.
2. It is also recommended to change working conditions and place of residence to more favorable ones.
3. You need to eat right. The food should have enough vitamins and nutrients - this activates the body's defenses.
4. It's worth thinking about hardening.
5. Fresh air is important - daily walks are a must.

Secondary prevention measures include timely consultation with a doctor if the condition worsens, and undergoing examinations. The period of good health lasts longer if the doctors' instructions are strictly followed.

At the first signs of obstructive bronchitis, be sure to see a pulmonologist. Only a doctor can make an accurate diagnosis and prescribe the correct treatment. Be healthy and take care of yourself!

Obstructive bronchitis is a lung disease associated with obstruction. When applied to the bronchi they say bronchial obstruction. The name comes from the Latin obstructio, which means “obstacle”. In medicine, there are synonyms for translation - blockage or obstruction.

During the development of obstructive bronchitis, when the patency of the bronchial tree is impaired, respiratory failure occurs. It is characteristic that along with inflammation, damage to the bronchial mucosa occurs. The tissues swell, narrowing the lumen of the bronchi by almost half, and the walls of the bronchi spasm. All these manifestations significantly complicate ventilation of the lungs and sputum discharge.

In the structure of general morbidity, respiratory diseases remain unchanged leaders by prevalence. The leading place among them belongs to diseases of the respiratory tract, which include bronchitis.

Attention. Bronchitis is often a manifestation of acute respiratory viral infection (ARVI). These are acute conditions that can be treated. Sometimes the disease becomes protracted and chronic. Chronic obstructive bronchitis leads to severe consequences, including permanent disability.

For reference. is an inflammatory disease of an infectious or non-infectious nature that diffusely affects the bronchial tree. Obstructive bronchitis is one of the types of this pathology.

There are several forms of bronchitis:

• Simple bronchitis is a common manifestation of ARVI. Cough during a cold most often occurs due to simple bronchitis.
• Bronchiolitis is an inflammation of the smallest branches of the bronchi - bronchioles. This is an intermediate stage between bronchitis and pneumonia and often occurs in children.
• Obstructive bronchitis is an inflammation of the bronchial tree, which is accompanied by obstruction.

Obstruction is a reduction or disappearance of the lumen of the bronchi, as a result of which the breathing process becomes difficult. When the lumen of the bronchial tree is blocked, it is difficult for the patient to exhale, therefore one of the manifestations of obstructive inflammation of the bronchi is expiratory shortness of breath.

Obstructive bronchitis is usually divided into acute and chronic. An acute process is said to occur when the symptoms of the disease last no more than three weeks and recur three times a year. This pathology is more common in children and less common in adults. The transition of the disease to a chronic form indicates the irreversibility of the process.

Acute obstructive bronchitis occurs when there is increased secretion of mucus, swelling of the bronchial mucosa and bronchospasm. All these processes are reversible, therefore such a pathological process passes without a trace. Chronic obstructive bronchitis occurs when the structure of the bronchial wall changes, it becomes less elastic and turns the distensible bronchi into narrow tubes.

Attention. Currently, there is no such diagnosis as chronic obstructive bronchitis in ICD 10. It was replaced by the term chronic obstructive pulmonary disease (COPD) - a collective concept that combines several nosologies.

This is due to the common pathogenesis and clinical manifestations of all the diseases included here. COPD includes not only chronic bronchitis, but also other pathologies of the respiratory system, as well as a number of heart and vascular diseases that lead to shortness of breath.

Etiology of obstructive inflammation

Acute bronchitis, as a rule, has a viral etiology. He is called:

• respiratory syncytial viruses,
• parainfluenza,
• adenoviruses,
• some types of enteroviruses.

For reference. Sometimes a bacterial flora joins the viral flora, then they talk about purulent obstructive bronchitis.

This pathology is extremely rare in adults. The fact is that the bronchial tree of adults is quite wide. Inflammatory changes in it are not enough to lead to obstruction. In children, the bronchi are small and narrow, so closure of the lumen occurs quickly.

The exact etiological nature of chronic obstructive bronchitis is unknown. There are a number of risk factors that can lead to the occurrence of this disease. Among them, smoking occupies a leading place.

Attention. In the vast majority of cases, COPD in people under 40 years of age occurs precisely because of smoking. In addition, passive smoking in children is a separate risk factor. People who inhale cigarette smoke as children are more likely to develop chronic obstructive bronchitis as adults.

In addition to smoking, occupational hazards occupy an important place among the risk factors. First of all, increased dustiness of the workplace. COPD is often found in miners, metallurgists and construction workers. Dust containing large amounts of silicon is especially dangerous.

Residents of large cities are more susceptible to chronic obstructive bronchitis, which is associated with a polluted environment and high dust levels in the air.

For reference. Irreversible pulmonary obstruction may be the outcome of bronchial asthma. A distinctive feature of the latter is the reversibility of bronchospasm. When bronchial asthma is uncontrolled, obstruction becomes irreversible and COPD develops.

At the moment, there is an assumption about another predisposing factor - hereditary. The fact that predisposition to chronic bronchitis is transmitted genetically is evidenced by the frequent occurrence of the disease in close relatives.

Pathogenesis of the disease

Bronchial obstruction can be a reversible or irreversible process. The first is characteristic of acute obstructive bronchitis.
In a chronic course, the ability to reverse the development of the process is lost, and the obstruction becomes permanent.

The pathogenesis of reversible obstruction is:

• Inflammatory swelling of the mucous membrane of the bronchial tree. The etiological factor damages the mucous membrane, causing an inflammatory reaction in it. One of the components of this reaction is pronounced swelling of the mucous membrane, which reduces the lumen of the bronchi.
• Hypersecretion. Epithelial cells of the bronchial mucosa always secrete small amounts of substances that moisturize the surface and prevent hazardous substances from entering the lungs. When the mucosa is damaged, the secretory activity of cells increases. In addition, the permeability of bronchial vessels increases, which leads to exudation of fluid into the lumen of the bronchial tree.
• Hyper-reactivity. Due to the inflammatory process, a large number of mediators act on the bronchi, which lead to spasm of the bronchial tree and narrowing of its lumen.

The pathogenetic links of irreversible obstruction are as follows:

• Epithelial metaplasia. Normally, the bronchial mucosa is covered with cylindrical ciliated epithelium, which is capable of producing mucus and clearing the bronchial tree of particles that enter it. With prolonged exposure to risk factors, the epithelium becomes flat. It is not able to protect the bronchi, as a result of which a cascade of further changes is triggered.
• Changes in the connective tissue part of the bronchial wall. Normally, the bronchi contain a large number of elastic fibers that can stretch and return to their original position during breathing. In chronic bronchitis, these fibers are replaced by collagen fibers, which are not capable of stretching and turn the bronchi into thin tubes.

For reference. In case of chronic obstructive bronchitis, during the period of remission in the patient, the lumen of the bronchial tree remains narrowed, as a result of which some of the complaints persist. During the period of exacerbation, bacterial flora joins, resulting in inflammation again. Chronic bronchitis always occurs with exacerbations and remissions.

Ultimately, complications arise such as: emphysema, bronchiectasis, hypertension in the pulmonary circulation, cor pulmonale.

Acute obstructive bronchitis - symptoms

This pathology is more common in young children. Two syndromes come to the fore - intoxication and respiratory.

Intoxication causes:

• refusal to eat,
• significant decrease in appetite,
• weakness,
• fatigue,
• increase in body temperature.

For reference. With obstructive bronchitis, even in young children, fever rarely exceeds 38 degrees.

Respiratory syndrome includes two manifestations: cough and frequent shallow difficulty breathing. The cough at the beginning of the disease is dry and hacking; later, scanty, viscous, transparent sputum may appear. If there is a lot of sputum and it acquires a greenish tint, then there is a bacterial infection in the pathological focus.

The shortness of breath is expiratory in nature; it is more difficult for the patient to exhale than to inhale. At the same time, breathing becomes noticeably faster. As you exhale, you can hear distant wheezing - noises that can be heard without a phonendoscope when approaching the patient.

For reference. Respiratory failure is accompanied by cyanosis. Initially, the cyanosis spreads to the nasolabial triangle and fingers and toes, and then to the entire body. Total cyanosis indicates severe respiratory failure. Such patients find it difficult to breathe. From the outside, it seems that the hands and face are involved in breathing - when breathing, the shoulders seem to rise, and the nose expands.

In the acute course of the disease, all symptoms gradually disappear within three weeks.

Chronic obstructive bronchitis - symptoms

Obstructive bronchitis in adults flows in waves, the patient’s condition either improves or worsens. During improvement the following manifestations are present:

• Cough. He appears first among all manifestations. Cough occurs most often in the morning when changing body position from horizontal to vertical; as the disease progresses, the cough torments the patient throughout the day.
• Sputum. Doesn't appear right away. At first, the cough is dry, and then a scant amount of very viscous, difficult-to-clean sputum appears. The cough usually becomes productive in the morning. While the patient is sleeping, sputum stagnates in the bronchi, and when the position changes to vertical, it irritates the bronchi and a productive cough occurs. There is no sputum during the day.
• Dyspnea. This is a typical symptom of obstructive bronchitis, but it does not appear immediately. Chronic bronchitis progresses over a very long time, and shortness of breath occurs years after the onset of the disease. It is expiratory in nature. It is difficult for the patient to exhale, causing breathing to become more shallow and frequent. First, difficulty breathing occurs during physical exercise, and then at rest.
• Forced body position. This symptom is the most recent and occurs along with severe respiratory failure. In order to ensure adequate gas exchange, the patient has to use all the auxiliary respiratory muscles, and for this it is necessary to fix the shoulder girdle. This is why such patients often sit or stand with their hands resting on a hard surface.

During exacerbations, bacterial flora joins the existing pathology.

Attention. In patients with chronic bronchitis, the airways cannot protect themselves from infection, so exacerbations occur frequently.

During the period of exacerbation, patients have a lot of sputum, it thins out and acquires a green tint. The cough is wet and bothers the patient all day. At the same time, manifestations of respiratory failure intensify. High temperature is not a characteristic sign of bronchitis, but some patients experience a fever.

Diagnostic methods

Bronchitis does not always require special confirmation. In the acute course of the disease, the diagnosis is made based on clinical symptoms. Often this disease does not require confirmation; diagnostic methods are uninformative. Chronic bronchitis requires more reliable confirmation.

A patient with suspected acute inflammation of the respiratory tract is prescribed a chest x-ray and a clinical blood test to rule out pneumonia.

For reference. On an x-ray with bronchitis, the pattern of the bronchial tree is enhanced; in some patients, emphysematous areas of clearing in the lungs are observed. If infiltration is visible in the lungs, then the patient has pneumonia. In a general blood test, leukocytosis with lymphocytosis is more common in bronchitis, and with neutrophilia in pneumonia.

These data are nonspecific and may occur in other pathologies of the respiratory system. The most informative is bronchoscopy - a method that allows you to see the bronchial tree from the inside and assess the condition of the bronchial mucosa. Bronchoscopy is rarely used, since the method is invasive and causes discomfort to the patient.

In chronic obstructive bronchitis, it is necessary not only to confirm the presence of obstruction, but also to exclude other pathologies. To confirm chronic bronchitis, X-rays and a clinical blood test are used.

For reference. Changes characteristic of bronchial obstruction are detected more often than in the acute course of the disease. The main method of confirming the diagnosis is spirometry.

Spirometry is a study of the function of the respiratory system. The patient is asked to take a deep breath and exhale, and then breathe at a normal pace into a special device. A computer program evaluates its results and prints them out.

During spirometry, two parameters are determined (FVC and FEV1) and their ratio is calculated. FVC is the amount of air that a person can exhale after a full inhalation. This parameter shows how much the lung tissue can stretch (the volume of inhaled air depends on this, which affects the enrichment of the blood with oxygen).

FEV1 is a measure of the speed at which air moves through the bronchi. With obstruction, that is, with blockage of the bronchi, the speed, of course, decreases.

To assess the type of violation, an indicator called the Tiffno Index was derived. This is the ratio of FEV1 to FVC.

In chronic obstructive bronchitis, there is a decrease in forced expiratory volume in the first second (FEV1) of less than 80% of normal. The Tiffno index decreases (norm 0.7).

Attention. The same changes are characteristic of bronchial asthma, therefore a test with salbutamol is a mandatory test.

The patient is given spirometry, then the drug is given and spirometry is performed again. If the indicators increase by 15% or more, we can talk about reversible bronchial obstruction. This confirms bronchial asthma. If the indicators increase slightly, remain unchanged or worsen, obstructive bronchitis is confirmed.

Spirometry allows not only to confirm the diagnosis, but also to determine the stage of the disease.

Obstructive bronchitis - treatment in adults and children

Acute inflammation of the bronchi is etiotropically treated with interferons, adding symptomatic therapy to them. The latter consists of prescribing mucolytic drugs (bromhexine, ACC). For severe obstruction, short-acting bronchodilators (ipratropium, salbutamol) are also prescribed.

If the patient has chronic obstructive bronchitis, treatment is prescribed according to the regimen. During the period of remission, such patients are prescribed mucolytics in the morning to thin the sputum and remove it. For severe obstruction, bronchodilators (salmeterol, pentoxifylline) are indicated. During an exacerbation, if the sputum becomes purulent, antibacterial drugs are added. If severe inflammation occurs, inhaled glucocorticosteroids are administered.

Attention. Respiratory failure of the third degree is an indication for oxygen therapy.

Of great importance in the treatment of the disease is changing habits, quitting smoking, moderate physical activity, relaxing at seaside resorts, and humidifying the air in the house.

Prognosis and prevention

Acute obstructive bronchitis has a good prognosis. With proper treatment, the disease goes away without a trace. Children can suffer from this form of bronchitis quite often, but get rid of all its manifestations in adulthood.

Prevention of acute inflammation of the respiratory tract is a nonspecific increase in immunity:

• proper nutrition,
• daily regime,
• walks in the open air,
• timely treatment of viral diseases.

Attention. Chronic obstructive bronchitis has a poor prognosis. Obstruction is irreversible and cannot be reduced, but progression of the disease can be prevented.

Primary prevention includes quitting active smoking, following the rules of personal protection in the workplace, and strengthening the immune system. Secondary prevention of chronic obstructive bronchitis consists of proper treatment of the disease and following the doctor's recommendations. COPD often causes disability for the patient.