Bronchitis in adults - causes, signs, symptoms and treatment, medications, prevention of bronchitis. Bronchitis - symptoms, modern diagnosis and effective treatment, anatomy of the bronchi, diet, how to properly place cupping and mustard plasters? Mode, use of nebula

is a diffuse inflammatory disease of the bronchi, affecting the mucous membrane or the entire thickness of the bronchial wall. 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 past 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.

ICD-10

J20 J40 J41 J42

General information

Bronchitis is a diffuse inflammatory disease of the bronchi, affecting the mucous membrane or the entire thickness of the bronchial wall. 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 past 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.

Acute bronchitis

The acute course of bronchitis is characteristic of many acute respiratory infections (ARVI, acute respiratory infections). The most common causes of acute bronchitis are parainfluenza viruses, respiratory syncytial virus, adenoviruses, less often - influenza virus, measles, enteroviruses, rhinoviruses, mycoplasma, chlamydia and mixed viral-bacterial infections. Acute bronchitis is rarely of a bacterial nature (pneumococci, staphylococci, streptococci, Haemophilus influenzae, whooping cough pathogen). The inflammatory process first affects the nasopharynx, tonsils, trachea, gradually spreading to the lower respiratory tract - the bronchi.

A viral infection can provoke the proliferation of opportunistic microflora, exacerbating catarrhal and infiltrative changes in the mucosa. The upper layers of the bronchial wall are affected: hyperemia and swelling of the mucous membrane, pronounced infiltration of the submucosal layer occurs, dystrophic changes and rejection of epithelial cells occur. With proper treatment, acute bronchitis has a favorable prognosis; the structure and function of the bronchi are completely restored within 3 to 4 weeks. Acute bronchitis is very often observed in childhood: this fact is explained by the high susceptibility of children to respiratory infections. Regularly recurring bronchitis contributes to the transition of the disease to a chronic form.

Chronical bronchitis

Chronic bronchitis is a long-term inflammatory disease of the bronchi, progressing over time and causing structural changes and dysfunction of the bronchial tree. Chronic bronchitis occurs with periods of exacerbations and remissions, and often has a hidden course. Recently, there has been an increase in the incidence of chronic bronchitis due to environmental deterioration (air pollution with harmful impurities), widespread bad habits (smoking), and a high level of allergenicity in the population. With prolonged exposure to unfavorable factors on the mucous membrane of the respiratory tract, gradual changes in the structure of the mucous membrane, increased sputum production, impaired drainage ability of the bronchi, and decreased local immunity develop. In chronic bronchitis, hypertrophy of the bronchial glands and thickening of the mucous membrane occur. The progression of sclerotic changes in the bronchial wall leads to the development of bronchiectasis and deforming bronchitis. A change in the air-conducting ability of the bronchi significantly impairs lung ventilation.

Classification of bronchitis

Bronchitis is classified according to a number of characteristics:

According to severity:

• mild degree
• medium degree
• severe

According to the clinical course:

Acute bronchitis

Acute bronchitis, depending on the etiological factor, is:

• infectious origin (viral, bacterial, viral-bacterial)
• non-infectious origin (chemical and physical harmful factors, allergens)
• mixed origin (combination of infection and the action of physical and chemical factors)
• unspecified etiology

According to the area of ​​inflammatory damage, they are distinguished:

• bronchitis with predominant damage to the bronchi of medium and small caliber
• bronchiolitis

According to the mechanism of occurrence, primary and secondary acute bronchitis are distinguished. According to the nature of the inflammatory exudate, bronchitis is distinguished: catarrhal, purulent, catarrhal-purulent and atrophic.

Chronical bronchitis

Depending on the nature of the inflammation, a distinction is made between catarrhal chronic bronchitis and purulent chronic bronchitis. Based on changes in the function of external respiration, obstructive bronchitis and non-obstructive forms of the disease are distinguished. According to the phases of the process during chronic bronchitis, exacerbations and remissions alternate.

The main factors contributing to the development of acute bronchitis are:

• physical factors (damp, cold air, sudden temperature changes, exposure to radiation, dust, smoke);
• chemical factors (the presence of pollutants in the atmospheric air - carbon monoxide, hydrogen sulfide, ammonia, chlorine vapor, acids and alkalis, tobacco smoke, etc.);
• bad habits (smoking, alcohol abuse);
• stagnant processes in the pulmonary circulation (cardiovascular pathologies, disruption of the mucociliary clearance mechanism);
• the presence of foci of chronic infection in the oral and nasal cavity - sinusitis, tonsillitis, adenoiditis;
• hereditary factor (allergic predisposition, congenital disorders of the bronchopulmonary system).

It has been established that smoking is the main provoking factor in the development of various bronchopulmonary pathologies, including chronic bronchitis. Smokers suffer from chronic bronchitis 2-5 times more often than non-smokers. The harmful effects of tobacco smoke are observed in both active and passive smoking.

Long-term exposure to harmful production conditions predisposes a person to the occurrence of chronic bronchitis: dust - cement, coal, flour, wood; vapors of acids, alkalis, gases; Uncomfortable temperature and humidity conditions. Atmospheric air pollution from industrial and transport emissions and fuel combustion products has an aggressive effect primarily on the human respiratory system, causing damage and irritation to the bronchi. A high concentration of harmful impurities in the air of large cities, especially in calm weather, leads to severe exacerbations of chronic bronchitis.

Repeated acute respiratory viral infections, acute bronchitis and pneumonia, chronic diseases of the nasopharynx and kidneys can further cause the development of chronic bronchitis. As a rule, the infection is layered on top of the existing damage to the respiratory mucosa by other damaging factors. A damp and cold climate contributes to the development and exacerbation of chronic diseases, including bronchitis. Heredity plays an important role, which under certain conditions increases the risk of chronic bronchitis.

Symptoms of bronchitis

Acute bronchitis

The main clinical symptom of acute bronchitis - low chest cough - usually appears against the background of existing manifestations of acute respiratory infection or simultaneously with them. The patient experiences fever (up to moderately high), weakness, malaise, nasal congestion, and runny nose. At the beginning of the disease, the cough is dry, with scanty, difficult to separate sputum, worsening at night. Frequent coughing attacks cause pain in the abdominal muscles and chest. After 2-3 days, sputum (mucous, mucopurulent) begins to come out abundantly, and the cough becomes moist and soft. Dry and moist rales are heard in the lungs. In uncomplicated cases of acute bronchitis, shortness of breath is not observed, and its appearance indicates damage to the small bronchi and the development of obstructive syndrome. The patient's condition returns to normal within a few days, but the cough may continue for several weeks. Prolonged high temperature indicates the addition of a bacterial infection and the development of complications.

Chronical bronchitis

Chronic bronchitis occurs, as a rule, in adults, after repeated acute bronchitis, or with prolonged irritation of the bronchi (cigarette smoke, dust, exhaust gases, chemical vapors). Symptoms of chronic bronchitis are determined by the activity of the disease (exacerbation, remission), nature (obstructive, non-obstructive), and the presence of complications.

The main manifestation of chronic bronchitis is a prolonged cough for several months for more than 2 years in a row. The cough is usually wet, appears in the morning, and is accompanied by the release of a small amount of sputum. Intensification of cough is observed in cold, damp weather, and subsidence is observed in the dry, warm season. The general well-being of patients remains almost unchanged; coughing becomes a common occurrence for smokers. Chronic bronchitis progresses over time, the cough intensifies, takes on the character of attacks, and becomes annoying and unproductive. There are complaints of purulent sputum, malaise, weakness, fatigue, sweating at night. Shortness of breath occurs during exertion, even minor ones. In patients with a predisposition to allergies, bronchospasm occurs, indicating the development of obstructive syndrome and asthmatic manifestations.

Complications

Bronchopneumonia is a common complication of acute bronchitis and develops as a result of decreased local immunity and the accumulation of bacterial infection. Repeated acute bronchitis (3 or more times a year) leads to the transition of the inflammatory process to a chronic form. The disappearance of provoking factors (cessation of smoking, climate change, change of place of work) can completely relieve the patient from chronic bronchitis. As chronic bronchitis progresses, repeated acute pneumonia occurs, and with a long course, the disease can develop into chronic obstructive pulmonary disease. Obstructive changes in the bronchial tree are considered a pre-asthma condition (asthmatic bronchitis) and increase the risk of bronchial asthma. Complications appear in the form of pulmonary emphysema, pulmonary hypertension, bronchiectasis, and cardiopulmonary failure.

Diagnostics

Treatment of bronchitis

In the case of bronchitis with a severe concomitant form of ARVI, treatment is indicated in the pulmonology department; in case of uncomplicated bronchitis, treatment is outpatient. Therapy for bronchitis should be comprehensive: fighting infection, restoring bronchial patency, eliminating harmful provoking factors. It is important to complete the full course of treatment for acute bronchitis to prevent it from becoming chronic. In the first days of the disease, bed rest, drinking plenty of fluids (1.5 - 2 times more than normal), and a dairy-vegetable diet are indicated. During treatment, smoking cessation is required. It is necessary to increase the air humidity in the room where a patient with bronchitis is located, since the cough intensifies in dry air.

Therapy for acute bronchitis may include antiviral drugs: interferon (intranasal), for influenza - rimantadine, ribavirin, for adenoviral infection - RNase. In most cases, antibiotics are not used, except in cases of bacterial infection, in the case of prolonged acute bronchitis, or in cases of a pronounced inflammatory reaction according to the results of laboratory tests. To improve the removal of sputum, mucolytic and expectorant agents are prescribed (bromhexine, ambroxol, expectorant herbal tea, inhalations with soda and saline solutions). In the treatment of bronchitis, vibration massage, therapeutic exercises, and physiotherapy are used. For a dry, unproductive, painful cough, the doctor may prescribe medications that suppress the cough reflex - oxeladine, prenoxdiazine, etc.

Chronic bronchitis requires long-term treatment, both during exacerbation and during remission. In case of exacerbation of bronchitis, with purulent sputum, antibiotics are prescribed (after determining the sensitivity of the isolated microflora to them), sputum thinners and expectorants. In the case of the allergic nature of chronic bronchitis, it is necessary to take antihistamines. The regime is semi-bed, be sure to drink plenty of warm water (alkaline mineral water, tea with raspberries, honey). Sometimes therapeutic bronchoscopy is performed, with washing of the bronchi with various medicinal solutions (bronchial lavage). Breathing exercises and physiotherapy (inhalations, UHF, electrophoresis) are indicated. At home, you can use mustard plasters, medical cups, and warm compresses. To strengthen the body's resistance, vitamins and immunostimulants are taken. Outside of exacerbation of bronchitis, sanatorium-resort treatment is desirable. Walking in the fresh air is very useful, normalizing respiratory function, sleep and general condition. If there are no exacerbations of chronic bronchitis within 2 years, the patient is removed from dispensary observation by a pulmonologist.

Forecast

Acute bronchitis in an uncomplicated form lasts about two weeks and ends with complete recovery. In the case of concomitant chronic diseases of the cardiovascular system, a protracted course of the disease is observed (a month or more). The chronic form of bronchitis has a long course, alternating periods of exacerbations and remissions.

Prevention

Preventive measures to prevent many bronchopulmonary diseases, including acute and chronic bronchitis, include: eliminating or reducing the impact of harmful factors on the respiratory system (dust, air pollution, smoking), timely treatment of chronic infections, prevention of allergic manifestations, increasing immunity, healthy lifestyle.

For example, ARVI, influenza, although it may also have a different origin. Bronchitis can occur due to exposure to aggressive physical or chemical factors, for example, dust, gasoline vapors, acetone, and paints. The disease develops under the influence of atypical factors and may be of an allergic nature.

But predominantly bronchitis is of an infectious nature - bacterial or viral, and is almost always accompanied by diffuse inflammation of the bronchial mucosa, which leads to a characteristic painful symptom - cough, which has a different character, greatly exhausts the sick person, especially since its duration is quite long, in on average, 3 weeks.

In this article we want to talk about the features of the occurrence, course and treatment of bronchitis in adults. This topic becomes very relevant not only during ARVI epidemics, but even in the summer, when people do not expect the appearance of colds that are complicated by bronchitis. But, alas, no one is immune from bronchitis at any time of the year.

Reasons for the development of bronchitis

As mentioned above, the most common and common cause of acute or chronic bronchitis among adults is viral, bacterial or atypical flora.

The main bacterial pathogens that cause the development of the inflammatory process in the bronchial tree today are different strains of staphylococci, pneumococci or streptococci.

Bronchitis can be of a viral nature; it occurs against the background of damage to the bronchial mucosa by influenza viruses, parainfluenza, adenoviruses, cytomegaloviruses, respiratory syncytial viruses, enteroviruses, etc.

Atypical factors leading to bronchitis include quite rare bacterial pathogens, such as chlamydia and mycoplasma. They are called atypical because their biological characteristics lead researchers to place them in an intermediate class between viruses and bacteria.

Very often, the cause of bronchitis is mixed pathogenic flora from the very beginning of the disease. But most often, against the background of damage to the bronchial mucosa, one type of infectious agent is associated with another type. For example, viral bronchitis gives way to bacterial bronchitis.

Viral infections almost always open the gates for bacterial infection and create the most favorable conditions for the proliferation of pathogenic microorganisms. This is why, at the height of viral epidemics in winter, bronchitis is so often reported in the adult population.

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Factors contributing to the occurrence of bronchitis among adults

The first and most important condition that is necessary for the occurrence of bronchitis is, of course, a weakening of the immune system in an adult, which, in its normal state, ensures the body’s resistance and immunity to various external environmental agents - viral and bacterial pathogenic flora.

If necessary, anti-inflammatory therapy and antibacterial agents are prescribed. They become necessary if there is a threat of a complication, as indicated, for example, by a high temperature for more than 3 days, or an increase in it a few days after the onset of the disease, even during treatment.

At the first symptoms of bronchitis, there is no point in turning to antibiotics, since most often (in the case of an acute form) the onset of the disease is caused by exposure to a viral infection, the effect of which is not covered by antibiotics. Treatment of chronic bronchitis requires antibiotic therapy if an obstructive form occurs.

The choice of antibiotic is carried out precisely in accordance with the pathogen, which is the real cause of inflammation in the lungs. With properly selected antibacterial treatment, the symptoms of bronchitis begin to subside within 4-5 days from the start of therapy.

For antibiotic treatment, the drugs 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 topical use - Bioparox. Antibiotics can be administered orally, parenterally, or by inhalation, such as a nebulizer.

For viral bronchitis, it is necessary to use antiviral drugs for treatment, for example, leukocyte Interferon, Remantadine for influenza, RNase and Deoxyribonuclease for adenovirus infection, Genferon, Viferon, Kipferon, etc. The duration of antiviral therapy is at least 10 days.

In addition to these medications, symptomatic and auxiliary treatment is used, which includes the use of antihistamines, immunotropic drugs, antipyretics, vitamins, cardiac medications, etc.

As an addition to the main scheme, you can use folk methods - herbal preparations, infusions, decoctions. The use of cups and mustard plasters in the treatment of bronchitis practically does not give any tangible results.

Very often a person picks up the usual cold, which quickly turns into bronchitis. To prevent this, it is important to distinguish bronchitis from colds and other infections in time. Bronchitis is an inflammation of the mucous membrane of the walls of the network of tubes - bronchi - that conduct inhaled air into the lungs. Most often, bronchitis is a complication after a cold or ARVI, but it can also develop as an independent disease.

The main reason for the development bronchitis is weak immunity, when the body, weakened after a cold or other illness, cannot resist the “attack” of various infections, as a result of which they affect the bronchi. To prevent bronchitis, treatment for colds and acute respiratory viral infections should be started in a timely manner in order to promptly create an obstacle to the spread of inflammation and prevent it from “descending” into the bronchi.

As recent research American scientists, in 45% of cases, bronchitis is the result of a severe runny nose, part of which from the nose enters the throat and affects the bronchial mucosa. After an infection occurs, the bronchi begin to secrete large amounts of mucus to improve the clearance of foreign viruses from the respiratory tract.

The more it stands out mucus, the more the passages of the lungs become clogged, which contributes to the appearance of the main symptom - a painful cough, as if tearing you apart from the inside. It can be quite difficult to independently understand what causes a cough, because we also cough during a common cold, acute respiratory viral infection and the flu.

If you have a dry and persistent cough, which is accompanied by a rise in body temperature and general weakness, then be sure to contact a therapist to make a diagnosis and prescribe treatment. If bronchitis is suspected, even while listening with a stethoscope, scattered wheezing and harsh breathing are detected.

Mild bronchitis easy treatable and leaves no complications. If bronchitis is not brought under control in a timely manner, it progresses and becomes chronic, from which asthma is a stone's throw away. Already with moderate or severe bronchitis, the patient begins to suffer from chest pain and shortness of breath. Therefore, it is very important to stop the inflammatory process of the bronchi at the very beginning of the disease, and for this you need to learn to independently distinguish a common cold from bronchitis. The distinctive signs of bronchitis from colds and acute respiratory viral infections are as follows:

1. During colds a dry cough lasts 2-3 days, and with bronchitis it can last up to 1-2 weeks.
2. During colds the temperature does not stay at high levels for a long time; a high temperature that persists for more than 7 days is typical when the infection spreads to the bronchi and lungs.

3. Wheezing whistles in the chest, night cough, difficulty breathing signal the transition of bronchitis to an obstructive form, when the amount of sputum produced sharply decreases and vasospasm occurs. With a common cold, the cough is accompanied by copious expectoration within 2-3 days.

Consequence untimely Once the treatment of acute bronchitis has begun, chronic bronchitis or pneumonia becomes. The likelihood of developing pneumonia and chronic bronchitis is especially high in children and the elderly. The doctor makes a diagnosis of bronchitis immediately after listening to breathing and taking into account the patient’s condition. To confirm the diagnosis, in some cases, a respiratory function test, sputum analysis to determine the causative agent of the disease, and bronchoscopy are prescribed. In order to exclude more serious diseases, such as lung cancer and tuberculosis, it will be necessary to undergo fluorography and sometimes an x-ray of the lungs.

90% of disease cases bronchitis are associated with a viral infection, so the use of antibiotics to treat inflammation of the bronchial mucosa is required only in rare cases. During your visit to the doctor, tell him about the nature of your cough, namely: what kind of cough you have - dry or with sputum, what color the sputum is, when and how it comes out. Basically, expectorants are prescribed for bronchitis, which increase the expectoration of sputum, and cough suppressants are prescribed only to relieve severe coughing attacks.

High effectiveness in treatment bronchitis show inhalation using a nebulizer. Solutions for inhalation can be ordinary saline solution, mineral water, lazolvan, fluimicil, ACC and other medications in the form of solutions that reduce the viscosity of sputum and inflammation of the bronchial mucosa. Before and after inhalation, while taking expectorants orally, drink as much liquid as possible to “dilute” the bronchial mixture and remove it from the lungs.

Especially healthy drink alkaline mineral waters, green tea with lemon and honey, decoctions of medicinal herbs with an expectorant effect. Carrot juice with the addition of one teaspoon of honey per glass will help calm even a severe cough, but drinking it in large doses is not recommended for those who have problems with the liver.

Video lecture on choosing an inhaler (nebulizer) for home use

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Medical statistics show that more often adults and children suffer from pulmonary pathologies. The most common of these is bronchitis. Modern treatment methods provide various options for getting rid of this disease. But inhalations are the most effective.

Only a doctor will tell you whether inhalations can be given to adults and children with bronchitis. It is important to follow the rules of the procedure. Then the treatment will be truly effective.

The advantage of this treatment is that the drugs penetrate deep into the respiratory system. This is how they have their effect. The positive side of this procedure is that it helps:

• relieve swelling of the bronchi;
• reduce the inflammatory process that develops in the upper respiratory tract;
• speed up the process of sputum discharge in children and adults.

Inhalations for bronchitis are indicated for patients to alleviate the patient's condition. In particular, this applies to breathing. After the procedure, the patient clears his throat more easily.

Despite all the positive aspects of the procedure, there are certain contraindications that should be remembered:

1. Firstly, you cannot do inhalations for bronchitis if the patient has an elevated body temperature (more than 37.5 degrees).
2. Secondly, the procedure is contraindicated for people who have heart or lung problems.
3. Thirdly, inhalations should not be done if a person has a tendency to frequent nosebleeds.

There is another positive point. With the help of inhalations, the mucous membrane in the respiratory organs of children and adults is moistened. As a rule, such procedures have a great effect, especially for bronchitis. And in the case of children, in whom the disease develops in a matter of hours, it is necessary to act quickly. If you inhale vapors of essential oils, garlic, eucalyptus or mint, rosemary, you can reduce coughing attacks. It will be easier for the person to cough.

General rules for adults and children

Inhalations for bronchitis can be done, but strict rules must be followed. Then the treatment will be most effective.

1. The procedure should be carried out an hour after eating.
2. The patient's clothing should be loose so that it does not interfere with breathing.
3. All recommended proportions regarding medications must be strictly observed. Otherwise, the opposite effect may occur.
4. To exclude complications after the procedure, the patient’s tolerance to medications should be determined.
5. For an adult, one inhalation lasts a maximum of 3 minutes. As for children, this time does not exceed 1 minute. You are allowed to do from 3 to 5 procedures per day.
6. Young children should be treated with caution. The younger the baby, the less time the procedure takes.
7. During inhalations for bronchitis, the patient should not talk or be distracted by other activities. It is necessary to fully concentrate on treatment.
8. After the procedure, it is not recommended to eat, sing, smoke or go outside for an hour.
9. If a patient has obstructive or acute bronchitis, doctors recommend inhalation through the mouth. If there are disturbances in the upper respiratory tract, then the medications should be inhaled through the nose. This applies to both adults and children.

Medicine involves steam, dry inhalations, as well as procedures with a special device called a nebulizer.

Steam inhalation for bronchitis: is it possible?

When the weather is cool and rainy outside, children and adults catch colds. Many of them contract a viral infection. This is how a runny nose, sore throat, bronchitis and other diseases of the respiratory system develop. A treatment method such as steam inhalation is old and proven. But you can use it only after consulting a doctor. There is a risk of serious complications.

When an inflammatory process develops in the respiratory system, the bronchial vessels dilate. Blood circulation changes slightly, blood outflow is slow, blood inflow is increased. Thus, nasal congestion occurs, the larynx and pharynx swell. Steam inhalations warm and moisturize soft tissues. As a result, the mucus in the bronchi thins out and is better excreted. But this effect does not last long. The fact is that after the procedure, the vessels dilate, the enlarged and already loose mucous membranes swell.

Heating and the loose structure of inflamed tissues lead to the formation of a favorable environment for the proliferation of pathogenic bacteria. As a result, they penetrate into the deeper parts of the respiratory system. Therefore, before you begin to treat bronchitis yourself, you need to consult with a qualified doctor. He will tell you how to do the procedure correctly to get a positive effect.

Modern medicine suggests using special devices to carry out the procedure. Their advantage is that they break down the medicine, so it gets into the respiratory system faster. Today, inhalations with a nebulizer are the most effective, there are reasons for this:

1. The device is affordable and easy to use.
2. It is possible to do the procedure with any medications. For example, antibiotics, mucolytics, bronchodilators.
3. Nebulizer inhalations for bronchitis are completely safe.
4. Due to splitting into an aerosol, the medicine is able to penetrate into the smallest bronchi.
5. The device can be used to perform the procedure on young children or elderly people.

In addition, the nebulizer can be used for inhalation for bronchitis with the addition of not only special medications, but also soda and mineral water. It is not recommended to use essential oils, herbal decoctions or infusions. Nebulizers are particularly effective for obstructive bronchitis.

Inhalations for acute bronchitis

With such a complex course of the disease in children or adults, against the background of the inflammatory process, acute bronchial obstruction syndrome develops. In simple words, these are bronchospasms. Pathological processes are accompanied by severe shortness of breath; it is difficult for the patient to exhale deeply. In addition, he is troubled by severe bouts of coughing, along with which bad, light-colored mucus is released.

Therefore, doctors prescribe medications to patients that help expand the bronchi. This way the patient can breathe better and more freely. As a rule, these are bronchodilators, medications that can also be used together with a nebulizer for inhalation.

Bronchitis is accompanied by a strong dry cough, so moist and warm inhalations help. Especially if the disease is acute. You can add saline or baking soda or Borjomi mineral water to the nebulizer.

When the cough becomes wet, then the patient is given inhalations with medications that remove mucus and phlegm from the bronchi. These are mucolytics and expectorants, bronchodilators, they speed up the process of removing sputum.

Important! If the cause of a child's cough is an allergic reaction, inhalation should not be done.

Before giving inhalations to young children for acute bronchitis, you should consult a qualified specialist. If the basis of a severe cough is an allergic reaction, and the parents independently made the diagnosis, inhalations can aggravate the situation. There is a risk of causing bronchial edema and obstruction. Therefore, doctors recommend that at the first symptoms of bronchitis, go to the hospital.

Inhalations for bronchitis with wet cough in children

It is important, first of all, to provide first aid to the child correctly. In most cases, due to negligence, cough quickly develops into pneumonia. Previously, inhalations were carried out strictly in an inpatient department, under the supervision of a doctor. Today, modern medicine offers small devices that you can use yourself at home.

In the case of treating bronchitis in an adult, the patient can take care of himself. If this is a child, the treatment of bronchitis and wet cough should be approached as responsibly as possible. Do not use medications unless prescribed by a doctor. It is not known at what stage bronchitis is. Based on the diagnosis and individual data, the doctor prescribes effective medications for inhalation.

If you strictly follow the rules for using a nebulizer, then the positive effect will come much faster:

1. Do not inhale if the child has a wet cough.
2. It is also not recommended to carry out the procedure on an empty stomach. And after eating you should wait at least 1 hour.
3. If there are no individual doctor’s prescriptions, then you can give only 3 inhalations per day to the child.
4. Depending on the prescribed medication, the duration of each inhalation is no more than 10 minutes.
5. During the procedure, you should explain to the child that inhalations and exhalations are performed slowly.

You can do inhalations at home using folk remedies. But it is better to use a nebulizer, especially for bronchitis in a small child. Since the times of their ancestors, parents have forced their children to breathe over a pan that is on the fire. The water is boiling, the child is breathing. But this is the wrong treatment. It can all end in a burn to the mucous membrane of the respiratory tract.

As a child, our parents often told us: don’t drink cold things - you’ll catch a cold, don’t walk around with your hat on - you’ll get pneumonia, don’t get your feet wet - your throat will hurt. But we didn’t listen and got sick. Either out of stubbornness, or for the sake of research interest, they tested the strength of their bodies. So, what causes bronchitis and what is it?

Acute bronchitis

Acute, when the volume of bronchial secretions increases and a reflex cough appears;
- chronic, when a change in the mucous membrane occurs at the cellular level, which leads to hypersecretion and impaired ventilation.

Etiology

As mentioned above, the causes of bronchitis can be very different. From the bacterial spectrum, the most common pathogens are streptococci, mycoplasmas, chlamydia, and anaerobic flora. Viral etiology is represented by influenza, parainfluenza and rhinovirus.

Bronchitis caused by chemical or toxic effects on the body is slightly less common. But even in this case, the addition of a secondary infection is inevitable. According to the International Classification of Diseases, Tenth Revision, acute bronchitis caused by identified pathogens is distinguished and acute bronchitis not otherwise specified.

According to the duration of the disease, they are distinguished:
- acute (up to three weeks);
- prolonged course (more than a month).

Acute bronchitis can occur with or without bronchospasm. Based on localization, one can distinguish between tracheobronchitis, when inflammatory changes are concentrated in the upper part of the bronchial tree, and bronchiolitis (the pathological process affects small bronchioles and alveoli). Based on the nature of the exudate, purulent, catarrhal and necrotizing bronchitis is distinguished.

Pathophysiology

How does bronchitis develop? Symptoms and treatment in adults directly depend on the mechanism of the disease, since therapy is aimed specifically at the links of the pathological process.

Etiological factors somehow damage the cells of the bronchial mucosa and cause their necrosis. These “gaps” in the protection create conditions for pathogen penetration. If the epithelium is primarily colonized by a virus, then within two or three days it will be joined by some bacterium, usually pneumococcus.

Inflammatory tissue reactions (swelling, redness, increased local temperature and dysfunction) cause disruption of blood flow in the capillary bed, compression of nerve endings and the formation of blood clots.

If the dynamics of the process are positive and treatment is prescribed on time, then after the inflammation disappears, the mucous membrane is restored within several months. But in a small percentage of patients this does not happen. Then the disease becomes chronic. If the changes affected only the mucous membrane, then this will not affect a person’s life too much. But damage to all layers of the bronchus can cause hemorrhages in the lung tissue, as well as blood staining of the sputum.

Clinic

Causes of obstructive bronchitis, such as bacteria or viruses, cause characteristic clinical manifestations. There is an increase in body temperature to febrile levels, weakness, drowsiness, loss of appetite, headaches, sweating, and rapid heartbeat.

Patients describe their sensations as a soreness or soreness in the throat and behind the sternum, which intensifies when inhaling cold air. In addition, they are bothered by a dry, barking cough that does not bring relief. After two to three days, patients develop thick sputum of mucus or pus. The cough may be accompanied by pain in the lower chest. This occurs due to overstrain of the pectoral muscles.

During a general examination, attention is drawn to excessive moisture in the skin and its redness against the background of bluish lips. With each inhalation, the muscles are drawn into the intercostal spaces, and auxiliary muscles are used for breathing.

On average, uncomplicated bronchitis lasts about two weeks and ends with complete recovery.

Diagnostics

The causes of bronchitis are easy to identify if diagnostic tools are used correctly. After a visual examination, it is necessary to carry out physical examination methods, such as palpation, percussion and auscultation. Feeling and tapping in this case will not show anything unusual, but through a phonendoscope you can hear scattered whistling wheezing sounds. When sputum appears, the wheezes become moist, large bubbles.

In a general blood test, an increase in the number of leukocytes and an increase in the erythrocyte sedimentation rate (ESR) will be observed. In urine analysis, as a rule, there are no changes, but at the height of the fever, protein may appear. A biochemical blood test allows you to see the appearance of C-reactive protein and an increase. Fibrin, leukocytes, desquamated bronchial epithelium and red blood cells are found in the sputum. In addition, the laboratory tests the contents of the bronchi for the presence of bacteria and viruses.

There will be no specific changes on the x-ray, except perhaps an increase in the pulmonary pattern. A spirogram will allow you to assess the presence and degree of obstruction.

Treatment

The causes of bronchitis also determine the choice of treatment tactics in each specific case. Depending on the severity of the pathological process, acute bronchitis can be treated either on an outpatient or inpatient basis, under round-the-clock medical supervision.

Therapy should include an antiviral or antibacterial component, as well as drugs that dilate the bronchi. In addition, it is necessary to eliminate factors that will contribute to the progression of the infection. The course of treatment must be completed to the end, regardless of whether the symptoms of the disease persist or not.

Currently, doctors are actively including physiotherapy, massage, and gymnastics in therapy. This helps to better evacuate secretions from the bronchi, and also allows you to change the methods of introducing drugs into the body.

Chronical bronchitis

The main reason for the development of bronchitis is damage to the epithelium of the mucous membrane of the lower respiratory tract. We can talk about chronic bronchitis four weeks after the onset of the disease, provided that the clinical picture and pathomorphological changes in the lungs are preserved.

This condition is characterized by diffuse damage to the bronchial wall, which is associated with a long-term inflammatory process leading to tissue sclerosis. The secretory apparatus of the bronchi undergoes a number of changes and is adjusted to increased mucus production.

Classification

There are several clinical classifications of chronic bronchitis. The following clinical forms of the disease are distinguished:
- simple (or catarrhal);
- purulent non-obstructive;
- simple form with poor ventilation;
- purulent obstructive;
- special, for example, fibrous or hemorrhagic.

Bronchitis of large and small bronchi is divided according to the level of damage. The presence of an asthmatic symptom complex and its severity are taken into account. According to the nature of the course, like other inflammatory diseases, bronchitis can be latent, have rare exacerbations, and constantly recur.

Complications after suffering from chronic bronchitis are:
- emphysema;
- hemoptysis;
- formation of respiratory failure;
- chronic pulmonary heart disease.

Causes

The chronic course is usually preceded by acute bronchitis. The causes of this process can be concentrated both inside the body and outside it. First of all, it is necessary to take into account the readiness of the immune system. If it is too strong or too weak, it can cause prolonged inflammation and tissue damage. In addition, reduced immunity will attract more and more new colonies of bacteria and viruses, so the disease will occur again and again.

In addition, long-term, over the course of years, irritation of the bronchial mucosa by too dry and cold air, tobacco smoking, dust, carbon monoxide and other chemicals found in some industries can negatively affect the course of the disease.

There is evidence that some genetic diseases can also contribute to the chronicity of inflammatory processes in the lungs.

Pathogenesis

The causes of bronchitis are directly related to the mechanism of formation of the disease. First of all, local bronchopulmonary protection decreases, namely: slowing down of the ciliated epithelium villi, reducing the amount of surfactant, lysozyme, interferons and immunoglobulins A, various groups of T cells and alveolar macrophages.

Secondly, a pathogenetic triad develops in the bronchi:
- hyperfunction of the mucous glands of the bronchi (hypercrinia);
- increased viscosity of sputum (discrimination);
- stagnation of secretions in the bronchi (mucostasis).

And thirdly, the development of sensitization to the pathogen and cross-reaction with the cells of one’s own body. These three points ensure that inflammation persists for more than four weeks.

Symptoms

The disease is manifested by a severe cough with sputum production of up to one hundred and fifty milliliters per day, usually in the morning. At times of exacerbation of inflammatory reactions, there may be a rise in temperature, sweating, and weakness.

With the progression of respiratory and heart failure, thickening of the phalanges of the fingers (“drum sticks”) and thickening of the nail plates (“watch glasses”) develops. Pain during bronchitis occurs only if the pleura is involved in the inflammatory process or the auxiliary muscles become too tense during a prolonged coughing attack.

Laboratory and instrumental studies

The diagnosis of bronchitis is made on the basis of laboratory and instrumental studies. In a general blood test, an increase in leukocytes, a shift in the leukocyte formula to the left, and an increase in the erythrocyte sedimentation rate are observed. Biochemically, the amount of sialic acids, seromucoids, alpha and gamma globulins in the blood is increased, and C-reactive protein appears. The sputum is mucous or purulent, and may be streaked with blood. It contains epithelial cells, red blood cells and neutrophils.

To morphologically confirm the diagnosis, bronchoscopy is performed. The x-ray shows an increase in the pulmonary pattern and its mesh deformation, as well as signs of pulmonary emphysema. Spirography helps guide the doctor about the presence or absence of signs of bronchial obstruction.

Treatment

What to do after a diagnosis of chronic bronchitis has been made? Symptoms and treatment in adults are not very different from those in the acute form. Typically, the doctor prescribes several combinations of drugs in the hope of influencing the etiological factor of the inflammatory response. If this fails, then it is necessary to stabilize the patient's condition. For this purpose, the following groups of drugs are used:
- antibiotics;
- expectorants;
- bronchodilators;
- antihistamines;
- inhalations and physiotherapeutic procedures.