Xp bronchitis treatment. Symptoms and treatment of exacerbations of chronic bronchitis. The disease and the causes of its development

Date of writing: 12.04.2022

Reading time: 53 minutes

Chronic bronchitis is an inflammatory process of the upper respiratory tract, characterized by a long course, with periodic alternating exacerbations and a latent period. The main symptom of the disease is a strong hysterical cough with the release of bronchial mucus, as is the case with the usual acute form of the disease.

Chronic bronchitis is diagnosed if exacerbations recur at least four times a year for two years. Symptoms and treatment of pathology in adults differ from the clinical picture and therapy of the acute form of the disease.

The bronchi are the intermediate region of the respiratory system between the trachea and the lungs. Their structure in shape and appearance resembles a tree, which is formed from hollow tubes, therefore in medicine this part of the respiratory system is called the bronchial tree.

It is responsible for the passage of air and its entry into the lungs. In case of malfunctions in the work of the bronchi, diseases of the respiratory tract inevitably occur.

The most frequent disturbances in the functioning of the bronchial tree occur due to inflammatory processes in their mucous membranes under the influence of various causes, which in 20% of cases leads to chronic bronchitis. The causes of the disease must be considered in more detail, since this factor plays a huge role in the appointment of therapy.

Important. To prevent bronchitis and other diseases of the respiratory system, constant prevention is needed, which includes increasing immunity by taking vitamin complexes. A healthy immune system of the human body does not allow viruses and bacteria to multiply in the body, preventing the spread of disease.

Smokers

Smoking is one of the causes of the chronic form and accounts for 80% of all cases of the disease. As a result of exposure to nicotine smoke on the mucous membrane of the bronchial tree, it becomes irritated, and a constant process of inflammation occurs.

Tobacco smoke in its composition has about 600 harmful components, the most dangerous of which are:

formaldehydes;
acids;
resins;
ammonia.

Under the negative influence of these and many other components, irritation of the mucous membranes occurs, and solid substances settle on them, leading to a constant inflammatory process. The temperature of tobacco smoke is not the last negative factor, it reaches 60 ° C and burns the respiratory tract.

All this leads to:

decrease in the drainage function and motor activity of the cilia of the epithelium;
to increase the viscosity of bronchial mucus;
stagnation of bronchial secretions.

It is characterized by slow development and asymptomatic course for a long period of time.

As a rule, the disease begins to manifest itself after 15 years of smoking, but this period is relative, since under the influence of certain factors it may decrease:

age category of the patient;
the number of cigarettes smoked per day;
an environment with poor ecological conditions exacerbates the course of the disease;
the state of the immune system;
work in hazardous production associated with the inhalation of chemical components accelerates the damage to the bronchi and the development of the disease.

Depending on the lesions of the bronchi and the intensity of symptoms, there are several stages of bronchitis.

Table No. 1. Stages of the disease:

Stage of the disease	Clinical picture
First stage	Signs in the first stage are a hysterical cough, especially in the morning. Its distinctive feature is episodic manifestation and disappearance. Cough is accompanied by discharge of bronchial mucus, viscous consistency. As the disease develops, shortness of breath joins with loads of moderate intensity. Exposure to respiratory diseases increases many times, and they have a longer and more severe course.
Second stage	The second stage of the disease exposes the bronchi to morphological changes, adding the following symptoms: Characteristic attacks of coughing on inspiration; Shortness of breath on exhalation and at this moment a rapid heartbeat.
Third stage	The third stage of the disease is pathological irreversible changes that lead to obstructive disease (impaired pulmonary patency). Symptoms: Strong shortness of breath even with minimal physical exertion; Cough from episodic becomes permanent; Difficulty breathing, especially when lying down.

Important. Chronic bronchitis of a smoker without proper treatment transforms into obstructive pulmonary disease, with impaired patency.

Asthmatic form

The disease develops as a result of irritation of the bronchial tree with all kinds of allergens, which, like tobacco smoke, cause inflammation of the bronchial mucosa.

Chronic bronchitis with an asthmatic component can develop as a result of the congenital predisposition of the bronchi to various allergens. Most often, large and medium-sized bronchi are affected by this effect.

Both infectious and non-infectious agents can act as an irritating component:

infectious- fungi, viruses, bacteria.
Non-infectious- air saturated with dust, animal hair, plant allergens, chemical constituents.

Regardless of the method of penetration of allergens into the body - aerosol (through the respiratory tract) or through the gastrointestinal tract, mucosal edema, bronchospasm and increased discharge of bronchial mucus occur.

It is characterized by an undulating course with a periodic change of exacerbations and a latent course. In this case, an exacerbation of bronchitis can last several weeks, and then be replaced by a period of remission.

The clinical picture of the disease is similar to the symptoms of SARS, the only difference is the absence of a hyperthermic reaction.

Symptoms of asthmatic bronchitis:

paroxysmal cough, which occurs sharply during physical exertion, a sharp change in temperature, laughter;
heavy breathing, mainly on exhalation;
rhinitis;
perspiration in the nasopharynx;
mucus discharge begins a few days after the onset of coughing.

If asthmatic or caused by a non-infectious irritant, for example, plant pollen, the symptoms of the disease completely disappear when contact with the irritant is stopped.

Important. Chronic bronchitis in an asthmatic child is often accompanied by concomitant allergic diseases - diathesis, neurodermatitis and hay fever.

Consequence of an infectious type of disease

The chronic form of bronchitis can manifest itself against the background of ordinary acute bronchitis caused by infectious pathogens, including:

viruses;
bacteria;
fungi.

As a rule, infectious bronchitis, with proper treatment, is not dangerous and can be treated in a few weeks, but in some cases it can become chronic.

Reasons why acute bronchitis can become chronic:

Ignoring the symptoms of the disease- a common cause of a chronic process. Most patients with a clinical picture of a common cold - fever, cough, general malaise, ignore symptoms and do not seek medical help or carry the disease on their feet. As a result, the acute symptoms of the disease disappear, but inflammation remains, which leads to a chronic process.
Unfinished Therapy. Very often, after the disappearance of the acute clinical picture of the disease, the patient stops taking the prescribed drugs, but the inflammatory process of the bronchial tree remains and takes on a sluggish form without visible symptoms. As a result, the disease becomes chronic.
Influence of non-infectious factors, such as smoking, the impact of chemical elements on the body in combination with a viral infection is the cause of chronic inflammation in the bronchi.
low immunity- the cause of frequent viral infections, which with frequent repetition turn into a chronic form of the disease.

Important. Treatment of the acute form of bronchitis lasts no more than two weeks, depending on the type of pathogen and the state of the immune system. If the disease takes a longer course or recurs several times a year, you should think about the presence of a chronic form of bronchitis and consult a doctor.

Clinical picture

The symptoms of the disease are very similar to many diseases of the respiratory tract, but a diagnosis of chronic bronchitis can only be made if the symptoms of the disease are repeated for several years at intervals of two or three times a year.

Symptoms:

Cough is the primary symptom of the disease. By its manifestation, it is possible to determine the area of damage to the bronchial tree. Dry unproductive cough with wheezing indicates a malfunction in the small bronchi, dry cough with minimal sputum discharge - bronchial obstruction, accompanied by bronchospasm. Cough with a large release of bronchial mucus - a violation of mucociliary clearance.
Labored breathing occurs due to the accumulation of bronchial mucus in the lumen of the bronchus. The patient may feel short of breath at the slightest physical exertion. In severe disease, accompanied by obstruction, there may be a lack of air due to narrowing of the respiratory lumen.
necessarily accompanies the inflammatory process of the chronic type. At the initial stage of the development of the disease, its release occurs in small quantities, with the progression of the disease, it becomes pronounced and its color changes from transparent to a green purulent hue.
Wheezing are a symptom of too much mucus accumulation when the bronchial lumen narrows. Depending on the stage of the disease, they can have a different character. At the initial stage of the disease and during the period of remission, dry rales are characteristic, during the period of exacerbation they acquire a wet character, reminiscent of the bursting of balls.
Hemoptysis it is characteristic only for a complicated course of the disease with the presence of a hysterical cough, during which there is a great tension in the muscles of the bronchial tree and rupture of small blood vessels. It should be noted that the presence of blood should be observed in a small amount (scanty streaks among the sputum), if there is an extensive discharge of blood - this is evidence of a more severe disease.
Temperature not necessarily a symptom of the disease. Only an exacerbation can be accompanied by a slight hyperthermic reaction, which is kept within 37 ° -37.5 ° C. As a rule, this symptom occurs against the background of an infection, during which the waste products of pathogenic organisms enter the bloodstream, which is accompanied by symptoms of intoxication.
Cyanosis- a symptom characteristic of a chronic disease with obstruction, during which the flow of air is disturbed and respiratory failure, causing discoloration of the skin. Cyanosis can be observed both in certain parts of the body (nose, ears, limbs), and throughout the skin.
Pain in the chest area does not always accompany the chronic course of the disease and is observed with an hysterical paroxysmal cough, when there is a strong muscle tension.

Important. Treatment of any form of chronic bronchitis involves a complete cessation of smoking, as tobacco smoke will continue to irritate the mucous membrane and the inflammatory process will not stop.

Therapy

Any type of chronic bronchitis and its any stage cannot be treated without the use of medications, but it must be remembered that self-medication is unacceptable.

The therapy of the disease is complex and schematic, which should be prescribed only by a general practitioner or pulmonologist, according to:

clinical picture of the disease;
the severity of the course of the disease;
the age of the patient;
the cause of the disease;
the presence of comorbidities.

Groups of drugs included in complex treatment, depending on its origin:

with bacterial bronchitis or with the addition of a secondary infection;
antiviral agents for viral etiology;
antihistamines in the allergic form of the disease;
immunomodulators - for all types of diseases, to improve regeneration and increase the body's resistance.

Groups of drugs for symptomatic treatment, depending on the clinical picture:

cough suppressants;
bronchodilators to eliminate the inflammatory process;
expectorants;
antipyretic drugs.

Antibiotics

Antibacterial therapy in the treatment of chronic forms of the disease is not always prescribed, only in the following cases:

accession of a bacterial infection;
during an exacerbation of the disease;
hyperthermic reaction that does not go away for several days;
intoxication of the body;
a sharp exacerbation of symptoms a few days after improvement;
a patient in the age category over 60 years (this age is characterized by a strong decrease in immunity and the disease is severe);
the presence of concomitant diseases (at the discretion of the doctor).

How to recognize the symptoms of exacerbation of chronic bronchitis in adults:

the presence of blood inclusions in the sputum;
a sharp increase in cough;
shortness of breath;
allocation of a large amount of purulent bronchial mucus;
general deterioration of the condition;
increase in body temperature.

Table number 2. Antibacterial drugs:

A drug	Application features
	Drug of choice. As part of the drug, clavulanic acid, which at times enhances the effect of the drug and expands the spectrum of antibiotic action on most bacterial pathogens. The course of treatment with Augmentin does not exceed 5 days
	Erythromycin is an analogue of popular drugs containing penicillin, but with fewer side effects. It is prescribed for intolerance to the penicillin group. The instruction prohibits taking an antibiotic for violations of the liver.
	An effective drug for the treatment of bronchitis, but is prescribed only in the early stages of the disease or with an uncomplicated form of the course of the disease
	An effective remedy, but it is prescribed only in rare cases when previous therapy has not yielded results, as it has many side effects.
	An antibacterial agent with a wide spectrum of effects and is effectively used in the treatment of protracted bronchitis. It has side effects in the form of nausea, stool disorders and headaches.
	The drug is prescribed during the period of exacerbation of chronic bronchitis and in severe cases of the disease.
	Antibiotic of the latest generation on a level with high efficiency and minimal side effects has a budget cost. Its price varies between 200-400 rubles, depending on the form of release of the drug.

Antivirals

A group of antiviral drugs is prescribed in case of a viral infection. The appointment of drugs is advisable only in the first days of the disease, when they have the highest therapeutic effect.

Antiviral drugs for chronic bronchitis:

Ingavirin is a complex drug that stops not only the spread of infection, but also develops body resistance, lowers body temperature and removes the symptoms of intoxication in the body.
Cycloferon is an antiviral agent of complex effects. The drug relieves coughing fits, removes the hyperthermic reaction, improves immunity, promotes sputum discharge.

Antitussive drugs

Cough medicine is prescribed only if there is a dry aggressive cough without the release of bronchial mucus, which irritates the throat and causes a painful relationship. When sputum is released, cough preparations are excluded, since this symptom helps to remove excess bronchial secretions.

Table number 3. Cough preparations:

A drug	pharmachologic effect
	The drug is in the form of tablets, drops and syrup. By acting on the cough center, it stops coughing attacks and has a mild expectorant effect. Side effects: allergic manifestations; bouts of nausea; diarrhea. The price is from 150 rubles (tablets) to 330 rubles (drops).
	Herbal preparation based on plantain, softens and relieves the cough symptom. It has an anti-inflammatory and expectorant effect. Allergies may occur with intolerance to the components of the drug. The price is from 200-240 rubles.
	Remedy for chronic bronchitis with a symptom of a hacking dry cough. Composed of: thermopsis extract; thyme; licorice; codeine. The drug is combined, simultaneously relieves cough and acts as an expectorant. The price is 150 rubles.
	The drug is available in tablet form and drops. Impact: thins mucus; removes excess bronchial secretions; relieves cough; The price of tableting form is 140 rubles, drops are 80 rubles.
	Release form - lozenges, syrup, elixir. A universal cough medicine for chronic bronchitis, one of the few that is used for wet and dry coughs at the same time. The price is 280-300 rubles.

As an additional therapy, you can use a folk remedy for chronic bronchitis based on herbs with an analgesic effect:

coltsfoot;
inflorescences of black elderberry;
linden flowers;
calamus root;
anise;
caraway;
St. John's wort.

Important. Cough is a cleaning function of the respiratory system, with the help of which the body removes foreign bodies. The symptom occurs when the mucous membranes are irritated by viruses, chemicals, dust, etc. It is necessary to stop a cough with medicines only if it is dry and unproductive. With a wet cough, it is necessary to allow the body to cleanse itself.

Bronchodilators

Bronchodilators are medicines for chronic bronchitis in adults that eliminate bronchospasm. They are prescribed when the disease is accompanied by bronchospasm.

Preparations of this group are made on the basis of Theophylline, the substance contributes to:

expansion of the bronchi;
stimulates the respiratory center;
speeds up heart contractions.

Preparations for chronic bronchitis based on Theophylline:

Durophyllin - capsules. It is not prescribed for patients under three years of age, during pregnancy, gastrointestinal ulcers and epilepsy.
Retafil - tablets. It is evenly absorbed into the bloodstream and maintains a stable concentration in the body, which ensures a lasting effect.
Atrovent - aerosol. The drug not only relieves severe bronchospasm, but also helps to prevent it. The drug has no side effects on the body, is not addictive.
Clenbuterol syrup. The medicine stops and prevents bronchospasm. Side effects: dryness of the oral mucosa, trembling of the extremities, headache and allergic manifestations.

Expectorants

In chronic bronchitis, the production of bronchial secretions increases, which the bronchi are unable to excrete on their own. Excess sputum in the bronchi makes it difficult for air to pass through and is a favorable environment for the life of various pathogenic microflora.

Therefore, to remove it, drugs with an expectorant effect are prescribed. They stimulate the glands that push mucus out.

Medications with expectorant effect:

Mukaltin;
Thermopsol;
Pertusin;
Tussamag;
Gelomirtol;
Amtersol.

Herbal preparations according to traditional medicine recipes can also be used as expectorants.

Table number 4. Phyto fees with expectorant effect:

Collection of herbs	Reception features
	birch leaves 40 gr; nettle 10 gr; oregano 20 gr. Infuse 30 g of the mixture in 500 ml of boiling water. Drink 50 g / three times a day.
	Mix all herbs in equal proportions. Infuse 40 g of the mixture in 500 ml of boiling water. Drink 100 ml / three times a day.
	Mix equal amounts of herbs. Brew 20 g of the mixture in 200 ml of boiling water and drink it like tea throughout the day.

Important. When sputum with blood content is discharged, it is necessary to seek help from a specialist. Such a symptom indicates irreversible changes in lung tissue and may be a harbinger of a serious illness.

Mucolytic drugs

This group of drugs is prescribed for difficult to excrete sputum, which has a viscous consistency. Medicines act on bronchial mucus, thinning it and making it easier to excrete.

How to treat chronic bronchitis in adults with mucolytic drugs, and what rules must be observed when taking them:

It is forbidden to use drugs for dry unproductive cough. Such a symptom is observed at the initial stage of the disease, when the bronchial secret is still produced in minimal quantities and there is no need to remove it.
Mucolytics dehydrate the body, requiring increased fluid intake.
Mucolytics should not be combined with cough suppressants. This will lead to bronchial obstruction.

Table number 5. Preparations based on Acetylcysteine, Ambroxol, Bromhexine for thinning sputum:

Active substance	pharmachologic effect	Preparations
	Changes the consistency of bronchial secretions, thinning it. Contraindicated in peptic ulcers.	Wix Active.
	They have a mucolytic and expectorant effect at the same time. Contraindicated in pregnancy, lactation.	Flavamed; Lazolvan; Ambrobene.
	It has a mucolytic and expectorant effect. Reception is prohibited during pregnancy, lactation and impaired renal function.	Bronchosan;

Important. Poor discharge of bronchial mucus can lead to intoxication of the body, which is manifested by a deterioration in well-being.

Antihistamines

A group of drugs is prescribed if chronic bronchitis is of allergic origin.

Action of drugs:

relieves swelling of the bronchial mucosa;
stop bronchospasm and prevent its manifestation;
relieve an allergic reaction.

Antihistamines:

Suprastin is a medicine for chronic bronchitis in allergic adults. Release form - tablets and solution for injection. Contraindications: pregnancy and lactation.
Tavegil is available in tablet form, as a syrup and injection solution. Contraindications: pregnancy and lactation.

Important. In the allergic form of bronchitis with a severe course, glucocorticoids are prescribed - drugs with anti-allergic and anti-inflammatory effects. These include Beclospir, Budesonide.

Preparations immunomodulators

Means of this group are prescribed for all types of chronic bronchitis. They increase the body's resistance and reduce the risk of complications.

The most common immunomodulatory drugs are:

Broncho-Munal.
Ribomunil

In addition to immunomodulatory drugs, vitamin complexes can be prescribed - Vitrum, Duovit, Multitabs, Centrum.

Inhalation therapy

Treatment of chronic bronchitis with the help of inhalations is an effective therapy in the fight against the disease.

Inhalations provide:

anti-inflammatory action;
bronchodilator and mucolytic effect;
act as an antiseptic.

Inhalation therapy is carried out using a nebulizer device. It breaks the medicinal liquid into microparticles, turning it into an aerosol.

This form of influence provides:

immediate absorption of the drug by the bronchial mucosa;
covers a large area of the bronchi with the drug;
longer retains the drug in the inflamed areas;
provides a high concentration directly to the inflamed area;
the intake of drugs by inhalation reduces their harmful effects on the digestive organs, liver and kidneys.

Preparations for inhalation:

Bronchodilators - Berotek, Salbutamol, Berodual, Atrovent.
Mucolytics - Lazolvan, Fluimucil.
Antiseptics and antibacterial agents - Fluimucil (antibiotic), Dioxidin, Furacilin.

Important. The basic rule of inhalation is to inhale therapeutic steam through the mouth, exhale through the nose.

Physiotherapeutic methods of treatment and prevention

A photo. Inhalations and taking medications are the right way to recovery

Physiotherapy procedures, unlike drug treatment, do not affect the biochemical processes in the body. Their action is based on the physical principles of stimulation of the body's defense mechanisms.

The video in this article demonstrates medical procedures in a sanatorium on the South Coast of Crimea. The price of vouchers to Crimean sanatoriums, for example, is quite acceptable for most categories of citizens.

Here are some of the physiotherapy treatments:

bronchoalveolar lavage;
bronchoscopy;
vibration chest massage;
diathermy;
breathing exercises;
postural drainage;
sanatorium-resort procedures in mountainous areas;
speleotherapy in salt caves;
UHF chest;
alkaline and medicinal inhalations using a nebulizer;
electrophoresis.

A complex combination of drug and physiotherapy treatment can cure even severe forms of chronic bronchitis.

Is it necessary to treat bronchitis during remission?

Patients suffering from a chronic form of inflammation of the bronchi should know that therapy between exacerbations is an equally important aspect in matters of how to cure chronic bronchitis forever.

During the period of remission, treatment is aimed at eliminating the causes of the inflammatory process, strengthening the body's resistance to various negative factors and increasing the local reactivity of the respiratory tract, and gradually restoring the altered functions of the bronchial epithelium. How to treat chronic bronchitis during remission is determined only by the attending physician.

At the same time, a special rehabilitation program is developed individually for each patient, taking into account the age, functional state of the body and the presence of concomitant diseases.

Treatment without exacerbation should include:

herbal medicine;
physiotherapy procedures;
breathing exercises and exercise therapy;
immunocorrection(as prescribed by a specialist) and vitamin therapy;
proper nutrition;
elimination of foci of chronic infection nasopharynx and oral cavity;
reflexology;
speleotherapy– visiting caves with a certain microclimate, which contributes to the effective treatment of bronchitis;
climatotherapy- visiting health-improving establishments (sanatoriums).

One of the most significant moments of therapy is the rejection of bad habits.

A complete cure for this disease is possible if therapy is started in the early stages, following the recommendations of a specialist. It is also necessary to minimize the impact of all negative factors - quit smoking, change jobs in the presence of occupational hazards and prevent a persistent decrease in immunity. In the absence of frequent exacerbations, the bronchial mucosa can recover.

But in the absence permanent treatment and the presence of active inflammation in the bronchi, irreversible changes occur (hypertrophy and atrophy of the mucosa, the occurrence of hemorrhages and constant spasm) - the price of a careless attitude to one's health in this case will lead to serious complications, progressive respiratory disorders and constant oxygen starvation of all organs and systems of the body.

How to treat chronic bronchitis in adults with medicines is the competence of a doctor, but it is in the power of each patient to help himself with a healthy lifestyle and giving up bad habits. The video in this article will tell you more about the pathology.

As with any chronic illness, with bronchitis two stages follow each other - exacerbation and remission; the pathological process drags on for years and decades, introducing irreversible changes in the structure and properties of the mucous membrane and muscles of the bronchi. The chronic form in the acute stage is often accompanied by obstruction - narrowing of the bronchial cavity, which causes shortness of breath, oxygen starvation and intoxication of the body.

How does an illness become chronic?

As a rule, at first the patient suffers an acute form of the disease, and then it turns into a chronic one. Bronchitis develops under the influence of an infection (viral, bacterial or fungal), often after a recent respiratory illness or due to severe hypothermia. The cause of a cough may be an allergic reaction to, for example, a medicine; then it is changed, and antihistamines are added to the main treatment. The disease becomes chronic when:

the disease remained untreated or transferred "on the legs";
provocative factors are constantly present: smoking, work in hazardous production, in a dusty or cold room;
low immunity in the patient;
hereditary predisposition to respiratory diseases, bronchial hypersensitivity;
frequent SARS;
the presence of foci of infection in the body.

How is the exacerbation manifested?

An exacerbation of chronic bronchitis is an increase in its main symptoms: cough, sputum production, difficulty breathing, often fever, weakness. Cough and shortness of breath are aggravated by inhalation of cold air, physical effort.

A large amount of mucus accumulates in the bronchi; It is thick in texture and difficult to separate. In the first days of exacerbation, sputum is taken from the patient for bacteriological analysis to determine the causative agent of the disease. If the mucus is transparent or white, then they talk about a simple form of bronchitis, if it is yellow-greenish, then the inflammation has gone far, pus is formed.

Treatment of chronic bronchitis

The treatment of any chronic disease continues throughout life: both in the acute stage and in the remission stage. If the patient's condition worsened due to an infection attack, it should be repelled: on the one hand, with the help of antibiotics, on the other, with antiviral therapy and strengthening the immune system.

Due to the fact that the result of sputum analysis becomes known only after 10-14 days, broad-spectrum antibiotics are prescribed. In uncomplicated chronic bronchitis, they begin with antibacterial agents of the penicillin series (amoxiclav, augmentin); if the patient does not tolerate penicillin, they switch to macrolides (sumamed, azithromycin).

In the presence of frequent exacerbations, as well as elderly patients, cephalosporins (cefazolin, ceftriaxone), produced in injection ampoules, are better suited.

And, finally, in case of intolerance to all these groups of antibiotics, the use of fluoroquinolones (levofloxacin) is indicated.

Antibacterial treatment of chronic bronchitis lasts 7-10 days until the inflammatory process is defeated. This is evidenced by the improvement in the patient's condition: the temperature decreases, the cough becomes productive, the sputum becomes transparent.

Simultaneously with antibiotics, mucolytics (sputum-thinning drugs) and expectorants are prescribed: lazolvan, erespal, ACC. If symptoms of bronchial obstruction are present - shortness of breath, a feeling of squeezing the chest, difficult exhalation - bronchodilators (broncholitin, salbutamol) are needed. All these drugs are taken until the symptoms of exacerbation subside.

Well help with bronchitis inhalation through a nebulizer or steam inhaler.

Treatment of chronic bronchitis with a nebulizer is much more effective, because the medicine, together with the inhaled air, reaches the smallest branches of the bronchi and pulmonary alveoli and has its effect faster. Through a nebulizer, you can only inhale drugs in solutions, through a steam inhaler - with any compositions for inhalation, decoctions of herbs. If there are no devices at hand, you can breathe over the steam with a hot soda solution or a small amount of Golden Star balm diluted in boiling water (at the tip of a knife - 2 liters of water), covered with a blanket on top, for 3-5 minutes. Then wipe your face and chest and go to bed.

As soon as the patient's temperature drops, thermal procedures are added to the bronchial area. At home, these can be mustard plasters (used every other day), jars, warming compresses (alcohol, oil, etc.); at night, you can soar your legs, rub your feet with warming ointments, then be sure to put on terry or woolen socks.

In a polyclinic, if it is possible to visit it, the patient is prescribed electrophoresis (to thin sputum), warming up (UHF, ozocerite applications), chest massage.

Folk remedies for the treatment of chronic bronchitis

There are many time tested folk remedies, perfectly coping with the symptoms of exacerbation of bronchitis:

Potato compress. Boil 2 potatoes in their skins, crush, add 1 tbsp. l. soda, mix, wrap the mass in a dense cloth and put on the area of the bronchi, cover with cellophane on top, fix with an elastic bandage and wrap with a scarf. Keep until the potatoes have cooled down.
Compress of cabbage and honey. Apply a thin layer of honey on a large cabbage leaf, apply to the area of the bronchi, fix with a bandage, warm from above. You can leave it all night.
Hot milk with honey and soda. Heat the milk strongly, pour it into a glass, add a teaspoon of honey, a pinch of soda and a little butter on the tip of a knife, stir, drink the whole glass at once in small sips at night, then lie down under the covers. Excellent warming, anti-inflammatory and expectorant.
Radish juice. Wash a large black radish, remove the core, make a hole at the bottom for the juice to drain. Fill the middle of the radish with honey and put on a glass. Juice, which will gather in a glass, take 1 tbsp. l. 3 times a day.

For the treatment of chronic bronchitis, decoctions of herbs are used, for example, a decoction of coltsfoot leaves, marshmallow root, licorice root, pharmacy herbal preparations(collection No. 4 is especially good).

Prevention of exacerbations of bronchitis

To avoid the frequent worsening of the symptoms of bronchitis, it is necessary to take care of your health: lead a healthy, active lifestyle, completely stop smoking, do gymnastics daily, go outside more often, harden your body, strengthen your immune system.

For bronchopulmonary patients, the Mediterranean climate is very useful (in Russia, the climate of the southern coast of Crimea is close to it), sea air, sunbathing and swimming. You need to use every opportunity to spend your vacation at sea.

Epidemiologically unfavorable places, work in hazardous industries, contact with dust and chemicals should be avoided. At home, you need to do wet cleaning daily, use a vacuum cleaner with a special filter, and have air purifiers. In the spring, when plants are flowering, you should be less outdoors and take antiallergic medicines.

Sudden hypothermia should be avoided. As hardening measures, you can apply daily dousing with cool water, then rub well with a towel.

Breathing exercises help well: it does not allow sputum to stagnate in the bronchi and trains proper, full breathing.

To strengthen the immune system, courses should be taken with immunomodulators, for example, methyluracil. All foci of inflammation in the body (caries, tonsillitis, rhinitis) must be treated in a timely manner to prevent the spread of infection to the bronchi.

Almost every one of us faces a disease of the respiratory system called bronchitis at least once in a lifetime. Its main symptom is a strong cough, sometimes with shortness of breath and viscous sputum, as well as headache, general weakness, etc.

But the worst thing is when a similar situation is repeated at intervals of several months, or even weeks. In this case, we can talk about a more serious form of the disease, that is, chronic bronchitis, which causes a lot of problems for a person and is difficult to treat. So, by what signs to recognize the chronic form of the disease, and how to get rid of it forever?

What it is?

Chronic bronchitis is a sluggish pathology, accompanied by a cough (dry, wet) and shortness of breath. Chronic inflammation of the bronchi is considered to be recurring for 2 years with clinical manifestations for 3 months. and more. At the same time, the bronchial mucosa loses the function of regeneration (recovery), and changes can affect the lung tissue and lead to fatal consequences for the whole organism.

Causes of the development of the chronic form

In the occurrence of a chronic inflammatory process in the bronchi, the following reasons may be involved:

Tobacco smoke. The main risk group for the development of chronic bronchitis are smokers;
Decreased immunity. It becomes a favorable background for the launch of the microbial factor;
Chemical pollutants. All chemical compounds, the vapors of which are regularly inhaled by a person, like dust cause a bronchial reaction in the form of inflammation or bronchospasm;
Climatic conditions. Climatic conditions are rarely the root cause. But they have a general unfavorable background against which all other causes are realized. These include low air temperatures, high humidity and industrial air pollution;
Infections. They are represented by bacterial, viral and atypical pathogens. Very rarely, only this factor is sufficient for the occurrence of a chronic process. There must be a combination of it with other reasons that will support the negative influence of each other. Extremely important in this regard belongs to chronic foci of infection in the tonsils, and carious teeth;
Work in conditions of occupational hazards. In such cases, constant inhalation of air contaminated with coal or other types of dust leads to its deposition in the bronchi. The natural reaction of the body to foreign particles is inflammatory. Naturally, under the conditions of the continued influx of dust particles, self-cleaning mechanisms cannot manage to remove all accumulated deposits. This is the basis of process timing;
Hereditary predisposition and congenital features of the bronchial tree. A very important group of reasons for which the bronchi are initially susceptible to any harmful environmental factors. Minimal provocateurs cause bronchospasm and increased mucus production. Its obstructed outflow contributes to the activation of the infection, the maintenance of inflammation with the possibility of developing bronchial obstruction.

The mechanism for triggering a chronic inflammatory process in the bronchus wall is quite complex. It is impossible to single out only one factor that implements it first. The exception is cases of professional and chronic bronchitis of smokers.

Classification

According to the nature of sputum discharge, the following types of chronic bronchitis are distinguished:

purulent;
hemorrhagic (admixture of blood in the discharge from the bronchi);
fibrinous.

Depending on which part of the bronchial tree is affected, proximal bronchitis (large bronchi) or distal (bronchioles are affected) are diagnosed.

In accordance with the presence or absence of a bronchospastic component, bronchitis is divided into obstructive and non-obstructive. The disease may be in remission or exacerbation, be uncomplicated or complicated (for example, emphysema).

First signs

The main signs of chronic bronchitis in the remission phase:

cough;
expectoration;
shortness of breath (with obstructive bronchitis, "smoker's bronchitis");
sweating (with little physical exertion, at night).

The severity of symptoms is individual, depending on the degree of change in the walls of the bronchi, on the age of the patient.

Symptoms of chronic bronchitis

The symptomatology of the disease is characterized by a pronounced severity and is represented by the following manifestations:

Cough. It is the main sign of chronic bronchitis, which determines the course of the disease, as well as the entire clinical picture in general. At the initial stage of the disease, cough makes itself felt only in the morning with a small amount of sputum. In the process of development of the disease, it becomes more wet and speeded up.
Sputum. At the initial stage of the disease, sputum is characterized by the appearance at the end of a coughing fit of a small amount of secretions in the form of mucus, which have a transparent or yellowish color. The development of chronic bronchitis is caused by the appearance of purulent viscous sputum with a green tint, which indicates the addition of a bacterial infection.
Dyspnea. Appears as a result of a very active process of inflammation in the bronchi. Initially, it occurs when performing any loads of a physical type. Further, in the process of progression of the disease, it begins to be accompanied by a cough and occur even at rest.
Wheezing. Phlegm provokes difficulties with the circulation of air masses, which is caused by the presence of wheezing. In the case of a weakening of the disease, wheezing is dry in nature, which is easy to listen to. In the presence of an exacerbation of the inflammation process, an increase in the amount of expectorated sputum occurs, and wheezing becomes wet. If small bronchi are affected, then wheezing begins to have a whistling character, which is clearly audible at a distance.
Cyanosis. The occurrence of this manifestation is not characteristic of the usual course of the disease. A change in the color of the skin indicates the activation of complications, when the bronchi become unable to properly carry out the flow of air masses to the lungs. The result is a bluish tint.
asthma syndrome. The occurrence of an asthmatic syndrome may be associated with a prolonged course of the inflammation process or bronchospasm, which indicates the possibility of the syndrome occurring at any stage of the disease.

Chronic obstructive bronchitis

The disease is initially asymptomatic. Then it is manifested by a hacking cough, wheezing and shortness of breath in the morning, which disappears after sputum discharge.

The main signs of chronic obstructive bronchitis are:

strong unproductive cough;
severe shortness of breath on exertion and irritation of the respiratory tract;
wheezing wheezing on exhalation;
prolongation of the expiratory phase.

Treatment of chronic bronchitis

This is a whole range of activities. Depending on the phase of the development of the disease the patient is in - remission or exacerbation, the doctor chooses the tactics of treatment.

During exacerbations, it is important:

Eliminate the inflammatory process in the bronchi;
Normalize mucus secretion;
Improve lung ventilation, eliminate bronchospasm;
Support the work of the heart.

During the period of relative attenuation of the disease, it is necessary:

Eliminate foci of infection of the nasopharynx;
Carry out sanatorium-resort treatment;
Do breathing exercises

Treatment regimen and drugs used for chronic bronchitis:

Elimination of the provoking factor. It should be remembered: no drug therapy will give a result without eliminating the cause. However, smoking cessation lasting 20 years or more will not bring the desired success due to the irreversibility of changes in the mucosa.
Antibiotics. They are used for purulent and purulent-catarrhal bronchitis, with catarrhal they are usually not needed! Appointed after sputum examination. This gives the doctor information about the sensitivity of bacteria to a particular drug. In the case when it is impossible to examine sputum, antibiotics of the penicillin group are prescribed. Recently, especially effective drugs Sumamed, Rulid have also been used, since most of the microorganisms that cause chronic bronchitis are sensitive to them. The antibiotic of the reserve group, Gentamicin, in the absence of a positive effect, is delivered directly to the bronchi in the conditions of inpatient treatment.
Considering that in chronic bronchitis the course of treatment can be quite long, we should not forget about the support of one of the most important organs of the human body - the liver. After all, this organ is a natural filter and passes all chemical elements through itself, while the liver cells weaken and die. To restore and support the liver, you need to take herbal hepatoprotectors (karsil, darsil, milk thistle extract, hepatophyte).
Bronchodilators. They are prescribed at the first attacks of obstruction. The attending physician chooses one of the drugs: Atrovent, Salbutamol, Berodual (combined drug) or Theophylline if the above-mentioned drugs are ineffective.
Expectorants. It is more expedient to take drugs that thin sputum (ACC, Fluimucil), mucoregulators (Lazolvan, Bromhexine) and reflex agents (potassium iodide, marshmallow and plantain syrups).
immunosuppressive agents. Recently, in the treatment of chronic bronchitis, drugs that specifically affect the body's immune system are increasingly being used. This is Timalin or T-activin. The positive effect of vitamins C, A, immunomodulators of plant origin also affects the successful treatment of chronic bronchitis.
If the exacerbation of chronic bronchitis is caused by influenza viruses or SARS, then it is advisable to take antiviral drugs (groprinosin, amizon, anaferon, aflubin).
Inhalations. The best option carrying out inhalations in chronic bronchitis - a nebulizer that ensures the supply of antibacterial (Dioxidin, etc.), anti-inflammatory (Rotokan) and expectorants even into small bronchi.
Physical methods. Massage and breathing exercises (breathing techniques according to Buteyko and Strelnikova are especially effective) noticeably improve the clearance of mucus from the bronchi. The only condition is the regularity of procedures.

Breathing exercises

Breathing exercises are the main physiotherapeutic procedure shown to help cure chronic bronchitis forever. It can consist not only of passive breathing exercises, but also involve the whole body.

One of the most famous complexes breathing exercises was developed in the USSR by A.N. Strelnikova and bears her name. It, for example, involves the use of arms, legs, tension of the shoulder, abdominal girdle. Due to the complex physical activity, tissue respiration is enhanced, the respiratory organs are toned, a cascade of reactions is launched that stimulates the immune system and improves mood.

In general, with bronchitis in the chronic stage, any moderate physical activity is useful: walking, climbing stairs, exercising, swimming.

Inhalations

This is one of the most effective physiotherapy procedures for bronchitis. Inhalations can be steam and fine. Such procedures can be carried out both in a hospital and at home. For steam inhalations, steams of herbs, essential oils, sodium bicarbonate are used. For fine inhalations with the help of a nebulizer, herbal infusions, mineral water of the Borjomi type, drugs that thin sputum (ACC, mukolvan, hypertonic potassium solution or sodium iodide) are used.

A lytic mixture administered with an inhaler will help relieve bronchospasm:

atropine 0.1% solution - 2 ml,
adrenaline 0.1% solution - 2 ml,
diphenhydramine 0.1% solution - 2 ml.

All ingredients are mixed, poured into the reservoir of the inhaler and introduced by fine spray into the respiratory organs. The advantage of this method is that inhalations can be used for a long time - up to 2-3 months.

Features of nutrition and lifestyle in bronchitis

Against the background of exacerbation of bronchitis, it is traditionally recommended to drink plenty of water. For an adult - the daily volume of fluid consumed should be at least 3 - 3.5 liters. Usually alkaline fruit drinks, hot milk with Borjomi in a ratio of 1: 1 are well tolerated.

The daily diet should contain a sufficient amount of proteins and vitamins. Against the background of high temperature and general intoxication, you can starve a little (if the body, of course, requires it), but in general, any restrictive diets are contraindicated for such patients.

High efficiency shows the use of inhalation using a nebulizer. As a solution for inhalation, you can use mineral water, Ringer's solution or normal saline. Procedures are carried out 2-3 times a day for 5-10 days. These manipulations contribute to the discharge of sputum, facilitate the drainage of the bronchial tree, and reduce inflammation.

It is necessary to correct lifestyle in order to eliminate risk factors for the development of infectious diseases of the upper respiratory tract. First of all, this concerns smoking and various kinds of occupational hazards (dusty production, work with paints and varnishes, frequent hypothermia, etc.). An excellent effect in chronic lung diseases is the use of breathing exercises, for example, according to the Strelnikova method. This also applies to chronic bronchitis.

Outside of exacerbation of bronchitis, hardening measures can be taken.

Forecast and prevention

The period of remission is characterized by a decrease in dry cough, which is not accompanied by shortness of breath. There is an improvement in bronchial patency. It is not necessary at this time to forget about secondary prevention, which will not allow a relapse to occur. The most important condition for forgetting about bronchitis forever is a healthy lifestyle with quitting smoking. The air in the room where the person is located should have normal humidity, therefore, if it is too dry, it is necessary to use humidifiers or at least arrange containers with water.

Clothing should always correspond to the weather conditions, it should not be cold. Since a patient with bronchitis is prone to excessive sweating, it should not provoke overheating of the body. When working with harmful substances, you need to take unprecedented measures to protect, and ideally, completely change the scope of activity. Walking in the fresh air and hardening will not be superfluous.

Bronchitis is an infectious disease accompanied by diffuse inflammation of the bronchi. Most often occurs against the background of colds, for example, SARS, influenza, although it may also have a different origin. There is no single recipe that suits absolutely everyone.

To answer the question of how to cure bronchitis, you need to figure out what kind of disease it is. In the article, we will consider the main causes and symptoms of bronchitis in adults, and also provide a list effective methods treatment of various forms of the disease.

What is bronchitis?

Bronchitis is an inflammatory lesion of bronchial tissues that develops as an independent nosological unit or as a complication of other diseases. In this case, lung tissue damage does not occur, and the inflammatory process is localized exclusively in the bronchial tree.

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

The first symptoms of bronchitis in adults are: chest pain, shortness of breath, painful cough, weakness of the whole body.

MKB code 10: J20 - J21.

- a rather serious disease, treatment should be carried out by a doctor. He determines the optimal drugs for treatment, their dosage and combination.

The reasons

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

The main bacterial pathogens: staphylococci, pneumococci, streptococci.
The causative agents of bronchitis of a viral nature: influenza virus, respiratory syncytial infection, adenovirus, parainfluenza, etc.

Inflammatory diseases of the bronchi, in particular bronchitis, in adults can be caused by various reasons:

the presence of a viral or bacterial infection in the body;
work in rooms with polluted air and in hazardous production;
smoking;
living in areas with unfavorable environmental conditions.

Acute bronchitis occurs when the body is damaged by viruses, usually the same ones that cause colds and flu. The virus cannot be destroyed by antibiotics, so this type of drug is used extremely rarely.

The most common cause of chronic bronchitis is cigarette smoking. Considerable harm is also caused by air pollution, increased levels of dust and toxic gases in the environment.

There are a number of factors that can significantly increase the risk of any type of bronchitis:

genetic predisposition;
life in adverse climatic conditions;
smoking (including passive);
ecology.

Classification

In modern pulmonological practice, the following types of bronchitis are distinguished:

having an infectious nature (bacterial, fungal or viral);
having a non-infectious nature (arising under the influence of allergens, physical, chemical factors);
mixed;
with unknown etiology.

Bronchitis is classified according to a number of criteria:

According to the severity of the flow:

mild degree
medium degree
severe

Depending on the symmetry of bronchial lesions, the disease is divided into:

Unilateral bronchitis. It affects either the right or left side of the bronchial tree.
Bilateral. The inflammation affected both the right and left parts of the bronchi.

By clinical course:

spicy;

Acute bronchitis

Acute ailment is caused by short-term development, which can last from 2-3 days and up to two weeks. In the process, a person suffers at first dry, and then developing into a wet cough with the release of a mucous substance (sputum). If the patient is not cured, then there is a high probability of the transition of the acute form to the chronic one. And then the malaise can drag on for an indefinite time.

In this case, the acute form of bronchitis can be of the following types:

simple;
obstructive;
obliterating;
bronchiolitis.

In adults, simple and obstructive types of acute bronchitis can occur very often, following each other, which is why this course of the disease is called recurrent bronchitis. It occurs more than 3 times a year. The cause of the obstruction may be too much secretion or a strong swelling of the bronchial mucosa.

Depending on the causative agent of the disease, there are:

Viral.
Infectious.
Bacterial.
Allergic.
Asthmatic.
Dust.
Fungal.
Chlamydial.
Toxic.

Chronical bronchitis

Chronic bronchitis is a long-term inflammatory disease of the bronchi that progresses over time and causes structural changes and dysfunction of the bronchial tree. Among the adult population, CB occurs in 4-7% of the population (some authors claim that in 10%). Men get sick more often than women.

One of the most dangerous complications is pneumonia - inflammation of the lung tissue. In most cases, it occurs in immunocompromised patients and in the elderly. Symptoms of chronic bronchitis: cough, shortness of breath, sputum.

First signs

If the body temperature has increased, the ability to work has decreased, weakness and dry cough tormented, which eventually becomes wet, it is likely that this is bronchitis.

The first signs of acute bronchitis, which you should pay attention to an adult:

a sharp deterioration in health and general feeling of the body;
increase in body temperature;
the manifestation of a wet cough (sometimes it can be dry);
feeling of pressure in the chest;
severe shortness of breath and rapid fatigue during exertion;
lack of appetite and general apathy;
the occurrence of intestinal dysfunction, constipation;
pain in the head and muscle weakness;
heaviness and burning sensation in the chest;
chills and feeling cold, desire not to get out of bed;
profuse runny nose.

Symptoms of bronchitis in adults

Such a disease is quite common, every person has had bronchitis at least once in his life, and therefore its symptoms are well known and quickly recognizable.

The main symptoms of bronchitis:

The cough may be dry (no sputum production) or wet (with sputum production).
Dry cough can be observed with a viral or atypical infection. Most often, the evolution of a cough from dry to wet is noted.
Sputum discharge, especially with a green tint, is a reliable indicator of bacterial inflammation. When the color of sputum is white, the patient's condition is regarded as the normal course of the disease. A yellowish color with bronchitis usually occurs in patients who smoke for a long time, pneumonia is determined by this color. brown sputum or with blood should alert - this is a dangerous sign, you need urgent help from a doctor.
The voice of adults, especially those who have a bad habit of smoking, simply disappears and they can only speak in a whisper. Often, wheezing in the voice and the severity of speech simply appear, it feels as if the conversation is causing physical fatigue. But in fact it is! At this time, breathing is due to frequent shortness of breath and heaviness. At night, the patient breathes not through the nose, but through the mouth, while making strong snores.

In acute bronchitis, the symptoms and treatment in adults are significantly different from those that are characteristic of a disease that occurs in a chronic form.

Impaired patency of the bronchi against the background of a very long course of the disease may indicate the occurrence of a chronic process.

Types of bronchitis	Symptoms in adults
Spicy	The appearance of a pronounced cough, which soon becomes wet from dry; Body temperature increases and can reach 39 degrees; Increased sweating joins the general malaise; Chills occur, performance decreases; Symptoms are either mild or severe; While listening to the chest, the doctor hears dry rales and hard scattered breathing;
Chronic	It occurs, as a rule, in adults, after repeated acute bronchitis, or with prolonged irritation of the bronchi (cigarette smoke, dust, exhaust fumes, chemical vapors). It manifests itself with the following symptoms: tachycardia, pain and discomfort when coughing, skin pallor, fluctuations in body temperature heavy sweating, wheezing wheezing on exhalation, hard breathing Cough. With this form of the disease, it is persistent, incessant, with a slight sputum discharge, recurrent. It is very difficult to stop seizures.

Complications

In most cases, the disease itself is not dangerous. Complications after bronchitis, which develop with insufficient effective treatment. The effects predominantly affect the respiratory system, but other organs may suffer.

Complications of bronchitis are:

Acute pneumonia;
Chronic obstructive pulmonary disease;
Asthmatic bronchitis, which increases the risk of developing bronchial asthma;
lungs;
Pulmonary hypertension;
expiratory stenosis of the trachea;
Chronic cor pulmonale;
Cardiopulmonary failure;
bronchiectasis.

Diagnostics

When the first symptoms of the disease occur, it is necessary to contact a therapist. It is he who performs all diagnostic measures and prescribes treatment. It is possible that the therapist will refer the patient to narrower specialists, such as: a pulmonologist, an infectious disease specialist, an allergist.

The diagnosis of "acute or chronic bronchitis" is made by a qualified doctor after examining the patient. The main indicators are complaints, on their basis the diagnosis is actually made. The main indicator is the presence of a cough with white and yellow sputum.

Diagnosis of bronchitis includes:

A chest x-ray can help diagnose pneumonia or another disease that is causing the cough. Radiography is most often prescribed to smokers, including former smokers.
A lung function test is done using a device called a spirometer. It determines the basic characteristics of breathing: how much air the lungs can hold and how fast the exhalation occurs.

Laboratory research:

Complete blood count - leukocytosis, shift of the leukocyte formula to the left, increased ESR.
Biochemical studies - an increase in the blood level of acute phase proteins, a2- and y-globulins, an increase in the activity of angiotensin-converting enzyme. Sometimes hypoxemia develops.
Bacteriological examination - sputum culture.
Serological analysis - determination of antibodies to viruses or mycoplasmas.

Treatment of bronchitis in adults

The treatment of bronchitis is a controversial and multifaceted issue, since there are a lot of methods for suppressing the symptoms and primary sources of the disease. The principles on which therapeutic measures are based play an important role here.

When the task is set - how to treat bronchitis in adults, then four main stages of treatment can be distinguished:

The first step is to voluntarily quit smoking. This greatly increases the effectiveness of the treatment.
At the second stage, drugs are prescribed that, by stimulating receptors, expand the bronchi: Bromide, Salbutamol, Terbutaline, Fenoterol, Ipratropium bromide.
Assign mucolytic and expectorant drugs that contribute to sputum production. They restore the ability of the epithelium of the bronchi, dilute sputum.
At the fourth stage of treatment of bronchitis, only antibiotics are prescribed: orally, intramuscularly and intravenously.

Compliance with the regime:

Against the background of exacerbation of bronchitis, it is traditionally recommended to drink plenty of water. For an adult - the daily volume of fluid consumed should be at least 3 - 3.5 liters. Usually alkaline fruit drinks, hot milk with Borjomi in a ratio of 1: 1 are well tolerated.
It also undergoes several changes in the composition of the daily food ration, which should become complete in terms of proteins and vitamins. The daily diet must contain a sufficient amount of proteins and vitamins. It is important to include as many fruits and vegetables as possible.
Elimination of physical and chemical factors that provoke the appearance of a cough (dust, smoke, etc.);
When the air is dry, the cough is much stronger, so try to moisten the air in the room where the patient is. It is best to use an air purifier and humidifier for this purpose. It is also desirable to carry out daily wet cleaning of the patient's room to purify the air.

Physiotherapy

Physiotherapy - very effective for bronchitis, is prescribed along with drug therapy. Among physiotherapeutic procedures, quartz treatment, UHF, ozekirite, inhalations are used.

Warming of the chest - is prescribed only as additional treatment procedures after the exacerbation of chronic bronchitis has been removed or the first stage of acute treatment has been completed.
Massage - done with poorly discharged sputum, provides better opening of the bronchi and acceleration of the outflow of serous-purulent or purulent sputum.
Therapeutic breathing exercises - helps to restore normal breathing and get rid of shortness of breath.
Inhalations. It is difficult to call them exclusively physiotherapy, because for the most part such procedures are a full-fledged therapy.

Bronchitis drugs for adults

Before using any medications, be sure to consult your doctor.

Bronchodilators

To improve sputum discharge, bronchodilators are prescribed. Adults with bronchitis with a wet cough are usually prescribed pills:

salbutamol,
Beroduala,
Eufillina,
Theotard.

Expectorants:

Mukaltin. Liquefies viscous sputum, facilitating its exit from the bronchi.
Means based on the herb thermopsis - Thermopsol and Codelac Broncho.
Syrup Gerbion, Stoptussin phyto, Bronchikum, Pertusin, Gelomirtol - are based on medicinal herbs.
ACC (acetylcysteine). An effective means of direct action. Has a direct effect on sputum. When taking the wrong dosage, it can cause diarrhea, vomiting, heartburn.

It is necessary to take these drugs for symptoms of acute bronchitis for treatment until the sputum is completely out of the bronchi. The duration of treatment with herbs is somewhere around 3 weeks, and with medicines 7-14 days.

Antibiotics

Antibacterial therapy is used for complicated courses of acute bronchitis, when there is no effectiveness from symptomatic and pathogenetic therapy, in debilitated individuals, when sputum changes (mucous sputum changes to purulent).

You should not try to independently determine which antibiotics for bronchitis in adults will be most effective - there are several groups of drugs, each of which is active against certain microorganisms. The most commonly used:

penicillins (Amoxiclav),
macrolides (Azithromycin, Rovamycin),
cephalosporins (ceftriaxone),
fluoroquinolones (Levofloxacin).

The dosage must also be determined by the doctor. If you take antibacterial drugs uncontrollably, you can seriously disrupt the intestinal microflora and cause a significant decrease in immunity. You need to drink these medicines strictly according to the scheme, without reducing or prolonging the course of treatment.

Antiseptics

Medicines with antiseptic action are used mainly in the form of inhalations. In acute bronchitis, in order to reduce the manifestation of symptoms, adults are treated with inhalations through a nebulizer with solutions of drugs such as Rivanol, Dioxidin.

The prognosis of bronchitis symptoms with rational treatment in adults is usually favorable. Complete healing usually occurs within 2-4 weeks. The prognosis of bronchiolitis is more serious and depends on the timely initiation of intensive treatment. With late diagnosis and untimely treatment, symptoms of chronic respiratory failure may develop.

Folk remedies for bronchitis

Boil some water, add 2 drops of fir, eucalyptus, pine or tea tree oil to it. Lean over the container with the resulting mixture and inhale the steam for 5-7 minutes.
Very old and effective recipe.- this is a radish, a small depression is made in it, into which a teaspoon of honey is placed. After a while, the radish gives juice and can be consumed 3 times a day. This is a good way to relieve a cough if you are not allergic to honey.
We treat bronchitis with calendula flowers. Pour 2 tablespoons of calendula flowers with a glass of boiling water and hold in a water bath for 15 minutes. Adults take 1-2 tablespoons 3 times a day 15 minutes before meals.
Pour a glass of milk into an enamel bowl, add 1 tablespoon of dry sage herb to it, cover tightly, bring to a boil over low heat, cool and strain. Then bring to a boil again, covered with a lid. Ready to drink hot before going to bed.
Horseradish and honey. The tool helps in the fight against bronchitis and lung diseases. Pass four parts of horseradish through a grater, mix with 5 parts of honey. Take one spoonful after meals.
Take 2 parts licorice root and 1 part lime blossom. Make a decoction of the herb and use it for dry coughs or excessively thick sputum.
10 g dried and chopped mandarin peel pour 100 ml of boiling water, insist, strain. Take 1 tablespoon 5 times a day before meals. Used as an expectorant.

Long-term treatment of bronchitis at home often leads to dangerous complications. If the cough does not go away after a month, contact the clinic. Refusal of treatment or relying on the knowledge of a pharmacy pharmacist in adults and the elderly can cause bronchotracheitis, purulent infection, tracheobronchitis, and long rehabilitation.

Prevention

Primary prevention measures:

In adults, for the prevention of bronchitis, it will be important to completely stop smoking, as well as regular alcohol consumption. Such abuses negatively affect the general condition of the body and, as a result, bronchitis and other diseases may appear.
limit the impact of harmful substances and gases that must be inhaled;
start treatment of various infections on time;
do not overcool the body;
take care of maintaining immunity;
during the heated period, maintain a normal level of humidity in the room.

Secondary prevention includes:

Eliminate all of the above risk factors. Timely diagnosis and early treatment of acute bronchitis (or chronic exacerbations).
Hardening of the body in the summer.
Prevention (ARVI) during the epidemic (usually from November to March).
Prophylactic use of antibacterial drugs for 5-7 days with exacerbation of bronchitis caused by a virus.
Daily breathing exercises (prevents stagnation of mucus and infection in the bronchial tree).

Bronchitis in adults is a dangerous disease that cannot be treated on its own. Self-treatment can lead to serious consequences in the form of disability, in some cases even life is at risk. Timely access to a doctor and a timely diagnosis help to avoid complications and alleviate the symptoms already in the initial stages of bronchitis.

Chronic bronchitis is a long-term sluggish or progressive inflammation in the bronchi. It is necessary to talk about it in cases where the central symptom of the disease is cough, which occurs in a patient over a three-month period (in total for a year or at the same time), at least 2 years in a row. All other cases of prolonged cough due to confirmed inflammation in the bronchi are classified as either acute or recurrent bronchitis.

The allocation of such a strict time frame for the diagnosis of chronic bronchitis is not accidental. Since diseases of the bronchial tree are among the most common, such restrictions have been introduced. If every case of a long-term one were perceived as chronic bronchitis, then there would not be a single person who would not have this diagnosis recorded. This is especially true for smokers and people with harmful working conditions in relation to the broncho-pulmonary system. Constant irritation of the bronchial mucosa leads to the maintenance of the inflammatory process.

Another point of relevance of the allocation of time frames for chronic bronchitis is the pathogenetic mechanisms of the disease. This means that only an inflammatory process that exists for a certain time can cause structural changes in the bronchi. Their result is a violation of bronchial patency, outflow of bronchial secretions, mechanisms of local immunity, which makes it impossible to completely cure the disease. On their background, the infection is activated. In case of further progression of inflammation, the process turns into chronic obstructive pulmonary disease. Its abbreviation is COPD. In such cases, we already have to talk about clinical manifestations, not only in the form of a cough, but also about signs of respiratory failure.

Symptoms of chronic bronchitis

Cough

Refers to the main symptoms of uncomplicated chronic bronchitis. According to its characteristics, the course and specific clinical variants of the disease are determined. It can be either dry or wet. Cough with expectoration of sputum indicates insufficient mucociliary clearance and refers to the protective mechanisms of the natural cleaning of the bronchial tree from excess mucus. The mechanism of its occurrence is associated with reflex influences, which are caused by irritation of the receptor apparatus of the bronchial and tracheal mucosa. In this case, the impulses are concentrated in the cough center of the brain, which leads to a reflex contraction of the respiratory muscles. With small bronchi, the situation is much more difficult, since there are practically no receptors in them. Consequently, the spread of the inflammatory process to this silent zone, with a narrow lumen, leads to its rapid and complete obturation. The defense mechanism in the form of a cough will not arise.

If chronic bronchitis is initially accompanied by manifestations of bronchial obstruction as a result of bronchospasm, this leads to a dry, unproductive cough. Sometimes it becomes paroxysmal, hacking. Such an attack ends with the expectoration of a small amount of mucus. Accompanying a dry cough with remote wheezing during forced expiration indicates the presence of impaired patency of the small bronchi.

Dyspnea

Typical cases of chronic bronchitis without bronchial obstruction are not accompanied by shortness of breath. For its occurrence, the inflammatory process must either be very active and progressively increase, or proceed for a long time (tens of years). Such patients cannot even clearly note the time when they fell ill. Dry cough with scanty sputum, especially in the morning, becomes a normal norm for them and is not perceived as a pathology at all. Therefore, the occurrence of shortness of breath in the complication of chronic bronchitis with respiratory failure is marked by patients as the onset of the disease. The most characteristic such clinical variant of the appearance of shortness of breath for smokers with a long history of smoking and those with frequent seasonal exacerbations of cough.

In a completely different way, shortness of breath manifests itself and is regarded in obstructive forms of chronic bronchitis. In such cases, it occurs, almost from the very beginning of the disease. In the initial stages of the process, it can occur only during physical exertion, accompanied by a cough. But the progression of this symptom is quickly noted with its occurrence at minimal exertion and even at rest.

Sputum

In the initial stages of chronic bronchitis, as well as in remission of a long process, its amount can be scarce. In this case, it is represented by mucous secretions at the end of a coughing fit. Its color can be from colorless transparent to yellow-brown or black (miners). It all depends on the cause of the disease.

The progression of the disease or its exacerbation is marked by expectoration of mucopurulent or purulent sputum. It has a greenish tint and high viscosity. The appearance of such sputum indicates the activation of the microbial flora and requires appropriate medical correction. By the amount and time of purulent sputum discharge, one can presumably determine the presence of complications of chronic bronchitis. If a large amount (about 60-100 ml) of purulent discharge from the respiratory tract is released once in the morning along with a cough, this indicates the presence of bronchiectasis (saccular dilatations of the bronchi, where mucus with pus accumulates).

Wheezing

If there is sputum in the lumen of the bronchus of any caliber, this obstructs the airflow. As a result, air turbulence occurs, which is manifested by wheezing. According to the characteristics of this symptom, one can roughly determine which bronchi are involved in the inflammatory process and the nature of its course. For remission of chronic bronchitis, dry rales are most characteristic, which are determined by auscultation. If the process aggravates, the amount of sputum increases and moist rales (large, medium or fine bubbling) can be heard, according to the diameter of the affected bronchi. The progression of bronchial obstruction of small-caliber bronchi is indicated by the appearance of high-pitched whistling rales on expiration, which can be heard at a distance.

Hemoptysis

Does not apply to the typical manifestations of chronic bronchitis. It can occur only with a long course of this disease and always indicates its progression or serious complications. According to the severity of hemoptysis, you can determine their presence. Of course, if these are small streaks of blood, blood-stained or dirty brown sputum, then its appearance at the end of a coughing fit can be considered quite natural. But, when blood is released more often or in large quantities, it is worth thinking about the cancerous transformation of the bronchial mucosa or hemorrhagic bronchitis.

asthmatic syndrome

Characteristic only for chronic bronchitis with the presence of bronchial obstruction. It can be caused both by a long course of a chronic inflammatory process, the result of which is a narrowing of the bronchus and its rigidity, and by bronchospasm. This suggests that the asthmatic syndrome in the form of attacks of shortness of breath and a feeling of lack of air with difficulty exhaling can occur at any stage of the disease. It all depends on the reactivity of the patient's bronchi to the effects of environmental factors (tobacco smoke, room dust, changes in air temperature). Over time, such coughing attacks begin to occur not only in the morning, but also at night and throughout the day.

Cyanosis

Typical cases of uncomplicated chronic bronchitis do not result in discoloration of the skin. But its obstructive forms, accompanied by the addition of respiratory failure, almost always cause cyanosis. It can be represented by acrocyanosis - cyanosis of the extremities, tip of the nose and ears, or diffuse cyanosis of the skin over the entire surface. Its occurrence indicates the decompensation of the disease and the irreversible loss of the ability of the bronchi to adequately conduct air to the lungs. At the same time, blood oxygenation is sharply reduced. Such blood is not able to provide normal metabolic processes in the tissues, which leads to their hypoxia. In practice, this is manifested by cyanosis.

Along with the difficulty in the intake of air, the possibility of removing the spent respiratory mixture also suffers. As a result, an excess of carbon dioxide in the alveolar lumen and blood. Clinically, this is manifested by increased cyanosis, sleep disturbance and, and, sweating and weakness. The prolonged existence of hypoxia leads to the appearance of additional signs in the form of deformation of the nail plates (like watch glasses) and thickening of the distal digital phalanges (like drumsticks).

auscultatory data

They are an important element in the diagnosis of chronic bronchitis. With the transition of the process to COPD, a change occurs not only in the bronchi, but also in the restructuring of the lung tissue. Auscultatory, this is recorded as hard breathing with possible weakening in emphysema, and scattered dry rales of different timbres. The appearance of dry wheezing of the whistling type, mainly in the expiratory phase, indicates the defeat of the smallest bronchi.

Chronic bronchitis without signs of bronchial obstruction in remission does not manifest itself at all. In the exacerbation phase, coarse rales may appear against the background of hard breathing, and in the presence of sputum, moist rales. Their character depends on the caliber of the affected bronchi. In chronic bronchitis at the stage of COPD, the auscultatory picture is supplemented by signs of cardiopulmonary insufficiency in the form of an accent of 2 tones on the pulmonary artery, hepatomegaly, tension of the jugular veins.

Causes of chronic bronchitis

In the occurrence of a chronic inflammatory process in the bronchi, the following reasons may be involved:

hereditary predisposition and congenital features of the bronchial tree. A very important group of reasons for which the bronchi are initially susceptible to any harmful environmental factors. Minimal provocateurs cause bronchospasm and increased mucus production. Its obstructed outflow contributes to the activation of the infection, the maintenance of inflammation with the possibility of developing bronchial obstruction;

Tobacco smoke. The main risk group for the development of chronic bronchitis are smokers;

Work in conditions of occupational hazards. In such cases, constant inhalation of air contaminated with coal or other types of dust leads to its deposition in the bronchi. The natural reaction of the body to foreign particles is inflammatory. Naturally, under the conditions of the continued influx of dust particles, self-cleaning mechanisms cannot manage to remove all accumulated deposits. This is the basis of process timing;

Chemical pollutants. All chemical compounds, the vapors of which are regularly inhaled by a person, like dust cause a bronchial reaction in the form of inflammation or bronchospasm;

Climatic conditions. Climatic conditions are rarely the root cause of chronic bronchitis. But they have a general unfavorable background against which all other causes are realized. These include low air temperatures, high humidity and industrial air pollution;

Decreased immunity. It becomes a favorable background for triggering the microbial factor, as one of the causes of chronic bronchitis.

The mechanism for triggering a chronic inflammatory process in the bronchus wall is quite complex. It is impossible to single out only one factor that implements it first. The exception is cases of professional and chronic bronchitis of smokers.

Chronic bronchitis in children

Chronic bronchitis in childhood has its own characteristics in relation to the causes of the development and course of the inflammatory process. First of all, it is worth pointing out that the rule of three months of coughing a year for two consecutive years in pediatric practice does not always work. This means that in children under the age of three, such a diagnosis cannot be made at all. It is this age group of children that can suffer from bronchitis for most of the year, even being in hospital, but the diagnosis will be recurrent, acute or obstructive bronchitis. But it will never be chronic.

The explanation for this approach is the spontaneous resolution of all inflammatory changes in the bronchi when the child reaches a certain age. Usually, this turning point happens after three years. Most children with stubborn bronchitis get rid of this problem for good. Only in that part of sick babies in which this did not happen and the symptoms of bronchitis continue to remind themselves of themselves with constant exacerbations, cough with sputum and signs of impaired bronchial patency, the diagnosis of chronic bronchitis becomes eligible. This is also logical from a pathogenetic point of view, since structural changes are already registered in the bronchi of such children, violating mucociliary clearance and the processes of natural bronchial cleansing.

Causes of chronic bronchitis in children

If in adults in the etiology of chronic bronchitis the main place is given to smoking and polluted air, then in children the infection comes to the fore. This is due to the imperfection of the immune defense mechanisms of the child's body against the background of constant contact with various pathogens. In educational and preschool institutions among limited groups of children, circulating pathogens are characterized by particular aggressiveness. The main place among them is given to respiratory viruses (, parainfluenza, RS viruses), hemophilic infection, marcellus, and streptococci, pneumococci, atypical pathogens.

Introduced into the bronchi of a child, the infection cannot always be fully neutralized by immune cells, which leads to its spread to the lymph nodes, or persistent penetration into the epithelium of the mucous membrane. Therefore, even after clinical improvement during the treatment of bronchitis, any hypothermia of a general nature or inhalation of cool air can cause a second exacerbation of the process.

The last cause of chronic bronchitis in children is the increased reactivity of the bronchial tree. Its result is excessive secretion of mucus and bronchial spasm. These causative mechanisms underlie the obstructive forms of chronic bronchitis. The cough reflex in children is also slightly inhibited compared to adults, which leads to a violation of sputum excretion with an aggravation of the condition.

Clinical Features

Among the symptoms of chronic bronchitis in children, it is not so much a cough that comes to the fore as a violation of the general condition. The younger the child, the more this pattern is observed. Almost every exacerbation is accompanied by a hyperthermic reaction, a decrease in appetite and activity of the child. It is possible to follow the nature of sputum only in older children, as they can collect it for analysis. Children of younger age groups cannot do this, because they simply swallow it.

As in adults, sputum may be clear mucous or yellow-green mucopurulent. Chronic bronchitis with bronchial obstruction always causes anxiety in the child, shortness of breath, wheezing, which can be heard even at a distance (remote wheezing). They can be both wet and whistling, dry, heard on exhalation or in both phases of the respiratory cycle. Emphysema and persistent signs of respiratory failure occur only in children with a long course of chronic bronchitis.

Treatment of chronic bronchitis

In the treatment of chronic bronchitis, etiopathogenetic drug therapy is used. It is not always possible to completely get rid of this problem, but it is quite realistic to achieve stabilization of the condition and maximum slowdown in the progression of the disease. For this can be used:

Antibacterial agents;

expectorants;

Bronchodilators;

Anti-inflammatory and antihistamines;

inhalation therapy;

Physiotherapeutic methods (halotherapy);

Normalization of lifestyle.

Antibiotic therapy for chronic bronchitis

It is prescribed in case of exacerbation of the process, which is accompanied by signs of intoxication, fever or expectoration of mucopurulent sputum in large quantities. Semi-synthetic aminopenicillins potentiated by beta-lactamase inhibitors (augmentin, amoxiclav), macrolides (azithromycin, macropen), cephalosporins (ceftriaxone, cefuroxime), fluoroquinolones (lefofloxacin, cyprom, avelox) can be prescribed. An antibiotic must be prescribed taking into account the results of sputum culture.

Expectorants for chronic bronchitis

Appointed in all cases of this disease. Two groups of agents are used: sputum disintegrators and expectorants. The first, contribute to the transformation of viscous sputum into liquid, the second - improve mucociliary clearance. In total, they get relief from coughing up sputum. ACC, lazolvan, flavamed, bromhexine are used.

Bronchodilators and anti-inflammatory drugs

This group of drugs helps to improve bronchial patency by expanding the lumen of the airways. Glucocorticoid anti-inflammatory drugs reduce the amount of secreted mucus and the activity of inflammatory cells in the mucous membrane. There are several types of such funds. They differ in their effects on different pathways of bronchodilation and elimination of obstruction:

Direct relaxation of the smooth muscles of the bronchi: aminophylline, theophylline, neophylline;

Action on cholinergic receptors (anticholinergics): ipratropium bromide (Atrovent), spirotropium bromide (Spiriva);

Adrenergic receptor agonists: salbutamol (Ventolin), fenoterol (Berotek);

Reduction of inflammation and secretion of bronchial mucus: fluticasone (flexotide);

Combined drugs: berodual, symbicort, seretide.

All these drugs, with the exception of aminophylline and its analogues, are available as individual metered mini-inhalers. Their convenience is that the patient can carry the drug with him and use it as needed. The active substance that enters the zone of inflammation at the time of inhalation quickly stops the symptoms of the disease.

Inhalations for chronic bronchitis

Along with individual inhalers, there are special ultrasonic devices - nebulizers. These devices are capable of pulverizing liquid medicines so that they can enter the smallest bronchioles along with the air we breathe. Such a correct and rational use of medicinal bases makes inhalation in chronic bronchitis the main method of treatment.

The cost of a nebulizer allows it to be purchased by almost every patient with chronic bronchitis. This has not only medical, but also economic feasibility. Indeed, as a drug used during inhalation, a remedy of any group, which is in a liquid state, can act.

Namely:

Dioxidine is an antiseptic agent with a wide antibacterial spectrum of action. Used for exacerbation of chronic bacterial bronchitis. For inhalation, the drug is diluted with saline 1:4. Single dose about 4 ml;

Chlorophyllipt is a local antiseptic drug. The solution is prepared by diluting it with physiological saline 1:10. A single dose of the prepared mixture is about 4 ml;

alkaline solutions. This can be either a ready-made soda preparation (sodium bicarbonate), or home-made (one teaspoon of soda per 200 ml of saline);

Atrovent is a bronchodilator drug of anticholinergic type of action. It is sold in pharmacies in liquid form. For inhalation, dilute 2 ml of the drug in 2 ml of saline. This is the single dose;

Berotek is a long-acting beta-adrenergic receptor agonist. For inhalation, 0.5-1.5 ml of the drug is used. Be sure to dilute with saline to 4 ml;

Ventolin is a short-acting beta-agonist. Produced in special nebulls, which contain a single dose of the drug. Diluted with saline 1:1;

Flexotide is a gluticocorticoid inhaled hormone fluticasone. Available in ready-made nebulls. For one inhalation, one nebula is needed, the contents of which are diluted with saline to 3-4 ml;

Acetylcysteine (fluimucil) is a drug that loosens sputum. The product is intended for inhalation, therefore it contains a ready-made diluted medicinal mixture. Single dose about 4 ml;

Lasolvan is a mucolytic and expectorant. Produced in special vials for inhalation administration. A single dose of the finished solution is 3-5 ml.

The necessary drugs are simply poured into a special nebulizer receiver and inhaled after it is turned on. The frequency of admission and specific means should be prescribed and controlled exclusively by a specialized specialist.

How to cure chronic bronchitis forever?

The answer to this question lies in the way of life of a person and the characteristics of the air that he breathes every day. Based on this, even the ancient peoples noticed that all broncho-pulmonary diseases are cured after staying in deep salt caves. In our time, the number of this pathology has increased significantly, but there is practically no opportunity to visit such natural caves. Therefore, scientists were able to recreate these very natural ideal microclimatic conditions that help the body cope with chronic bronchitis. A positive effect has been noted not only in relation to this pathology, but also to many other diseases.

This method of treatment is called halotherapy. Sessions are held in a special halochamber, in which optimal microclimatic conditions are created. This is, first of all, ideally clean air with optimal humidity and temperature indicators, enriched with various aerosol components, the basis of which is always the salt component. This method is very simple, does not require any manipulations and medicines. It is desirable to include it in the treatment of any chronic bronchitis. Mild forms of the disease can be cured forever, while severe ones greatly facilitate their course and require smaller doses of medications. For this, 2 single 3-4-week courses of treatment per year are sufficient. The number of daily sessions is not limited. The main thing is that there are small time intervals between them.

Conducted by scientists, randomized studies have shown the effectiveness of halotherapy in various diseases:

With bronchial asthma, chronic bronchitis (obstructive and simple). Improvement in the condition in the study group of patients was 76%;

Chronic sinusitis (sinusitis, frontal sinusitis, sphenoiditis, ethmoiditis). The condition of patients improved by an average of 71%;

Skin-allergic diseases. Positive dynamics amounted to 89-92%;

Depressive and anxiety syndromes. Improvement is noted but 71-72%;

Rheumatic injury. Dynamics of a positive nature by 80%;

Astheno-vegetative syndrome and fatigue. The result of the improvement of the condition is 94%;

Immune dysfunction of various origins. Immunogram parameters improved in 72% of cases.

Education: Moscow medical institute them. I. M. Sechenov, specialty - "Medicine" in 1991, in 1993 "Occupational diseases", in 1996 "Therapy".