Obstructive bronchitis. Treatment of obstructive bronchitis in children

• About obstructive bronchitis
• Symptoms of obstructive bronchitis
• Causes of obstructive bronchitis
• Obstructive bronchitis in children
• Treatment of obstructive bronchitis

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About obstructive bronchitis

Inflammation of the lining of the bronchi is the first stage of obstructive bronchitis. Usually this disease is accompanied by a large amount of mucus or sputum, which clogs the bronchi and other organs of the respiratory system and impairs their patency. Obstructive bronchitis is bronchitis with spasm . A bronchospasm occurs, in which all the mucus accumulates in the organs of the respiratory system. Patients with this diagnosis experience difficulty breathing.

Video - Bronchitis: causes of development, symptoms and treatment

Obstructive bronchitis is a serious disease. In addition to inflammation of the bronchi, their slow narrowing occurs. This is obstruction. It causes disruption of the respiratory system. The disease is constantly progressing. The main thing is that bronchitis does not develop to the point of respiratory failure, pulmonary hypertension, or bronchial circulatory failure.

During the period of illness, a person has weak immunity. Any infection that enters the body can begin to infect it. The infection can overcome a weak immune system and the body will no longer have the strength to cope with this disease. At this stage, it is necessary to support the body with immunostimulating drugs. They will help you cope with the disease.

This pathological condition of the respiratory system combines chronic bronchitis and emphysema and is characterized by progressive airflow limitation as a result of a chronic inflammatory process in the bronchopulmonary system. In the absence of treatment and prevention, this disease progresses and leads to the development of respiratory failure, the development of pulmonary hypertension, damage to the cardiovascular system and internal organs.

Risk factors for the development of obstructive disease include conditions such as congenital absence or deficiency of alpha1-antitrypsin, frequent or severe respiratory infections in childhood, asthma or increased bronchial reactivity, and environmental pollution with various pollutants. The main cause of COPD development is smoking. Inhalation of irritating particles leads to a chronic inflammatory process and the development of disease. In pathogenesis (the mechanism of disease development), it is important to increase the number of nonspecific immune cells, which, while performing a protective function, themselves lead to the formation of a vicious circle - they secrete protective substances, which in large quantities lead to oxidative stress and damage to lung tissue. Obstruction (judgment) in the respiratory system is caused by both reversible and irreversible factors. Irreversible include the development of fibrosis of the bronchial wall, destruction of the elastic fibers of the lung tissue with a decrease in air draft and loss of tone of the terminal sections (ending with the transition of bronchioles to the alveolar sacs). It is impossible to influence these links, which is why they are called irreversible. Reversible include the formation of excess mucus in the bronchi, spasm of the smooth muscles of the bronchial walls and increased airiness during exercise. The progression of disorders leads to disruption of the gas exchange process in the lungs and an increase in pressure in the pulmonary artery system, which causes the development of symptoms.

The main symptom of chronic obstructive pulmonary disease is shortness of breath during exhalation, which appears with severe exertion and subsequently progresses. Exercise tolerance also decreases and a cough characteristic of bronchitis occurs. The classification of COPD includes 4 stages of the course, which are determined by spirometry and determination of forced expiratory volume in the first second: stage 1 - FEV1 greater than or equal to 80% of predicted, stage 2 from 50% to 80%, stage 3 - from 50% to 30 %, and stage 4 is less than 30% or less than 50% in combination with chronic respiratory failure.

Diagnosis and treatment of COPD is carried out by a pulmonologist or internist.

Differential diagnosis includes pathologies such as bronchial asthma, chronic non-obstructive bronchitis, tuberculosis, cancer, interstitial lung diseases (nonspecific intermediate tissue of the lungs is affected) or heart failure.

Diagnosis includes identifying characteristic complaints, conducting a physical examination and prescribing instrumental and laboratory examination methods. All patients are advised to undergo chest x-ray. The main diagnostic method is spirometry (determining the function of external respiration). At the same time, such basic characteristics as vital capacity and forced expiratory volume in the first second, Tiffno index are determined. To determine the reversibility of changes in lung tissue and carry out differential diagnosis with asthma, a bronchodilation test is performed, in which an increase in indicators higher than 12% is more typical for bronchial asthma. Monitoring of peak expiratory flow throughout the day and during therapy is indicated. Additionally, if the diagnosis is in doubt, studies such as bronchoscopy, CT, MRI, histological examination and other methods may be prescribed.

When treating obstructive pulmonary disease, you can achieve an improvement in quality of life through symptomatic therapy, prevention of exacerbations and complications, and slowdown of disease progression. Conservative therapy includes a categorical cessation of smoking, prescription of medications (adrenergic agonists, anticholinergic blockers, glucocorticosteroids, PDE inhibitors, mucolytics and others), oxygen therapy and removal of excess mucus from the bronchial lumen. Patients with this disease are advised to receive vaccination against influenza and pneumococcal infection, as well as lifelong medical supervision by a specialist.

Symptoms of obstructive bronchitis

The main symptoms of obstructive bronchitis are:

Obstructive bronchitis occurs in both children and adults

• The appearance of a cough;
• The appearance of shortness of breath;
• Mild cough with a small amount of sputum;
• Increased cough in the morning and disturbing cough throughout the day;
• Cough caused by irritants (smoke, dust);
• The appearance of wheezing (most often noticed during rapid exhalation);
• The appearance of shortness of breath during sleep;
• The appearance of cough during physical activity.

Causes

The main factors contributing to the development of chronic obstructive bronchitis are smoking (passive and active), occupational risks (contact with silicon, cadmium), air pollution (mainly sulfur dioxide), etc. The risk group for the development of chronic obstructive bronchitis includes miners , construction workers, metallurgical and agricultural industries, railway workers, office employees associated with printing on laser printers, etc. Chronic obstructive bronchitis most often affects men.

Obstructive bronchitis in children

Today, one of the most common diseases in children is obstructive bronchitis - a disease of the respiratory tract. But this is not just an acute respiratory viral infection, this disease can lead to laryngitis, tracheitis, and pneumonia. Obstruction is an obstruction, narrowing, or blockage with a large amount of mucus or phlegm. This obstruction in children interferes with the normal functioning of the respiratory system. The most important thing is that this disease does not become chronic and does not lead to complications, because a broad category of diseases, for example, bronchial asthma, can lead children to early disability.

Cough and mild shortness of breath are the first signs of obstructive bronchitis in children . Shortness of breath usually occurs during intense physical exertion. You can track the symptoms of the disease while you sleep. When sleeping, the child usually lies on his stomach, sometimes hangs his head - this position helps the phlegm to pass away. It is necessary to start treating the disease with the use of antibiotics, but if they do not work within a few days, then it is necessary to switch to effective treatment. To protect the respiratory organs from dysbacteriosis, it is necessary to use antifungal drugs.

A thorough back massage is also necessary (this helps to separate phlegm), a diet rich in vitamins and breathing exercises. These procedures will lead your child to a full recovery.

Diagnostics

The beginning of diagnosis consists of a thorough collection of complaints and medical history. An informative method is to listen to breathing in the lungs using a phonendoscope. Obstruction is characterized by the presence of scattered dry or moist rales. In addition to the examination, if necessary, the doctor may prescribe additional tests:

• X-ray of the OGK;
• Spirometry;
• General blood analysis;
• Blood biochemistry (to determine markers of inflammation);
• Bacteriological examination of sputum and culture for sensitivity to antibiotics;
• CT or MRI of the lungs to assess the presence and nature of changes in them3.

After making a diagnosis, the doctor should talk about the prevention of exacerbations of obstructive bronchitis and prescribe a course of treatment.

Treatment of obstructive bronchitis

The main goal of treating obstructive bronchitis is to relieve bronchospasm, thin and remove mucus. It is almost impossible to cure obstructive bronchitis on your own.

If not treated correctly, obstructive bronchitis can develop into pneumonia or bronchial asthma.

The most important thing is to restore the patency of the respiratory system. It is necessary to rinse the nasopharynx with saline solution or other medications. If you have a stuffy nose, you need to use vasoconstrictor medications. It is also necessary to drink plenty of fluids (the infection is washed away with the liquid). It is imperative to quit smoking.

Pharmacological treatment consists of anticholinergics and antibiotics. Medicines prescribed by your doctor kill infections and reduce shortness of breath. During the period of obstructive bronchitis, many people may begin to snore. This happens because mucus accumulates in the bronchi. In this case, a specialist doctor can prescribe medications that dilute and cough up mucus from the respiratory tract and the entire body. In addition, inhalation with drugs is prescribed.

The entire process of treating obstructive bronchitis is carried out against the background of strengthening the human immune system..

To prevent obstructive bronchitis and increase immunity, it is necessary:

• Do not overheat, do not overcool;
• Maintain a daily routine (full sleep and walking);
• Healthy lifestyle;
• Proper nutrition.

If you or your child have the first symptoms of obstructive bronchitis or a weakened immune system, then you need to seek advice from highly qualified specialists at the ENT-Asthma clinic.

Video reviews about the treatment of bronchitis at the ENT-Asthma clinic

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Treatment of cough in COPD

The development of COPD can be prevented by limiting the influence of negative factors, but it cannot be cured. Treatment only slows down the progression of the disease, but does not contribute to a full recovery.

First of all, smokers should completely stop using tobacco products, and passive smokers should try to distance themselves from the source of tobacco smoke. The attending physician may prescribe medications from various groups that can alleviate symptoms:

• Inhaled bronchodilators that dilate the bronchi;
• Mucolytic drugs to reduce the viscosity of sputum and expectoration;
• Antibiotics for identified infection;
• Anti-inflammatory drugs;
• Anticholinergics to suppress the reaction of the bronchi to irritating agents.

Often, an exacerbation of COPD requires emergency hospitalization.

Cost of treatment

* — When paying for the full course of treatment procedures, the cost of a doctor’s appointment is included in the amount of treatment. The course of treatment is prescribed by a doctor. The course duration is 7-12 sessions depending on the diagnosis.

Complications

When obstruction develops, the lungs no longer receive the required amount of air. Inhalations become heavy, the diaphragm does not open completely. In addition, we inhale more than we exhale.

Some part remains in the lungs and provokes pulmonary emphysema. In severe and chronic forms, pulmonary failure may occur, and this is a cause of mortality. Untreated bronchitis almost always ends in pneumonia, which is much more difficult to treat.

How does an obstruction form?

The wall of the bronchi consists of cartilaginous tissue, which changes its structure and becomes thinner as it moves away from the trachea. The volume of smooth muscle cells increases as their caliber decreases, and their sensitivity to carbon dioxide (the more of it, the wider the diameter) increases.

The decrease in bronchial lumen is caused by three mechanisms:

• swelling of their mucous membrane, resulting from the ingress of allergens or microbial antigens;
• accumulation of viscous thick sputum in the lumen;
• contraction of small-caliber smooth muscles of the bronchi.

These are three links of one process that potentiate each other.

Nutrition and diet

The diet during an exacerbation of the disease is aimed at eliminating swelling of the bronchial tree, stimulating the immune system, and replenishing protein reserves. Food should be high in calories, at least 3000 cal/day, with a predominance of proteins.

Healthy foods:

• fruits with vitamin C: orange, lemon, raspberry, grapefruit;
• dairy products: cheese, milk, cottage cheese;
• products containing magnesium: nuts, bananas, sesame seeds, pumpkin seeds, rye bread, buckwheat, olives, tomatoes;
• products with Omega-3 acids: fish oil, cod liver;
• vitamins A and E: green peas, beans, spinach, peach, avocado, carrots.

During the treatment of a relapse, it is necessary to reduce the consumption of sugar and salt, limit the intake of allergenic foods (tea, chocolate, coffee, cocoa). Hot, spicy, smoked foods contribute to the development of bronchospasm, so they should also be excluded from the diet or eaten in small quantities.