How does chronic bronchitis manifest itself? Chronic bronchitis in adults: symptoms, treatment, folk remedies

An agonizing cough, weakness, shortness of breath and a slightly elevated temperature can all indicate chronic bronchitis. What is the disease, and how to cure it?

Bronchitis is one of the most common diseases respiratory system. At least once in a lifetime, every person was ill with it - but unfortunately, for many, bronchitis becomes chronic and continues for many months, then calming down, then aggravating again.

As you might guess from the name, bronchitis is a disease that affects the bronchi. The disease is characterized by the presence of prolonged inflammation, leading to a constant separation of sputum, a change in the structure of the bronchi and a violation of their normal operation. The bronchi cease to be normally cleansed of foreign bodies, lose the ability to cope with the disease - hence there is a prolonged wet cough, respiratory failure and general weakness.

What kind of bronchitis can be considered chronic? According to existing medical standards, the disease passes into the chronic stage if its symptoms do not disappear for three months in a row - or they appear periodically during the year, but in total they take all the same three months.

Chronical bronchitis divided into certain types. In particular, there are primary and secondary varieties.

• Primary chronic bronchitis arises from ordinary acute bronchitis. The cause of the disease can be both viruses and infections, as well as hypothermia, bad habits, and an unhealthy lifestyle.
• Secondary bronchitis develops against the background of another lung disease. For example, very often chronic damage to the bronchi becomes the result of tuberculosis, pneumonia and other ailments.

In addition, chronic bronchitis can be obstructive - and non-obstructive. What do these terms mean?

• Non-obstructive bronchitis is the easiest to treat. It is characterized by increased sputum production, cough, general weakness and other symptoms of the disease. However, its important feature is that the very structure of the bronchi remains unchanged.
• Obstructive bronchitis is a much more unpleasant and serious disease. With it, the bronchial tree itself undergoes negative changes - the so-called obstruction, degeneration and dystrophy of bronchial tissues occurs. The causes of obstructive disease can be viruses, allergies, bacterial inflammation - and it is much more difficult to treat such bronchitis.

Of course, not every disease of the respiratory system is bronchitis. To make a diagnosis, you need to see a doctor. Diagnosis is carried out comprehensively and includes both an external examination and listening to the patient's breathing, as well as x-rays and laboratory tests of sputum, urine and blood. Only after a comprehensive study of the anamnesis, the doctor will be able to state with confidence that the cause of poor health is precisely chronic bronchitis. Treatment will be prescribed depending on the type and severity of the disease.

Symptoms of chronic bronchitis

Symptoms of chronic bronchitis cannot be called sharply specific - as a rule, they are accompanied by most diseases of the respiratory system. However, if you have found at least some of the problems listed below, this gives you the right to think about chronic bronchial damage as well.

• Wet cough that does not go away for a long time. Persistent sputum production is the main sign that the bronchi are not working properly. The mucous membranes of the bronchial tree are irritated by the presence foreign body, which in this case is sputum itself, and they are trying to get rid of the interference - this gives rise to a desire to cough. With an exacerbation of the disease, the sputum secreted is characterized by increased viscosity, so the cough is more often observed dry - the secret is not yet amenable to expectoration.
• Labored breathing. Since the constantly accumulating sputum "clogs" the bronchi with itself, wheezing appears in the breath, there is a feeling of lack of air, any physical effort is accompanied by severe shortness of breath. With particularly severe obstructive lesions, the patient can literally suffocate - since dystrophy of the bronchial tissues also leads to a narrowing of the respiratory lumen.
• Temperature. As a rule, with chronic bronchitis, the body temperature rises not high, up to 37ºС or slightly higher - but it stays at this level for a long time. An increase in temperature is due to the fact that a long bacterial process takes place in the bronchi - the waste products of microorganisms enter the blood, due to which there is a slight intoxication, or poisoning. The feeling of general weakness that accompanies chronic bronchitis is also associated with this.

• Chest pain. This symptom accompanies chronic bronchitis is not always. More often, pain in the chest is fixed during an exacerbation of the disease - at a time when the sputum is still too viscous for expectoration, and each coughing fit is accompanied by a fair amount of smooth muscle tension. Pain is one of the most "fuzzy" symptoms, since almost any disease of the respiratory system, from the mildest to the most severe, accompanies similar sensations.
• The presence of blood in the sputum. This symptom is not observed in all patients - the presence of blood in the secretion separated by the bronchi depends on the severity of the course of the disease. Usually blood streaks appear in the sputum during an exacerbation of bronchitis. Since the cough is accompanied by a great tension of the muscles of the bronchi, small blood vessels can simply burst - and release a small amount of blood. It is very important to emphasize that the blood in the sputum with bronchitis should be exactly scarce, in the form of barely noticeable streaks. If we are talking about profuse hemoptysis, this certainly indicates much more severe lung ailments.

What causes ordinary bronchitis to become chronic?

Why does ordinary bronchitis - primary or secondary - generally become chronic? Indeed, at first glance it seems that this disease is not so serious that it cannot be completely cured.

Unfortunately, it is a frivolous attitude to bronchitis that often becomes the cause of its aggravation. The following factors can lead to the chronic form of the disease:

• Late diagnosis of the disease. There is no point in hiding - the psychology of most Russians is such that people go to the doctor only as a last resort. Bronchitis often does not seem like such a “case” - patients prefer to carry cough, weakness and fever on their feet, hoping that the disease will go away on its own. Without treatment, inflammation in the bronchi becomes a sluggish chronic form - and reminds of itself several times a year.
• Careless treatment. Even if bronchitis is diagnosed on time and the correct treatment is prescribed, it is very important to complete the therapy. It often happens that at the first improvement, the patient stops taking antibiotics and attending medical procedures, thinking that he has recovered. Meanwhile, the inflammatory process in the bronchi can continue without obvious symptoms - which again leads to a chronic form of bronchitis.
• Smoking. No one is more prone to chronic bronchitis than heavy smokers. The lungs and bronchi of smokers are constantly exposed to harmful substances and carcinogens - all this is deposited in the tissues, eventually starting to irritate the mucous membranes. There is inflammation and coughing. It is quite natural that in 90% of cases, bronchitis in smokers becomes chronic - since the root cause of the disease itself does not disappear anywhere.
• careless attitude towards own health. And finally, many patients are extremely careless about protecting their body from hypothermia and viruses. The habit of dressing lightly in the cold season, drafts, the tradition of enduring colds on the legs - all this weakens the immune system, reduces the protective functions of the bronchi. The inflammatory process occurs again and again - and eventually becomes chronic.

In addition, chronic bronchitis very often accompanies people living in unfavorable areas or working in hazardous industries. In this case, the fault of the patients themselves is minimal - poor ecology leads to the development of a chronic form of bronchitis. specific area cities or the need to constantly inhale harmful substances and fumes during the working day.

Bronchitis Treatment - Antibiotics and Folk Home Remedies

As already mentioned, the treatment of chronic bronchitis should be dealt with only by a doctor who will conduct the necessary studies and make a diagnosis. Therefore, the first thing to do with bronchitis is prescribed medications - antibiotics and expectorants that help thin the sputum.

Antibiotic drugs that prevent the development of inflammation and the activity of pathogens may belong to different groups.

• Most often, in the treatment of bronchitis, drugs containing penicillin are prescribed - such as Augmentin, Amoxiclav.
• In addition, macrolide agents are used - for example, Erythromycin.
• Cephalosporin drugs are often used, among which Levofloxacin and Ceftriaxone are popular.

Let us remind you once again that you can take antibiotics only on the recommendation of a doctor - and exactly as much as prescribed in the treatment.

In addition, to improve sputum separation, the doctor without fail prescribes mucolytics - such as Bromhexine, Mukaltin, Ambrobene. All of these drugs help to remove accumulated mucus from the bronchi.

Is it possible to cure chronic bronchitis with folk remedies? Of course, trying to cope with the disease with herbal preparations and decoctions alone is useless and dangerous - such an attitude can aggravate the situation.

But at the same time, folk remedies become a good addition to antibiotic treatment.

• Herbal decoctions based on coltsfoot, chamomile, linden or thyme supply the body important vitamins- They also help reduce inflammation. It is recommended to drink medicinal herbs three times a day for at least a week.
• In the treatment of chronic bronchitis, in general, you need to drink as much as possible - the liquid helps to thin the sputum. Well suited hot tea with honey, raspberries, mint, sage, lemon. These funds reduce the temperature, help the body cope with intoxication, help in the fight against infections.
• Another popular folk remedy is inhalation, or inhalation of hot steam from potatoes, eucalyptus or lemon essential oil. Such steam effectively warms up the respiratory organs - however, be careful not to take deep breaths, otherwise you risk getting burned.

Do not forget that strong physical activity during exacerbation of chronic bronchitis is contraindicated. However, patients are advised to pay special attention to breathing exercises. Due to sputum accumulating in the bronchi, breathing is constantly difficult - so that the body does not lack oxygen, it is recommended to take at least 15 minutes a day for a set of exercises based on slow and very deep breaths.

When treating bronchitis, it is very important to monitor the purity of the air. Ventilate the room regularly - the accumulated dust and dirt create ideal conditions for the reproduction of pathogenic bacteria.

How to prevent exacerbations of chronic bronchial disease?

Chronic bronchitis is difficult to treat. Actually, chronic diseases are called such precisely because the threat of their exacerbation always remains elevated. Even with the most thorough treatment, it cannot be guaranteed that the disease has completely disappeared - especially if the bronchitis is expressed in an obstructive form and has affected the very structure of the bronchi.

However, following some rules will help reduce the risk of relapse.

• First, you need to completely stop smoking and reduce alcohol consumption. Both bad habits greatly weaken the body's resistance to viruses and bacterial inflammation, and tobacco smoke itself leads to direct damage to the respiratory system.
• Secondly, any colds should be treated very carefully. If you suffer from a chronic form of bronchitis, it is strictly contraindicated for you to let even the simplest acute respiratory disease take its course - you need timely consultation with a doctor, taking antibiotics, and observing a special regimen.
• Thirdly, you need to make sure that the air around you is as clean as possible. If possible, try to avoid working in dusty, polluted areas, do not come into contact with hazardous production - and if this is not possible, then at least use masks and respirators. Go out in nature more often, take long walks - while avoiding hypothermia of the body.

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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 is when similar situation repeats 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:

1. Tobacco smoke. The main risk group for the development of chronic bronchitis are smokers;
2. Decreased immunity. It becomes a favorable background for the launch of the microbial factor;
3. Chemical pollutants. All chemical compounds, whose vapors are regularly inhaled by a person, like dust cause a bronchial reaction in the form of inflammation or bronchospasm;
4. Climatic conditions. Climatic conditions are rarely the root cause. But they have a general unfavorable background against which all other causes are realized. These can be attributed low temperatures air, high humidity and industrial air pollution;
5. 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 importance in this respect belongs to chronic foci of infection in the tonsils, and carious teeth;
6. 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;
7. 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 factors environment. 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 activity, 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:

1. Cough. It is the main symptom of chronic bronchitis, which determines the course of the disease, as well as the entire clinical picture all in all. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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:

1. 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.
2. 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. AT recent times especially effective drugs Sumamed, Rulid are also 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.
3. 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 the 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).
4. 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.
5. 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).
6. 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.
7. If exacerbation of chronic bronchitis is caused by influenza viruses or SARS, then it is advisable to take antiviral drugs (groprinosin, amizon, anaferon, aflubin).
8. 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.
9. Physical methods. Massage and breathing exercises(breathing techniques according to Buteyko and Strelnikova are especially effective) significantly improve the clearance of bronchi from mucus. 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 respiratory gymnastics complexes 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 using a nebulizer, herbal infusions are used, mineral water type "Borjomi", drugs that thin sputum (ACC, mukolvan, hypertonic potassium solution or sodium iodide).

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 inhaler reservoir and administered 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. It will not be superfluous to walk on fresh air and hardening.

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 long time(decades). 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 typical manifestations 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 secreted more often or in in large numbers, you should think 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. most years, 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 training 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 general or inhalation of cool air can cause a second exacerbation of the process.

The last reason chronic bronchitis in children is an increased reactivity of the bronchial tree. Its result is excessive secretion of mucus and bronchial spasm. These causal 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 disintegrants 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. so right and rational use 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 enough. 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 positive 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. I. M. Sechenov, specialty - "Medicine" in 1991, in 1993 "Occupational diseases", in 1996 "Therapy".

Chronical bronchitis- bronchial disease associated with prolonged irritation of the respiratory tract by harmful agents and accompanied by chronic inflammation of the bronchial mucosa, atrophy and sclerosis of the deep layers of the bronchial walls, excessive secretion of mucus and difficulty in clearing the bronchi, which is manifested by periodic wet cough and shortness of breath. Chronic bronchitis can be both primary and secondary, arising on the basis of other diseases of the respiratory and other body systems.

provocateurs of chronic bronchitis

The most important role in the development of the disease is played by the so-called pollutants - impurities from the inhaled air that have a mechanical and / or chemical irritating effect on the mucous membrane of the bronchial tree. These include tobacco smoke, which is dangerous both for the smoker himself and for the people around him; industrial pollutants (coal, silicon dust, combustion products of coal, gas and oil, chemicals and reagents); household chemicals, house dust. They play the role of SARS, which exacerbate the course of chronic bronchitis and diseases associated with impaired nasal breathing - passing through the nasal passages, the air is cleansed and warmed, otherwise the pollution it contains enters directly into the bronchi. Genetic, hereditary predisposition to respiratory diseases is also important.

Symptoms of chronic bronchitis

The most typical symptom of the disease is a chronic cough, sometimes dry, but more often wet, with up to 100-150 ml of sputum (usually mucous or purulent, less often streaked with blood). At the beginning of the disease, sputum comes out only in the morning, but with the progression of the disease it can be coughed up throughout the day, more often after episodes of physical activity. Over time, shortness of breath joins the cough, which indicates the appearance of bronchial obstruction. Characterized by profuse sweating even with little physical exertion and at night, and general weakness, lethargy, decreased performance.

The doctor diagnoses "chronic bronchitis" on the basis of the patient's complaints, examination data and objective studies. In the initial stage of the disease, there are usually no external manifestations, but as the process progresses, symptoms of respiratory failure appear in the bronchi: swelling of the legs, cyanosis of the lips and tip of the nose, swelling of the cervical veins, thickening of the terminal phalanges of the fingers like “drumsticks” and deformation of the nails on them, reminiscent of watch glasses. To confirm the diagnosis, an X-ray examination of the chest organs and respiratory function tests - spirometry, flowometry - are required.

How to treat chronic bronchitis?

Can chronic bronchitis be cured permanently? This question worries every patient. It cannot be denied that chronic bronchitis is a very unpleasant disease, characterized by a persistent course and frequent exacerbations, but if you approach the issue of treatment correctly, you can cope with it and achieve a stable, long-term remission, and in some cases a complete cure.

Treatment of chronic bronchitis in adults should be comprehensive. First of all, it is important to exclude, if possible, the impact of pollutant substances on the respiratory system. If we are talking about the inhalation of tobacco smoke and the associated chronic bronchitis of a smoker, you need to get rid of bad habit or eliminate passive smoking; if work is associated with the inhalation of pollutants, you will have to change it or improve working conditions.

In the stage of exacerbation of chronic bronchitis, the fight against infection, in most cases bacterial, takes on a paramount role. As a rule, from the very beginning of an exacerbation, it is advisable to use broad-spectrum antibiotics. If within 2-3 days no signs of improvement are observed, it is necessary to replace the antibacterial drug, choosing it in accordance with the sensitivity of the bacteria that cause the disease. It must be remembered that during broad-spectrum antibiotic therapy, a fungal infection often joins a bacterial infection, in which case antibacterial drugs must be supplemented with antifungal ones. The duration of antibiotic treatment is individual and determined by the doctor. As a rule, exacerbation of chronic bronchitis is treated according to the same principle as acute bronchitis: treatment should last at least 7 days. If you stop taking antibacterial drugs immediately after the temperature drops and the symptoms of exacerbation disappear, the result will only be the “addiction” of the infectious flora to the antibiotic and the emergence of resistant forms of bacteria. With frequent exacerbations of bronchitis, long-term, continuous treatment for several months is indicated. In addition to treating bronchitis itself, it is necessary to sanitize foci of chronic infection in the tonsils, paranasal sinuses, carious teeth, etc.

Helper Methods

Along with antibiotic therapy, it is necessary to take measures to thin the sputum and clear the bronchial lumen from it. Expectorants can be taken orally or applied topically, in the form of aerosols or inhalations. In addition to traditional pharmaceuticals, decoctions work well. medicinal plants(breast collection). To thin sputum, it is important to drink a lot, steam inhalation of the solution has a good effect baking soda, salt, decoctions of medicinal herbs. In combination with vitamin therapy, physiotherapy exercises and means of strengthening the immune system, such treatment quickly eliminates the exacerbation of chronic bronchitis.

Combination Therapy

In the presence of an obstructive component of chronic bronchitis, the patient needs more intensive treatment - in addition to antibiotic therapy and drugs that thin the sputum, he is shown drugs that relieve bronchospasm and restore bronchial patency. These drugs include beta-adrenergic stimulants and antispasmodics. If the obstructive component of chronic bronchitis is a consequence of an allergic reaction of the body, it is necessary to add antiallergic therapy and stop contact with the allergen. A huge role is played by breathing exercises, which must be carried out both in addition to treatment during exacerbations of bronchitis, and during remissions - to prevent new exacerbations.

Treatment of chronic bronchitis folk remedies in adults

Recipes traditional medicine, accumulated over the centuries, will serve as a good addition to the traditional pharmacological therapy of the disease.

One of the most popular folk remedies - badger fat, which can be purchased at the pharmacy in liquid form and in capsules for oral administration. Badger fat strengthens the immune system, saturates the body with vitamins and speeds up recovery, but it must be remembered that individual intolerance to it is possible, in addition, badger fat should not be taken orally by people with severe diseases of the liver and biliary tract. The most popular method of treatment is rubbing with badger fat, which is applied to the back and chest before going to bed, parchment or film is applied on top and wrapped warmly, the compress is removed in the morning. Mixture badger fat and melted butter and honey is taken orally three times a day.

Another popular and proven treatment for chronic bronchitis is mutton fat, which treats cough well, accelerates recovery during exacerbation of chronic bronchitis. Melted mutton fat, mixed with honey, is applied to the chest and back, and covered with a film at night - as a rule, one or two such compresses are enough to eliminate a cough.

Well-known immune system stimulant aloe– can also be useful in chronic bronchitis. To prepare the tincture in half a liter of red wine, 4 large leaves of aloe cut into pieces are kept for four days. Take three times a day, 1 dessert spoon.

A popular remedy for acute and chronic bronchitis - vodka. It is used both in the form of rubbing at night, and as a component of compresses. For example, good healing effect gives a compress equal parts vodka, grated onion, honey and flour - a cake is made, which is placed on the upper part of the chest, covered with a film and a warm blanket for the night, in the morning the remaining gruel is washed off.

Propolis bee product- a popular remedy in folk medicine for the treatment of many diseases, it is also used in the treatment of bronchitis. Propolis has a strong antimicrobial and antioxidant effect, is rich in vitamins and trace elements, but it must be used with caution, remembering that some people can develop a severe allergic reaction to any bee products, up to anaphylactic shock and Quincke's edema. Propolis for bronchitis is used as an additive to inhalations, in the form of tinctures on water (20 g of propolis per 200 g of hot water, insist in a thermos for several hours) or on alcohol (grind 20 g of propolis, mix with 200 g of vodka, insist in a dark place for two weeks). A good therapeutic and restorative effect for bronchitis has an ointment with propolis, which can be bought at a pharmacy, or prepared independently, heated in a water bath (not to a boil!) 500 g of petroleum jelly, 100 g of butter and 20 g of crushed propolis.

A popular folk recipe for any cough that works well for bronchitis - reception crushed banana puree: Mix 2 bananas with a blender with a glass of water and a tablespoon of sugar, drink half a glass for coughing.

A proven folk remedy that thins sputum and stimulates expectoration - liquorice root. You can buy ready-made syrup or prepare a decoction yourself by pouring 30 g of dry root with two glasses of boiling water and boiling it for 10 minutes.

A mixture of black radish juice with honey: in equal proportions, radish juice squeezed through cheesecloth and liquid honey are mixed, taken three times a day before meals, 2 tbsp.

Milk with figs: a dozen dried figs are put in boiling milk (1/2 liter), boiled for a quarter of an hour, a delicious drink is obtained that should be drunk warm, in small portions three times a day.

mustard plasters- one of the most beloved and popular means of traditional medicine. The basis of their therapeutic action is irritation of skin areas connected by neuro-reflex connections with the bronchopulmonary system, acceleration of blood circulation in them, due to which a distracting effect is manifested and edema decreases in bronchial tissues. Besides, essential oil mustard has an anti-inflammatory effect. Mustard must not be used at high temperatures, they may have an allergic reaction, they are not suitable for people with sensitive skin.

How to get rid of chronic bronchitis? The main thing is to approach the treatment responsibly, eliminating the factors predisposing to the disease and following all the doctor's instructions. With persistent, complex treatment of chronic bronchitis, strengthening the immune system, correcting working conditions and lifestyle, exacerbations will soon become rare, and then, possibly, they will stop altogether.

Cough, shortness of breath, chest pain, feeling short of breath and general weakness, a temperature that stays at or above 37 ° C for a long time are symptoms of chronic bronchitis, a serious disease that is often diagnosed in adults, especially in the second half of life. Fortunately, there is a cure for it, and if it is taken on time, it is possible to completely get rid of the disease.

According to the WHO (World Health Organization), chronic bronchitis is the second most common, after bronchial asthma, non-specific disease of the bronchopulmonary system in adults, with which they go to medical institutions.

Chronic bronchitis and its symptoms appear if progressive diffuse inflammation is present in the bronchi. The disease is characterized by a sluggish course and occurs as a result of prolonged exposure to aggressive agents on the mucous membrane of the bronchial tree. In this case, changes occur in the mechanism of sputum production, there is a violation in the mechanism of self-purification of the bronchi.

There are WHO criteria, according to which the diagnosis of a chronic form of the inflammatory process in the bronchi is possible if sputum is coughed up by patients for three months (in a row or in total for a year).

Chronic inflammation of the bronchi is:

• primary (independent disease);
• secondary (due to bronchiectasis, tuberculosis, other diseases).

According to the type of flow, non-obstructive and obstructive bronchitis are distinguished in a chronic form. Obstructive is diagnosed if supersecreted sputum clogged the bronchial lumen, disrupted its patency. Treatment of this type of disease is more complicated.

The causes of the disease are:

1. Infections. The anamnesis of patients with chronic bronchitis in adults is frequent acute respiratory viral infections, influenza, etc. infectious diseases respiratory system. Viruses and bacteria also become provocateurs of exacerbations of the disease.
2. Colds and hypothermia. Signs of chronic bronchitis in patients become aggravated in late autumn or early spring against the background of a sharp change in weather conditions.
3. Smoking. Tobacco smoke has a destructive effect on the mucous membrane of the bronchial tree, the normal mechanism for the production of sputum by it. The clinical picture of smoker's bronchitis in adults is the same as if the disease had another cause. But its treatment is impossible without giving up a bad habit.
4. Industrial-production pollutants (pollutants). A protracted inflammatory process in the bronchi occurs in people who work in industrial enterprises or live in polluted areas.

Symptoms of chronic inflammation in the bronchi

According to WHO, the symptoms of chronic bronchitis are:

• cough with sputum;
• pain in the chest;
• dyspnea;
• hemoptysis;
• body temperature is about 37 o C.

In addition, adults with this disease may have complaints of general weakness, loss of appetite, bad dream, shortness of breath, cyanosis.

1. WHO identifies an obligatory sign of sluggish inflammation of the bronchi - a prolonged cough with sputum. Cough occurs reflexively in response to irritation of the mucous membrane of the bronchial tree. With it, the body tries to clear the respiratory tract from sputum. Once the illness worsens, the cough is usually dry. The secret secreted by the bronchial mucosa is still viscous, it is impossible to expectorate it. Therefore, an unproductive paroxysmal cough literally exhausts the patient, during his attacks pain in the chest and throat can be felt. If the diagnosis of the disease in adults is correct, treatment begins with the onset of exacerbation, already on the 3rd day the sputum liquefies, the cough becomes productive and not so painful.
2. If the inflammation of the bronchi is obstructive, the cough is accompanied by a meager sputum, mainly in the morning. By itself, sputum is not the main symptom of a chronic form of bronchial inflammation. It is not a sign of disease at all. By this term, WHO understands the secret produced by goblet cells, which form the ciliated epithelium of the bronchi. They provide local immunity to the respiratory organ. If the mucous membrane is exposed to dust, harmful substances, viruses, bacteria for a long time, and this effect is of a protracted nature, the number of goblet cells increases, respectively, and the amount of secretion they produce increases. At the same time, it is viscous, difficult to separate. When the sputum is too thick, it can completely clog the small bronchioles and larger bronchi, and an obstructive process will begin in the organ. In addition, due to its chemical composition, bronchial secretions are a favorable environment for the reproduction of pathogens. Therefore, it often happens that acute inflammation of a viral nature develops into a chronic bacterial one, the treatment of which will be mandatory with antibiotics. If the chronic inflammatory process in the bronchi is obstructive, the sputum may be purulent.
   
3. Shortness of breath, as a symptom of a chronic form of inflammation in the bronchi, designated by WHO, especially if it is obstructive, occurs due to narrowing of the respiratory lumen and spasm of smooth muscles. A sufficient amount of air ceases to flow into the lungs, the body is forced to turn on the compensatory mechanism.
4. Hemoptysis is a very bad sign of many serious diseases of the bronchopulmonary system, such as tuberculosis or lung cancer. If blood is present in the sputum, the WHO recommends a differential diagnosis. In adults in the first half of life, it is necessary, first of all, to exclude tuberculosis, in the elderly - oncology. As a rule, hemoptysis in the chronic form of bronchitis is poor, in the expectorant mucus or purulent secretion, blood is present in the form of small streaks. The reason for this is a strong cough, during which small blood vessels can burst. At the same time, blood loss is insignificant, in adults it is up to 50 ml per day, as a result of which anemia does not occur. A more significant loss of blood, from 100 ml per day, according to WHO, is no longer hemoptysis, but pulmonary bleeding. This rarely happens with an inflammatory process in the bronchi, even if it is running.
5. Chest pain can be of various origins, but, as a rule, they are signs of diseases of the bronchopulmonary, cardiovascular or musculoskeletal systems. Pain in the lungs and bronchi, radiating to the back, collarbone, diaphragm in adults occurs with pneumonia, COPD, emphysema and lung cancer, pneumothorax, pleurisy. Usually, it is intense, affecting the quality of life. It becomes necessary to treat with analgesics or stronger painkillers. With chronic inflammation of the bronchial mucosa, the occurrence of pain is more of an unpleasant sensation. More often, pain accompanies a cough at the start of an exacerbation, when it is dry and unproductive. If sluggish bronchitis is obstructive, chest pain may be present all the time.
   
6. The temperature in chronic inflammation of the bronchi rises to 37 ° C or slightly higher, but always remains within the low-grade. WHO believes that this is due to the general intoxication of the body, when the waste products of pathogens enter the bloodstream. Since the inflammatory process caused by them is sluggish, the clinical picture is characterized by the fact that the temperature rises to 37 ° C and stays at this mark for a long period of time, up to several months. The temperature is accompanied by other manifestations of intoxication: lethargy, loss of appetite, decreased ability to work.

How is chronic bronchitis diagnosed?

Since some manifestations of chronic bronchitis in adults, such as subfebrile temperature, shortness of breath, chest pain, cough, blood present in sputum, can occur with more severe, sometimes irreversible bronchopulmonary diseases (bronchial asthma, tuberculosis, emphysema, COPD, oncological neoplasms of the lungs ), its diagnosis is quite complex and multi-stage.

According to WHO recommendations, the diagnosis of chronic inflammation of the bronchi includes:

Methods of treatment of chronic bronchitis

Treatment of chronic inflammation of the bronchial mucosa is long-term. It consists in taking etiotropic and symptomatic drugs.

Etiotropic treatment is aimed at eliminating the cause of the disease, which was identified when the history was taken. In the case of sluggish bronchitis, it comes down to taking antibiotics from the groups of penicillins (Flemoxin), cephalosporins (Augmentin) and macrolides (Sumamed). The course of taking the drug is at least 7 days, and sometimes 2 weeks. Do not stop taking the antibiotic if the patient's temperature normalizes or the cough becomes moist. If the cause of chronic inflammation is not completely eliminated, it will soon worsen again.

To relieve swelling and reduce swelling of the bronchial mucosa, treatment with antihistamines is used. It is advisable for adults to take Suprastin, Cetrin, L-cet, Claritin.

If sluggish bronchitis is obstructive, so that the patient has shortness of breath, he is prescribed bronchodilator drugs, for example, Ventolin by inhalation.

Symptomatically in chronic bronchitis, cough is treated. At the first stage of the disease, when it is dry and literally interferes with life, antitussive drugs are prescribed. For adults, they may be codeine-containing, such as Cofex or Codterpin.

To reduce the viscosity of bronchial secretion, mucolytics are prescribed: Ambrocol, ACC, Inspiron.

There is no need to bring down the temperature below 38.5 ° C, therefore, anti-inflammatory drugs such as Ibuprofen or Nimesil are taken only to relieve pain.

In chronic bronchitis, physiotherapy is effective. According to WHO, it is recommended to carry it out for another month after the patient's temperature returns to normal and other symptoms of exacerbation disappear. Methods of inhalation, UHF, electrophoresis, as well as gymnastics, exercise therapy and massage are used.

Video: Live Healthy! Bronchitis symptoms