Chronic bronchitis is a diffuse inflammation of the bronchial mucosa, which engulfs the deep layers of the bronchus wall with the development of peribronchitis.It lasts for a long time with a change in the periods of exacerbations and remissions.
This is one of the most common diseases of the respiratory system, which occurs mainly at the age of over 50 years; in men it is found 2-3 times more often than in women.
The clinical significance of chronic bronchitis is very high, since the development of a number of chronic lung diseases: emphysema, chronic pneumonia, bronchial asthma and lung cancer.
Classification
Pulmonologists suggest separating chronic bronchitis, the symptoms of which occur in 3-8% of the adult population, into two forms - primary and secondary.
- Whenprimary formthe patient has a diffuse lesion of the bronchial tree, not associated with other inflammatory processes occurring in the human body.
- Secondary formis caused by chronic diseases of the lungs, nose, sinuses, chronic kidney failure, severe heart disease and some other diseases.
Isolated obstructive bronchitis, which also has a chronic course.
Causes
If the pathogenic factors act on the body for a long period of time, then a person has chronic bronchitis. The treatment of which is aimed at eliminating the causes of the disease, which most often are:
- tobacco smoke;
- dust and air pollution in the workplace;
- any bacterial infection.
The disease develops slowly, but covers the entire surface of the walls of the bronchi, causing their constriction and other irreversible deformations. Various microorganisms (bacteria, viruses, mycoplasmas) can provoke the development of chronic bronchitis, as well as the emergence of its exacerbations. Sometimes the chronic form is a consequence of an earlier acute bronchitis.
Symptoms of chronic bronchitis
Chronic bronchitis in adults and its symptoms develop gradually. In the initial stages, the patient's condition is usually satisfactory. But as the disease develops, there is weakness, fatigue, respiratory failure.
The main symptom of this disease is cough. At first it arises only in the mornings, but later it starts to bother the sufferer in the daytime, in the evening, and at night. In cold, damp weather, it intensifies. Cough is deaf, with phlegm, but during an exacerbation may be "barking". Sputum is usually mucous, clear, odorless.
Depending on the condition of the ventilation of the lungs, the following types of disease are distinguished:
- non-obstructive bronchitis, in which there are no ventilation violations;
- obstructive bronchitis, which is characterized by a permanent persistent violation of ventilation.
In the first case, the ventilation capacity of the lungs is normal and does not depend on the phase of the process, and with chronic obstructive bronchitis there is a violation of bronchial patency and ventilation.
Chronic bronchitis in acute stage
Exacerbation of chronic bronchitis is characterized by increased and increased coughing attacks, an increase in the number of cough expectoration and changes in its quality. The purulent character of sputum testifies to the activation of pathogenic microbes and the appearance of a bacterial component of exacerbation.
With exacerbation of chronic bronchitis, the patient has an increase in body temperature. The push to activate the disease usually gives an episode of ARVI.
Bronchitis of a smoker
What is the smoker's bronchitis is well known to people who have this bad habit. It occurs due to the ingress of combustion products and harmful substances into the lungs. This form of the disease is characterized by a continuous cough with sputum discharge.
Attacks of morning protracted cough begin immediately after awakening, repeated throughout the day. Bronchitis smoker begins as a one-sided, but eventually flows into a two-sided. If treatment is not performed, the disease progresses, leading to the development of pneumonia and chronic cough.
Chronic obstructive bronchitis
The main signs of chronic obstructive bronchitis are:
- strong, slightly productive cough;
- severe shortness of breath during physical exertion and irritation of the respiratory tract;
- wheezing in exhalation;
- elongation of the exhalation phase.
The obstructive form of the disease first proceeds little. Then it manifests as a coughing, wheezing and shortness of breath in the morning, which disappears after the sputum is out.
Prevention
To prevent the development of the disease helps a healthy lifestyle. But if the chronic bronchitis has appeared, then all efforts should be thrown on the prevention of exacerbations.
First of all, it is necessary to eliminate the effect of provoking factors. Treatment of chronic diseases of the nasal cavity and paranasal sinuses, refusal to smoke and work in harmful dust, chemical production significantly improve the health of many patients. In addition, in the presence of this disease it is desirable to live in a dry and warm climate, and not cold and wet.
To prevent exacerbations of chronic bronchitis, it is recommended to regularly conduct courses of sanatorium treatment, especially in resorts with mountain and coastal climate.
Treatment of chronic bronchitis
In the presence of chronic bronchitis treatment in adults should be individual, that is, the doctor must learn about the course of the patient's illness, about his lifestyle and work. It is not always possible to completely get rid of this problem, but to achieve stabilization of the state and maximum slowdown of the disease progression is quite realistic.
For this, the following can be used:
- antibacterial agents;
- expectorant drugs;
- bronchodilators;
- anti-inflammatory and antihistamines;
- inhalation therapy;
- physiotherapeutic methods (halotherapy);
- normalization of a way of life.
In severe chronic bronchitis, medical (sanative) bronchoscopy, bronchoalveolar lavage can be performed. To restore the drainage function of the bronchi, auxiliary therapies are used: alkaline and medicinal inhalations, postural drainage, massage chest (vibration, percussion), respiratory gymnastics, physiotherapy (UHF and electrophoresis on the chest, diathermy), speleotherapy. Outside exacerbation it is recommended to stay in sanatoriums of the Southern coast of Crimea.
How to treat chronic bronchitis at home
Treatment of patients with chronic bronchitis should be comprehensive, provide for the impact on the main pathogenetic mechanisms, take into account the individual characteristics and severity of the course of the disease, the presence of complications. To conduct experiments on treatment only folk remedies at home is not recommended. To permanently cure bronchitis individual and effective therapy should appoint a specialist.
In adults, the approximate scheme of treatment is as follows:
- Required condition -elimination of a provoking factor: to give up smoking. Treatment of chronic infections of the nasopharynx - tonsillitis, sinusitis - will also slow the progression of the disease. Unfortunately, contact with toxic substances or dust is often of a professional nature. Of course, not everyone can change jobs or move from a metropolis to a village.
- Antibioticsappointed in the case of exacerbation of the process, which is accompanied by signs of intoxication, an increase in body temperature or expectoration of mucopurulent sputum in large quantities. The best ones are: penicillins (ospamox, augmentin, amoxiclav, amoxil), preparations of cephalosporin series (ceftriaxone, cefazolin, cefix, cyphadox, suprax), torhylonone preparations (doxycycline, moxifloxacin). To restore the intestinal microflora, probiotics (lactovite, bifiform, linex) are prescribed.
- Expectorants. Two groups of agents are used: sputum disintegrants and ekspedoranty. The first, promote the transformation of viscous sputum in the liquid, the second - improve mucociliary clearance. In total, they get relief from sputum coughing. Used ATSTS, lazolvan, flavamed, bromgessin.
- Inhalation. Anti-inflammatory and expectorant action exhales the essential oils of fir, eucalyptus, rosemary, camphor, phytoncides onions and garlic. Enough aroma lamps, you can just apply essential oils on clothes. Steam inhalation in bronchitis is ineffective, so devices for their conduct are not needed, but the compressor nebulizer is a good purchase. With its help expectorants (ATSTS, alkaline mineral water or saline), anti-inflammatory (Rotokan, Chlorophyllipt) and antibacterial (Dioxydinum, Furacillin) substances penetrate to the bronchi of the smallest caliber.
- If the exacerbation of chronic bronchitis is caused by influenza viruses or ARVI, then it is advisable to take antiviral drugs (grosrinosine, amizon, anaferon, aflubin).
- Glucocorticoid anti-inflammatory drugsreduce the amount of mucus secreted and the activity of inflammatory cells in the mucosa. There are several types of such funds. They are distinguished by the effect on different ways of bronchodilation and elimination of obstruction.
- Complex treatmentchronic bronchitis includes the use of immunomodulating drugs, multivitamin complexes.
During the remission, chronic bronchitis in adults does not require virtually no treatment, but during the relapse of the disease, a whole range of treatment procedures should be used.
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