Bronchitis is an inflammatory process that affects the trachea and bronchi. Depending on the causes of development, the nature of the course and possible complications.
There are 2 types of bronchitis: acute and chronic
- Acute bronchitis is characterized by sudden development, acute course and, most importantly, reversibility of the process.
- Chronic bronchitis is a long-term, progressive inflammation of the airways with an undulating course (alternating stages of exacerbation and remission), leading to a decrease in physical activity due to an increase in respiratory failure.
Causes of bronchitis
It is believed that in most cases, the cause of the development of bronchitis is an infection: a virus, bacteria, atypical microorganisms. But this is actually only true for acute inflammation. For chronic bronchitis, infection is the cause of inflammation only in 10-12% of cases: in most cases, these are long-term mixed (viral-bacterial) infections with a severe course. The main reason for the development of a chronic inflammatory process is the long-term effect on the bronchial mucosa of inorganic irritants: tobacco smoke (80% of cases!), Dust, unfavorable climatic conditions.
The risk factors for the development of the disease include age (over 50), smoking, work in hazardous industrial conditions, frequent hypothermia, alcoholism.
Symptoms of bronchitis
They can vary significantly depending on the cause and form of the course of the inflammatory process. But the main symptom in all cases will be cough.
- Acute bronchitis is characterized by a sudden increase in body temperature to 37.5-39 o C, accompanied by symptoms of intoxication of the body (general weakness, sweating, chills, headache). In the future, a cough joins. Depending on the causative agent of the disease, the nature of the cough may vary. With a viral or atypical infection, a dry (without sputum discharge) develops, most often a paroxysmal cough. In the future, the evolution of cough from dry to wet (with sputum discharge) is noted, accompanied by a decrease in the intensity and frequency of seizures. The appearance of sputum of a yellowish, greenish color, accompanied by an unpleasant taste or smell, is characteristic of a bacterial infection.
- In chronic bronchitis, the clinical picture depends on the stage of the process. In the initial stages, most patients do not consider themselves sick at all, and the recurrent cough is explained by work in hazardous production conditions or smoking tobacco. They are characterized by a periodic cough with the separation of a small amount of light (mucous) or yellowish (mucopurulent) sputum, mainly in the morning. Sometimes a cough appears when inhaling cold air, tobacco smoke. With the progression of the disease, more bronchi are affected (from large to smaller), which leads to the appearance and further increase of shortness of breath (respiratory failure). At first, patients notice the appearance of shortness of breath with the usual exertion. But in the later stages of the process, shortness of breath becomes constant and does not go away even in complete rest.
Diagnosis of bronchitis
A mandatory study is a general (clinical) blood test, which allows you to assess the degree of activity and the nature of the inflammatory process. It is also necessary to study sputum (if any), which includes a cytological study (counting cellular elements), culture on nutrient media for microflora (with mandatory determination of sensitivity to antibacterial drugs), according to indications – a study for acid-fast bacteria. Sometimes, to clarify the pathogen, a blood test is carried out for antibodies (immunoglobulins) to atypical infections or a smear from the pharynx. When a doctor suspects pneumonia, a chest X-ray is taken (in one, two or three projections).
In case of chronic bronchitis (or suspicion of them), an additional examination is carried out:
- Examination of the function of external respiration (spirography), which makes it possible to assess the degree of damage to the respiratory tract (large, medium and small bronchi, bronchioles). To determine the reversibility of the process and differential diagnosis with bronchial asthma, the study is supplemented with a respiratory test with an inhaled bronchodilator (“Salbutamol”, “Berotek”, “Berodual”).
- Video bronchoscopy is an endoscopic examination of large and medium bronchi. A diagnostic FBS is distinguished, which allows to assess the severity of the inflammatory process, to exclude oncopathology, to take washings (if it is impossible to study sputum), and therapeutic (flushing and cleansing the airways from thick, difficult to separate mucous and purulent sputum).
Treatment of bronchitis
Treatment can be divided into medication (medication-related) and non-medication.
Non-drug treatment includes a gentle regimen (bed or half-bed), plentiful warm drinks (at least 2 liters per day, and with a fever above 38 o C – up to 3-3.5 l / day), food with a sufficient protein and vitamins … In chronic bronchitis, breathing exercises (for example, according to the Strelnikova method), physiotherapy methods of exposure (halochamber, inhalation with alkaline mineral waters) also have a positive effect.
In drug treatment, etiotropic therapy is distinguished (aimed at destroying the infectious agent) and symptomatic (aimed at relieving the symptoms of the disease). Etiotropic therapy (antiviral, antibacterial, antimycotic drugs) should be prescribed by the attending physician based on the individual clinical picture, the results of an objective examination, laboratory and instrumental examination methods. Self-medication is not permissible, since an incorrectly selected drug will postpone seeking medical attention, which will lead to the progression of the disease; and an incorrect dosage regimen of a medicinal product can be the cause of an overdose or the appearance of a particularly dangerous microflora that is resistant to the action of known antibacterial agents.
Symptomatic therapy includes:
- Antipyretics (with increase in body temperature to 38 on C or more).
- Expectorant drugs (to make it easier for sputum to pass). The dose of the drug is selected individually.
- Bronchodilator drugs (to reduce shortness of breath), among which are inhaled drugs and tablets. Tablet formulations are more convenient to take, while inhalers have an early onset of action and fewer side effects.
- It must be remembered that each drug has its own side effects and contraindications! Antipyretic drugs will help normalize body temperature, but can provoke an exacerbation in people with stomach diseases. Expectorant drugs in the absence of phlegm will aggravate a dry cough. And pill bronchodilators can cause complications in people with heart rhythm disturbances. Prevention of bronchitis includes various methods, which is associated with a variety of factors in the development of bronchitis.
Prevention of bronchitis
For the prevention of acute bronchitis, it is important to take immuno-strengthening drugs, as well as to vaccinate people at risk: over 50 years old, suffering from chronic diseases of internal organs, constantly communicating with people and taking anticoagulant drugs for a long time.
For the prevention of chronic bronchitis, it is also very important to maintain a healthy lifestyle (rejection of bad habits, good balanced nutrition, rational physical activity, walks in the fresh air), exclusion of exposure to harmful environmental factors (smoke, dust, gas, temperature changes).
If you suspect bronchitis, you should immediately consult a doctor (therapist, pulmonologist) for examination and selection of individual therapy. This will reduce the time of illness, avoid a number of complications (pneumonia, lung abscess) and reduce the risk of developing chronic obstructive pulmonary disease, pulmonary emphysema, bronchiectasis.
