Obstructive bronchitis, symptoms and treatment for adults

Obstructive bronchitis - a bronchial tubes disease associated with long-term inflammation of the mucosa and its damage and narrowing of the bronchi, which is why there are difficulties in breeding outside accumulating in the airways mucus. The disease is accompanied by periodic spasms of the bronchial tree, which manifest difficulty breathing.

Over time, the inflammation in the bronchial wall progresses, increasing bronchospasm and dyspnea, develop obstructive syndrome and chronic disorder of the pulmonary ventilation.

What it is?

Obstructive bronchitis - is the emergence of reflex spasms, preventing mucus go outside. Obstruction can be periodic, particularly in chronic form. Bronchitis feature such that it is able to flow latently.

Causes of

The disease is in most cases becomes complicated by the continuation of respiratory viral infections, exposure to external factors of trouble: smoking, unfavorable environmental conditions, hazardous industry, poor living conditions.

Environmental factors:

1. The presence of chemical irritants in the air in the production or in household - inorganic and organic dust, vapors acid, ozone, chlorine, ammonia, silicon, cadmium, sulfur dioxide and others. (cm. the effect of household chemicals on health).
2. Prolonged exposure to the bronchial mucosa of physical stimuli, which are in the external environment - allergens such as pollen of certain plants, house dust, animal hair, etc.

Socio-economic factors:

1. Alcohol abuse;
2. Adverse living conditions;
3. Smoking, passive smoking (see. Video of what makes cigarettes);
4. Elderly age.

Medical factors:

1. Tumors of the trachea and bronchi;
2. Airway hyperresponsiveness;
3. Genetic predisposition;
4. Propensity to allergic reactions;
5. Trauma and burns;
6. poisoning;
7. Infectious-inflammatory diseases of the respiratory organs and violation of nasal breathing, foci of infection in the upper respiratory tract - bronchitis, pneumonia;
8. Repeated viral infections, nose and throat diseases.

Chronic obstructive bronchitis

This progressive obstruction of the bronchi in response to various stimuli. Bronchial obstruction conventionally divided into: reversible and irreversible.

Symptoms, which patients usually go to the doctor:

1. Severe coughing, with the release of the morning sputum scanty mucous character
2. Shortness of breath, initially only appears during exercise
3. Wheezing, shortness of breath
4. Sputum may acquire purulent during the joining of other infections and viruses, and is regarded as a recurrent obstructive bronchitis.

Over time, the irreversible process of chronic disease progresses, and the intervals between relapses are shorter.

symptoms

The clinical picture of obstructive bronchitis formed by the following symptoms:

• Cough - in the early stages of dry without sputum, "swishing", mainly in the morning and at night, when a person is in a horizontal position. Symptom amplified in the cold season. Over time, if there is expectoration sputum, clots in the elderly may be traces of blood in the discharge of secretions;
• Difficulty breathing, or shortness of breath (after 7-10 years after the onset of coughing) - first appears during exercise, then in a period of rest;
• At an exacerbation - fever, sweating, fatigue, headaches, muscle pain;
• Akrozianoz - blueness of the lips, nose, fingers;
• Syndrome "hour glasses", "nail Hippocratic" - deformation of nail plates when they become similar to a watch glass;
• The symptom of "drumsticks" - a characteristic change in the phalanges;
• Emphysematous chest - blades firmly against your chest, epigastric angle is deployed, its value exceeds 90, "short neck" enlarged intercostal spaces.

It is important to remember that obstructive bronchitis makes itself felt immediately. Usually symptoms appear when the disease is already in full sway in the body. As a rule, the majority of patients seek treatment too late, after the age of 40 years.

Diagnostics

Usually diagnosis is based on the patient's complaints, concomitant clinical history, auscultation of lungs and heart rate.

Differential diagnosis object - to exclude the development of severe pathologies such as tuberculosis of lung, pneumonia, lung tumor tissue, of developing heart failure due to decreased cardiac fraction emissions. If the patient is marked decrease in cardiac ejection fraction, there is a strong ongoing cough, there is a suspicion of alveolar edema (pulmonary edema), the doctor's actions should be lightning.

Obstructive bronchitis is characterized by the following:

• listening to the sound of percussion over the light;
• loss of mobility of the pulmonary region;
• hard breathing;
• inspiratory auskultiruyutsya wheezing;
• appearance moist rales at an exacerbation of the disease.

If the patient is a smoker, then the doctor needs to know the total length of the habit, to calculate the index of smoking. In the classification of obstructive bronchitis in a development phase indicator is used in forced expiratory volume over 1 min (abbreviation FEV) against lung capacity (in abbr. VC). Allocate the following steps:

1. Stage I. FEV = 50% of normal. At this stage, the patient hardly knows the discomfort and dispensary control in this situation is not necessary.
2. Step II. OFI = 34-40% of normal. Patients are advised to visit a doctor-pulmonologist in connection with a pronounced deterioration in the quality of life.
3. Step III. FEV <33% of normal. This stage of the disease involves a stationary or ambulatory treatment.

To exclude pneumonia, pulmonary tuberculosis, cardiac dilation departments carry out chest X-ray procedure. As additional research methods necessary laboratory data analyzes (blood, urine, sputum, or mucus scrapings). Accurate diagnosis allows you to quickly identify the underlying disease, to stop the symptoms of obstructive bronchitis, eliminate its recurrence in the future.

complications

When developing obstruction in the lungs cease to do the required amount of air. Breaths become severe, the diaphragm is not fully disclosed. In addition, we breathe more than to breathe.

Some part remains in the lungs and pulmonary emphysema provoked. In severe or chronic forms of pulmonary insufficiency may occur, and this is the reason for mortality. Untreated bronchitis is almost always ends with pneumonia, which greatly problemnee treat.

How to treat obstructive bronchitis?

In the first place in the treatment of obstructive bronchitis in adults it is important to minimize, where possible - completely avoid contact with irritating factors which may be a prerequisite for the progression of the process in the bronchi and exacerbations.

You need to stop smoking and other bad habits, to cease contact with allergens, which in some cases may require quite a radical step: changing jobs or places residence.

The next step should be treated at home with modern efficient tools.

medication

When obstructive bronchitis, which is caused by a viral infection, antiviral drugs are appointed:

1. Rimantadine (Alguire, Orvirem) has an intensive antiviral action by blocking healthy cells from viral penetration. The drug is given by 100 mg (1 tablet) 1-3 times a day for 3-4 days. Allergic reactions are rare.
2. Inosine pranobex (Isoprinosine, Groprinozin) have antiviral (stimulate the destruction of viral cells) and immunomodulatory (strengthen the immune system) action. The drug is prescribed 1-2 tablets 3-4 times a day. The course of treatment is 7-10 days, but can be extended by 1 month if indicated. The drug was well tolerated and generally does not cause allergic reactions.

When obstructive bronchitis caused by bacterial infection, antibiotics are appointed, by which you can cure the disease in 5-10 days:

1. Macrolides (clarithromycin Rovamycinum) have a bactericidal action. Appoint 500 mg 1 time per day. Course of treatment 5-7 days. Allergic manifestations of the drug does not cause;
2. Protected penicillins (Augmentin, Flemoksin-soljutab) have bacteriostatic (reduce bacterial growth and division of cells) and bactericidal (bacteria promote death) effect. The drug administered in tablets of 625 mg 3 times a day, or 1000 mg 2 times a day for 7-14 days. With care, this group of drugs is given to patients with frequent allergic reactions;
3. In extremely severe cases of the disease drugs of choice are respiratory fluoroquinolones - levofloxacin (Loksof, Leflok) 500 mg 1 time per day, or 500-1000 mg vial of 100.0 ml of intravenously once in 1 day. The medicament can cause acute allergic manifestations.

If you experience coughing - mucolytic drugs:

1. Ambroxol (Mucosolvan, Abrol) has an expectorant action and stimulates movement ciliated epithelium in the bronchi, which contributes to the removal of phlegm. Is assigned to 30 mg (1 tablet) 3 times a day or 75 mL (1 tablet) 1 time per day. The course of treatment 10 days. The drug does not cause allergic effects;
2. Acetylcysteine ​​(NAC) reduces the viscosity of mucus and thereby stimulates a better expectoration. Assigned 400 - 800 mg of 1 - 2 times a day for 10 days. Allergic reactions such as skin rash;
3. Anti-inflammatory drugs of local action - Erespal, Inspiron eliminate overproduction of mucus and reduce swelling of the mucous and submucosal layers of the bronchial tree. Appointed on 1 tablet 2 times a day. The course of treatment 10 days. Cautions: causes heart palpitations and disruption of the heart. Allergic reactions are rare.

At elevated body temperature is used NSAIDs - Nimesulide, Ibuprofen - have antipyretic, anti-inflammatory and analgesic effect. Assigned 200 mg 1-2 times a day.

In the event of apnea treatment of obstructive bronchitis in aerosol bronchodilators complement (Salmeterol, Berodual, Ventolin, Salbutamol), which have a bronchodilator effect and contribute to a better discharge of phlegm from the bronchial tubes. 2 are assigned by inhalation 3-6 times per day.

inhalation

During exacerbation of obstructive chronic bronchitis says:

• dyspnea gain with a change in respiratory rate, inspiratory depth;
• the changing nature of cough, sputum;
• tightness in the chest.

When these symptoms indicating exacerbation, inhaled bronchodilators are administered in all three groups. Read about the properties of these drugs can be in the article bronchodilators.

The main cause of obstruction in adults - bronchospasm. To eliminate it, resort to drugs of short and long action. Drugs of choice for chronic obstructive bronchitis serve Atrovent, Troventol, oksitorpium bromide. Their effect appears after 30 minutes, lasts up to 6 hours per day do 3-4 doses.

When ineffectiveness therapy further designate:

• adrenostimulyatorov - Ventolin, Brikanil, Berotek inhaled Tablets Sopharma Clenbuterol, Clenbuterol syrup;
• theophylline tablets - teopeka, Teotard.

In acute conditions prescribed inhaled combination products combine the action of a hormonal agent with a bronchodilator. For more information on inhalation bronchitis, read our article bronchitis Inhalation with nebuliser.

Physiotherapy

The patient's condition will improve physiotherapy. One of its tools - massage (percussion, vibration, back muscles). Such manipulations relax the bronchial eliminate secretions from the respiratory tract. Apply modulated currents, electrophoresis. The state of health is stabilized after the spa treatment for the southern resorts Krasnodar and Primorye.

Nutrition and diet

Diet during the exacerbation of the disease is aimed at the elimination of edema of the bronchial tree, to stimulate immunity, protein replenishment of stocks. Food should be high-calorie, no less than 3000 calories / 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, tomato;
• foods with omega-3 fish oil, cod liver oil;
• Vitamins A and E: peas, beans, spinach, peaches, avocados, carrots.

At the time of relapse treatment is necessary to reduce the consumption of sugar and salt, limit the use in food-allergen products (tea, chocolate, coffee, cocoa). Promote the development of bronchospasm sharp, spicy, smoked foods, so they should also be excluded from the diet, or eat in small amounts.

prevention

Prevention obstructive bronchitis also includes:

• abandonment of harmful habits - smoking;
• reduction of dust in the home by means of wet cleaning. You can replace the pillows filled with feather on hypoallergenic fillers. You can also clean carpets and soft toys, which are the first drive of the dust particles;
• compliance hypoallergenic diet, during which excludes all products that can enhance the cough;
• vitamins of groups B and C to maintain immunity. For this purpose one can use herbal teas, also contributing to a retracted from bronchial mucus;
• during dusting plants can organize your stay in a comfortable microclimate, which excluded any allergens.

Patients with obstructive asthmatic bronchitis is first necessary to carry out tempering procedures, perform therapeutic respiratory complexes.