Bronchitis is an inflammatory disease in which the mucous membranes of the walls of the bronchi are involved in the pathological process. If obstructive bronchitis is diagnosed, this means that the inflammation is accompanied by a bronchial obstruction syndrome, that is, a narrowing of the lumen of the bronchi is observed, which prevents the passage of air.
Mechanism of bronchial obstruction
Bronchi are a pair organ of the respiratory system, anatomically looking like a bifurcation of the trachea into two parts, from which secondary branchings (bronchial tree) depart. The smallest bronchial branches are connected to the alveolar courses, at the ends of which the alveoli are located - bubble formations of the lungs, through which the gas exchange takes place. The main function of the bronchial tubes is to hold air during inspiration with simultaneous cleansing, moisturizing and heating, as well as removing it during exhalation.
Against the backdrop of inflammatory processes developing in the bronchi under the influence of irritating factors, there is a decrease in local immunity, the defense system of the bronchi ceases to cope with its functions. In the tissues of the mucosa, structural changes are associated with hypertrophy of the glands that produce the bronchial secretion and the transformation of cells of the ciliated epithelium that lead to phlegm into the mucus-producing goblet cells. As a result, a so-called pathogenetic triad is created:
- increased bronchial secretion;
- deterioration of outflow of sputum from them;
- delay and accumulation of inflammatory secretions.
These processes lead to the launch of mechanisms of bronchial obstruction, different from those that occur with non-obstructive inflammation. Experts note that bronchial obstruction develops through reversible and irreversible mechanisms. The first ones are:
- narrowing of the lumen of the bronchi due to a sharp muscle contraction (bronchospasm);
- inflammation associated with swelling of mucous and submucosa bronchi;
- filling of the bronchial tree with thick, poorly draining mucus masses.
In the future, these mechanisms are replaced by irreversible:
- stenosis of the bronchi, accompanied by the overgrowth of its lumen connective tissues;
- a sharp reduction in the airflow emerging from the small branches of the bronchi;
- prolapse of the membrane wall of the large bronchi and trachea with protrusion into the lumen of the airways.
Causes of obstructive bronchitis
In adult patients, obstructive bronchitis often develops under the influence of the following factors:
- tobacco smoking, in which the airways accumulate resinous substances that disrupt the purification process, and inflammation of mucous membranes due to smoke irritation;
- harmful working conditions associated with the inhalation of air, which contains dust, chemical compounds;
- frequent respiratory diseases, weakening the protective mechanisms of the respiratory system;
- genetic factor - a violation of the production of α1-antitrypsin protein, leading to destruction of the lungs.
There are several degrees of decrease in the lumen of the bronchi:
- Easy obstruction - does not cause a significant deterioration in airway patency and related changes.
- Moderate obstruction of the bronchi - when the lumen of the bronchi is blocked by less than 50%.
- Severe degree of obstruction - patency of the lumen of the bronchi is significantly reduced, which causes a decrease in oxygen in the blood and a deterioration in the work of all organs and systems.
Acute obstructive bronchitis
Obstructive bronchitis in acute form often develops in childhood when infected with viral pathogens, with bacterial infection or as a result of allergic reactions. Predisposed to the disease are children with weakened immunity, having an elevated allergic background, genetic predisposition. In general, small and medium-sized branches are affected, and obstruction of large bronchi is rare.
Chronic obstructive bronchitis
In a chronic process, there are periods of remission and exacerbation, which are characterized by their manifestations. Exposed to this form of the disease mainly men, as the probability of action on them of harmful provoking factors (smoking, occupational hazards) is higher. In this case, there may be obstruction of the small bronchi, and a decrease in the lumen of large and medium bronchi, and sometimes inflammation of the alveolar tissue.
Obstructive bronchitis - symptoms
Acute bronchitis with obstruction, the duration of which does not exceed three weeks, is accompanied by a clinical picture:
- increased body temperature;
- dry or unproductive cough (often paroxysmal, worse at night and morning);
- increase in the frequency of respiratory movements up to 18 times per minute;
- the appearance of wheezing wheezes with exhalation, which can be discerned by the surrounding ones even at a distance, which are amplified in the prone position.
Chronic relapsing obstructive bronchitis, diagnosed with recurrence of the disease three or more times a year, manifests itself with the following symptoms:
- frequent headaches;
- severe fatigue;
- sweating;
- dyspnea;
- "Habitual" cough with hard to separate sputum, sometimes yellowish brown, with an admixture of blood;
- wheezing, whistling when breathing;
- poor appetite.
The periods of an exacerbation, basically, correspond to a cold season and are observed against a background of acute virus infections or hypothermia. In this case, the body temperature can increase, it becomes stronger and becomes more constant and painful cough, there is a noticeable difficulty in breathing. The duration of relapse is about 2-3 weeks.
Cough with obstructive bronchitis
The abundant secretion of viscous sputum, accumulating in the bronchi, provokes an obsessive cough with obstructive bronchitis, which is amplified in the prone position. Expressed and prolonged seizures are observed at night and immediately after morning awakening. The bronchial secretion is weak, it can acquire a purulent character, and in this case it is regarded as a relapse of the disease. Coughing is always accompanied by shortness of breath. Distal obstruction of the bronchi, which can lead to pulmonary insufficiency, is accompanied by a deep cough and blanching of the skin.
Temperature with obstructive bronchitis
Often, patients who suspect a disease, worried about whether there is a temperature with obstructive bronchitis. It is worth knowing that with this pathology the temperature does not rise very often and rarely reaches high marks (often not higher than 38 ° C). The febrile state is more typical for the acute form of the disease, and chronic obstructive bronchitis in most cases occurs against the background of normal temperatures.
Obstructive bronchitis - treatment
To determine how to treat obstructive bronchitis, the doctor prescribes a number of diagnostic procedures, which make it possible to identify the cause of the pathology and the degree of its severity. Such procedures include:
- auscultation and percussion of the lungs;
- Radiography (including with the introduction of contrast medium);
- spirography ;
- microscopic and bacteriological analysis of sputum;
- blood test (general, biochemistry);
- immunological tests and so on.
In severe cases hospitalization is carried out in a hospital. Acute and acute bronchitis with obstruction, especially accompanied by fever, necessarily require bed rest. After alleviating the condition, patients are encouraged to take leisurely walks in the fresh air, especially in the mornings. In addition, patients should observe the following important recommendations:
- Refusal of smoking (fencing from passive smoking).
- Warm and plentiful drink (the usual norm of drinking should be increased 1.5-2 times).
- A healthy diet with the exclusion of hard-to-digest, fatty, fried foods.
- The air in the room where the patient is staying must be clean, moist.
Main medical methods:
- drug therapy;
- physiotherapeutic procedures (percussion and vibrating massage, electrophoresis, inhalation);
- respiratory, drainage exercises.
Obstructive bronchitis - first aid
People who developed obstructive bronchitis, emergency care can be required at any time, because the attack of choking can develop quickly and unexpectedly. Symptoms that indicate a dangerous condition are: forced posture sitting on the edge of a chair with legs apart, intense dry cough with wheezing and whistling, blue lips and nose, palpitations. In this case, you need to call an ambulance.
Before the arrival of doctors, you need:
- Provide the patient with airflow.
- Remove clothing that restricts breathing.
- Apply an inhaler-aerosol with a bronchodilator, if he was previously appointed a doctor.
- Use the method of relieving spasm of the bronchi, consisting in breathing in a carbon-rich gas - exhale and inhale the air, tightly pressing the cap to the person.
Obstructive bronchitis - drugs for treatment
Patients with a diagnosis of "obstructive bronchitis" drugs may be prescribed the following:
- bronchodilators ( Salbutamol , Atrovent, Serevent);
- mucolytics (Ambroxol, Trypsin, Acetylcysteine);
- antibiotics for obstructive bronchitis (Azithromycin, Cefuroxime, Clarithromycin);
- glucocorticosteroids (Prednisolone, Fluticasone);
- non-steroidal anti-inflammatory drugs (Ibuprofen, Paracetamol, Nimesulide).
Inhalation with obstructive bronchitis
When treatment of bronchial obstruction is required, one of the preferred routes of administration is inhalation by nebulizers. The active substances of the used agents are delivered in a short time to the pathological focus, allowing to remove spasm, reduce inflammation, and withdraw phlegm. We list the common drugs for inhalation:
- Berodual ;
- Atrovent;
- Berotek;
- Ventolin;
- Lazolvan;
- Budesonid and others.
Obstructive bronchitis - folk methods of treatment
Treatment of obstructive bronchitis with folk remedies is acceptable after agreement with the attending physician, and folk recipes can only be aids to basic therapy. Often, healers recommend taking broths of various herbs and dues that exert an expectorant and anti-inflammatory effect (mother-and-stepmother, licorice root, thyme).
Effective recipe based on onions
Ingredients:
- onion - 500 g;
- sugar - 400 g;
- honey - 50 g;
- water - 1 liter.
Preparation and use
- Peel and chop the onions.
- Mix with sugar, honey, add water.
- Boil on low heat for three hours, cool, drain.
- Take a tablespoon 4-6 times a day.
Obstructive bronchitis - complications
Chronic obstructive bronchitis complications often has the following:
- emphysema of the lungs ;
- respiratory insufficiency;
- pulmonary heart ;
- bronchiectasis;
- secondary pulmonary arterial hypertension.