Exacerbation hron bronchitis how to treat. Bronchitis in adults. Treatment of acute and chronic bronchitis in an adult patient. Chronic bronchitis in the acute stage

With disease respiratory system under the name bronchitis at least once in a lifetime, almost every one of us encounters. Its main symptom is a severe cough, sometimes with shortness of breath and viscous sputum, as well as headache, general weakness, etc. But the worst thing is when a similar situation is repeated at intervals of several weeks, or even months. 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?

As mentioned above, a key symptom of any bronchitis is a cough, and in a neglected form it lasts about three months a year for two years in a row.

However, even in the presence of a prolonged cough, it is not worth making such a diagnosis on your own, because for the development of the disease, appropriate conditions and factors are needed:

The essence of chronic bronchitis is that the above factors (one or more) have a negative effect on the bronchi and their mucous membrane. An abnormal amount of sputum begins to be released in it, which does not have time to be brought out, which creates an excellent environment for the reproduction of bacteria and pathogenic microorganisms.

On examination, the doctor may note too long expiration, whistling and moist rales in the lungs. For a more accurate diagnosis, a number of studies are carried out, including x-rays, bronchoscopy, as well as tests to rule out tuberculosis, emphysema, neoplasms and other diseases.

Why is the disease dangerous?

Initially, a patient with chronic bronchitis is concerned only with a cough, dry or wet, which can appear at any time of the day. Over time, it intensifies, sputum appears yellow color odorless, then its volume increases, the release of purulent masses begins. There is a violation of the patency of the bronchi, a person feels severe shortness of breath, first after physical exertion, and then at rest. At the same time, chronic fatigue, a feeling of weakness, and a decrease in efficiency appear.

This form of the disease is called chronic obstructive pulmonary disease, since not only the bronchi, but also the lungs suffer from a lack of oxygen. The body begins to experience hypoxia, which leads to the development of a variety of disorders and pathologies, and in the end can cause death.

Can chronic bronchitis be cured permanently?

This question worries all patients who had to deal with a similar phenomenon. The answer to it depends on the spread of the pathological process, the stage and phase of the disease, but it is quite possible to get rid of chronic bronchitis in a mild degree once and for all. This requires timely access to a specialist, accurate diagnosis and adequate therapy.

traditional medicine

Most often, medications for the chronic course of bronchitis are used in the exacerbation phase, but during periods of remission, doctors often prescribe drugs that alleviate the patient's condition and support the body.

Antibiotics

Antibiotic treatment is carried out in acute periods, when an active inflammatory process caused by pathogenic microorganisms takes place in the patient's bronchi. The appointment of a specific drug is carried out after clarifying the causative agent of the disease and conducting the necessary tests.

Group	Preparations	Image example	Efficiency	Reception features
Semi-synthetic penicillins	"Augmentin", "Amoxiclav", "Amoxicillin"		It has an effect on gram-negative strains, less effective against streptococci, staphylococci, spirochetes. Not active against Pseudomonas aeruginosa and Klebsiella	It is taken on an empty stomach, the dosage is set depending on the severity of the disease and the characteristics of the patient's body. The course of treatment is 5-14 days
Macrolides	"Sumamed", "Clarithromycin"		They are effective against streptococci and staphylococci, Haemophilus influenzae, chlamydia. No effect on Gram-positive bacteria resistant to erythromycin	It is taken one hour before meals or regardless of meals. The average course of treatment is 3-5 days
Fluoroquinolones respiratory	Moxifloxacin, Levofloxacin		They suppress gram-positive strains (streptococci, pneumococci, listeria, to a lesser extent enterococci), as well as gram-negative bacteria (hemophilic bacillus, gonococci). Suppress tuberculosis mycobacteria and some anaerobes	Taken 1-2 times a day, therapeutic course - 10-14 days
Cevalosporins II, III generations	Cefaclor, Ofloxacin		Effectively destroy gram-positive and gram-negative aerobes. Does not affect some enterococci and a number of streptococci	Take three times a day, the dosage is selected individually. The duration of treatment is 7-10 days

Expectorants and bronchodilators

In addition to the destruction of infectious agents, with an exacerbation of chronic bronchitis, it is necessary to restore the main function of the bronchi, eliminate their narrowing and reduce the amount of mucus produced. For this, bronchodilators and mucolytics are used, which turn viscous mucus into liquid, so that it is well excreted with a cough, and expand the lumen of the bronchi, making it easier for the patient to breathe.

Group	A drug	Image	Efficiency	Reception features
	"ACC"		Liquefies and removes sputum from the bronchi, reduces the formation of secretions. Also effective against purulent sputum	The dosage and course of treatment depend on the course of the disease and the characteristics of the patient's body.
Mucus thinners	Mukodin		Reduces the viscosity of bronchial secretions, reduces cough	The average dosage is 50-750 mg per day until a therapeutic effect is achieved (treatment duration 8-10 days)
Mucoregulators	Bromhexine		Increases bronchial secretion, has a pronounced expectorant effect	One tablet is taken with or without food. The course of treatment - from 4 days to 4 weeks
Mucoregulators	"Ambroxol"		The action of the drug is similar to Bromhexine. Effective in respiratory failure syndrome	The average dosage is 1-3 tablets, depending on the age of the patient and the course of the disease. It is taken after meals, long-term treatment is necessary to achieve the desired effect.

It is important to note that the effectiveness of mucolytic and expectorant drugs is significantly increased when taking a large amount of drink (especially alkaline).

Bronchodilators

Good action in chronic bronchitis means called bronchodilators (bronchodilators). They must be used after the first signs of obstruction appear, i.e. shortness of breath, difficult exhalation, etc. These drugs include Eufillin», « Atrovent», « Berodual», « Salbutamol, « neophyllin», « Fluticasone". They widen the gap respiratory tract and eliminate the negative processes associated with the disease. The best option for using such drugs is inhalation using a nebulizer or inhaler, as they relieve bronchial spasm as quickly and efficiently as possible.

One of the most modern methods of combating chronic bronchitis is halotherapy. The procedures are carried out in specially equipped chambers, where optimal conditions for humidity and temperature are created, and the air is thoroughly cleaned and saturated with saline solutions. With the help of halotherapy, patients can completely get rid of mild forms of the disease, and with a complex course, significant relief is achieved, so that a person can do without drugs for a long time.

Folk remedies

Alternative medicines are often used in the fight against chronic bronchitis in combination with medications, but their use has a number of side effects and requires consultation with a pulmonologist.

Application folk remedies and conventional drugs should be carried out in such a way that the interval between their intake is at least an hour.

Lemon with glycerin

An easy-to-use product that is suitable for patients of any age. Take a medium lemon, wash well and boil for 5 minutes. Allow to cool, squeeze juice from half of the fruit into a 250 ml bowl, add 2 tbsp. glycerin. Stir, add honey so that the resulting mixture fills the container to the top. Mix again, insist in a cool place for 2-3 hours. Drink one tablespoon before meals (30 minutes) to achieve a therapeutic effect.

Black radish

Black radish is one of the oldest and most widely used remedies for combating bronchitis and other diseases of the pulmonary system. Take a medium-sized root crop, remove the core so that you get a cup-shaped container with a recess. Put a tablespoon of honey into it, without filling it to the brim, as the radish will release a lot of juice. Put in a suitable dish, leave for 12 hours, then take the resulting juice in a tablespoon four times a day, the course of treatment is 1-2 weeks.

Onion

Onion is a strong natural phytoncide that destroys harmful microorganisms and helps relieve cough in chronic bronchitis. Onion juice can be used for inhalation, or it can be used to make effective oral medicines from the fruit.

Dissolve a glass of sugar in a liter of water, put two medium onions in the syrup and boil until the volume of liquid is reduced by half. For the treatment of chronic bronchitis, the remedy should be drunk in two days, and in other cases, take half a glass 2-3 times a day until the condition is relieved.

Another effective recipe is as follows. Peel and chop two or three small onions, place in a saucepan and pour milk over. Boil until the onion becomes soft, then add honey to the liquid at the rate of a teaspoon per glass. Take an hourly tablespoon, the course of treatment is 1-3 days.

Herbal decoctions

Decoctions from medicinal herbs, as well as the fruits of coniferous trees, help well not only with chronic bronchitis, but even with confirmed pulmonary emphysema. Tablespoon of soft pine buds pour a glass of boiling water, steam for half an hour and let it brew for 15 minutes. Take a tablespoon three times a day until the condition is relieved. The mixture can be used as a solution for inhalation.

If speak about medicinal herbs, then lanceolate thermopsis, licorice, plantain, coltsfoot, licorice, creeping thyme have the greatest healing effect. They are taken orally in the form of decoctions, as well as alcohol or water infusions.

Video - How to treat bronchitis at home with folk remedies

General rules for the treatment of chronic bronchitis

The first and main condition for recovery for all people diagnosed with chronic bronchitis is a complete cessation of smoking, and patients should not even be in rooms where cigarette smoke is present. The apartment should be regularly wet cleaned, avoiding the accumulation of dust, as well as ventilation (regardless of the time of year).

In combination with drugs, it is necessary to do therapeutic gymnastics, breathing exercises and hardening of the body. It is important to note that measures for hardening the body are carried out exclusively during the period of remissions with great care in order to prevent hypothermia of the body. plays an important role in the healing process proper nutrition, being outdoors and taking vitamins. Subject to all of the above rules, you can get rid of not only chronic bronchitis, but also forget about colds and SARS forever. study the link.

Video - How to treat chronic bronchitis

• Cough (first dry, then sputum).
• Shortness of breath (with damage to the small bronchi).
• Increase in body temperature.
• General weakness, decreased performance.
• Increased sweating.
• Possible chest pain.

Forms

With the flow:

• spicy- symptoms persist for no more than 3 weeks;
• chronic- symptoms persist for at least 3 months a year for 2 or more years. The course is characterized by periods of exacerbation and remission (a favorable period during which there are no manifestations of the disease or a slight cough persists with a small amount of sputum).

Classification of chronic bronchitis:

• chronic simple- has an infectious onset, is characterized by the release of mucous sputum;
• chronic mucopurulent- has an infectious onset, is characterized by the release of mucopurulent sputum;
• chronic mixed– its development is caused by many factors (infection, physical and chemical agents);
• chronic, unspecified- the cause of development is not determined.

The reasons

The following factors can be named as the causes of bronchitis:

• infection (viruses, bacteria, less commonly fungi);
• physical agents (excessively dry, hot or cold air);
• chemical agents (for example, vapors of acids, alkalis)

Predisposing factors (reducing the local immunity of the bronchial tree and contributing to the development of bronchitis) include:

• smoking (active and passive);
• pathology of the nasopharynx: chronic inflammatory processes (for example, pharyngitis - an inflammatory process in the pharynx, sinusitis - an inflammatory process in the paranasal sinuses), impaired nasal breathing and purification of inhaled air (for example, polyps in the nasal cavity - growths of soft tissues that rise above the mucous membrane);
• alcohol abuse;
• unfavorable climatic factors and working conditions: frequent hypothermia, dampness, inhalation of polluted atmospheric air;
• congestion in the lungs (for example, with heart failure);
• frequent SARS (frequent acute respiratory viral infections, colds).

Diagnostics

• Collection of complaints (cough, sputum production, fever, shortness of breath, chest pain) and anamnesis (history of development) of the disease (for example, in chronic bronchitis, cough with sputum is disturbed for at least 3 months a year for 2 and over years).
• General inspection: inspection chest, listening to the lungs with a phonendoscope: hard breathing, dry or wet rales are determined in the lungs.
• Complete blood count - signs of an inflammatory reaction are possible (an increase in the level of leukocytes, an acceleration of the erythrocyte sedimentation rate (ESR)).
• Sputum analysis (if any) - to detect the pathogen and its sensitivity to antibiotics (if their appointment is required).

In order to exclude other diseases that have similar symptoms, additional examination methods may be required:

• X-ray of the chest organs (to exclude pneumonia - inflammation of the lungs);
• spirometry (spirography) - allows you to assess the airway patency of the respiratory tract and the ability of the lungs to straighten. It is used to exclude bronchial asthma and chronic obstructive pulmonary disease (COPD);
• computed tomography of the chest;
• bronchoscopy is a study that allows you to examine the mucous membrane of the bronchi from the inside and examine its cellular composition using a special apparatus.

Consultation is also possible.

Treatment of bronchitis (acute, chronic)

Non-drug treatment:

• plentiful drink - tea with lemon, raspberry jam, lime blossom tea, heated alkaline mineral waters;
• to give up smoking;
• elimination of the influence of factors environment that cause cough (for example: smoke, dust);
• rational nutrition (high-calorie, enriched with vitamins);
• physiotherapy procedures (for example, calcium electrophoresis - the introduction of calcium ions into the body through intact skin under the influence of direct current).

Medical therapy:

• antiviral drugs, since viruses are the most common cause of bronchitis;
• Antibiotics are NOT recommended for uncomplicated bronchitis. They should only be assigned obvious signs bacterial damage to the bronchi (excretion of purulent sputum and an increase in its amount, the occurrence or increase in shortness of breath and the increase in signs of intoxication - persistent high body temperature). The use of antibiotics in other cases is irrational, since the main causative agents of bronchitis are viral infections, against which antibiotics do not work. Their unjustified use only contributes to the formation of antibiotic-resistant strains of microorganisms that pose a serious threat to others;
• mucolytic drugs (sputum thinners) - are prescribed in the presence of viscous, difficult to separate sputum;
• bronchodilators - expand the narrowed bronchus, helping to improve the passage of air through the respiratory tract. They are prescribed for shortness of breath, difficulty breathing, the presence of dry wheezing in the lungs;
• antitussive drugs (suppress cough) - only in the presence of a painful dry cough. It should not be used simultaneously with mucolytics (sputum thinning agents), since cough suppression in this case will contribute to the stagnation of liquid sputum in the bronchi;
• alkaline inhalations (with mineral waters, Ringer's solution, saline) - contribute to better sputum discharge, reduce the inflammatory process;
• antipyretic drugs (only at high body temperature - over 38 ° C);
• immunomodulators (drugs that stimulate the body's immune system) - with frequent exacerbations of chronic bronchitis. They are prescribed during the period of remission (the period of absence of symptoms).

Complications and consequences

• As a rule, acute bronchitis ends in complete recovery.
• Transition to a chronic form is possible.
• Respiratory failure is insufficient supply of oxygen to the body.
• The development of pneumonia (pneumonia) - as a rule, with a neglected course and no treatment.

Prevention of bronchitis (acute, chronic)

• Vaccination (pneumococcal, influenza vaccine, Haemophilus influenzae vaccine).
  • Vaccination is very important for people belonging to the “risk group”: the elderly, people with immunodeficiency conditions, people suffering from chronic lung diseases, of cardio-vascular system, diabetes mellitus.
  • Optimal vaccination time: October - mid-November.
  • In the future, the effectiveness of vaccination decreases significantly, since the likelihood that the body has already been in contact with the viruses and bacteria that are activated at this time increases sharply, and, therefore, will not be able to provide a sufficient immune response even after vaccination.

• Taking immuno-strengthening drugs during the season of possible exacerbation (autumn-winter) with frequent exacerbations of chronic bronchitis.
• Compliance with the rules of personal hygiene (frequent handwashing, limiting visits to crowded places during the flu epidemic).

Bronchitis is an inflammatory pathology that affects the bronchial tree. Most often, the disease is provoked by viruses, but later a secondary one can join. bacterial infection. A fairly common cause of bronchitis is respiratory diseases, in which case the infection from the upper respiratory tract enters the bronchi, where inflammation develops. If the disease is not treated, it quickly becomes chronic. In this case, a strong cough and malaise can be observed for several months. Exacerbation of chronic bronchitis brings a lot of trouble to the patient and requires the intervention of a doctor.

What changes are observed

Chronic bronchitis always starts gradually. The bronchial mucosa produces more and more sputum, while it is getting worse and worse. This leads to a strong cough, which initially occurs only after waking up in the morning, and then accompanies the patient all day. Cough attacks become more intense if a person inhales too cold or humid air. If the disease is not treated for a long time, then after a few years the cough will be a constant companion of the patient.

In the chronic form of bronchitis, a person regularly coughs up a large amount of transparent, odorless, vitreous sputum. Exacerbation of bronchitis can occur with the release of yellowish-purulent mucus, which may have a specific putrid odor.

With long-term chronic bronchitis, the lumen of the bronchi is greatly narrowed, which leads to a violation of the passage capacity of the respiratory organ. The patient periodically has attacks of severe shortness of breath with the impossibility of a normal exhalation. Quite often at such patients there are asthma attacks. This leads to the development of another dangerous disease- chronic obstructive pulmonary disease. In this case, not only the bronchial tree, but also the lungs suffer. Such disorders can quickly lead to the development of emphysema.

In chronic bronchitis, breathing is severely impaired, which leads to oxygen starvation important organs and systems in the body. With a prolonged lack of oxygen, the patient's condition worsens and irreversible changes in the body may occur.

In chronic bronchitis, scarring of the respiratory organs occurs, due to which the small bronchi can be completely clogged.

Symptoms

Symptoms of exacerbation of chronic bronchitis are quite specific, they are difficult to confuse with another disease.

1. The main symptom of chronic bronchitis is a persistent cough, which can be with or without phlegm. If the disease continues for too long, then the sputum becomes purulent.
2. As the disease progresses, shortness of breath progresses. At first, it appears only with strong physical exertion, but over time, such a symptom is observed even in a state of complete rest.
3. Bronchospasm may occur. This is a condition in which the patient cannot exhale normally. In this case, there is a strong cough, which is often accompanied by signs of suffocation.

In addition, in the acute stage, the patient may have an increase in body temperature and severe weakness may occur. Against the background of hyperthermia, symptoms of intoxication of the body are often observed.

In children, exacerbation of chronic bronchitis is always more severe than in adults, and appetite also worsens significantly, which can lead to weight loss in the baby.

How to treat exacerbation of chronic bronchitis

Treatment of exacerbation of chronic bronchitis in adults is always complex. Not in all cases, such treatment helps to completely get rid of the disease, but drug therapy can significantly increase the periods of remission and stop the progression of the disease.

To treat an exacerbation, antibiotics, cough medicines, antiallergic and anti-inflammatory drugs can be prescribed. Inhalations and physiotherapeutic methods are also shown. Do not forget that the patient must give up bad habits, normalize nutrition and adhere to a healthy lifestyle.

Antibiotics

The appointment of antibiotics is advisable if the patient's condition is quite severe, symptoms of intoxication are observed, or a large amount of purulent sputum is coughed up. In this case, penicillins, macrolides, cephalosporins and fluoroquinolones can be prescribed. The most common drugs of choice are:

Doctors try to prescribe antibiotics based on the results of bacterial culture of sputum. If for some reason it is impossible to collect sputum for analysis, then broad-spectrum antibiotics are prescribed.

Antibacterial agents can be prescribed both in tablets and in injections. The form of the drug is determined by the attending physician. Small children are prescribed antibiotics in the form of a syrup.

Before prescribing antibiotics, the doctor must conduct a test for sensitivity to a particular drug. It should be borne in mind that most often allergies are provoked by antibiotics of the penicillin group.

Cough preparations

In order for a patient to be cured of a debilitating cough, it is necessary to take several drugs of different drug groups. Basically, drugs are prescribed that thin the sputum and contribute to its gentle removal from the respiratory organs. Most often, doctors prescribe ACC, Lazolvan, Ascoril, Ambrobene and Bromhexine.

Treatment can be supplemented with various herbal cough medicines. It can be medications based on licorice root, thermopsis herb or marshmallow. A doctor should prescribe herbal medicines, taking into account the age of the patient and the severity of his condition.

Anti-inflammatory drugs

In severe cases of bronchitis, anti-inflammatory drugs may be prescribed. Such drugs help to reduce the amount of secreted mucus and reduce the activity of inflammatory cells in the mucosa. The doctor may prescribe the following medications:

• Eufillin;
• Atrovent;
• Spiriva;
• Ventolin;
• Flexotide;
• Berodual.

Most of these drugs are available in the form of metered sprays. Such medicines are quite practical. The patient can carry a small can in a pocket or bag and use it as needed.

With an exacerbation of chronic bronchitis, sprays are injected at the time of inspiration. Due to this, it is possible to achieve a quick hit medicinal product to the site of inflammation.

Inhalations

In the treatment of exacerbation of chronic bronchitis, inhalation through a nebulizer helps well. Such a device allows you to spray medicinal solutions to the smallest particles, after which they easily fall directly into the focus of inflammation.

For inhalation, both in the hospital and at home, the following solutions can be used:

Medicines for inhalation are mixed with saline and poured into the nebulizer container. The duration of one procedure can be up to 20 minutes. The frequency of such procedures per day is determined by the attending physician.

Medicines for inhalation should be selected by a doctor. Without a doctor's prescription, it is allowed to inhale only vapors of mineral water or soda solution.

How to get rid of chronic bronchitis

To completely recover from chronic bronchitis, you should radically reconsider your habits and your entire lifestyle. First of all, it is worth giving up smoking if such a bad habit exists. It has been noticed that heavy smokers are more likely to suffer from pathologies of the respiratory organs and often face complications.

Patients with chronic bronchitis are shown Spa treatment at least once a year. In this case, preference should be given to health resorts, which are located in a pine forest. A good effect gives a stay in salt caves or salt rooms.

To reduce the frequency of relapses in chronic bronchitis, it is advisable for the patient to do breathing exercises. With these simple exercises, you can significantly improve your well-being.

Chronic bronchitis is more difficult to treat than acute bronchitis, but you can significantly reduce the likelihood of exacerbations if you follow the doctor's recommendations. The treatment of such a pathology is always complex, with the use of antibiotics and cough medicines.

Any disease of an inflammatory nature can turn into a chronic, tormenting person. for a long time, then calming down, then escalating.

Bronchitis is no exception catarrh of the bronchi with mucus on expectoration.

Attention! ethnoscience in case of recurrence of chronic bronchitis, it is used only as an auxiliary aid, but not as the main therapy. And only after the consent of the attending physician.

With exacerbation of chronic bronchitis, a special place is given breastfeeding(No. 1 and 3):

Breast Collection #3. It is famous for its expectorant and anti-inflammatory effect. It is used at the beginning of the development of complicated chronic bronchitis without the presence of additional exacerbations. The collection consists of marshmallow root (2 parts) and oregano, birch buds and elecampane root (1 part of each plant). The course of additional herbal therapy lasts up to 2-3 months.

Healing potions are prepared according to one recipe: grass (1.5-2 tablespoons) is steamed with boiling water (200 ml). The container is tightly closed and placed in a boiling water bath for a quarter of an hour (for tincture), for half an hour to prepare a decoction. After that, the mass is squeezed out, and the finished medicine is diluted with water to 180-200 ml. Take 8-10 times daily: every 1.5-2 hours for a tablespoon.

How to treat exacerbation of chronic bronchitis - prevention of relapse

The modern course of therapy for complications of chronic bronchitis includes a physiotherapy course, massages, menu adjustments (more protein, fresh vegetables and fruits are included in the diet) and the intake of multivitamin complexes and immunomodulators. An important role is also given to the prevention of relapses in chronic bronchitis. Need:

• get vaccinated against the flu;
• master a healthy lifestyle;
• completely stop smoking;

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 thing is when a similar situation is repeated 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. main group risk 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 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.

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 exertion, 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. Color change 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. Recently, especially effective drugs Sumamed, Rulid have also been 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, one should not forget about the support of one of the most important organs human body- liver. After all, this body is a natural filter and passes everything 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 ( combination drug) or Theophylline with the ineffectiveness of the above-mentioned means.
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. positive action vitamins C, A, immunomodulators of plant origin also affect 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) noticeably improve the clearance of mucus from the bronchi. 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 may 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 inhalation, pairs of herbs are used, essential oils, sodium bicarbonate. 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. On the background 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.

Lifestyle adjustments are needed to eliminate risk factors for development infectious diseases 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. Walking in the fresh air and hardening will not be superfluous.