Obstruction is the obstruction of the respiratory tract. It can occur in any of its areas, from the pharynx to bronchioles. Accordingly, in this state of affairs, an obstructive cough occurs due to this obstruction. In turn, it is a symptom of the same name bronchitis (caused by obstruction, abstraction). In the article we will analyze the causes of this condition, concomitant symptoms of the disease, methods of diagnosis, alleviation of the patient's condition, direction of treatment.
What is it?
Obstructive cough accompanies the eponymous form of bronchitis. This is called inflammation of the bronchi, which is complicated by obstruction. With the disease, there is also swelling of the respiratory tract, deterioration of the ventilation function of the lungs. The mucous membranes and trachea, and the bronchial tree are affected.
Obstructive bronchitis mainly occurs in two forms:
- Acute. Most often, small children suffer from it. This form of the disease is usually triggered by viral infections - influenza, adenoviruses, parainfluenza, respiratory syncytial virus.
- Chronic. This form of bronchitis is characteristic already for adults. It is dangerous because it can go into bronchial asthma. The consequence of both viral and bacterial infections.
Causes of the acute form
The cause of obstructive cough is obstruction. That is, the obstruction that blocks the respiratory tract (respiratory tract). Obstructive cough is not an independent disease. This is one of the characteristic symptoms of the same name bronchitis. What are the causes of this disease?
In most cases, the development of a similar form of bronchitis provokes the following:
- Respiratory syncytial viruses.
- The causative agents of influenza.
- Adenoviruses.
- Parainfluenza viruses of the 3rd type.
- Rhinoviruses.
- Viral and bacterial associations.
All of the above becomes the cause of an acute form of the disease, accompanied by coughing attacks. Also among indirect reasons, in some cases, the following can be called:
- DNA persistent pathogens of infections. This is a virus of herpes, mycoplasma and chlamydia.
- Weakened immunity. Acute obstructive bronchitis usually affects children who are often ill.
- Children with a hereditary predisposition to bronchitis.
- Patients predisposed to allergic reactions.
Causes of the chronic form
Obstructive cough torments the patient due to the fact that his airways are not free, irritated, inflamed. The body instinctively tries to free them in this way. The result is an excruciating cough in fits. It is triggered here by three factors at once:
- Swelling of the mucous membranes of the bronchi.
- Increased production of thicker bronchial mucus, which is then filled with actively propagating pathogens - bacteria, fungi, viruses (their metabolic products additionally irritate the respiratory tract, which causes a strong cough).
- Spasms of smooth muscles.
But coughing with obstructive bronchitis is just a symptom. The chronic form of this disease usually causes the following:
- Both active and passive smoking.
- Polluted atmosphere. Especially if the air contains sulfur dioxide.
- Adverse working conditions. Especially, work with silicon or cadmium.
How does the acute form manifest
Symptoms of obstructive cough are signs of the disease that it accompanies. Since he is not an independent disease, he himself is a sign. In this case, obstructive bronchitis. In addition to a paroxysmal strong obsessive cough (both dry and wet, with the release of sputum) cough, the patient has the following:
- Elevated body temperature.
- Weakness.
- Headache.
- Dyspeptic disorder.
- Dyspnea.
This form of the disease is most often diagnosed in children under three years of age. The disease is characterized by an acute onset. During the act of breathing, auxiliary muscles (neck muscles, shoulder girdle, abdominal muscles) will also take part. During inhalation, the wings of the baby’s nose swell widely. There will be characteristic whistling elongated exhalations, "musical" rales. This is due to respiratory obstruction that makes breathing difficult.
The duration of the disease is 1-3 weeks. If it reappears within a year, it makes sense to talk about a relapse of the disease. If symptoms torment the patient for more than two years, the doctor translates the diagnosis into a chronic one.
Symptoms of a chronic form
What does obstructive cough mean? This is a form caused by obstruction of the respiratory tract. That is, the occurrence of an obstacle in them for breathing. In the case of bronchitis, it is thick mucus, swelling, muscle cramps. Both appearances are unpleasant for humans.
The main symptoms of obstructive bronchitis are coughing and shortness of breath. At the first, a small amount of sputum is released. During an exacerbation of the disease, it is purulent or mucopurulent. Coughing torments the patient not only throughout the day, but also at night. May be accompanied by wheezing (due to the same obstruction). In some cases, blood pressure rises and hemoptysis is observed.
Then difficult breaths appear - this is expiratory shortness of breath. The patient may feel as if lack of oxygen during physical exertion, respiratory failure. The severity of the disease depends on the presence of concomitant pathologies, the state of immunity.
As the chronic form of bronchitis progresses, the patient may also begin to note the following:
- Headache.
- Fatigue.
- Increased sweating.
The nature of cough in obstructive bronchitis is obsessive. These are attacks that significantly impair the patient's quality of life.
Diagnostic directions
The diagnosis of obstructive bronchitis should only be made by an experienced pulmonologist. After all, coughing and shortness of breath can also indicate two serious diseases - tuberculosis and lung cancer. To exclude them, the patient is assigned a whole range of diagnostic procedures:
- Endoscopic.
- Functional.
- X-ray
- Laboratory
- Physical.
Diagnostic measures
As for the physical diagnosis, the doctor notes the nature of the cough, breathing of the patient, the presence of whistles and wheezing, trembling voice, decreased mobility of the pulmonary edges. X-rays provide an opportunity to exclude or identify the presence of lung diseases.
A cough medicine for obstructive bronchitis is prescribed only with confirmation of the diagnosis. For this, special procedures are carried out:
- Spirometry. This is called measuring the volume of external respiration.
- Pneumotachometry. The study of high-speed and volume air flows during forced and calm breathing.
- Peak flowmetry. This is the maximum speed of the forced inspiration of the patient.
An important event is bronchoscopy. This is not only a diagnostic, but also a therapeutic method. The mucous membranes of the bronchi are examined, sputum is taken, a bronchial tree is sanitized with the introduction of an antiseptic and the removal of a viscous secretion that causes obstruction.
Laboratory diagnostics is the collection of urine and blood for analysis, biochemical and immunological. The acid-base state, the gas composition of the blood, is investigated. A microscopic and bacteriological examination of the collected sputum is carried out.
According to the results of the examination, treatment is prescribed. For the most part, it is conservative, medication.
The main means of therapy
How to treat a strong cough in a child? Drugs must be prescribed by a pulmonologist. Antiviral drugs are prescribed against the causative agents of the disease - "Interferon", "Ribavirin." If obstruction is severe, the following will be shown:
- Mucolytic drugs. "Lazolvan", "Acetylcysteine."
- Expectorants. "ACC", "Ambroxol".
- Painkillers, antispasmodics. “No-shpa”, “Papaverin”.
- Bronchodilators. Berodual, Salbutamol, Astmopent.
Additional funds
How to treat a strong cough in a child? If it is obstructive in nature, then additional procedures are needed to improve the discharge of sputum (it causes obstruction):
- Percussion massage of the chest. The skin is rubbed, paying attention to the muscles of the chest, intercostal space. Then the patient lies on his back and lowers his head down. The masseur at this time carries out the percussion of the chest from the back.
- Massage of the spinal muscles.
- Vibrating chest massage. It is carried out using special vibratory massagers. Such an event helps to weaken the inflammatory processes.
- Breathing exercises.
The need for special medicines
How to treat obstructive cough? If the cause of the disease is viral, bacterial in nature, then the patient will be prescribed antibiotics. Usually in the following cases:
- Joining a secondary microbial infectious disease.
- In the case when the primary disease was caused by pathogens, bacteria.
- In the absence of the effect of already used drugs.
The best effect with the obstructive form of bronchitis can be achieved by the following antibiotic drugs:
- Macrolides. Azithromycin or erythromycin.
- Protected Penicillins. Amoxicillin and clavulanic acid.
In some cases, bronchodilators are also prescribed that can improve the quality of life of patients by normalizing breathing. These are such drugs:
- Xanthines. For example, "Theophylline."
- Anticholinergics. Atrovent.
- B2 agonists. Berotek.
If the patient has been found to have high levels of carbon dioxide in the blood, he is also prescribed oxygen therapy. Air treatment allows you to increase oxygen pressure. And already due to this, activation of regenerative, oxidative, detoxification processes takes place, both the heartbeat and the respiratory rate are normalized, and the patient’s overall well-being improves.
Danger of disease
Since coughing is not a disease in itself, it cannot cause a danger to the life or health of the patient. This form of the disease, as obstructive acute bronchitis, responds well to treatment. But if a child is prone to allergic reactions, the disease can go on to asthma, asthmatic bronchitis. In some cases, the acute form smoothly flows into a chronic one.
According to statistics, in 5% of cases a secondary infection that affects the lungs joins bronchitis. Pneumonia is already diagnosed. Most often, complications of the chronic form of obstructive bronchitis occur in the following individuals:
- Smokers.
- People with heart disease, kidney disease, heart disease.
- Patients with chronically weakened immune systems.
As for complications, the following is diagnosed:
- Emphysema.
- Respiratory failure.
- Pulmonary heart.
- Violation of protein metabolism in body tissues.
Risk groups
According to the same medical statistics, the following people have a tendency to obstructive form of bronchitis:
- More often prone to colds or infectious diseases.
- Allergic sufferers.
- Passive or active smokers.
- Living in adverse environmental conditions.
- Working in adverse conditions: railway workers, miners, workers in the construction, metallurgy, agricultural industries, office workers involved in printing.
They need to take the most care of their immunity, lead a healthy lifestyle, and try to improve working conditions. As for the secondary prevention of the disease, it is necessary to try to prevent exacerbations of the disease. And in case of a disease, timely and fully treat the studied bronchitis, follow all the recommendations of the doctor.
Obstructive cough is not a disease, but a symptom. Accordingly, diagnosis, treatment consists in identifying and eliminating the cause. They are aimed at combating obstructive chronic or acute bronchitis.