Each inflammatory disease can develop into a chronic form and will bother a person for a long time. Chronic bronchitis, the exacerbation of which causes mucus to separate when coughing, is no exception. Catarrh of the bronchial mucosa occurs. Together with it, the structure of tissues in the lungs changes. Exacerbation occurs 2-3 times a year. Why does pathology come back, how to treat and how?
Why does bronchitis become chronic?
In chronic bronchitis, the bronchi become inflamed. Pathology causes coughing attacks and excessive sputum production, general weakness is observed. Relapses can occur within two or more years.
Like any chronic disease, bronchitis has two stages: exacerbation and remission. Pathology can last for decades. In addition, each exacerbation makes irreversible changes in the structure and properties of the mucous membrane and muscles of the bronchi.
Obstruction may occur - a narrowing of the bronchial cavity, which is characteristic of chronic bronchitis. An exacerbation (a medical history indicates this) provokes shortness of breath, oxygen starvation and intoxication of the body.
Why does bronchitis become chronic? Initially, the patient suffers an acute form of bronchitis. Under the influence of infections (bacterial, fungal, viral), respiratory illness, hypothermia, the course of the disease is complicated.
Coughing may be caused by an allergic reaction. For example, for a specific drug.
Negative factors
Exacerbation of chronic bronchitis occurs in such cases:
- untreated disease or was carried on the legs;
- negative external factors: smoking, work in a dusty or cold room, in hazardous work;
- weak immunity;
- hereditary predisposition to respiratory diseases;
- hypersensitivity of the bronchi;
- ARVI frequent;
- infectious foci of inflammation in the body.
Relapse most often occurs in patients who live in areas with a humid and cold climate.
Predisposing conditions
The launch of chronic inflammation in the bronchi is quite complicated. It is impossible to single out a specific factor.
So, the conditions that suggest exacerbation of bronchitis:
- pathology of the upper respiratory tract;
- foci of infection in the body (for example, chronic pyelonephritis);
- violation of nasal breathing (due to a broken nasal septum, polyps in the nose);
- congestion in the lungs (cause: heart failure);
- alcoholism;
Most often, chronic bronchitis occurs in smokers with experience.
The manifestation of exacerbation: symptoms
The main symptom of chronic bronchitis is a cough. With its strengthening, we can talk about a relapse of the disease. Sometimes a cough becomes painful and provokes a severe headache.
During remission of bronchitis, the cough becomes dry, the mucus is slightly separated. Coughing may be accompanied by wheezing. If chronic bronchitis is in the acute stage, then the sputum volume increases sharply.
Chronic bronchitis is a pathology during the development of which the bronchial mucosa functionally changes:
- the mechanism of secretion of bronchial mucus is damaged;
- the mechanism of cleaning mucus in the bronchi is deformed;
- immunity of the bronchi weakens;
- the walls of the bronchi become inflamed, thicken.
Chronic bronchitis develops quickly enough, because the bronchial mucosa is constantly affected by viruses that are in the air.
The main symptoms of exacerbation of chronic bronchitis:
- shortness of breath even when walking;
- nausea;
- sweating
- weakness of the body;
- wheezing while breathing
- the tip of the nose and ears turns blue, fingers and toes;
- sleep disturbance;
- decreased performance;
- dizzy;
- rapid heart rate even at rest;
- Strong headache.
Cough in chronic bronchitis may be dry, or may be wet. The amount of sputum excreted per day is less than 150 grams. Sputum has a different nature: watery, transparent, slimy, with blood or purulent impurities.
With exacerbation in the mucosa, pus of a greenish tint is formed. When such sputum appears, the microbial flora is activated. In this case, you must immediately consult a doctor so that he adjusts the treatment.
Wheezing almost always occurs during an exacerbation, due to the fact that the gaps of the bronchi are clogged with sputum.
During an exacerbation, the patient most often suffers a viral or bacterial infection. He is its carrier. The doctor assesses the severity of the disease by the expressed symptoms and indicators of external respiration.
Classification
The causes of chronic bronchitis "dictate" their classification. So, chronic bronchitis is divided into "causal" types:
- an independent type of bronchitis - appears without the influence of the inflammatory process in the body;
- secondary view - a complication from other diseases. Common: pneumonia, tuberculosis. These pathology manifests itself as a complication in the form of bronchitis.
There is another classification - by the degree of involvement of bronchopulmonary tissue in the pathological inflammatory process:
- obstructive bronchitis - the lumen of the bronchi narrows;
- non-obstructive bronchitis - the width of the bronchi remains the same.
By the nature of sputum, bronchitis is divided into:
- catarrhal bronchitis - mucous, but there is no pus in the transparent detachable mucus;
- catarrhal-purulent and purulent bronchitis - opaque purulent inclusions in the sputum.
An exacerbation of chronic obstructive bronchitis is most often caused by a respiratory infection, arrhythmia, spontaneous pneumothorax and intense physical exertion.
Stages of exacerbation
By expectorant mucus, the stage of exacerbation can be clearly established. So, such signs play an important role: color, volume, consistency. These signs are “dictated” by the medical history. Chronic bronchitis in the acute stage is expressed by respiratory failure.
We analyze the stages of exacerbation:
- The onset of relapse. During this period, sputum excreted is quite viscous, thick and is difficult to separate. The color of the consistency is greenish. Most often, expectoration occurs in the morning. And during the day the mucus liquefies, is excreted in a small amount.
- Late date. Sputum purulent brown. Separated in large quantities.
Separate types of relapses, based on the clinical picture of pathology:
- 1st type: with relapse, the volume of expectorant sputum increases. She may be purulent. Dyspnea intensifies.
- Type 2: in the second type of relapse, chronic bronchitis is characterized by the release of purulent sputum.
- Type 3: the following symptomatic signs must be added to all the symptoms of the first two types:
- fever of the patient;
- increased and increased coughing;
- ARI (within a week);
- dry wheezing during breathing;
- breathing quickens by 25% (when compared with breathing in a healthy state);
- heart rate and heart rate increase (comparing with a healthy state).
Relapse of the disease can lead to hypoxia and exacerbation of other chronic diseases in the patient.
ICD code for exacerbation of chronic bronchitis
It should be noted that the ICD is an international classification of diseases. This is a specific regulatory document that ensures the unity of the methodological approach.
According to the ICD, with exacerbation of chronic bronchitis, subcodes are distinguished, depending on the form of the development of the ailment, namely:
- J40 - code of catarrhal bronchitis (form: acute and chronic);
- J42 - chronic unspecified bronchitis.
The purulent-obstructive form (mixed) of bronchitis has the following codes: J41 or J44. The specific code depends on the presence of a purulent mass or spasm in the bronchi.
This disease is also divided into other codes, depending on the stage of development of the exacerbation. So, the ICD-10 code J41 is an exacerbation of chronic bronchitis, tracheitis, tracheobronchitis with the release of purulent sputum.
Diagnostics
Diagnosis of chronic bronchitis is to identify clinical symptoms and interview the patient. As a result of the survey, the doctor finds out the alleged negative factors that caused the pathology.
Diagnosis is complicated. The patient must undergo such tests:
- blood test (general and biochemical) to detect the presence of inflammatory processes;
- Analysis of urine;
- laboratory examination of expectorant sputum;
- chest x-ray to identify lesions;
- spirography to determine the function of external respiration;
- FBS (fibrobronchoscopy) is the most informative laboratory diagnostic method. Thanks to him, you can objectively see the clinical picture of the disease and in time to identify possible oncological or tuberculous pathologies.
Mandatory x-ray examination and computed tomography.
Treatment
With exacerbation of chronic bronchitis, treatment should be comprehensive. Effective treatment methods are aimed:
- to reduce exacerbation;
- to improve the quality of life;
- to increase resistance to physical activity;
- to extend remission.
If the acute phase has begun, then the primary task of therapy is to eliminate the inflammatory process in the bronchi and improve bronchial patency.
If the cause has a viral etiology, then treatment should be with antiviral drugs.
- Expectorant drugs: “ATSTS”, “Lazolvan”, “Flavamed”, “Bromhexine”.
- It is recommended to take mucolytics: Ambroxol, Bromhexine, Carbocysteine.
- Bronchodilator drugs: “Eufillin”, “Theophylline”, “Salbutamol”.
Comprehensive treatment involves the use of antibacterial, expectorant, bronchodilators, anti-inflammatory, antihistamines. Recommended inhalation, physiotherapy.
Antibiotics
The use of antibacterial drugs is necessary in cases where a purulent exacerbation of chronic bronchitis develops. Treatment, preparations for which are prescribed semi-synthetic composition, should be comprehensive.
So, if acute pneumonia (as a complication) develops against a background of chronic bronchitis, then the doctor prescribes such drugs:
- penicillins (Amoxicillin, Augmentin),
- cephalosporins ("Ceftriaxone"),
- macrolides (Sumamed, Azithromycin),
- fluoroquinolones ("Ciprofloxacin").
Antibiotics kill the beneficial intestinal microflora. To restore it, it is recommended to take probiotics (Linex, Lactovit, Bifiform).
Complications
Exacerbation of chronic bronchitis can lead to a number of complications. Their doctors are divided into two groups:
- infectious group (pneumonia, bronchiectasis, asthmatic and bronchospastic components);
- second group: progression of the underlying disease.
Complications such as pulmonary emphysema, pulmonary hypertension, pulmonary heart, cardiopulmonary failure, pneumonia, bronchial asthma are possible.
ethnoscience
Treatment of exacerbation of chronic bronchitis can be carried out using folk remedies. Consider the most common recipes:
- Apricot kernel decoction. From 20 g of seeds, nucleoli must be removed. Pour them with 1 cup of boiling water. Bring to a boil and boil for 5 minutes over low heat. Remove from stove and strain after 2 hours. Drink a decoction ÂĽ cup 3-4 times a day. Nucleoli can be eaten.
- Gruel and horseradish gruel. You will need 150 g of horseradish and 3 pieces of lemons. Scroll components in a meat grinder and mix thoroughly. The resulting slurry should be taken on an empty stomach in the morning and before bedtime. This remedy has an anti-inflammatory effect and promotes good expectoration.
- Medicinal herbs. It is necessary to make a drug collection of such herbs: coltsfoot, plantain, licorice, thyme. 1 tbsp. pour a spoon of a mixture of 0.5 l of boiling water. Let it brew for 3 hours. Consume 1/3 cup for 10 days.
- Hot milk with honey and soda. It is necessary to warm the milk, pour it into a glass. Add to it 1 tsp . honey, a pinch of salt and a small piece of butter (literally on the tip of a knife). Stir thoroughly and consume in small sips. You need to drink the whole glass, and then take cover with a warm blanket. It is an effective anti-inflammatory, warming and expectorant.
- Compress from cabbage and honey. It will take a big cabbage leaf. A thin layer of honey should be applied to it. Apply a compress to the area of ​​the bronchi and fix. Top must be insulated. Keep the compress all night.
What to do with an exacerbation?
If chronic bronchitis has made itself felt, the exacerbation of which is treated with drugs, it is recommended to add to the drug treatment:
- physiotherapy - contribute to a speedy recovery;
- physiotherapy exercises (allowed during treatment of exacerbation of obstructive bronchitis);
- intake of vitamins A, B, C and biostimulants (aloe juice, propolis).
You can do massage. It promotes sputum discharge and has a bronchodilator effect.
Chronic bronchitis is a disease that can lead to serious consequences. It is not worth putting off with therapy. You can not engage in self-medication. Entrust your health to an experienced, qualified doctor. Only he can prescribe an effective method of treatment. Be healthy!