If a person has chronic bronchitis among the other diseases in the history of the disease, it can be said with confidence that the person is faced with considerable problems and discomfort in everyday life. It is important to regularly practice measures to prevent relapse, and in case of exacerbation, immediately begin treatment. Consider what this pathology is and what are its key features.
general information
As can be learned from directories telling about medical histories, chronic bronchitis has troubled humanity since ancient times. Modern doctors understand by this term such a diffuse disease that encompasses the bronchial system and is explained by the prolonged influence of the inflammatory focus or irritating factors. The pathological process begins with the formation of endobronchitis, that is, a condition in which the quality and characteristics of the mucous membranes of the bronchial tree are adjusted. This leads to a change in the secretory activity of the internal system.
The progress of the disease is accompanied by tissue degeneration and the formation of stable foci of inflammation. Bronchial walls undergo sclerotic changes. Studies diagnose mesobronchitis or panbronchitis. The process is accompanied by excessive secretion of the bronchi. The ability of organs to cleanse themselves is impaired.
Relevance of the issue
As statistical medical research shows, in patients in the history of the disease, chronic bronchitis is very common. The disease belongs to the category of common. In 1998, research activities were organized that made it possible to determine: among the pathologies of the respiratory system that are not caused by tuberculosis, bronchitis in the form of a chronicle accounts for almost a third of all cases. Doctors have identified the tendency of the disease to increase prevalence in society. Scientists attribute this fact to the fact that an increasing percentage of humanity is dependent on tobacco products, is faced with harmful compounds due to the characteristics of professional activities. The deterioration of the environmental situation and the decrease in the quality of the air we breathe play a role. The level of reactivity of people is changing. The main percentage of victims of the disease are people who smoke tobacco products for a long time. Among patients there are more men than women. The chronic form is more common among residents of large cities, in which there are a sufficient number of industrial facilities.
One of the problems of the present time, fixed in all directories devoted to case histories: chronic bronchitis in a number of patients is very difficult to diagnose. There are many cases of erroneous detection of the chronicle instead of the acute form of the disease, if the case is protracted or the patient is characterized by numerous relapses. A relatively common disease is obstructive bronchitis in the form of a chronicle. It can be confused with a simple chronic one, if the manifestations of obstruction are weak or absent at the time of investigation of the condition.
Specification Features
Chronic bronchitis is a disease, the refinement of which is carried out taking into account international criteria introduced by WHO and adopted on the territory of our country. According to this system, the considered pathology in the version of the chronicle is considered to be current with cough and sputum production, lasting for a quarter of a year, observed for two consecutive years with such a frequency. In this case, it is necessary to organize measures for differential diagnosis in order to exclude other explanations of symptoms. Take into account that the problem can be caused by inflammatory and other diseases not only of the bronchial tree, but also of the pulmonary system and upper airways.
A case classification system has been developed. Following it, it is necessary to check the patient's condition for the presence of the primary form of the disease - this is independent. The second type is a secondary disease. In this case, in children, in adults, in the history of the disease, chronic bronchitis appears against the background of a different pathological condition. There are many known cases of the formation of this pathology in tuberculosis or oncological processes, uremia. Chronic bronchitis can appear with a congestive type of heart failure, as well as in the case of bronchiectasis.
About categories
Studying the examples of case histories with chronic bronchitis given in special medical textbooks and reference books, one can see that in the context of clarifying the case, some indicate an obstructive form of the disease, but more often an obstructive form of the disease is recorded. The division by this criterion is due to the functional manifestations of the case. The doctor assesses how severe dyspnea is. Be sure to check the forced expiration parameters. It is necessary to take a measurement in one second.
To clarify the characteristics of the case, it is important to check the laboratory parameters of organic fluids and identify the clinical features of the case. Sputum is examined and its nature is formulated, cytology of bronchial flushing is analyzed, and the level of neutrophil shift in the screening is revealed. It is necessary to check the reaction of the acute phase. Based on the information received, the disease is considered a catarrhal form or purulent mucosa.
In the history of the disease with chronic bronchitis (non-obstructive, obstructive), it is necessary to specify what the phase of the case is. The disease can be detected during remission with the clinical features of this stage. There is a possibility of an exacerbation step.
Polutants and health
Quite often, the doctor writes “professional chronic bronchitis” in the patient’s card in the medical history. The disease develops with a prolonged effect on the human body of volatile compounds that are harmful to health - they are called in medicine pollutants. The disease can cause non-indifferent dust. Such ingredients in the atmosphere irritate the bronchial mucosa due to mechanical damage and chemical activity.
Of the most dangerous and common pollutants, tobacco dust comes first. Active and passive smoking are equally dangerous for human health. The smoke generated in this case is formed by numerous fractions. In the form of gas, formaldehydes and urethane, chlorides and other hazardous ingredients enter the environment. The solid parts of the smoke are formed by nicotine, cadmium and a number of other compounds that are no less dangerous to humans. Smoke leads to the ingestion of a huge amount of particles into the human respiratory system, which are irritating to the mucous membranes.
Dangers: what else?
Occupational disease, chronic dust bronchitis, is not less common . In the history of a particular person’s illness, this appears with a high degree of probability if a person is forced to regularly encounter volatile pollutants while working in an industrial zone, on a production site. Certain hazardous compounds are found in the home. Studies have shown the serious impact of products formed during the combustion of coal and oil. Dangerous ingredients released during incomplete combustion of gas, as well as sulfur oxides. The air is heavily polluted by dust, smoke and gases produced by moving vehicles. The atmosphere contains an abundance of toxic ingredients that irritate the mucous membranes.
Another danger that can provoke bronchitis in the form of a chronicle is infectious pollution of the environment. Influenza, adenovirus, bacterial contamination, mycoplasma - all these pathological life forms with a high degree of probability affect human health, provoking a complex of diseases.
It is known that bronchitis is more often formed in people who are forced to live in an unfavorable, unfriendly climate. If the individual structural features of the body, health are such that a person suffers from disorders of the nasopharynx, cannot breathe normally through the nose, the risk of chronic bronchitis increases significantly.
Pathogenesis of the disease
As can be concluded from the publications devoted to the characteristics of therapy, the medical history, many studies have been conducted on chronic bronchitis. Those showed that in many ways pathogenesis is due to a failure of the ability of the bronchial system to secrete secretions and protect tissues from aggressive factors. No less important is mucociliary clearance, that is, the ability of an organ to cleanse. This is most often explained by the influence of external factors - that is, pollutants.
Normally, mucous secretions in the bronchial tree are a multicomponent substance formed by mucous cells, secretions of submucosal glandular elements, and tissue transudate. In secret there are cellular elements of the epithelial surface layer, alveolar surfactant. On average, only 5% of the substance is secreted; the rest is discharged under water. Mucus is fundamentally important for local protection, in its composition there are lysozyme and acids, various elements due to which the bronchi are protected from infectious agents. Here, the first alpha form of antitrypsin is present, thanks to which the system is protected from proteolytic enzymes. Mucous discharge is a natural protective layer covering the bronchial epithelial cilia.
As is known from numerous case histories, chronic dust bronchitis is one of the most common forms of pathology. It is formed due to the influence of dust - a common pollutant. The influence of any aggressive volatile compound initiates excessive secretory activity, which causes too much mucus to form. At first it helps to protect the body, being an irritant, due to which a cough is excreted, which removes pollutants.
Process development
According to the official description of the disease encoded by the codes J41, J42 in the ICD, chronic bronchitis is accompanied by an increase in the viscosity of the substance secreted in the bronchi. For this reason, the excretion of fluid slows down, the secret sticks to the ciliary layer, which makes the movement blocked, the clearance is lost. Cells cannot function and develop normally, which leads to their death and the appearance of so-called bald spots. These areas are distinguished by the lack of movement of the mucociliary substance, so the mucus adheres to the tissues, and an inflammatory process is initiated. This phenomenon allows you to diagnose endobronchitis.
The inflammatory process leads to the correction of the cellular state of mucus of bronchitis - the concentration of neutrophils increases, sputum receives purulent inclusions, its viscosity increases. It is very difficult to cough up such a substance.
CNB: non-obstructive disease
This form of bronchial disease is detected with diffuse violation of the bronchial mucosa due to prolonged exposure to aggressive factors. Fixed by the ciphers J41, J42 in the ICD, chronic bronchitis of this type is accompanied by the formation of a focus of inflammation, excessive mucus secretion in violation of the purifying bronchial function. More often localization is the proximal part of the bronchial tree, where the concentration of cells in the form of glasses increases, the percentage of ciliary cells structures decreases. Metaplasia is observed. Usually the changes are superficial.
The main manifestation of the pathology is cough. Relapses are more often pursued during a period when the street is cold and humid, the temperature regime changes dramatically. Exacerbations due to colds, flu, acute respiratory infections are frequent. A symptom of chronic bronchitis of the considered form, indicating the need for treatment, is a cough, in which up to 100 ml of mucus is released per day. In the case of a catarrhal course of discharge, the mucous membranes, with a purulent mucosa, contain pus inclusions. When the most acute phase passes, the cough continues to bother, but periodically.
In the case of a purulent variety, manifestations of general poisoning of the body are possible. The patient is drawn to sleep, the functioning of the sweat glands is activated. Another typical manifestation is dry wheezing of low tonality, indicating the density of sputum. If the secret is thin enough, wheezing becomes wet.
Features of manifestation
Symptoms of chronic bronchitis in adults and children include difficulty breathing. With an obstructive type, this phenomenon is recorded only in a relatively small percentage of patients. The complication of the respiratory act accompanies a cough, a sharp change in the temperature of the environment. Symptoms can suspect the spread of the inflammatory process to small parts of the bronchial tree.
With a purulent inflammatory process, ESR increases. Bronchoscopy shows hyperemia of tissues. During the period of remission, the patient's condition is good, but coughing in the morning worries. In the case of progress and the spread of the process to small structures, the probability of the transition of the form to obstructive is high.
Obstructive type: manifestations
Encrypted with codes J41, J42 in ICD 10, chronic bronchitis of obstructive format manifests itself as a cough, accompanied by the release of a small amount of sputum. This is more pronounced in the morning. The secreted secret in the catarrhal course is formed by mucus, in the case of purulent contains purulent components. This is observed if the pathological process is complicated by infection.
A feature of the disease is expiratory dyspnea due to obstructive changes. At first, the patient notes an insufficient amount of air during exercise and exposure to cold during an act of coughing. Over time, respiratory failure disturbs in a calm state.
A purulent version of the course is usually accompanied by general poisoning of the body. The activity of sweat glands is activated, the patient feels weak. Some people have a fever.
On average, as one can conclude from a study of case histories devoted to manifestations and therapy, chronic obstructive bronchitis (in frequency in one out of four) is first accompanied by inflammatory processes in small bronchial elements. There is no cough, therefore, it is difficult to clarify the phenomenon. If a cough forms, it can be assumed the progression of the pathology and the coverage of large structures.
Case Clarification Features
An X-ray of the lungs does not provide enough useful information, but allows you to clarify the presence of individual sections of the seal. Coded as J41, J42 in ICD 10, chronic bronchitis is a pathological process, the refinement of which is possible through bronchoscopy. This exercise helps determine how active the inflammatory areas are. The doctor evaluates the clearance of bronchial secretions. Cytological examination of the flush is a procedure during which the cellular format of the secreted substance is determined. Often shown to do a biopsy. The event helps to assess the condition of the mucosa.
A cytological study gives an idea of ​​the nature of the inflammatory focus, the activity of this process. With a purulent option, an increased concentration of neutrophils can be detected.
The progress of pathology is accompanied by a deterioration in the supply of oxygen to the body. It is shown to check the gas composition of the blood to determine the extent of the problem. The results of the study give an idea of ​​respiratory failure.
Treatment
As can be concluded from numerous case histories, chronic bronchitis (of dust etiology and provoked by other factors) in the general case is more difficult, has a worse prognosis if the patient is a person of advanced age. Negatively affect the prognosis of smoking addiction, poor body response to drugs. The prognosis is worse for severe obstruction and severe hypoxemia. Decompensated pulmonary heart disease is another factor that worsens the prognosis of a case.
The therapeutic course is selected by the doctor. Its effectiveness is determined by the patient’s ability to give up smoking, to exclude dangerous factors from his life. Only the removal of pollutants does not yet provide a cure, but improves the prognosis. Therapy is selected based on the nuances of the case. It is shown to take drugs that cleanse the bronchial tree and reduce the viscosity of the secreted secretion. Recommended funds, due to which coughing becomes more effective. Cough suppressing drugs, especially for systematic consumption, are prohibited. The objective of the course is to exclude congestive bronchial processes leading to the multiplication of pathological microflora and aggravation of inflammation.
What to use?
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The patient will benefit from the means that regulate the ability to secrete secretions by the bronchi. They correct not only the secretion generation, but also glycoproteins (this process proceeds in the bronchial epithelium). Popular remedies are Lazolvan, Ambrohexol. Useful are Mukodin and Bromkatar.
Mucolytics will sometimes benefit. Substances make sputum thinner, due to which its excretion from the body is simplified. Most often, cysteine ​​processing products are prescribed. In pharmacies, they are presented under the names "Mukomist" and "Broncholysin." Medicines containing acetylcysteine ​​are sometimes recommended because they initiate the active production of glutathione.
Treatment: features
When symptoms of chronic bronchitis are indicated in adults and minors, antibiotics are sometimes indicated. Such drugs are taken in case of a purulent form of the disease. First you need to check the sensitivity of pathological microflora to different substances. The duration of antibiotic use is from a week to two. Prophylactic administration of such drugs does not give a result. With a pronounced purulent process, sanitation of the bronchial tree with the help of a bronchoscope is indicated.
If there is obstruction
In the case of chronic obstructive bronchitis, treatment is complicated when compared with case management of an obstructive process. The main task of the doctor is to choose a program in which the rate of progress of the disease decreases. It is important to increase the resistance of a person to stress, to make a higher quality of life. An integrated approach is required taking into account individual characteristics. An outpatient course is indicated, and in case of relapse - hospitalization.
A key aspect is the use of drugs that expand the bronchi. Bronchodilators and expectorants are medicines that are basic for this course. Three types of drugs are known: second type beta agonists, methylxanthines, and anticholinergic drugs.
Some experts advise starting a therapeutic program with Atrovent or ipratropium bromide. The drugs are available in the form of sprays, are applied four times a day. Reversibility is inherent in anticholinergics, a decrease in parasympathetic tone is observed in the body. The use of "Atrovent" in chronic obstructive bronchitis does not lead to the formation of systemic negative phenomena, does not affect the heart. The effect is rather slow, the maximum is recorded approximately an hour after administration. The effect lasts up to eight hours. A stable result is observed a week or a half after the start of use.
Treatment and cure
The main objective of the therapeutic program is to exclude exacerbation of chronic bronchitis. For this, it is necessary to practice the treatment prescribed by the doctor, to attend physiotherapeutic procedures. The classic approach is a combination of massage, treatment with magnetic fields, mud and paraffin. Additionally shown UHF and electrophoresis. This combined approach improves blood flow, relieves swelling of tissues and stimulates local immunity. An organism that receives comprehensive medication and physiotherapy support is restored faster and more effectively copes with the infectious focus, pathogenic microflora.
There is a good effect of using medicinal herbs. During relapse, these drugs relieve symptoms and improve the patient’s condition, during remission, increase its duration and exclude exacerbation. One of the most effective plants is thyme. Mucokinetic qualities and reparative abilities are inherent in him. In pharmacies, fees are presented with this plant. Grass can be harvested independently, brewed instead of tea at any convenient time.
More about herbs
No less useful licorice, which has anti-inflammatory qualities. This plant contains components that can fight viruses. Rhizomes are especially useful. Almost any pharmacy has syrups and tinctures made using licorice extract. At home, drinks, infusions, decoctions with licorice rhizomes are prepared. They are used instead of tea in a glass per day. This supplementation of the diet helps to reduce the likelihood of exacerbation of a chronic disease.
It is recommended to use fir oil. This natural preparation contains components that deactivate the inflammatory focus.
Many drugs are made with the inclusion of herbal ingredients. If you do not want to use pharmacy products, they prepare infusions and decoctions on their own, using them inside daily instead of tea and coffee.