In addition to cough, signs of chronic bronchitis can be: shortness of breath - in the early stages of the disease occurs only with physical exertion; over time becomes so pronounced that it makes it much more difficult or impossible to perform daily activities (for example, dressing); increased susceptibility to infections - with colds and other respiratory infections, there is a tendency for their rapid spread to the chest, increased sputum production, shortness of breath and lung damage; drowsiness, inhibition, decreased ability to concentrate, general malaise.
Morbidity
Chronic bronchitis is usually observed in the elderly. This disease occurs in 17% of men and 8% of women aged 40 to 64 years. Most of them are smokers.
Causes
The main cause of chronic bronchitis and emphysema is tobacco smoke. Chronic bronchitis is practically not observed in nonsmokers, and the degree of its severity directly correlates with the number of cigarettes smoked each day. Less significant factors are air pollution and industrial dust, but they can exacerbate the already existing disease. Symptoms observed in chronic bronchitis are caused by the following pathological chain:
- Slime-producing glands in the walls of the bronchi and trachea increase in volume; the enlargement of glands entails the excessive production of a viscous secret, which is separated in the form of sputum;
- Excess of sputum leads to blockage of the bronchi;
- There is a thickening of the walls of the bronchi, which leads to an even greater narrowing of their lumen.
Running chronic bronchitis can be accompanied by a marked inflammation of the bronchi, accumulation of pus in them, the formation of ulcers and scars. In most patients with COPD (chronic obstructive pulmonary disease), along with chronic bronchitis, there are signs of emphysema. Emphysema of the lungs is characterized by the following symptoms:
- irreversible changes in the lungs, in which the alveoli (air sacs) increase in size and lose elasticity;
- the patency of the respiratory tract progressively worsens, which is accompanied by the appearance of dyspnea;
- in most cases, emphysema occurs in smokers;
- some patients have a genetic predisposition to the development of emphysema.
The presence of a persistent cough with sputum discharge in a smoker with a long history leads to the assumption of a diagnosis of chronic bronchitis. However, it is necessary to exclude other possible causes of chronic cough and shortness of breath - for example, asthma, tuberculosis or lung cancer. When examining a patient with chronic bronchitis, the following symptoms can be found:
- dyspnea;
- crepitation or signs of a decrease in the passage of air into the lungs during auscultation;
- rapid breathing;
- difficulty breathing - the entrainment of the intercostal muscles and nostrils with inspiration;
- reduction of chest excursion on inspiration;
- cyanosis - the skin of the patient looks bluish due to insufficient air intake or increased stress on the heart due to pathological changes in the lungs (the so-called pulmonary heart).
Diagnostics
Diagnosis of chronic bronchitis is based on the following methods:
- chest radiography is not always informative, in the early stages of the disease can not detect abnormalities;
- blood tests - the level of hemoglobin and the volume of precipitated erythrocytes can be increased as a result of compensatory reaction to a decrease in the level of oxygen in the lungs;
- electrocardiogram (ECG) - can detect an overload of the right heart, performing blood pumping to the lungs;
- functional pulmonary tests - used to measure the volume of inhaled and exhaled air, as well as the vital capacity of the lungs.
The task of primary importance in the treatment of bronchitis is the cessation of smoking. Even with a severe form of the disease, this often leads to a reduction in cough. The impact of other provoking factors, such as air pollution and industrial dust, should also be avoided.
Medication
There are several groups of drugs used to treat chronic bronchitis:
- bronchodilators. Preparations of this group (salbutamol, ipratropium bromide) promote the expansion of the bronchi, which leads to better breathing. They act most effectively and are best tolerated by patients in the form of aerosols for inhalation;
- corticosteroids. Reduce inflammatory changes. Not all patients respond to treatment with corticosteroids. However, if a trial course of oral intake of prednisolone for 2-3 days leads to a reduction in dyspnea, long-term therapy with inhaled steroids can be indicated. Effective doses of inhaled steroids are lower than tablets, which reduces the risk of side effects;
- antibiotics. In acute respiratory infections, an antibiotic is prescribed to prevent complications from the lungs. Treatment is recommended to begin when sputum appears yellowish or greenish;
- infection prevention. In chronic bronchitis, it is important not to neglect the annual
- immunization against influenza, as this disease increases the risk of developing pulmonary infections;
- oxygen therapy. Especially shown with a sharp deterioration in respiratory function against respiratory infections. In severe exacerbation of chronic bronchitis, prolonged ocongenatherapy, conducted around the clock (even during sleep), can help reduce shortness of breath and improve the survival of patients.
Other treatments
The following methods can also improve the condition of bronchitis:
- Physiotherapy - promotes sputum discharge;
- steam inhalations - contribute to the dilution of phlegm, which flies over its coughing;
- exercise therapy - creating a patient's motivation for regular light physical exercises can help reduce shortness of breath and fatigue;
- auxiliary ventilation of the lungs - if the condition worsens against the background of an acute infection, a special respirator can be used (in cases when the difficulty of breathing becomes life-threatening).
At the onset of the disease, symptoms can be expressed slightly. The patient has a cough with little sputum. If you quit smoking at this stage, there may be no progression of the disease and even the reverse development of inflammatory changes in the bronchi. With a more severe form of bronchitis and the continuation of smoking, a predisposition to respiratory tract infections is formed, which can be complicated by pneumonia and respiratory failure. The risk of death from chronic bronchitis in smokers is higher than that of non-smokers. In almost 50% of cases, patients with severe respiratory disorders die within five years of the onset of the disease, but the prognosis improves with quitting. Mortality rates increase with significant air pollution. Now we know how the exacerbation of chronic bronchitis, the treatment of this ailment, is proceeding.