Each inflammatory disease can develop into a chronic form and will disturb a person for a long time. Chronic bronchitis is no exception, the exacerbation of which causes the separation of mucus during coughing. There is catarrhal inflammation of the bronchial mucosa. Along with it, the structure of tissues in the lungs changes. Exacerbation occurs 2-3 times a year. Why does the pathology return, how to treat and how?
Why does bronchitis become chronic?
In chronic bronchitis, the bronchi become inflamed. Pathology causes coughing fits and copious sputum production, general weakness is observed. Relapses can occur for two or more years.
Like any chronic disease, bronchitis has two stages: exacerbation and remission. Pathology can stretch for decades. At the same time, each exacerbation introduces irreversiblechanges in the structure and properties of the bronchial mucosa and muscles.
Obstruction may occur - narrowing of the bronchial cavity, this is typical for chronic bronchitis. An exacerbation (the medical history testifies to 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), past respiratory disease, hypothermia, the course of the disease is complicated.
Cough can be caused by an allergic reaction. For example, for a certain drug.
Negative factors
Exacerbation of chronic bronchitis occurs in such cases:
- undertreated disease or was carried on the legs;
- negative external factors: smoking, working in a dusty or cold room, in hazardous production;
- poor immunity;
- hereditary predisposition to respiratory diseases;
- bronchial hypersensitivity;
- SARS frequent;
- infectious foci of inflammation in the body.
Relapse most often occurs in patients who live in areas with a humid and cold climate.
Conditions predisposing to exacerbation
Triggering chronic inflammation in the bronchi is quite difficult. It is impossible to single out a specific factor.
So, the conditions that implyexacerbation of bronchitis:
- pathology of the upper respiratory tract;
- foci of infection in the body (for example, chronic pyelonephritis);
- impaired nasal breathing (due to a broken nasal septum, nasal polyps);
- congestion in the lungs (reason: heart failure);
- alcoholism;
chronic renal failure
Chronic bronchitis most often occurs in long-term smokers.
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 the cough becomes excruciating and provokes a severe headache.
During the remission of bronchitis, the cough becomes dry, mucus separates slightly. The cough may be accompanied by wheezing. If chronic bronchitis is in the acute stage, then the volume of sputum increases dramatically.
Chronic bronchitis is a pathology during the development of which the bronchial mucosa functionally changes:
- damaged bronchial mucus secretion mechanism;
- deformed mechanism for clearing mucus in the bronchi;
- bronchial immunity is weakening;
- bronchial walls become inflamed, thickened.
Chronic bronchitis develops quite quickly, since the bronchial mucosa is constantly affected by viruses that are in the air.
Main symptoms of exacerbation of chronic bronchitis:
- shortness of breath even withwalking;
- nausea;
- sweating;
- weakness of the body;
- wheezing while breathing;
- blue tip of nose and ears, fingers and toes;
- sleep is disturbed;
- decrease in performance level;
- dizzy;
- rapid heart rate even at rest;
- severe headache.
Cough in chronic bronchitis can be dry or wet. The volume of sputum secreted per day is less than 150 grams. Sputum has a different character: watery, transparent, mucous, with blood or purulent impurities.
When exacerbated, pus of a greenish hue is formed in the mucosa. When such sputum appears, the microbial flora is activated. In this case, you should immediately seek the advice of a doctor so that he can adjust the treatment.
Wheezing almost always occurs during an exacerbation, due to the fact that the gaps in the bronchi are clogged with sputum.
During an exacerbation, the patient most often suffers a viral or bacterial infection. He is her bearer. 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 type - a complication from other diseases. Common: pneumonia, tuberculosis. This pathology manifests itself as a complicationin the form of bronchitis.
There is another classification - according to 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.
Based on the nature of sputum, bronchitis is divided into:
- catarrhal bronchitis is mucous, but there is no pus in the clear discharge of mucus;
- catarrhal-purulent and purulent bronchitis - opaque purulent inclusions in the sputum.
Exacerbation of chronic obstructive bronchitis is most often caused by respiratory infection, arrhythmia, spontaneous pneumothorax and intense physical activity.
Stages of exacerbation
The stage of exacerbation can be clearly established by the expectorant mucus. So, such signs play an important role: color, volume, consistency. These signs "dictate" the history of the disease. Chronic bronchitis in the acute stage is expressed by respiratory failure.
Let's analyze the stages of exacerbation:
- The beginning of a relapse. During this period, the secreted sputum is quite viscous, thick and 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 released in a small amount.
- Late deadline. Sputum purulent brown. Separated in large quantities.
Separate types of relapses are distinguished based on the clinical picture of the pathology:
- 1st type: relapse increases volumeexpectorant sputum. She may be purulent. Shortness of breath worsens.
- 2nd type: in the second type of relapse, chronic bronchitis is characterized by purulent sputum production.
- 3rd type: to all signs of the first two types, the following symptomatic signs must be added:
- febrile state of the patient;
- increased and more frequent coughing;
- ORZ (during the week);
- dry wheezing during breathing;
- breathing increases by 25% (when compared with breathing in a he althy state);
- increases heart rate and heart rate (compared to a he althy 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 an exacerbation of chronic bronchitis, depending on the form of development of the disease, subcodes are distinguished, namely:
- J40 - code for catarrhal bronchitis (forms: acute and chronic);
- J42 - Chronic bronchitis, unspecified.
Purulent-obstructive form (mixed) bronchitis has the following codes: J41 or J44. The specific code depends on the presence of a purulent formation or spasm in the bronchi.
This disease is also divided into other codes, depending on the stage of development of the exacerbation. So, code J41 according to ICD-10 - exacerbation of chronic bronchitis, tracheitis, tracheobronchitis withpurulent sputum.
Diagnosis
Diagnosis of chronic bronchitis is to identify clinical symptoms and interview the patient. As a result of the survey, the doctor finds out the suggestive negative factors that caused the pathology.
Diagnosis is difficult. The patient needs to pass the following tests:
- blood test (general and biochemical) to detect the presence of inflammatory processes;
- urinalysis;
- laboratory study of expectorant sputum;
- chest x-ray to detect 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 identify possible oncological or tuberculosis pathologies in time.
Compulsory x-ray and CT scan.
Treatment
In case of exacerbation of chronic bronchitis, treatment should be comprehensive. Effective treatments target:
- to reduce exacerbation;
- to improve the quality of life;
- to improve exercise tolerance;
- to prolong remission.
If an exacerbation 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 antiviraldrugs.
- Expectorants: ACC, Lazolvan, Flavamed, Bromhexine.
- It is recommended to take mucolytics: Ambroxol, Bromhexine, Carbocysteine.
- Bronchodilators: Eufillin, Theophylline, Salbutamol.
Complex treatment involves the use of antibacterial, expectorant, bronchodilators, anti-inflammatory, antihistamines. Recommended inhalation, physiotherapy.
Antibiotics
It is necessary to use antibacterial drugs in cases where a purulent exacerbation of chronic bronchitis develops. Treatment, for which drugs are prescribed semi-synthetic composition, should be complex.
So, if acute pneumonia develops (as a complication) against the background of chronic bronchitis, the doctor prescribes the following drugs:
- penicillins ("Amoxicillin", "Augmentin"),
- cephalosporins ("Ceftriaxone"),
- macrolides ("Sumamed", "Azithromycin"),
- fluoroquinolones ("Ciprofloxacin").
Antibiotics kill beneficial intestinal microflora. To restore it, it is recommended to take probiotics ("Lineks", "Laktovit", "Bifiform").
Complications
Exacerbation of chronic bronchitis can lead to a number of complications. Doctors divide them into two groups:
- infectious group (pneumonia, bronchiectasis, asthmatic and bronchospastic components);
- second group: progression of the underlying disease.
Maybethe appearance of complications such as emphysema, pulmonary hypertension, cor pulmonale, cardiopulmonary failure, pneumonia, bronchial asthma.
Traditional medicine
Treatment of exacerbation of chronic bronchitis can be carried out with the help of folk remedies. Consider the most common recipes:
- Decoction of apricot kernels. From 20 g of seeds, it is necessary to extract the nucleoli. Pour 1 cup boiling water over them. Bring to a boil and simmer for 5 minutes over low heat. Remove from stove and strain after 2 hours. Drink a decoction of ¼ cup 3-4 times a day. Kernels can be eaten.
- Gush of horseradish and lemon. It will take 150 g of horseradish and 3 pieces of lemons. Scroll through the ingredients in a meat grinder and mix thoroughly. The resulting slurry should be taken on an empty stomach in the morning and at bedtime. This remedy has an anti-inflammatory effect and promotes good expectoration.
- Medicinal herbs. It is necessary to make a medicinal collection from such herbs: coltsfoot, plantain, licorice, thyme. 1 st. Pour a spoonful of the mixture with 0.5 liters 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 1 tsp to it. honey, a pinch of s alt and a small piece of butter (literally on the tip of a knife). Mix thoroughly and consume in small sips. You need to drink the whole glass, and then cover yourself with a warm blanket. It is an effective anti-inflammatory, warming andexpectorant.
Cabbage and honey compress. You will need a large cabbage leaf. Honey should be applied on it with a thin layer. Apply a compress to the bronchial area and fix. Be sure to insulate the top. 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 non-obstructive bronchitis);
- taking vitamins A, B, C and biostimulants (aloe juice, propolis).
You can do a massage. It promotes expectoration and has a bronchodilatory effect.
Chronic bronchitis is a disease that can lead to serious consequences. There is no need to delay therapy. You cannot self-medicate. Entrust your he alth to an experienced qualified doctor. Only he can prescribe an effective method of treatment. Stay he althy!
