Acute bronchitis code ICD. Classification, symptoms, diagnosis and treatment of chronic bronchitis Acute simple bronchitis ICD

RCHR (Republican Center for Health Development of the Ministry of Health of the Republic of Kazakhstan)
Version: Clinical protocols of the Ministry of Health of the Republic of Kazakhstan - 2013

Acute bronchitis caused by other specified agents (J20.8)

Pulmonology

general information

Short description

Approved
minutes of the meeting of the Expert Commission
on health development issues of the Ministry of Health of the Republic of Kazakhstan
No. 18 dated September 19, 2013

Classification

Clinical classification of acute bronchitis
The epidemiology of acute bronchitis is related to the epidemiology of influenza and other respiratory viral diseases. Most often occurs in the autumn-winter period. The main etiological factor of acute bronchitis (80-95%) is a viral infection, which is confirmed by many studies. The most common viral agents are influenza A and B, parainfluenza, rhinosyncytial virus, less common are coronoviruses, adenoviruses and rhinoviruses. Among bacterial pathogens, a certain role in the etiology of acute bronchitis is assigned to such pathogens as mycoplasma, chlamydia, pneumococcus, and Haemophilus influenzae. No special studies have been conducted on the epidemiology of acute bronchitis in Kazakhstan. According to international data, acute bronchitis is the fifth most common acute disease, debuting with cough.
Acute bronchitis is classified into non-obstructive and obstructive. In addition, there is a protracted course of acute bronchitis, when the symptoms persist for up to 4-6 weeks.

Diagnostics

List of basic and additional diagnostic measures
List of main diagnostic measures:
General blood test according to indications:
cough for more than 3 weeks
· age over 75 years

febrile fever over 38.0 C
for the purpose of differential diagnosis

Fluorography according to indications:
cough for more than 3 weeks
· age over 75 years
· suspicion of pneumonia
· for the purpose of differential diagnosis.

List of additional diagnostic measures:
general sputum analysis (if available)
Sputum microscopy with Gram stain
· bacteriological examination of sputum
· sputum microscopy for CD
· spirography
X-ray of the chest organs
· electrocardiography
· consultation with a pulmonologist (if differential diagnosis is necessary and treatment is ineffective)

Diagnostic criteria
Complaints and anamnesis:
History risk factors may be:
· contact with a patient with a viral respiratory infection,
· seasonality (winter-autumn period),
· hypothermia,
· presence of bad habits (smoking, drinking alcohol),
· exposure to physical and chemical factors (inhalation of sulfur, hydrogen sulfide, chlorine, bromine and ammonia vapors).
Main complaints:
· a cough that is first dry, then with sputum, painful, annoying (a feeling of “scratching” behind the sternum and between the shoulder blades), which goes away when sputum appears.
general weakness, malaise,
· chills,
· Pain in muscles and back.

Physical examination:
body temperature is subfebrile or normal
· on auscultation - hard breathing, sometimes scattered dry rales.

Laboratory research
· in the general blood test, slight leukocytosis and acceleration of ESR are possible.

Instrumental studies
In the typical course of acute bronchitis, the use of radiation diagnostic methods is not recommended. Fluorography or chest x-ray is indicated for prolonged cough (more than 3 weeks), physical detection of signs of pulmonary infiltrate (local shortening of percussion sound, appearance of moist rales), patients over 75 years of age, because their pneumonia often has blurred clinical signs.

Indications for consultation with specialists:
pulmonologist (if differential diagnosis is necessary and therapy is ineffective)
otorhinolaryngologist (to exclude pathology of the upper respiratory tract (URT))
· gastroenterologist (to exclude gastroesophageal reflux in patients with gastroduodenal pathology).

Differential diagnosis

Differential diagnosis:
Differential diagnosis of acute bronchitis is carried out according to the symptom “Cough”.

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Treatment

Treatment goals:
Relieving the severity and reducing the duration of cough;
· restoration of working capacity;
· elimination of symptoms of intoxication, improvement of well-being, normalization of body temperature;
· recovery and prevention of complications.

Treatment tactics:
Non-drug treatment
Treatment of uncomplicated acute bronchitis is usually done at home;
To reduce intoxication syndrome and facilitate sputum production - maintain adequate hydration (drink plenty of water, up to 2-3 liters of fruit drinks per day);
Stop smoking;
Eliminating the patient's exposure to environmental factors that cause coughing (smoke, dust, strong odors, cold air).

Drug treatment:
Since the infectious agent in the vast majority of cases is viral in nature, it is not recommended to routinely prescribe antibiotics. Green color of sputum in the absence of other signs of infection of the lower respiratory tract indicated above is not a reason for prescribing antibacterial drugs.
Empirical antiviral therapy is not usually performed in patients with acute bronchitis. Only in the first 48 hours from the onset of symptoms of the disease, in an unfavorable epidemiological situation, is it possible to use antiviral drugs (ingavirin, umifenovir) and neuraminidase inhibitors (zanamivir, oseltamivir) (level C).
For a limited group of patients, the prescription of antibiotics is indicated, but there is no clear data on the identification of this group. Obviously, this category includes patients with no effect and persistence of intoxication symptoms for more than 6-7 days, as well as persons over 65 years of age with the presence of concomitant nosologies.
The choice of antibiotic is based on activity against the most common bacterial pathogens of acute bronchitis (pneumococcus, Haemophilus influenzae, mycoplasma, chlamydia). The drugs of choice are aminopenicillins (amoxicillin), including protected ones (amoxicillin/clavulanate, amoxicillin/sulbactam) or macrolides (spiramycin, azithromycin, clarithromycin, josamycin), an alternative (if it is impossible to prescribe the former) are 2-3 generation cephalosporins per os. The estimated average duration of antibacterial therapy is 5-7 days.

Principles of pathogenetic treatment of acute bronchitis:
· normalization of the quantity and rheological properties of tracheobronchial secretion (viscosity, elasticity, fluidity);
· anti-inflammatory therapy;
· elimination of annoying non-productive cough;
· normalization of bronchial smooth muscle tone.

If acute bronchitis is caused by inhalation of a known toxic gas, it is necessary to find out the existence of its antidotes and the possibility of their use. For acute bronchitis caused by acid vapors, inhalation of vapors of a 5% sodium bicarbonate solution is indicated; if after inhalation of alkaline vapors, then inhalation of vapors of a 5% solution of ascorbic acid is indicated.
In the presence of viscous sputum, mucoactive drugs are indicated (ambroxol, bisolvon, acetylcysteine, carbocisteine, erdosteine); It is possible to prescribe reflex drugs, expectorants (usually expectorant herbs) orally.
Bronchodilators are indicated for patients with symptoms of bronchial obstruction and airway hyperresponsiveness. The best effect is achieved by short-acting beta-2 agonists (salbutamol, fenoterol) and anticholinergics (ipratropium bromide), as well as combination drugs (fenoterol + ipratropium bromide) in inhalation form (including through a nebulizer).
It is possible to use oral combination drugs containing expectorants, mucolytics, and bronchodilators.
If a lingering cough persists and signs of respiratory tract hyperreactivity appear, it is possible to use anti-inflammatory non-steroidal drugs (fenspiride); if they are ineffective, inhaled glucocorticosteroid drugs (budesonide, beclomethasone, fluticasone, ciclesonide), including through a nebulizer (budesonide suspension). The use of fixed combination inhaled drugs (budesonide/formoterol or fluticasone/salmeterol) is acceptable.
In the absence of sputum during therapy, an obsessive, dry hacking cough, antitussives (cough suppressants) of peripheral and central action are used: prenoxdiazine hydrochloride, cloperastine, glaucine, butamirate, oxeladin.

Other types of treatment: No

Surgical intervention: No

Further management:
After relief of general symptoms, further observation and medical examination are not required.

Indicators of treatment effectiveness and safety of diagnostic and treatment methods:
· elimination of clinical manifestations within 3 weeks and return to work.

Hospitalization

Indications for hospitalization:
Acute uncomplicated bronchitis is treated on an outpatient basis.
Indications for hospitalization (emergency) are the occurrence of complications:
· signs of the spread of a bacterial infection to the respiratory parts of the lungs with the development of pneumonia;
· signs of respiratory failure;
· lack of effect from therapy, the need for differential diagnosis;
· exacerbation of serious concomitant diseases with signs of functional failure (cardiovascular, renal pathologies, etc.).

Prevention

Preventive actions:
In order to prevent acute bronchitis, possible risk factors for acute bronchitis should be eliminated (hypothermia, dust and gas contamination of work areas, smoking, chronic infection of the upper respiratory tract). Vaccination against influenza is recommended, especially for persons at increased risk: pregnant women, patients over 65 years of age with concomitant diseases.

Information

Sources and literature

1. Minutes of meetings of the Expert Commission on Health Development of the Ministry of Health of the Republic of Kazakhstan, 2013
   1. List of used literature 1) Wenzel R.P., Flower A.A. Acute bronchitis. //N. Engl. J. Med. - 2006; 355 (20): 2125-2130. 2) Braman S.S. Chronic cough due to bronchitis: ACCP evidence-based clinical practice guidelines. //Chest. – 2006; 129:95-103. 3) Irwin R.S. et al. Diagnosis and management of cough. ACCP evidence–based clinical practice guidelines. Executive summary. Chest 2006; 129:1S–23S. 4) Ross A.H. Diagnosis and treatment of acute bronchitis. //Am. Fam. Physician. - 2010; 82 (11): 1345-1350. 5) Worrall G. Acute bronchitis. //Can. Fam. Physician. - 2008; 54: 238-239. 6) Clinical Microbiology and Infection. Guidelines for the management of adult lower respiratory tract infections. ERS Task Force. // Infect.Dis. – 2011; 17 (6): 1-24, E1-E59. 7) Uteshev D.B. Management of patients with acute bronchitis in outpatient practice. //Russian medical journal. – 2010; 18(2): 60–64. 8) Smucny J., Flynn C., Becker L., Glazer R. Beta-2-agonists for acute bronchitis. //Cochrane Database Syst. Rev. – 2004; 1:CD001726. 9) Smith S.M., Fahey T., Smucny J., Becker L.A. Antibiotics for acute bronchitis. // Cochrane Database Syst. Rev. – 2010; 4: CD000245. 10) Sinopalnikov A.I. Community-acquired respiratory tract infections // Health of Ukraine – 2008. – No. 21. - With. 37–38. 11) Johnson AL, Hampson DF, Hampson NB. Sputum color: potential implications for clinical practice. RespiraCare. 2008. vol.53. – No. 4. – pp. 450–454. 12) Ladd E. The use of antibiotics for viral upper respiratory tract infections: an analysis of nurse practitioner and physician prescribing practices in ambulatory care, 1997–2001 // J Am Acad Nurse Pract. – 2005. – vol.17. – No. 10. – pp. 416–424. 13) Rutschmann OT, Domino ME. Antibiotics for upper respiratory tract infections in ambulatory practice in the United States, 1997–1999: does physician specialty matter? // J Am Board FamPract. – 2004. – vol.17. – No. 3. – pp.196–200.

Information

List of protocol developers with qualification information:
1) Kozlova I.Yu. - Doctor of Medical Sciences, Head of the Department of Pulmonology and Phthisiology of Astana Medical University JSC
2) Kalieva M.M. - candidate of medical sciences, associate professor of the department of clinical pharmacology, exercise therapy and physiotherapy of Kazakh National Medical University named after S.D. Asfendiyarov.
3) Kunanbai K. - Doctor of Medical Sciences, Professor of the Department of Clinical Pharmacology, Exercise Therapy and Physiotherapy of Kazakh National Medical University named after S.D. Asfendiyarov.
4) Mubarkshinova D.E. - assistant of the department of clinical pharmacology, exercise therapy and physiotherapy of Kazakh National Medical University named after S.D. Asfendiyarov

Disclosure of no conflict of interest: The developers of this protocol confirm that there is no conflict of interest associated with preferential treatment of a particular group of pharmaceuticals, methods of examination or treatment of patients with acute bronchitis.

Reviewers:
Tokesheva B.Sh. - Professor of the Department of Therapy of KazNMU, Doctor of Medical Sciences.

Conditions for reviewing the protocol - after 3 years from the date of publication of the protocol or when new evidence appears.

Attached files

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Chronic bronchitis is assigned to a person if inflammation of the bronchial mucosa does not go away for a long time. According to ICD 10, chronic bronchitis is a lung disease; it has some differences in its course, which are coded J40-J42, J44.

These digital designations are designed for specialists, so that the doctor, at the first glance at the code, can understand what disease he is dealing with.

The main manifestation of chronic inflammation of the bronchi is cough.

Chronic bronchitis is diagnosed if a person suffers from a cough for three months. These episodes are summarized over the course of a year, or if the illness lasts continuously for a specified period of time. This pattern should persist for two years in a row.

If these time intervals do not correspond to the conditions for diagnosis, then coughing episodes are classified as either acute or recurrent bronchitis.

Important: if temporary features were not taken into account, then any prolonged cough would be defined as chronic bronchitis, and a huge number of patients had this diagnosis.

Often situations of prolonged cough are observed in people:

• addicted to smoking;
• who are forced to work under unfavorable working conditions and heavily polluted air.

How does chronic bronchitis form?

1. Inflammation exists in the lungs so long time that changes and restructuring occur in the structure of the bronchi.
2. Changes in the bronchi cause airflow problems.
3. The discharge of secretions from the bronchi becomes difficult.
4. Local pulmonary immunity decreases.
5. When an infection occurs, it becomes extremely difficult for the body to recover completely.
6. The infection continues to develop and inflammation continues to spread.
7. If the development of the disease is not prevented by therapeutic measures, the disease will transform into chronic obstructive pulmonary disease (COPD). This disease has more severe manifestations and its main problem is not only cough, but also the development of respiratory failure.

Photos and videos in this article will show how the disease is formed.

Classification

Chronic bronchitis code according to ICD 10 refers to the block of chronic respiratory diseases, among them there are several conditions that differ in clinical manifestations, they also have different codes in this medical reference book.

Table No. 1. Types of pathology and their designations:

Important: chronic bronchitis can be cured; for this, patients must diligently follow the instructions of the attending physician.

Signs of illness

Chronic inflammation in the bronchi has certain signs of progression, they are described below.

Cough

Cough is the main symptom of most pulmonary diseases. It invariably accompanies the disease and is a symptom that defines the disease.

Cough is divided according to its characteristics:

1. Moist cough– in which expectoration of mucus occurs. This is considered a protective element, in which the produced sputum is naturally evacuated from the bronchial tree, due to this the lumen of the bronchi remains free and the patient’s breathing is not difficult. It is very important that there is no bronchospasm, which prevents normal coughing up of phlegm.
2. Dry cough otherwise it is called non-productive, since it does not separate sputum and remove it from the body, since it is simply absent in the bronchi. Dry cough is assessed by patients as painful. It often occurs in attacks, makes it difficult for the patient to stop, and causes pain in the abdomen and chest. After an attack, the patient still coughs up a meager lump of mucus.

During chronic bronchitis, a wet cough predominates, since sputum is actively produced in the bronchi.

Cough itself is a reflex reaction that occurs in response to the stimulation of numerous receptors located in the mucous membrane of the bronchi and trachea. Impulses from the receptor apparatus rush to the brain, to a special cough center. The brain reacts to impulses and causes the respiratory muscles to contract - this is how a cough occurs.

There is one problem in the nature of cough - the uneven distribution of receptors in the tissues of the bronchi of different sizes:

• a large number of receptors are located in large bronchi and trachea;
• There are practically no receptors in the small bronchi.

In such a situation, if inflammation occurs in small pulmonary structures, then complete blockage occurs quite quickly. A cough does not occur, even in the presence of sputum, the lungs do not provide air movement - bronchial obstruction develops.

Important: it is possible to determine that the cause of the problem is the small bronchi during forced exhalation; if wheezing is heard, then their patency is impaired.

Dyspnea

If chronic bronchitis passes without bronchial obstruction, then shortness of breath does not occur.

It occurs in people in the following cases:

• if an exacerbation occurs, ICD 10 code is J44, the disease is active and symptoms are rapidly increasing;
• if the inflammatory process continues for a very long time, for more than one year, it can be considered a sluggish disease, patients in this case do not even notice the moment when the disease returned to them;
• if a person is a smoker or has a seasonal reaction to changing weather in the form of a cough;
• when a person suffers from an obstructive form of the disease, then shortness of breath forms from the very beginning;
• may occur along with a cough during physical exertion, even with ordinary bronchitis at the initial stage; with further development of the disease, the syndrome increases - symptoms develop in the patient even with minimal activity;
• in severe cases, shortness of breath begins even at rest.

Sputum separation

Important: if a person has difficult working conditions - severe air pollution, then the color of the sputum will vary; among miners, the sputum may be black.

The amount of sputum may vary depending on the stage of the disease and its type.

Table No. 2. How sputum is actively produced under various conditions:

Important: pronounced purulent sputum indicates strong microbial activity, which requires serious treatment.

Wheezing

The occurrence of wheezing is associated with difficulty in normal air movement. Sputum located in the bronchi interferes with the normal movement of air - turbulences are formed, which cause sounds.

By the nature of the sounds you can tell what stage the disease is in:

• when the disease is in remission, dry wheezing is heard;
• If the disease is progressing and sputum is produced, the wheezing becomes moist.

The higher the tone of the wheeze, the smaller the bronchi suffer from obstruction. Such wheezing can be heard even at a distance from the patient.

Bleeding during coughing

The discharge of blood during coughing is not a typical symptom of chronic bronchitis. Such cases arise only when the disease has a very long course.

Important: coughing up blood is a sign of deterioration and complications in the patient.

Blood can appear in different ways:

1. If, after a long bout of coughing, you notice streaks of blood or the sputum has a brown tint, then this fact is not a cause for great concern, but requires mandatory consultation with a specialist.
2. If the blood after a cough is bright red and is released in significant quantities, then this indicates a pronounced pathological change in the bronchial mucosa or the development of hemorrhagic bronchitis. The worst reason for the release of a significant amount of blood is the patient’s oncological status.

Signs of asthma

They occur when chronic bronchitis is accompanied by significant obstruction; it is formed for the following reasons:

• the inflammatory process has been going on for a long time, as a result the bronchi narrow and cease to respond adequately, becoming rigid;
• obstruction may occur due to bronchospasm.

Asthmatic syndrome in chronic bronchitis has the following symptoms:

• a complex of shortness of breath occurs - pressure in the chest, a feeling that there is not enough air;
• significantly difficult exhalation;
• the condition increases or renews when the patient comes into contact with tobacco smoke, room dust, or changes in ambient temperature, especially during a sharp cold snap or frost;
• night cough.

This set of complaints can occur at any stage of the disease. If the disease is not treated, then asthmatic cough occurs not only at night, it appears both in the morning and during the day.

Cyanosis

Occurs only in complicated forms of pathology.

With obstruction, there is a lack of oxygen supply of such strength that cyanosis of one of two types is formed:

• acrocyanosis– limbs turn blue, as well as the ears and tip of the nose;
• diffuse cyanosis– the skin turns blue over the entire surface.

Cyanosis indicates that the bronchi have forever lost the ability to fully ensure air movement. So the air does not have the opportunity to saturate the blood with oxygen and take in the products of respiratory activity. The blood becomes poor, does not saturate tissues and cells with oxygen, and hypoxia occurs.

Symptoms of impaired removal of carbon dioxide, which is concentrated in the lumens of the alveoli and in the blood, with cyanosis will be as follows:

• the patient's sleep will be disturbed, insomnia may occur;
• headache;
• dizziness;
• sweating;
• weakness.

If hypoxia is not eliminated for a long time, then the following symptoms that are not typical for breathing problems occur:

• the nail plates change, taking on the appearance of a watch glass;
• the finger phalanges lengthen, becoming like drumsticks.

The International Classification of Diseases is a reference book for medical professionals; specialists rely on it when prescribing the correct treatment. It is currently in its tenth revision, which is why it is called ICD-10. According to the ICD, chronic bronchitis refers to diseases of the lower parts of the lung and has various types of course.

Only a pulmonologist can properly cure the disease; it is impossible to defeat it on your own. The price of self-medication is a rapid deterioration of the condition, up to a threat to the patient’s life.

It is very important to treat the disease under the guidance of a doctor, based on data about the specific type, this guarantees recovery and the absence of complications.

Obstructive bronchitis (OB) is a serious disease of the upper respiratory tract. It begins with inflammation of the lining of the bronchi, then a spasm joins the inflammation, during which all the mucus accumulates in the organs of the respiratory system. In most cases, breathing is difficult with these symptoms.

The most serious symptom of this bronchitis is acute obstruction (most often found in children) - a slow narrowing of the lumen of the bronchi. Pathological wheezing occurs.

Due to the rapid progression of the disease, it is necessary not to let the disease progress and not allow it to develop into pulmonary hypertension or respiratory failure

Disease code according to ICD-10

According to the international classification of diseases, it belongs to class 10. It has the code J20, J40 or J44. Class 10 is respiratory diseases. J20 is acute bronchitis, j40 is bronchitis as unspecified, chronic or acute and j44 is other chronic obstructive pulmonary disease.

Symptoms and risk factors

Obstructive bronchitis can be divided into two types:

• Primary, it is in no way associated with other diseases;
• Secondary is also associated with concomitant diseases. These include kidney disease (renal failure) and cardiovascular disease; other respiratory diseases;

Risk factors for primary obstructive bronchitis:

• Smoking(also passive);
• Contaminated air;
• Profession(work in a dusty, poorly ventilated area, work in a mine or quarry);
• Age(most often children and elderly people get sick);
• Genetic predisposition(if there is a family history of such a disease, it occurs mainly in women).

Despite the above factors, bacteria remain the main etiological factor

The main ones are the following: Haemophilus influenzae, it occurs in half of the cases, pneumococcus, it accounts for about 25%, as well as chlamydia, mycoplasma, Staphylococcus aureus and Pseudomonas aeruginosa, they each account for 10% of cases.

Symptoms of acute and chronic forms

Chronic bronchitis is classified according to the nature of the sputum:

• Catarrhal;
• Catarrhal-purulent;
• Purulent.

Catarrhal bronchitis occurs in its mildest form and is characterized by a diffuse inflammatory process that does not affect the tissues of the bronchi and lungs. Light sputum contains only mucus.

Catarrhal-purulent– when examining sputum, purulent discharge is found in the mucus.

Purulent obstructive bronchitis- when the patient coughs, purulent exudate is released. When examining sputum, purulent discharge will be present in large quantities.

Symptoms of the acute form:

• In the first 2-3 days of illness, a dry cough is observed;
• At about 3-4 days, the cough becomes wet, and depending on the degree of obstruction of mucus in the bronchial mucosa, it is divided into obstructive and non-obstructive;
• Headache;
• The temperature rise does not exceed 38 degrees;
• Dyspnea;
• Respiratory dysfunction.

Symptoms of the chronic form:

• Relatively satisfactory condition;
• Isolation of a small amount of mucopurulent and purulent sputum;
• The period of exacerbation is most often winter;
• Mostly adults over 40 years of age are affected.

Acute bronchitis often develops in children in the first year of life, since children at this age are predominantly in a horizontal position.

Due to this position of the body, when a child begins to have an acute respiratory viral infection accompanied by a runny nose, the mucus cannot properly come out and descends into the bronchi.

A child at this age cannot cough up mucus, which complicates the treatment and recovery process. Most cases of acute bronchitis are caused by a virus.

Obstructive bronchitis It occurs in children aged approximately 2 to 3 years, and this is due to the physiology of the child. Children at this age have a narrow lumen of the bronchi. Signs of the disease can develop already on the first day of acute respiratory viral infection (earlier than with acute bronchitis).

Symptoms of acute bronchitis:

• Fever 2–3 days;
• General weakness;
• Cough;
• The nasolabial triangle turns blue;
• Dyspnea;
• Bloating of the chest;

Symptoms of OB in children:

• The temperature remains within normal limits;
• Restless behavior;
• Breathing becomes noisy whistling;
• The child often changes body position;
• The chest is enlarged;
• On auscultation - dry whistling rales, as well as a large number of medium and large bubble rales;
• General condition is satisfactory;

Chronic obstructive bronchitis Adults and only in rare cases children get sick. This disease lasts for several years and only gets worse over the years, the period of remission becomes shorter, and the course of exacerbation becomes more severe. Some symptoms, such as shortness of breath, do not go away and remain with the patient constantly.

Diagnosis of the disease

Usually, examination and analysis of physical data are sufficient to confirm the diagnosis. As mentioned above, in a patient with a disease such as obstructive bronchitis, the chest will be enlarged; when examined with a phonendoscope, whistling and buzzing sounds will be heard in the lungs.

But for reliability it is worth conducting a sputum analysis, in order to exclude asthma, whooping cough or a foreign body in the bronchi. To complete the data, you will need to donate blood to see the indicators of ESR and leukocytes; in case of a viral infection, these indicators will be increased.

If the doctor decides on an additional X-ray study of the lungs, then the image will show a bilateral enhancement of the pulmonary pattern with expansion of the roots of the bronchi

Treatment

Treatment of obstructive bronchitis usually takes place on an outpatient basis, with the only exception being children under 3 years of age in severe cases. During treatment, it is necessary to exclude all types of irritants (dust, perfumes, cigarette smoke, household chemicals).

The room where the patient is located must be well ventilated and humidified. Rest and rest are also indicated for this disease. To remove sputum, mucolytic and bronchodilator drugs are prescribed.

To avoid complications and transition from an acute to a chronic condition, the main therapy will be the use of antiviral drugs. The use of antibiotics is justified only if there is no visible improvement and pneumonia is suspected.

Physiotherapeutic procedures (electrophoresis, UHF, laser) will not be superfluous; you can do foot and hand baths with hot water, which helps with sputum removal and percussion massage of the chest.

Drug treatment

Bronchodilator therapy– is in most cases the main method of treating obstructive bronchitis, since it allows you to restore airway patency. There are drugs that last from 12 to 24 hours, which make life much easier for patients.

But it is true that when more intensive bronchodilator therapy is needed, they are not suitable, since there is a risk of overdose. In such cases, more “controlled” drugs are used, for example, Berodual.

It is a symbiosis of two bronchodilators(Fenoterol and Ipratropium bromide). By relaxing blood vessels and smooth muscles of the bronchi, it helps prevent the development of bronchospasm.

Berodual also releases mediators from inflamed cells, has the properties of stimulating respiration, and also reduces the secretion of the bronchial glands.

Mucolytic therapy is aimed at liquefying mucus in the bronchi and removing it from the patient’s body.

There are several groups of mucolytics:

1. Vasicinoids. Vasicinoids and mucolytics, these drugs do not have side effects like the previous groups. They can be used in pediatrics.
   Representatives of vasicinoids are ambroxol and bromhexine.
   Bromhexine is a derivative of vasicine, created synthetically, providing a mucolytic effect. Ambroxol is a new generation medicine that is approved for nursing mothers and pregnant women.
2. Enzymatic. This group of drugs is not recommended for use in pediatrics, since damage to the pulmonary matrix is ​​possible. Because they have a long list of side effects such as coughing up blood and allergies.
3. Thiol-containing. The thiol-containing drug acetylcystiine is capable of breaking down disulfide bonds of mucus.
   But its use in pediatrics is also inappropriate due to the possibility of bronchospasms and suppression of the actions of ciliated cells, which protect the bronchi from infections.
4. Mucolytics are mucoregulators. Representatives of mucolytics - mucoregulators are carbocysteine ​​derivatives, which have both a mucolytic (reduce the viscosity of mucus) and a mucoregulatory effect (reduce the production of mucus).
   In addition, this group of drugs helps restore the bronchial mucosa and regenerate it.

Another group of drugs prescribed to patients with obstructive bronchitis are corticosteroids. I prescribe them only when quitting smoking and bronchodilator therapy do not help.

The ability to work is lost and airway obstruction remains severe. The drugs are usually prescribed in tablet form, less often injections.

Bronchodilator therapy remains the mainstay; corticosteroids are emergency treatment for this disease. The most common medicine in this group is Prednisolone.

Talking about folk medicine, You should not completely rely on it and self-medicate, but it can be used as an auxiliary therapy for the main treatment prescribed by a doctor.

Here are some tips for treatment:

• To stop When a cough begins, you need to drink warm milk with propolis dissolved in it (15 drops).
• Black turnip and honey are great for removing mucus. Take a turnip, wash it well, cut out the middle and put a spoonful of honey there.
  When the turnip gives juice, which mixes with honey, the infusion is ready. You need to drink it 3-4 times a day, a teaspoon.

Antibiotics for obstructive bronchitis

As mentioned above, antibiotics are prescribed only for bronchitis caused by a bactericidal infection.

In all other cases, the use of antibiotics is unjustified and can lead to the opposite effect - dysbacteriosis, development of resistance to this drug, decreased immunity and allergic reactions. Therefore, you should take antibiotics only as prescribed by your doctor and the dosage and regimen prescribed by him.

Urgent Care

Broncho-obstructive syndrome- this is a general symptom complex that includes disorders of bronchial obstruction, based on occlusion or narrowing of the airways.

To alleviate this syndrome It is better to carry out inhalation using a nebulizer and Berodual solution, this will help quickly restore respiratory function. If you don’t have a nebulizer at hand or the ability to use one, you can use this drug in the form of an aerosol.

Prevention

Important role in the prevention of obstructive bronchitis smoking cessation plays a role. It is also worth saying about the room where a person works and lives, it must be ventilated, humidified and clean.

For people with weakened immune systems, it is worth taking immunomodulators to avoid catching an infection, which in turn can lead to a relapse of the disease

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

Code of bronchitis (acute, chronic, obstructive) according to ICD-10

Knowledge of the classification of bronchitis proposed in the International Classification of Diseases, X Revision, is necessary for any doctor to maintain statistical reporting documentation and correctly register diagnoses. However, it does have some disadvantages. In particular, the approaches to identifying disease categories are such that the applicability of the classification in the daily activities of a practicing physician is quite controversial.

Bronchitis is an inflammatory disease of the mucous membrane covering the bronchial tree. Unlike pneumonia, bronchitis causes diffuse damage to the bronchi and there are no focal infiltrative changes. According to the International Classification of Diseases, Injuries and Causes of Death, Xth Revision (ICD-10), there are:

• acute bronchitis;
• Chronical bronchitis.

Acute bronchitis (AB) is an acutely occurring widespread inflammation of the mucous membrane of the bronchial tree, accompanied by increased production of bronchial mucus and the formation of sputum. Often combined with damage to the upper respiratory tract. The ICD-10 code for bronchitis is J20.

Chronic bronchitis (CB) is a long-term widespread inflammation of the mucous membrane lining the bronchial tree. The disease is prone to progression. It is characterized by a gradual persistent change in the mechanisms of secretory activity of the bronchial mucosa, the development of disorders of mucociliary clearance. Chronic bronchitis is considered when there is a cough with sputum for two years or more. Moreover, each year the cough lasts at least three months. Encoded by characters J40, J41, J42.

Some people suffering from CB develop obstructive disorders. Obstruction is a decrease in the lumen of the bronchi, accompanied by a disruption of the exhalation mechanism and its lengthening.

As a result of expiratory disorders, there is always a residual volume of air in the lungs that exceeds normal values ​​(air traps). Pulmonary emphysema is formed - a pathological condition characterized by increased airiness of the lungs.

The occurrence of obstruction is also possible with OB, but in this case it is reversible.

The combination of chronic disease with persistent obstructive disorders and pulmonary emphysema is called chronic obstructive pulmonary disease (COPD) - an extremely common pathology in smokers. Encoded with J44 characters. At the present stage, it is unacceptable to use the formulation “chronic obstructive bronchitis complicated by pulmonary emphysema” when making a diagnosis. Both of these concepts are included in the term chronic obstructive pulmonary disease.

The classification of bronchitis is designed for both children and adults. For OB, the main classification criterion is the etiology of the disease. In most cases, OB is a viral infection. However, identification of the pathogen in clinical practice is extremely rare. The disease is most often assigned code J20. 9.

Acute bronchitis can be caused by:

• J20. 0 - M.pneumoniae;
• J20. 1 - H.influenzae;
• J20. 2 - streptococcus;
• J20. 3 - Coxsackie virus;
• J20. 4 - parainfluenza virus;
• J20. 5 - respiratory syncytial virus;
• J20. 6 - rhinovirus;
• J20. 7 - echovirus;
• J20. 8 - other specified agents;
• J20. 9 - other unspecified agents.

Unspecified (acute or chronic) bronchitis J40 is not otherwise classified.

Chronic bronchitis is classified depending on the nature of the sputum:

• J41. 0 - simple HB;
• J41. 1 - mucopurulent chronic disease;
• J41. 8 - mixed cotton.

Nonspecific CB J42 may be called chronic tracheitis or chronic tracheobronchitis.

COPD is divided depending on the period of the disease (exacerbation/remission):

• J44. 0 - COPD with acute respiratory infection of the lower respiratory tract;
• J44. 1 - COPD with exacerbation, unspecified;
• J44. 8 - other specified COPD;
• J44. 9 - COPD, unspecified.

Diseases of the lung tissue caused by external agents (chemicals, dust, etc.) do not relate to bronchitis and are discussed in other sections - J60-J70. The term "allergic bronchitis" is also not used. It has been completely replaced by the concept of bronchial asthma (code J45).

In everyday life practical activities To make a diagnosis, Russian doctors resort to the domestic classification. In accordance with it, acute bronchitis (obstructive or non-obstructive) and chronic are distinguished. Chronic obstructive pulmonary disease is considered separately.

The classification of inflammatory diseases of the bronchi according to ICD-10 with its etiological approach in Russia has little practical significance. It is mainly used as a source of statistical data.

All information on the site is provided for informational purposes. Before using any recommendations, be sure to consult your doctor.

Full or partial copying of information from the site without providing an active link to it is prohibited.

Acute bronchitis: ICD 10 as a guide for treatment

Medicine, like any science, is constantly evolving, based on the experience of past generations. All knowledge accumulated over centuries is recorded, stored and classified. A detailed description of diseases and recommendations for their treatment are posted in a document called the International Classification of Diseases and Related Health Problems (ICD).

The data in this document is continually reviewed and updated. Today, doctors around the world are guided by the provisions of the ICD 10th revision, the next one is scheduled for 2015. This document contains a complete classification of acute forms of bronchitis, which we invite you to familiarize yourself with.

Classification of acute forms

In ICD-10, bronchitis is included in block J20-J22. This list does not include chronic obstructive pulmonary disease (COPD) with exacerbation and acute respiratory infection of the lower respiratory tract.

Each type of acute type is assigned a specific code:

• J20.0 - the disease is caused by Mycoplasma pneumoniae;
• J20.1 - caused by the Afanasyev-Pfeiffer bacillus;
• J20.2 - the causative agent is streptococcus;
• J20.3 - the disease is caused by the Coxsackie virus entering the body;
• J20.4 - acute form of viral bronchitis (caused by parainfluenza);
• J20.5 - the disease is provoked by a syncytial virus;
• J20.6 - the cause of the disease is rhinovirus;
• J20.7 - the disease was caused by an echovirus;
• J20.8 - means that the cause of the disease is other specified agents;
• J20.9 - acute bronchitis, the causative agent of which is unspecified;
• J21.0 - bronchiolitis;
• J22 - acute respiratory infection of the lower respiratory tract, unspecified.

Criteria for diagnosis

The acute form of the disease is diagnosed by the following parameters and symptoms:

1. The patient suffers from an obsessive, unproductive, dry cough. From about the 2nd week it becomes wet, productive, and the cough gradually goes away.
2. Listening to breathing and wheezing. The onset of the disease is characterized by dry wheezing, which gradually becomes silent and moist.

Treatment according to ICD-10

In accordance with the provisions of ICD-10, hospitalization is indicated only in cases where complications are suspected. Dietary nutrition and symptomatic treatment are provided.

• mucolytics, expectorants of plant and synthetic origin;
• if the patient is tormented by a dry, obsessive, unproductive cough, then antitussive drugs are prescribed;
• in the presence of allergic reactions, taking antihistamines is indicated;
• antipyretics;
• vitamins.

Massage is done for a productive cough, regardless of what code is assigned to the type of acute bronchitis. Physiotherapeutic procedures include UHF therapy, electrophoresis, and microwave therapy.

In the first 2-3 days, antiviral drugs are prescribed, which will help minimize the use of antibiotics.

Perhaps the doctor will consider it necessary to resort to antibacterial therapy. But this can only be done under strict indications.

During the recovery stage, massage, breathing exercises and physiotherapy will help restore the patient’s strength.

General protocol described therapeutic measures for diseases with code J20-J20.9 according to ICD-10, it is a guide for making a diagnosis. But the doctor must always take into account the individual characteristics of a particular patient and the course of the disease. Only in this case will the maximum benefit be obtained from the treatment, and the likelihood of complications will be minimized.

All information provided on this site is for reference only. Do not self-medicate. At the first sign of disease, consult a doctor. An active link is required when quoting.

Acute bronchitis code ICD

Chronic bronchitis: causes and effective treatments

Chronic bronchitis (ICD code 10 - J42) is still a very common disease today. And perhaps one of the most common in the field of respiratory tract diseases. Chronic bronchitis is a consequence of acute bronchitis. It is the acute form, constantly repeated, that leads to the chronic form. In order not to suffer from this disease, it is important to prevent the recurrence of acute bronchitis.

What is chronic bronchitis?

In simple terms, this is inflammation of the bronchial mucosa. As a result of inflammation, a large amount of sputum (mucus) is released. A person's breathing suffers. It's broken. If excess mucus is not removed, bronchial ventilation is impaired. Mucus literally floods the cilia of the ciliated epithelium, and they cannot perform their function, the function of expulsion. Although due to an insufficient amount of mucus, the active activity of the cilia is also disrupted.

There are two forms of chronic bronchitis - primary (independent inflammation of the bronchi) and secondary (bronchi are affected by infection due to infectious diseases). The cause is damage by a virus or bacteria. Exposure to various physical (or chemical) irritants is also possible. Bronchitis is also caused by dust. They are called dust bronchitis.

The nature of sputum can also be different: simply mucous or mucopurulent; putrefactive; may be accompanied by hemorrhage; lobar.

Chronic bronchitis can cause complications:

• asthmatic syndrome;
• focal pneumonia; From this article you can find out what to do when a cough after pneumonia does not go away.
• peribronchitis;
• emphysema.

Causes and risk factors

The development of chronic bronchitis is facilitated by foci of chronic infection, diseases of the nose, nasopharynx, and paranasal cavities.

Repeated acute bronchitis leads to chronic bronchitis. So the best prevention in this case will be a quick recovery from the acute form of the disease.

Prevention of secondary bronchitis: therapeutic exercises, hardening (of great importance), taking general tonics. These remedies include: pantocrine, ginseng, eleutherococcus, lemongrass, apilak, vitamins.

The development of chronic bronchitis is promoted by smoking, dust, air pollution, and alcohol abuse. Diseases of the nose, nasopharynx, and paranasal cavities may also be the cause. Foci of chronic infection contribute to re-infection. This disease can be caused by a weak immune system.

The very first signs

With exacerbations of chronic bronchitis, the cough intensifies, the purulence of the sputum increases, and fever is possible

The first, most important sign is a cough. It can be “dry” or “wet”, that is, with or without phlegm. Chest pain appears. Most often the temperature rises. Absence of temperature is a sign of weakness immune system.

In the simple form of bronchitis, bronchial ventilation is not impaired. Symptoms of obstructive bronchitis are wheezing, as ventilation is impaired. During exacerbations, the cough intensifies, the purulence of the sputum increases, and fever is possible.

Diagnosis of chronic bronchitis is usually not in doubt.

The four main symptoms are cough, sputum, shortness of breath, and deterioration in general condition. However, when making a diagnosis, it is necessary to exclude other respiratory diseases.

Treatment methods

Bed rest, humidified air and a ventilated room are the main conditions for the treatment of bronchitis

Treatment depends on the stage of the disease. General measures for various forms are prohibition of smoking, elimination of substances that irritate the respiratory tract; treatment of a runny nose, if any, throat; use of physical therapy and expectorants. Additionally, for purulent bronchitis, antibiotics are prescribed, and for obstructive bronchitis, bronchospasmolytics and glucocortecoids (steroid hormones).

What are the symptoms of untreated bronchitis are indicated in this article.

How bronchitis is treated with pine buds is indicated in the article.

What antibiotics should be taken for acute bronchitis is indicated in the article here: http://prolor.ru/g/lechenie/kak-vylechit-bronxit-antibiotikami.html

Hospitalization is required only in very severe cases.

At high temperatures, bed rest is necessary. In other cases, you can do without bed rest, but it is worth observing more or less strict rest. The air in the room needs to be humidified. Now let's talk specifically about treatment methods.

Treatment with medications

Strong antibiotics for bronchitis are used only in severe or advanced forms, because First of all, the immune system suffers from their use. Prescribed only by a doctor individually.

Here it is necessary to remember that there are also natural antibiotics. These include primarily propolis. Chronic bronchitis most often affects adults and you can use an alcohol tincture: 40 drops should be diluted with water. Take this solution 3 times a day. Propolis should be taken in this proportion for the first three days, then the dosage is reduced drop by drop. You can use its aqueous extract: 1 tsp. 4-6 times a day. Treatment with propolis (as with herbs) is long-term, up to a month. Natural antibiotics also include calendula flowers. Let us remind you about other effective drugs:

• Acetylsalicylic acid. Such a simple remedy should not be neglected in our time. It should be taken strictly after meals, three times a day. It reduces chest pain, reduces temperature, and eliminates fever. Acts like a raspberry decoction.
• Expectorants. Here you need to decide what you like best – herbs or ready-made pharmaceutical forms. Pharmacists offer a huge selection of different syrups: marshmallow, licorice root, primrose flowers, etc. Doctor MOM syrups and ointments are very effective. They are exclusively plant based. There are also ready-made drugs, such as bromhexine, ambrobene, gedelix, fervex. All of them are effective, but pay special attention to contraindications. This article contains expectorant cough syrups for children.
• For obstructive bronchitis, lycorine hydrochloride is effective. The drug has a bronchodilator effect and thins mucus well. But it has contraindications.

Folk remedies

To treat chronic bronchitis with folk remedies in adults, the following are used:

Radish juice (black) with honey or aloe juice. They need to be mixed in equal proportions.

What other herbs are used in the treatment of chronic bronchitis? Calamus, marshmallow and anise. Black elderberry (used for fever), common heather, spring adonis. These include sweet clover, lungwort, and tricolor violet.

And one more remedy, if there are no contraindications, available to everyone is milk. Nothing cleanses the bronchi and lungs like milk. But if you get sick, you need to drink it with soda and butter (even better - fat, lard). If bronchitis is accompanied by a cough, your grandmother's effective cough recipes will help, for example, figs with milk, milk with soda, and homemade cough drops.

The first recommendation for bronchitis is to drink plenty of fluids! It would be great if it was berry juice. Cranberries, viburnum, raspberries, sea buckthorn, and lingonberries are very effective. Chamomile tea, just tea with lemon (freshly brewed). The drink must be warm! Cold, even at room temperature, is unacceptable.

Physiotherapy is a necessary part of treatment. But you can start physical treatment no earlier than the temperature subsides. What does this have to do with it? Mustard plasters and jars are well-known and accessible to everyone. Compresses on the chest will also help. They should be warming. You can do it on your back. It is advisable to use inhalations with medicinal herbs. Rubbing with interior lard, badger fat, pharmaceutical rubs. A light rubbing massage is useful.

You can do “dry” inhalation: drop 4-5 drops of essential oil (pine, spruce, juniper, eucalyptus, etc.) onto a hot frying pan.

The role of nutrition. For chronic bronchitis, nutrition should be light! The presence of a large number of vitamins is invaluable, especially vitamin C. Non-fat chicken broth is healthy. This cannot be neglected.

Note: if at the very beginning of treatment you take a laxative (senna leaf, buckthorn bark), i.e. cleanse the body, it will be easier for it to cope with the disease. The body's defenses will become stronger.

Important: products that restore the immune system should be used in acute stage it is forbidden! These include: apilac, pollen, immunal, ginseng, eleutherococcus, etc. You will take this during the recovery period.

Video

Learn more about the correct treatment of chronic bronchitis in this video:

Let's summarize: chronic bronchitis can be cured! The main thing is not to give up and not give up treatment. Don't let the disease return. It is very important to individually choose the medicine that is right for you. Weigh the pros and cons". And don't forget about prevention.

Bronchitis in children

Bronchitis is an inflammatory process in the bronchi of various etiologies (infectious, allergic, chemical, physical, etc.). The term “bronchitis” covers lesions of the bronchi of any caliber: small bronchioles - bronchiolitis, trachea - tracheitis or tracheobronchitis.

ICD-10 code

Bronchitis, unspecified. both acute and chronic, has code J40. In children under 15 years of age may be considered acute in nature and should be classified as J20. Recurrent bronchitis and recurrent obstructive bronchitis are included in ICD-10 under the code J40.0-J43.0.

Read also: Acute bronchitis

ICD-10 code J20 Acute bronchitis J20.0 Acute bronchitis caused by Mycoplasma pneumoniae J20.1 Acute bronchitis caused by Haemophilus influenzae [Afanasyev-Pfeiffer bacillus] J20.2 Acute bronchitis caused by streptococcus J20.3 Acute bronchitis caused by the Coxsackie virus J20 .4 Acute bronchitis caused by parainfluenza virus J20.5 Acute bronchitis caused by respiratory syncytial virus J20.6 Acute bronchitis caused by rhinovirus J20.7 Acute bronchitis caused by echovirus J20.8 Acute bronchitis caused by other specified agents J20.9 Acute bronchitis unspecified J41.0 Simple chronic bronchitis

Epidemiology of bronchitis

Bronchitis continues to occupy one of the first places in the structure of bronchopulmonary diseases in pediatrics. It is known that children who often suffer from acute infectious respiratory diseases constitute a risk group for the development of acute bronchitis, the formation of recurrent bronchitis, including obstructive forms, and chronic pulmonary pathology. The most common form of complications of ARVI is bronchitis. especially in young children (the age peak of incidence is observed in children 1 year - 3 years). The incidence of acute bronchitis is cases per 1000 children per year.

The incidence of bronchitis is seasonal: people get sick more often in the cold season. Obstructive forms of bronchitis are more often observed in spring and autumn, i.e. during periods of peak MS and parainfluenza infection. Mycoplasma bronchitis - at the end of summer and autumn, adenoviral - every 3-5 years.

Causes of bronchitis in children

Acute bronchitis often develops against the background of ARVI. Inflammation of the bronchial mucosa is observed more often with viral PC, parainfluenza. adenovirus, rhinovirus infection and influenza.

IN last years There is an increase in the number of bronchitis caused by atypical pathogens - mycoplasma (Mycoplasma pneumonia) and chlamydial (Chlamydia trachomatis, Chlamydia pneumonia) infections (7-30%).

What causes bronchitis in children?

Symptoms of bronchitis in children

Acute bronchitis (simple) develops in the first days of ARVI (1-3 days of illness). The main general symptoms of a viral infection are characteristic (low-grade fever, moderate toxicosis, etc.), there are no clinical signs of obstruction. Features of the course of bronchitis depend on the etiology: with most respiratory viral infections, the condition normalizes starting from 2 days, with adenovirus infection, high temperatures persist for up to 5-8 days.

Acute obstructive bronchitis is accompanied by bronchial obstruction syndrome, most often in young children on the 2-3rd day of ARVI, with a repeated episode - from the first day of ARVI and develops gradually. Acute obstructive bronchitis occurs against the background of PC viral and parainfluenza type 3 infections, in 20% of cases - with ARVI of another viral etiology. In older children, the obstructive nature of bronchitis is observed with mycoplasma and chlamydial etiology.

Symptoms of bronchitis in children

Where does it hurt?

What's troubling?

Classification of bronchitis

In the vast majority of children with bronchitis, obstructive syndrome is observed (50-80%), and therefore acute obstructive and recurrent obstructive bronchitis were included in the classification of bronchopulmonary diseases of children in 1995.

The following classification of bronchitis is distinguished:

• Acute bronchitis (simple): bronchitis that occurs without signs of bronchial obstruction.
• Acute obstructive bronchitis, bronchiolitis: acute bronchitis occurring with bronchial obstruction syndrome. Obstructive bronchitis is characterized by wheezing, while bronchiolitis is characterized by respiratory failure and fine moist rales in the lungs.
• Acute bronchiolitis obliterans: bronchitis with obliteration of bronchioles and alveoli, has a viral or immunopathological nature, and is severe.
• Recurrent bronchitis: bronchitis without obstruction, episodes occurring for 2 weeks or more with a frequency of 2-3 times a year for 1-2 years against the background of ARVI.
• Recurrent obstructive bronchitis: obstructive bronchitis with repeated episodes of bronchial obstruction against the background of ARVI in young children. The attacks are not paroxysmal in nature and are not associated with exposure to non-infectious allergens.
• Chronic bronchitis: chronic inflammatory damage to the bronchi, occurring with repeated exacerbations.

Diagnosis of bronchitis in children

The diagnosis of bronchitis is established on the basis of its clinical picture (for example, the presence of obstructive syndrome) and in the absence of signs of damage to the lung tissue (no infiltrative or focal shadows on the radiograph). Often bronchitis is combined with pneumonia, in which case it is included in the diagnosis if it significantly complements the clinical picture of the disease. Unlike pneumonia, bronchitis with ARVI is always diffuse in nature and usually evenly affects the bronchi of both lungs. When local bronchitis changes predominate in any part of the lung, the appropriate definitions are used: basal bronchitis, unilateral bronchitis, bronchitis of the afferent bronchus, etc.

Diagnosis of bronchitis in children

What needs to be examined?

How to examine?

What tests are needed?

Who to contact?

Treatment of bronchitis in children

The proposed protocols for the treatment of acute bronchitis include necessary and sufficient prescriptions.

Simple acute viral bronchitis: treatment at home.

Drink plenty of warm drinks (100 ml/kg per day), chest massage, and for wet coughs - drainage.

Antibacterial therapy is indicated only if the elevated temperature persists for more than 3 days (amoxicillin, macrolides, etc.).

Treatment of bronchitis in children

More information about treatment

Allergic tracheobronchitis

Allergic tracheobronchitis is an inflammatory change that occurs in the tracheobronchial tree. In this case, increased sensitivity is observed. This pathology can arise due to infections existing in the body, in particular laryngitis, chronic tracheitis. Inflammation occurs due to bacteria such as staphylococci and pneumococci. Chemical factors, allergens and low immunity play a significant role in this.

ICD-10 code

ICD 10 code is a characteristic of the disease according to the international classification of diseases. Number 10 hides ailments of the respiratory system. There are several main indicators from J00 to J99.

If the lesion involves more than one anatomical region, then it is classified directly according to this condition. That is, tracheobronchitis refers to bronchitis, but under the heading J40. The exception is conditions caused during the perinatal period. So, the classification of the disease is divided into several main blocks.

J00-J06: Determines the presence of acute respiratory inflammation occurring directly in the respiratory tract. J10-J18: pneumonia and influenza. J20-J22: other cold infections originating in the lower respiratory tract. J30-J39: diseases of the upper respiratory tract. J40-J47: diseases that have a chronic course and affect the upper respiratory tract. J60-J70: lung diseases caused by external agents. J80-J84: respiratory diseases, the main focus of damage is interstitial tissue. J85-J86: formations affecting the lower respiratory system. J90-J94: inflammation of the pleura. J95-J99: other ailments associated with the respiratory system.

Causes of allergic tracheobronchitis

The causes of allergic tracheobronchitis can be hidden in many factors, and the nature of their development is multifaceted. Some people simply suffer from sneezing and runny nose during the flowering period. Other patients suffer from increased tearing of the eyes. A skin rash often appears. The nature of the development of this phenomenon may be hidden in the consumption of certain foods or the use of special cosmetics.

Some people constantly suffer from severe coughing attacks, and this is not accompanied by any illness. Based on this, it is worth noting that the main reason for the development of the disease is the presence of an allergen. It is he who settles on the mucous membrane of the bronchi and thereby causes a number of unpleasant symptoms.

Some of the most common allergens include pollen, animal dander, bird feathers, and even detergents. What’s most interesting is that ordinary dust in an apartment can provoke allergic reactions. Therefore, the issue of constant wet cleaning is relevant.

After some research, it was discovered that allergic tracheobronchitis can develop while taking any medication. In any case, the occurrence of a problem should not be compared with the presence of a cold. It is likely that this is a chronic form of bronchitis, but this conclusion was made solely based on similar symptoms.

Pathogenesis

The pathogenesis of allergic tracheobronchitis is truly complex, because the location of the main conflict is in the large and medium bronchi. With allergic manifestations of the disease, the small bronchi remain completely intact. This process completely explains the absence of asthma attacks.

If there is an illness, the mucous membrane has a pale tint. It is quite inflamed and is characterized by narrowing of the lumen of the segmental bronchi. If bacteria play a dominant role in this process, then a purulent secretion is observed. In children, the situation is somewhat different; swelling and hypersecretion predominate here. This factor greatly complicates differential diagnosis.

The disease can develop in children of any age category. Moreover, relapses cannot be ruled out, the frequency of which reaches 1-2 times per month. Symptoms appear at normal temperatures, long-term relapse depends on the child’s immunity. The cough is dry and can even be caused by negative emotions or increased physical activity. Changes in the lungs are diffuse. The main feature is the constant change in physical data. Moreover, this can happen several times during the day. Wheezing may disappear, but after a while it will reappear. The chest does not increase.

If we consider the issue from the perspective of the child’s body, the disease negatively affects the nervous system. Kids become irritable, sweat a lot, and get tired quickly. When determining the disease, an x-ray image shows a significant increase in the transparency of the lung tissue.

Allergic tracheitis mainly affects preschool children. It is provoked by an immune conflict. During the process, biological substances are actively released. Repeated coughing attacks are normal. It torments at night and is often accompanied by pain. Redness of the face and bouts of vomiting are possible. Parents often confuse this condition with the development of whooping cough. The disease is characterized by a long course.

Symptoms of allergic tracheobronchitis

The symptoms of allergic tracheobronchitis are comparable to a common allergic reaction. So, a person is constantly bothered by a cough, but the most unpleasant thing is that the peak of its “activity” occurs at night. An increase in temperature is not observed, but if it is, it is insignificant. In general, the person feels bad and has a painful condition. Moreover, it can worsen at the slightest contact with an allergen.

The first signs are characterized by the presence of a dry cough. Over time it becomes damp. A person may experience shortness of breath and difficulty breathing. When examining the patient, wheezing is clearly audible. A pronounced inflammatory process is observed. It is characterized by swelling of the mucous membrane. There are no asthma attacks.

Against the background of an infection in the body, nasal discharge may appear. They are triggered by the presence of an allergen. Inflammation of the trachea is possible. The condition worsens significantly with exacerbation. The patient complains of weakness and often breaks into a sweat.

Children also suffer from the disease often. The symptoms are similar and no different from those in adults. The only thing is that the disease can affect the nervous system. This leads to increased irritability and moodiness.

First signs

The first signs of allergic tracheobronchitis are the appearance of a cough. It pesters a person throughout the day, but increased “activity” is observed at night. There may be complaints of mild malaise. When coughing, pain appears in the diaphragm.

Temperature does not bother a person at all. It can occur, but is extremely rare. Its increase is insignificant, usually not exceeding 38 degrees. A person is unable to take a deep breath and exhale completely. Breathing is difficult, shortness of breath is annoying. Due to the inability to breathe normally, the lips may take on a bluish tint. Increased sweating is possible.

All these signs manifest themselves at first and do not change over time. Exacerbation occurs with direct contact with the allergen. If symptoms appear, you should go to the hospital. If the voice becomes hoarse, inflammation of the larynx may develop. In the absence of normal treatment, complications will not keep you waiting.

Allergic tracheobronchitis in a child

Allergic tracheobronchitis in a child is a completely developing disease. It affects schoolchildren and preschool age. Bacteria can cause problems. An allergy is a complete inconsistency of the body with the fact that foreign microorganisms with an adverse effect have entered it. The problem can arise from taking medications and coming into contact with industrial gases.

This disease manifests itself in children as complications after a cold. It arises due to poor quality treatment or complete ignorance of it. The course of the disease is comparable to laryngitis. The baby’s immune system is not so strong, so any stress can provoke the development of the disease. Poor nutrition can contribute to everything. For the current generation, this is a completely “normal” unfavorable factor.

Identifying the presence of an allergic disease is not always easy. After all, the main symptoms are runny nose, coughing and sneezing. Often parents confuse this manifestation with a common cold and initially begin the wrong treatment. It is difficult to recognize the disease at an early stage. Therefore, there is a possibility of misdiagnosis.

The main symptoms in children are severe coughing, typical at night, malaise, rashes, sweating, pain in the chest and blue lips. During the period of exacerbation, the cough is the most severe. Elimination of the disease is possible after a correct diagnosis is made.

What's troubling?

Consequences and complications

The consequences of allergic tracheobronchitis can become severe. In the absence of quality treatment, the development of serious diseases is possible. Typically, respiratory problems develop into a more complicated form. An ordinary allergy develops into bronchitis or pneumonia. These diseases are dangerous due to their complications. Especially pneumonia.

The existing process may be aggravated by the involvement of infection. This condition is characterized by an increase in temperature, and this happens quickly. There is harsh breathing in the lungs and pronounced wheezing. A person complains of general malaise. Symptoms of worsening intoxication cannot be excluded. Local dullness of sound is observed in the lungs.

Constant problems with the respiratory system can lead to neoplasms of any nature. If the allergen affects a person long time, then tracheitis can develop into allergic bronchitis. Difficulty breathing and attacks of suffocation are its main symptoms.

Complications of allergic tracheobronchitis pose a particular danger. In the presence of an untreated illness, pneumonia may develop. Moreover, the nature of pneumonia depends on the patient’s immune system. The problem is often accompanied by bronchitis.

A disease that is not eliminated in time and involves infection is fraught with pronounced symptoms. A person suffers from elevated temperature, and its jump can be sharp. The cough becomes more intense, breathing is difficult, but shortness of breath is not yet observed. If we are talking about pneumonia, then the person’s condition as a whole worsens. Symptoms of general intoxication actively manifest themselves.

The constant presence of infection and changes in the mucous membrane of the trachea can provoke a neoplasm. Moreover, its character can be both benign and malignant. If allergens actively affect the body, bronchial asthma occurs. It is difficult for a person to breathe, he is plagued by shortness of breath.

Diagnosis of allergic tracheobronchitis

Diagnosis of allergic tracheobronchitis includes a whole range of research measures. First of all, the doctor listens to the patient and becomes familiar with the symptoms that appear. After which a general blood test is prescribed. It is necessary to detect eosinophilia, increased ESR and moderate leukocytosis. Then he begins to study the secreted sputum. Its character is determined, usually it is glassy. Diagnosed by the presence of eosinophils.

Ordinary listening plays an important role. Thanks to it, the lungs are listened to and the presence/absence of wheezing is diagnosed. They can be varied. True, it is difficult to determine the presence of tracheobronchitis from one such study.

X-ray examinations of the lungs are an integral part of diagnosis. Thanks to them, it is possible to exclude/confirm the presence of an inflammatory process in the lungs. Laryngoscopy is also performed. A visit to a pulmonologist and allergist is often mandatory.

Analyzes

Tests for allergic tracheobronchitis are mandatory. Thanks to them, you can notice changes in the human body. Basically, a general blood test is taken. It allows you to determine the presence of eosinophilia. Based on the data obtained, it is possible to diagnose an increased ESR.

A blood test can detect leukocytosis of any degree. Normally it should be moderate. The attending physician prescribes blood donation. This is a mandatory procedure. Based on the main symptoms and X-ray examination, it is not so easy to determine the presence of a problem. Other confirmations are required. That's why a person takes a blood test. Based on the data obtained, it is possible to monitor the main indicators and find out in what condition they are. Without this data, a correct diagnosis is not possible. As a rule, blood is donated directly at the clinic, and the results are known within 24 hours. This is a necessary measure to compile a complete clinical picture.

Instrumental diagnostics

Instrumental diagnosis of allergic tracheobronchitis includes a number of procedures, without which a correct diagnosis is impossible. First of all, a person is sent for an X-ray of the lungs. This procedure allows you to see deviations in them, inflammatory processes and any other modifications.

Instrumental diagnostics include laryngotracheoscopy. This technique is based on a complete examination of the respiratory tract using a special laryngoscope device. Pharyngoscopy plays an important role in the study. This procedure involves examining the pharynx and pharynx using a special mirror.

In many cases, a routine examination of the throat is sufficient. In addition, a sample is taken for an allergic reaction and auscultation is performed. Using tests, it is revealed exactly how the allergen causes the reaction. This will protect the patient from direct contact with him. All of the above procedures are used to make a diagnosis.

Differential diagnostics

Differential diagnosis of allergic tracheobronchitis also includes a number of special procedures. Initially, a person must take a clinical blood test. Thanks to it, eosinophilia is determined. The rate of cell production is examined and how resistance is carried out when foreign microorganisms enter the body.

In addition to the blood test, bacteriological culture of the sputum is performed. This procedure allows us to exclude the infectious nature of the development of the disease. As you know, inflammation can be caused by both bacteria and infections.

An important procedure is taking an allergy test. It allows you to determine individual sensitivity to major allergens. Based on the data obtained, a diagnosis is made. But its correct setting is impossible without comprehensive data from an instrumental examination of the patient. Therefore, there is no need to separate the main diagnostic methods from each other; they “work” exclusively together.

What needs to be examined?

How to examine?

What tests are needed?

Who to contact?

Treatment of allergic tracheobronchitis

Treatment of allergic tracheobronchitis is agreed with the attending physician. When the maximum tolerated dose of the main allergen is reached, treatment continues with a maintenance dosage.

Elimination of the disease in children is carried out using specific hyposensitization. This technique gives a positive result. The existing pathological process is not capable of developing into bronchial asthma. Therefore, the procedure completely eliminates the possibility of serious complications.

Nonspecific therapy includes a number of basic drugs. Histaglobulin, Sodium Nucleinate, Pentoxyl are widely used. Antihistamines have an antiallergic effect. These include Pipolfen, Diphenhydramine, Tavegil. Regarding these drugs detailed description will be presented below.

Physiotherapeutic procedures play a significant role. Ultraviolet rays are often used. It is recommended to resort to therapeutic exercises and general massage. Eliminating the disease in adults is impossible without completely quitting smoking. In some cases, a change of job and even place of residence is required.

Drug treatment

Medicines for allergic tracheobronchitis are prescribed by the attending physician, based on the general condition of the patient. First of all, it is necessary to completely eliminate the possibility of an allergen entering the human body. Medicines should completely suppress the allergic reaction, as well as relieve the main symptoms.

Such drugs as Taveig, Suprastin and Diazolin will help reduce allergies. It is often recommended to use Suprastin directly. This can be either tablets or an injection solution. The product is prescribed for children and adults. It is recommended to use one tablet 3 times a day. If the drug is administered intramuscularly, then 1-2 ml is sufficient. Children under 14 years of age should take half a tablet, also 3 times a day. The drug has pronounced side effects. They consist of general weakness and dizziness. The main contraindications include possible stomach ulcers and prostate adenoma.

Tavegil is widely used in any form. There is no need to take it often, because the positive effect lasts for 7 hours. One tablet twice a day is enough. It is not recommended for children under one year of age to take it. This ban applies to pregnant girls and nursing mothers. Side effects include increased fatigue, headache, and tinnitus. Disorders from the gastrointestinal tract are possible. The product should not be taken by people with increased hypersensitivity to its main components.

To eliminate cough, a specialist will definitely prescribe special medications. Bronholitin and Pertusin are often recommended. These are syrups that need to be taken 2 times a day, a tablespoon. You can resort to using tablets. The most recommended are Mucaltin and Bromhexine. You need to take them 1-2 tablets 3 times a day.

Volmax will significantly reduce the frequency of coughing attacks. It will restore bronchial patency and alleviate the person’s condition. You need to take it 8 mg no more than 2 times a day. 4 mg is enough for a child. Like any other medicine, this one has side effects. They manifest themselves in the form of headaches, hand tremors and tachycardia. There are contraindications: pregnancy, lactation and sensitivity to the components of the drug.

If the medications described above do not have the necessary effect, glucocorticoids come to their aid. These include Flunisolide, Cutivate, Fluticasone. These drugs have anti-inflammatory and antiallergic effects. Even small children can take them. The dosage is prescribed on an individual basis.

Singleton for allergic tracheobronchitis

The drug singlelon is widely used for allergic tracheobronchitis. It can be used by both adults and children. The medication is prescribed 1 tablet in the evening. This dosage is only relevant for children under 5 years of age. From 6 to 14 years old, prescribes 5 mg of medication, also in the evening. The product should be consumed an hour before a meal or 2 hours after a meal. No dose adjustment is required.

The effect of taking the drug is observed on the first day. Despite this, the use of the drug should continue, even during a period of significant improvement. The dose is adjusted for people with renal failure.

The drug does not exclude the possibility of an overdose. It is characterized by the appearance of disorders of the gastrointestinal tract and nervous system. Headache, abdominal pain and thirst often occur. Overdose occurs only with an unplanned increase in dose. Side effects from the digestive tract cannot be excluded. Possible increased allergic reactions. You should not take the drug if you have increased hypersensitivity, pregnancy or during breastfeeding.

Traditional treatment

Alternative treatment of allergic tracheobronchitis is not excluded, but is carried out only with the permission of a doctor. There are a couple of basic recipes that show the most pronounced effectiveness.

• Recipe 1. You need to take 30 grams of marshmallow roots. The ingredient is poured with cold water in a small amount. It is enough that the roots are completely immersed in liquid. All this is left alone for a day. During this period, the roots will be able to secrete a special mucus, which is mixed with 100 ml of vodka. The resulting product is infused again throughout the day. It should be taken in small dosages until the cough is completely eliminated.
• Recipe 2. Take a liter jar of hay dust and pour it into a saucepan. The ingredient is poured with water in such an amount that the raw material is completely covered. Place the pan on the fire and boil for 15 minutes. Then the product is removed from the heat and infused for 45 minutes. The resulting decoction is used for a bath. You need to take it every other day, and stay in it for at least 15 minutes. In total, you should take a course of ten baths. On the days of the so-called break, you can drink violet infusion. To do this, take the main ingredient and pour a glass of boiling water. All this is languished in a water bath and infused. You need to take the product 3 times a day, half a glass, but strain before doing so.

Herbal treatment

Herbal treatment of allergic tracheobronchitis is possible only in combination with other methods and after the approval of the attending physician. For a moist, unpleasant cough, it is recommended to use dried herbs. So, sage, alder and oak bark are suitable. It is recommended to take the product in the form of tinctures. To speed up the healing process, you should pay attention to expectorant herbs. This can be European hoof, sweet clover and hyssop. Decoctions are prepared with extreme care.

Thyme and wild rosemary have good antibacterial properties. Basil and eucalyptus have a similar effect. Calendula will also work. If the disease is fungal in nature, then you should take yarrow.

A universal recipe that helps speed up the healing process. For preparation, take black elderberry flowers, 5 tablespoons are enough. To this ingredient add 3 tablespoons of sundew herb and 4 tablespoons of plantain. You need to take 2 tablespoons of the resulting mixture and pour 600 ml of boiling water. Steam the product all night, and in the morning place it in a water bath for 15 minutes. After that, everything is filtered, squeezed out and taken half a glass 4-5 times a day.

Homeopathy

Homeopathy for allergic tracheobronchitis is not so widespread. But, nevertheless, the use of this method is effective. Complex medications that are often used: Aconite, Apis, Arnica, Belladonna. But this is not all medicine. For understanding, it is worth characterizing these excerpts a little.

• Aconitum. Used for acute inflammatory processes. It perfectly eliminates the first symptoms of the disease and promotes rapid relief of a person’s condition.
• Apis. Eliminates inflammatory processes that are accompanied by severe swelling. Widely applicable for bronchitis, tracheobronchitis.
• Arnica. Eliminates bleeding of any origin. Fights flu, acute tonsillitis. Provides quick relief.
• Belladonna. The main purpose is to combat inflammatory processes that arise in the upper respiratory tract. The dosage is prescribed by the doctor. These are homeopathic medicines, they cannot be used just like that.

Surgical treatment

Surgical treatment of allergic tracheobronchitis is not particularly used. Usually the problem is solved with medication. It is enough to correctly diagnose the disease and begin its treatment. To do this, when the first symptoms appear, you should immediately go to the hospital. Suppression of signs at the initial stage does not entail any complications.

Complex treatment of the disease is usually used. Medicines alone are not always enough. They also resort to therapeutic exercises. Surgical intervention is not used just because it is not necessary. The swelling will thus clearly not be relieved.

As a rule, the problem arises due to the negative impact of an allergen on the body. If you eliminate it and protect a person from contact with it, the condition will improve on its own. Naturally, it will be difficult to achieve complete stabilization of the condition without medications. Your doctor can provide more detailed information.

Prevention of allergic tracheobronchitis

Prevention of allergic tracheobronchitis involves eliminating the main irritants. If a person has pathologies of the respiratory system, they need to be eliminated. In order to eliminate contact with major allergens, you should adhere to the basic rules. In an apartment or house, it is necessary to do wet cleaning. It should be done at least 2 times a week. Bed linen should be changed every week.

In the room in which a person suffering from allergic tracheobronchitis lives, it is worth removing the carpets and upholstered furniture. Simply put, get rid of the items that accumulate dust the most. Plants should be eliminated. Soft toys are completely removed from the nursery. Animals should not be allowed into the premises, as they can cause an allergic reaction. Food products that negatively affect the patient’s body are completely excluded.

The main method of prevention is the timely elimination of problems with the respiratory system. It is important to maintain normal living conditions, constantly clean, and eliminate allergens. Most importantly, timely diagnosis of the problem can save you from a lot in the future.

Prognosis of allergic tracheobronchitis

The prognosis of allergic tracheobronchitis is usually favorable, but it all depends on the condition of the person himself and the causes of the problem. So, if an allergy occurs against the background of a previous illness, then it is worth looking at the root of the problem. This means that the previous illness was not qualitatively eliminated. In this case, you should continue to fight the problem and protect the person from serious complications. All this entails an extremely favorable course.

If the problem was not identified immediately and gained momentum, then the prognosis may not be reassuring. The fact is that allergic tracheobronchitis can occur against the background of a serious complication. And it itself can provoke the development of asthma and pneumonia. Therefore, the prognosis depends solely on the person’s condition.

Only the attending physician can accurately answer this question, based on the condition of his patient. No one can say unequivocally what will happen next. Therefore, you should not delay treatment, then any prognosis will be extremely favorable.

Tracheobronchitis

The inflammatory process occurring in the bronchioles, bronchi and trachea is tracheobronchitis. Let's look at the symptoms of the disease, diagnostic methods, treatment and prognosis for recovery.

This disease is characterized by damage to the mucous membrane of the respiratory system and rapid spread. Today there are several types of it, but the most common are acute, chronic and allergic. Each type is an independent disease that requires proper diagnosis and therapy.

Inflammation affects the upper respiratory tract, spreading lower, covering the bronchi. It often occurs as a result of bronchitis and other lesions of the respiratory system, subject to improper or untimely treatment.

ICD-10 code

The ICD 10 code indicates in which category of the international classification of diseases a particular pathology is located.

Tracheobronchitis belongs to class X. Respiratory diseases (J00-J99):

• J00-J06 – Acute respiratory infections of the upper respiratory tract.
• J10-J18 – Flu and pneumonia.
• J20-J22 – Other acute respiratory infections of the lower respiratory tract.
• J30-J39 – Other diseases of the upper respiratory tract.

J40-J47 – Chronic diseases of the lower respiratory tract.

• (J40) Bronchitis, not specified as acute or chronic
• (J41) Simple and mucopurulent chronic bronchitis
  • (J41.0) Simple chronic bronchitis
  • (J41.1) Mucopurulent chronic bronchitis
  • (J41.8) Mixed, simple and mucopurulent chronic bronchitis
• (J42) Nonspecific chronic bronchitis
  • Chronic tracheitis
  • Chronic tracheobronchitis
• J60-J70 – Lung diseases caused by external agents.
• J80-J84 – Other respiratory diseases affecting primarily interstitial tissue.
• J85-J86 – Purulent and necrotic conditions of the lower respiratory tract.
• J90-J94 – Other diseases of the pleura.
• J95-J99 – Other respiratory diseases

ICD-10 code J04.1 Acute tracheitis J20 Acute bronchitis

Causes of tracheobronchitis

The main etiological factor in the development of inflammation is the activation of viral or bacterial flora. As a rule, this occurs due to a disruption of the normal state of the protective functions of the body and mucous membrane under the influence of provoking factors.

The most common reasons diseases:

• Hypothermia.
• Smoking and drinking alcohol.
• Drinking cold drinks and large amounts of cold food.
• Injury to the mucous membrane of the trachea.
• Chronic infectious diseases (sinusitis, tonsillitis, pharyngitis).

In most cases, the disease appears due to the interaction of two factors, for example, hypothermia due to alcohol intoxication. A separate category includes smokers. The mucous membrane becomes inflamed due to constant injury from smoke and harmful substances released by cigarettes. This type of disease requires long-term and complex treatment and often recurs.

There is a risk group that includes people who suffer from frequent mood swings, stress, and do not adhere to diet and rest. In this case, even a slight weakening of the immune system allows the virus to enter the body and spread in the mucous tissues of the respiratory tract.

To protect yourself from damage to the respiratory tract, it is necessary to avoid overwork and hypothermia, especially in the winter-spring period, when the body is most weakened. In addition, it is better to give up bad habits, that is, smoking and drinking alcohol. Acute respiratory viral infections, pneumonia, whooping cough, typhus and other diseases provoke secondary, but more serious damage to the respiratory system.

Is tracheobronchitis contagious?

Many patients suffering from inflammatory diseases of the respiratory tract are interested in the same question: how sick they are. So, regardless of the form of the disease, the infection is transmitted by airborne droplets or respiratory transmission. The duration of the incubation period is 2-30 days, depending on the type of pathogen. But most often, symptoms begin to appear in the first three days after infection.

In some cases, malaise is a complication of influenza or acute respiratory viral infections, but can occur on its own. The patient complains of mild ailments, a dry cough appears, after which there is pain in the diaphragm and abdominal muscles. Feeling worse, body temperature rises, possible shortness of breath, difficulty breathing. In addition, anxiety, sweating, and rapid breathing appear. These signs indicate that the pathology is progressing, and the patient can infect others.

Symptoms of tracheobronchitis

The main symptoms are soreness, dry hacking cough and rawness in the lower throat and chest. The disease is characterized by the following manifestations:

• Mild feeling
• Dry cough
• Painful sensations after coughing in the diaphragm area
• Excessive sweating
• Rapid breathing
• Elevated temperature up to 38°C
• Inability to take a deep breath and exhale completely
• Shortness of breath
• Bluish lip color
• Hoarse voice (indicates the development of laryngitis)

The picture of symptoms is complemented by pain between the ribs and in the area of ​​the anterior abdominal wall, and fever. After a while, shortness of breath and sputum production appear, which indicate that the pathology has taken a chronic form and the patient’s condition is worsening. It is also possible to develop angina due to poor circulation. Please note that ignoring the symptoms leads to the disease transforming into a more dangerous form - pneumonia, that is, pneumonia.

Temperature with tracheobronchitis

An increase in temperature with inflammatory damage to the mucous membrane of the bronchi, trachea and bronchioles is a concomitant phenomenon. In addition to coughing, the disease is accompanied by fever; if it is not present, this may indicate bronchial asthma or other more serious pathologies. Cough without fever occurs in patients with lung pathologies, for example, congenital defects or bronchiectasis.

An elevated temperature is a protective reaction of the immune system, that is, in this way the body tries to contain the further spread of infection. Due to a viral or infectious infection, the body begins to produce interleukin, which enters one of the parts of the brain. The hypothalamus is responsible for these processes, which stops heat transfer due to the production of additional energy. This protective function inhibits the reproduction and development of infection.

In addition to fever, patients complain of severe headaches and general malaise, aches throughout the body, and a hoarse voice. As a rule, the temperature lasts for the first 2-4 days of illness. If adequate therapy has been provided, the patient's condition improves. If this does not happen, then the patient is prescribed antibiotics, medicines and other medicines. Sometimes the elevated temperature persists even after suffering inflammation of the bronchi and trachea, in this case it is just by-effect an illness that will go away after the body recovers.

Cough with tracheobronchitis

Cough is one of the main symptoms of tracheobronchitis. In a healthy body, glands located in the bronchi produce a small amount of mucus, which is independently removed from the body. But due to the inflammatory process, the mucous membrane dries out, resulting in cough, chest pain and increased mucus production. It can be paroxysmal and become more frequent in acute and chronic forms of the disease. Very often, the main diagnosis and treatment plan depend on its type.

It may be accompanied by sputum production. In the early stages of the disease, the cough is quite painful and loud. But over time, it becomes dry, turns into a wet form and is characterized by increased sputum production. The duration depends on the stage of the disease and accompanying symptoms. If it becomes strong and causes sharp pain, then this indicates complex damage to the respiratory system, which requires urgent medical attention.

Acute tracheobronchitis

Diffuse inflammation of the upper respiratory tract or acute tracheobronchitis is a viral disease. Its main cause is infection with bacteria (streptococci, staphylococci, pneumococci). There are many reasons that provoke malaise: smoking, advanced colds, exposure to external irritants. The disease is characterized by seasonal exacerbations and without proper treatment becomes chronic.

Chronic tracheobronchitis

Most often, people who work in dusty conditions (miners) or have bad habits (smoking, alcoholism) suffer from chronic tracheobronchitis. The chronic form is characterized by a paroxysmal dry cough with a small amount of sputum. The disease causes associated pathologies (sinusitis, rhinitis, sinusitis) and can last more than three months.

Protracted tracheobronchitis

A protracted form of inflammation of the upper respiratory tract occurs due to improper or untimely treatment. In this case, therapy is a long process and a long recovery period, since the body has been exposed to microbial influence, and gas exchange in the lungs is impaired. The patient suffers from fever and severe cough, which occurs both during the day and at night.

Treatment involves drug therapy and strengthening the immune system. Patients are prescribed antibiotics and drugs to increase immune strength. Particular attention should be paid to alternative medicine methods. Patients are advised to consume more citrus fruits, freshly squeezed juices and fruits, as they increase the body's resistance to the disease. Black radish juice helps get rid of the disease in a short time, preventing the transformation of inflammation into chronic inflammation.

Allergic tracheobronchitis

Allergic tracheobronchitis is characterized by acute inflammatory damage to the respiratory tract. The main causative agents of infection are pneumococci, staphylococci, streptococci and other microorganisms. During the period of illness, there is a general deterioration in the patient's condition, lethargy, decreased appetite, and fever. The peculiarity of allergic inflammation is pain and burning behind the sternum, a strong dry cough, which is accompanied by the release of mucous sputum.

Infectious tracheobronchitis

The infectious form of damage to the bronchi and trachea is characterized by an acute mixed infection. Patients develop general weakness and malaise, increased body temperature, pain in the chest, a dry cough, which eventually turns into a wet one. Breathing becomes harsh and wheezing appears.

As a rule, this type of disease most often occurs in winter. People susceptible to respiratory diseases and smokers suffer from relapses of the disease. A prolonged course of the pathology can cause allergies, sinusitis and bronchiectasis. Both adults and children are susceptible to the disease. Without proper therapy, blockage of small bronchi and the development of hypoxia due to impaired gas exchange in the bronchi and lungs are possible.

Purulent tracheobronchitis

A purulent form of inflammation of the upper respiratory tract occurs due to improper or insufficient treatment of the acute form. Most often it appears due to the use of drugs to which the causative agents of the disease are not sensitive. Fluid gradually accumulates in the bronchi in the form of sputum and purulent discharge. About 250 ml of sputum may be released per day, which indicates the progression of the pathological process.

The main symptom of purulent inflammation is a severe cough, rapid breathing and shortness of breath. Previously suffered diseases that have become chronic can provoke its development. In this case, a wet cough appears with the release of purulent mucous or thick purulent sputum. Low-grade fever persists for a long period of time, the patient complains of increased fatigue, general weakness and sweating.

Without proper treatment, pathological symptoms lead to obstruction, that is, obstruction of the bronchial tubes due to the accumulation of secretions. This pathology is considered the most severe, so in most cases treatment takes place in a hospital setting. If the disease takes a chronic form, it can worsen due to colds, allergic reactions, stress and overexertion.

For recovery, antibiotics are used that are sensitive to harmful microorganisms. To do this, a sputum smear is taken from the patient to culture the flora. To make sputum and purulent accumulations disappear faster, mucolytic agents and antihistamines are used. In addition to drug therapy, patients are prescribed inhalations, physiotherapy, therapeutic exercises and thermal procedures. Drinking plenty of fluids, eating a healthy diet and strengthening the immune system will speed up the healing process.

Obstructive tracheobronchitis

Non-allergic chronic inflammation of the bronchi is an obstructive disease. It is dangerous because due to obstruction of the bronchi, their ventilation and gas exchange are disrupted. Most often, illness occurs in long-term smokers, and passive smokers, that is, people who are in a smoky room, are at risk. Unfavorable environmental conditions, occupational hazards, bad habits and viral infections contribute to the development of the inflammatory process.

There are a number of internal factors that increase the risk of developing the disease, primarily genetic predisposition. There is a theory that says that people with blood group II have a predisposition to this pathology. Premature infants, patients with congenital alpha1-antitrypsin deficiency and lack of Ig A are also included in the group. As for the symptoms of the obstructive form, these are cough and shortness of breath, heavy, wheezing, and fever.

• Diagnosis begins with an examination. Due to the prolonged inflammatory process, the chest becomes barrel-shaped, and the supraclavicular spaces may bulge and the jugular veins will swell.
• If the disease is complicated by cardiac or respiratory failure, then swelling of the lower extremities, cyanosis of the lips, fingertips, and epigastric pulsation appear. In addition to breathing problems, the disease causes tachycardia, hypercapnia and high blood pressure.
• Instrumental research methods are mandatory. For this purpose, pneumotachometry and peak flowmetry are used to assess bronchial patency. Electrocardiography and x-rays allow you to diagnose pathologies of the lungs and heart. Complications in the form of secondary infection and chronic pulmonary heart disease are possible.

As therapy, patients are prescribed antibacterial and expectorant drugs. A prerequisite for recovery is the elimination of risk factors. It will not be superfluous to adhere to dietary nutrition and physiotherapeutic procedures.

Recurrent tracheobronchitis

The occurrence of 2-5 episodes of respiratory damage per year indicates a recurrent disease. As a rule, the disease lasts 2-3 weeks and is characterized by the reversibility of pathological changes in the bronchopulmonary system. Relapses are directly related to colds, inflammatory diseases, viral and bacterial lesions. Risk factors play a major role. These may be chronic infectious foci, for example, sinusitis, adenoiditis or rhinitis. Environmental factors also negatively affect health: smoking, including passive smoking, harmful working and living conditions.

Diagnosis is approached carefully, since anamnesis is of great importance. The doctor’s task is to find out the factors causing painful symptoms. The clinical picture of the inflammatory process completely depends on its period; it can be an exacerbation, complete remission or reverse development. As a rule, relapses do not differ from the acute form and are characterized by seasonal occurrence. Recovery is long and difficult.

Viral tracheobronchitis

Viral damage to the trachea, bronchi and bronchioles, that is, the upper respiratory tract, most often occurs due to a weakened immune system. The body cannot cope with infectious pathogens, so it appears characteristic features ailments. Impaired nasal breathing and nasopharyngeal infections are considered risk factors. The main symptoms are fever, general weakness, cough with sputum.

The viral variant of the disease can be transmitted through personal contact with a patient. For infection, it is sufficient for infected particles of mucus and saliva to enter the air. Treatment begins with a complete diagnosis of the patient’s body. Antibiotics are not used for therapy, since this type of drug is not effective. The patient is prescribed expectorant syrups, rubbing and other thermal procedures.

It will not be superfluous to observe the rules of hygiene: ventilation of the patient’s room, frequent wet cleaning with disinfectants. To prevent relapses, strengthening the immune system is recommended. Patients are prescribed vitamins, preventive exercises, giving up bad habits and a balanced diet.

Catarrhal tracheobronchitis

The catarrhal type of tracheobronchitis does not spread to the lungs, but is characterized by copious mucus secretion and the absence of obstruction. It can take an acute or chronic form. Most often, smokers and people working in conditions of increased dust and gas pollution suffer from it. The main cause of the disease is untimely or inadequate treatment of colds. An acute respiratory disease causes inflammation of the bronchi, which can become chronic. Failure to maintain oral hygiene, hypothermia, smoking, and alcoholism are some of the causes of illness.

The main symptom is cough and fever. In addition, drowsiness, general malaise, headaches, and rapid heartbeat are possible. After a few days, sputum and runny nose appear. If you ignore the above-described signs for 2-3 weeks, then the disease takes a chronic form, the treatment of which is very complex and lengthy. Without proper treatment, the disease can lead to bronchial asthma, pneumosclerosis or emphysema.

Tracheobronchitis in children

Tracheobronchitis in children is most often a complication after ARVI. The main causes of the disease in childhood are a weakened immune system, malnutrition, congestion in the pulmonary system and complications after infectious diseases. Symptoms are similar to viral infections and laryngitis, so careful diagnosis is required.

The child complains of a dry, severe cough leading to vomiting, laryngitis, fever, hoarse voice, and chest pain. If these symptoms appear, immediate attention is needed health care. Based on the characteristics of the child’s body and the severity of the disease, the doctor selects treatment. To speed up recovery, I prescribe rubbing the interscapular space and sternum with irritating ointments. Inhalations, therapeutic exercises, thermal procedures (mustard plasters) and physiotherapy will not be superfluous.

Tracheobronchitis during pregnancy

The main causative agent of inflammatory disease during pregnancy is bacteria and viruses. The allergic form is extremely rare. Due to contact with the mucous membrane of the upper respiratory tract, pathogenic microorganisms actively multiply, causing poor circulation and swelling. Gradually, the inflammation spreads to the bronchi, which causes intense production of sputum, that is, bronchial mucus.

Symptoms of the disease in pregnant women are similar to those of ARVI. The woman complains of cough, fever, and general weakness. As the cough progresses, it becomes dangerous as it is accompanied by tension in the abdominal muscles. By the nature of the secreted sputum, the type and severity of the ailment can be determined. In some cases, bronchospasms are added to the symptoms described above, that is, difficulty in exhaling and a severe convulsive cough.

The acute course of the disease lasts from 7 to 32 days. If a woman had chronic inflammation before pregnancy, it may worsen during pregnancy. Impaired respiratory functions and oxygen starvation are dangerous for the unborn child, as they can lead to hypoxia, hypertonicity of the uterus, uterine bleeding, premature birth or I'll miscarry. The treatment plan is drawn up after consultation and diagnosis with a doctor. If the disease is acute, treatment can be carried out in a hospital setting.

• Good rest, sleep and walks in the fresh air will prevent intoxication and speed up the release of mucus accumulated in the bronchi.
• Drinking plenty of liquid accelerates the removal of mucus. You can use not only warm water, but also teas, herbal infusions, compotes and natural juices. It is better to avoid drinks containing caffeine.
• Air humidification – in order to prevent the bronchial mucosa from drying out, it is recommended to humidify the air. For these purposes, a special humidifier is suitable, which will prevent the proliferation of microbes.
• Eating healthier and strengthening the immune system will make it easier to endure the unpleasant manifestations of the disease and speed up the recovery process.

Residual effects of tracheobronchitis

Residual effects after tracheal bronchitis indicate that the disease has become chronic. The bronchial system is deformed, breathing is impaired, and attacks of suffocation often occur. In addition, there is a slight increase in temperature, which lasts for a long period of time, and sputum production. Patients feel general weakness, aches throughout the body and pain in the chest. This all happens against the background of decreased appetite and attacks of dry cough.

• Fever - to eliminate it you can take Aspirin or Paracetamol. Drugs such as Coldrex, Antigrippin and Fervex have an analgesic and anti-inflammatory effect.
• Cough – a strong cough causes pain in the chest. To eliminate it, it is recommended to take Tusuprex and Bronholitin. To speed up the discharge of sputum, take Ambroxol and Bromhexine.
• Shortness of breath - to eliminate it, take bronchodilator medications, for example, Teopek tablets, Salbutomol inhalation aerosol or Berotec.
• Headaches – appear due to a runny nose and cough. Combination drugs are used for treatment. Folk remedies, for example, menthol oil and eucalyptus extract, also have medicinal properties.

Complications

If inflammation of the bronchi and trachea has a long course or constantly progresses, then this indicates the development of complications. As a rule, this occurs due to the lack of suitable therapy. The most common complication is the transition of a simple disease to a chronic one. In some cases, the disease leads to the development of emphysema, acute respiratory failure, bronchopneumonia and inflammation of other systems and organs due to the ingress of infectious agents that are carried through the bloodstream.

• Bronchopneumonia is a complication of acute inflammation. Develops due to the layering of bacterial infection and due to a decrease in local immunity.
• Chronic form - occurs due to repeated acute inflammation (more than 3 times a year). When the provoking factors are eliminated, it may disappear completely.
• Obstructive pulmonary disease - appears due to secondary infection and a long course of the disease. Obstructive changes indicate a pre-asthma condition and increase the risk of bronchial asthma. In addition, cardiopulmonary and respiratory failure occurs.

Diagnosis of tracheobronchitis

Diagnosis of inflammatory disease of the trachea and bronchial tree is an important process, the effectiveness and results of which determine the treatment regimen and prognosis for recovery.

Basic diagnostic methods:

• Examination of the patient, percussion and auscultation, that is, listening and tapping the lungs.
• X-ray – allows you to identify pathological processes in the lungs and possible complications of the disease.
• Sputum analysis - culture of bacterial flora is necessary to exclude severe and dangerous diseases of the respiratory system (cancer, bronchial asthma, tuberculosis).

Based on the diagnostic results, the patient is selected with antibiotics sensitive to pathogenic microflora and drugs to remove sputum, reduce temperature and other painful symptoms.

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Treatment of tracheobronchitis

The treatment regimen depends entirely on the form of inflammation of the upper respiratory organs and the patient’s condition.

• If the malaise is without complications, that is, mild, then compliance with the regime and physiotherapeutic procedures (electrophoresis, inhalations) can improve your health. In this case, antipyretic and mucolytic drugs are taken to control the temperature and to produce sputum. Antibiotics are prescribed only when other medications are not effective against microorganisms that cause inflammation. Typically, patients are prescribed a seven-day course of sulfonamide medication.
• For the treatment of acute lesions of the respiratory system, it is extremely important to ventilate the room in which the patient is located. This will protect against overheating and speed up recovery. If the disease is accompanied by complications, then antibiotics are prescribed: Penicillin, Oxacillin, Mecillin, as well as inhalation sprays that easily penetrate the bronchi and trachea, distributing evenly throughout the mucous membrane.
• If the disease proceeds without complications, then only sulfonamide drugs are prescribed. In case of circulatory and respiratory problems, use Strophanthin, glucose solution and Cititon intravenously. Oxygen therapy, that is, the introduction of oxygen into the patient’s body, has proven itself in the treatment of severe forms.
• If the inflammation is allergic in nature, then the patient is prescribed expectorants and antihistamines, alkaline inhalations, physiotherapy and therapeutic exercises.

In all cases, the prognosis is favorable, but in the chronic form, complex therapy is used, the results of which determine the duration of the disease and the degree of possible damage to the entire body.

Read more about the treatment of tracheobronchitis here.

Diet for tracheobronchitis

Dietary nutrition is important for any disease, including colds. A properly formulated diet will make it easier to endure the symptoms of inflammation of the mucous membrane of the bronchi and trachea, and to overcome pathogenic viruses and bacteria. Food should be balanced, rich in vitamins, minerals and proteins.

• You need to eat often, but in small portions, that is, adhere to a fractional regimen. A large amount of protein will prevent protein starvation, which occurs due to its loss during severe coughing and phlegm production. The thing is that protein is a material for building tissues, organs and cells; it participates in muscle contractions and synthesizes peptide hormones, hemoglobin and enzymes.
• In addition to protein, the diet should contain fats and carbohydrates. They can be obtained from cereals, baked goods, fruits and berries. Don't forget about complex carbohydrates, improving digestion and stabilizing blood sugar levels.
• Fermented milk products enrich the body with lacto and bifidobacteria and stimulate the digestion process. These products reduce the harmful effects of antibiotics used in treatment and prevent putrefactive processes in the intestines.
• To remove phlegm, you need to drink more fluid. Herbal decoctions, infusions and teas are perfect. For example, hot tea made from sage, linden or elderberry has a diaphoretic effect. Whey or a decoction with honey or anise is useful for dry cough. And onion juice speeds up expectoration.
• Freshly squeezed juices, especially a drink made from beets, carrots and apples, will give not only a boost of energy, but also a daily dose of vitamins necessary to restore the body.

Prevention

Any preventive measures are always aimed at preventing relapses of the disease. The most important rule is timely treatment of any colds. If you have a dry cough, you should take a course of antitussive medications that will stop the pathological process. At this time, you can moisturize the inflamed tracheal mucosa with hot drinks and milk, honey, raspberries or through inhalation.

• If you work outdoors or in open space, then you are at risk for developing inflammatory diseases of the respiratory tract. As a preventative measure, it is recommended to wear a special respirator mask that covers the nose and mouth.
• At the first symptoms of illness, take inhalations. Physical exercise and sports help strengthen the respiratory system and have a beneficial effect on the entire body. Exercising helps to expel mucus faster.
• It is forbidden to carry colds on your feet. It is better to let the body recover and fight the viral infection. To do this, you need to spend a couple of days at home, eat right and drink more fluids.
• Bad habits such as smoking are one of the factors causing illness. Passive smoking significantly increases the risk of developing the disease. Give up this bad habit to stay healthy.

Forecast

The prognosis depends entirely on the form and extent of the inflammatory process. As a rule, acute and allergic forms have a favorable prognosis. But the chronic version requires an integrated approach. The result of treatment depends entirely on the duration of the disease and the degree of damage to internal organs.

The acute uncomplicated form lasts about 14 days. If complications arise or the disease has a protracted course, the pathological process will last for a month or more. Chronic inflammation is also characterized by a particular duration, characterized by periods of exacerbations and remissions.

Sick leave for tracheobronchitis

Sick leave for diseases of the respiratory system is given for up to 10 days. This is the case if the disease is mild. If recovery does not occur within the allotted time and the patient needs additional days for treatment, then a hospital commission of the VKK is created and the sick leave is extended. But on average, patients are sick for 5-7 days.

Tracheobronchitis is a dangerous disease, the wrong or neglected treatment of which can lead to serious consequences. Timely diagnosis and compliance with preventive measures is the key to healthy breathing.

Acute tracheobronchitis

Acute tracheobronchitis is an inflammatory disease of the respiratory tract that affects the mucous membrane of the windpipe (trachea), as well as the bronchial epithelium.

This respiratory disease has an ICD 10 code - J06-J21.

ICD-10 code J00-J06 Acute respiratory infections of the upper respiratory tract

Causes of acute tracheobronchitis

Experts associate the pathogenesis of the disease with the penetration of infection into the respiratory tract: adeno- or rhinovirus, influenza or parainfluenza viruses, coronavirus, respiratory syncytial virus, as well as bacteria: staphylococci, streptococci, Mycoplasma pneumoniae, Moraxella catarrhalis, coccobacteria Bordetella pertussis or Bordetella parapertussis.

First, a viral or microbial infection can affect the nasopharynx, and then go down: this path of spread of pathology in the case of ARVI, influenza, and whooping cough that the patient already has is noted as the leading cause of acute tracheobronchitis. Also, a cause-and-effect relationship between the development of this disease and general hypothermia of the body, exposure of the mucous membranes of the respiratory tract to tobacco smoke or their irritation by gaseous chemicals cannot be ruled out.

With lymphocytic interstitial inflammation, the ciliated epithelium of the trachea and bronchi swells and thickens, and then loosens, after which its desquamation (desquamation) begins - due to damage to the basal membranes of ciliated epithelial cells.

Symptoms of acute tracheobronchitis

The first signs of acute tracheobronchitis are a convulsive cough, attacks of which most often begin during inspiration. In many cases, uncontrollable coughing attacks occur at night.

At first, the cough is dry, scratching the throat and causing pain in the larynx, hoarseness (or hoarseness) and pain after coughing in the chest area. After a few days, a dry cough becomes productive with the release of serous mucous secretion - sputum, which may contain impurities of pus or blood. When listening, the breathing is harsh, with whistling on exhalation and wheezing.

Symptoms of acute tracheobronchitis such as rhinitis, sore and sore throat, low-grade body temperature (in the first days of illness), shortness of breath, pain in the chest and diaphragm, and general weakness are also possible.

One of the most alarming aspects of this disease is the long-term nature of the inflammatory process: according to statistics, the average duration of cough in adults with this diagnosis is 18 days. Acute tracheobronchitis in young children has many identical symptoms, and in infants and children up to 1.5-2.5 years old, the clinical picture is complemented by: increased breathing and pulse, vomiting during coughing attacks, increased chest volume, cyanosis of the lips and skin, swelling of soft tissues, increased agitation, seizures.

Complications of acute tracheobronchitis in elderly patients and in children under five years of age are expressed in the development of a chronic form of the disease, obstructive bronchitis, focal pneumonia, pulmonary emphysema, and chronic obstructive pulmonary disease. The consequences of the disease in young children can lead to chronic breathing problems (partial obstruction of the bronchi) and even respiratory arrest.

Acute tracheobronchitis during pregnancy

It should be borne in mind that acute tracheobronchitis during pregnancy can lead to the most negative consequences, especially in the last trimester. During a strong cough, the muscles of the peritoneum and the diaphragm tense, intense movements of the diaphragm push the uterus, bringing it to tone. After the 32nd week, this can cause preterm labor.

Treatment of cough in pregnant women is possible only with the safest means. These include alkaline drinks (milk with mineral water or soda), inhalation with pine buds, eucalyptus, baking soda and steam from boiled potatoes with skins. Among medicinal plants, pregnant women can take an infusion or decoction of marshmallow root and coltsfoot leaves (in the first three months, also an infusion of thyme). Neither oregano, nor sweet clover or elecampane, nor licorice, nor anise seeds should be used by pregnant women.

It is contraindicated to use antibiotics in the treatment of pregnant women, and if there is an urgent need - a severe infection, then they should be prescribed by an experienced doctor, since these drugs penetrate the placenta, and the study of their effect on the unborn child is not always carried out. Even with macrolides, which are generally considered the most harmless antibiotics, in many cases the instructions state that the drug should be used during pregnancy and lactation “only in the absence of an adequate alternative drug.”

Acute tracheobronchitis in a nursing mother is treated in almost the same ways as in pregnant women.

Diagnosis of acute tracheobronchitis

Diagnosis is carried out using auscultation - listening with a phonendoscope to the sounds present during breathing. A laryngoscope is used to examine the windpipe.

Tests are also needed for acute tracheobronchitis, in particular a general clinical blood test. And to determine the type of infection and the possible detection of cocci, antigens, eosinophils, and mycoplasma in the serum, a biochemical study of the blood is carried out. For the same purpose, the composition of sputum is examined (bacteria culture for pathogenic microflora).

However, only a blood serum test for procalcitonin levels can absolutely accurately confirm the bacterial origin of pathological conditions of the respiratory tract.

Hardware and instrumental diagnosis of the disease implies:

• X-ray of the chest organs, which allows you to determine structural changes in tissue;
• X-ray of the bronchi with a contrast agent (bronchography);
• spirometry (determination of the functional load of the respiratory organs);
• Ultrasound of the trachea, bronchi and lungs.

Since the list of pathologies of the respiratory system with similar symptoms is very extensive, differential diagnosis of acute tracheobronchitis is necessary - to distinguish it from influenza, to exclude laryngitis, whooping cough, pneumonia, eosinophilic bronchitis, bronchial asthma, respiratory mycoplasmosis, obstructive pulmonary disease, etc.

Acute tracheobronchitis in children must be distinguished from many other bacterial and viral lesions of the upper respiratory tract; in addition, children should undergo a stool test to rule out helminthic infestation and cystic fibrosis (which also causes severe paroxysmal coughing).

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Treatment of acute tracheobronchitis

In more than 80% of cases, the cause of the disease is a viral infection, so treatment of acute tracheobronchitis with antimicrobial drugs is carried out either in the case of a combined infection (when bacteria are attached to the virus and pus appears in the sputum), or when the pathogen is identified from the very beginning of the disease. And this is possible if the level of procalcitonin in the blood serum was determined during the diagnosis.

As a physiotherapeutic effect on the bronchi - to expand their lumens and better passage of air to the tissues of the lungs - procedures are needed that promote a rush of blood and activate intracellular metabolism: mustard plasters and cupping, as well as hot foot baths (if the body temperature is normal). Doctors recommend taking the following medications for acute tracheobronchitis (they inhibit the cough reflex with a strong dry cough):

• Libexin (Prenoxdiazine, Tibexin, Toparten): adults - 0.1 g (one tablet) three times a day; in severe forms of the disease - two pills; dosage for children depends on age (from 0.025 to 0.05 g three times a day;
• Sinekod (Butamirate) in the form of syrup: adults and children over 12 years old – 15 ml three times a day (before meals); children 6-12 years old - 10 ml; 3-6 years - 5 ml. Sinekod drops: adults and children over three years old – 25 drops four times a day; children 1-3 years old - 15 drops, newborns from 2 to 12 months - 10 drops 4 times a day.

In case of thick sputum, the following are prescribed to thin it and allow it to clear better:

• Ambroxol syrup (Ambrobene, Lazolvan) for children over five years old is given 5 ml three times a day (after meals); 2-5 years - 2.5 ml and in the same dosage for children under two years of age. Adults can take Ambroxol tablets (Bronchopront, Mucozan) - 30 mg (one piece) two to three times a day;
• Acetylcysteine ​​(ACC) is used for adults and children over 12 years of age - pomg three times a day;
• Mucaltin tablets - 1-2 pills three times a day;
• Terpinhydrate tablets - one pill three times a day.

To prevent swelling of the mucous membranes of the trachea and bronchi during acute tracheobronchitis, doctors recommend antihistamines, for example, Suprastin tablets (0.025 g each): for adults - a pill twice a day (during meals); for children - a quarter of a tablet, after 6 years - half a tablet 2 times a day. Adults should take the drug Erespal 2-3 times a day (before meals), and children should be given syrup - 4 mg per kilogram of body weight (once a day).

In case of bacterial etiology of this pathology, antibiotics such as Amoxicillin (Augmentin, Amoxiclav) may be prescribed - adults and children over 12 years old - one pill twice a day; Azithromycin – 0.5 g once a day; and for children - Sumamed suspension - 10 mg per kilogram of body weight once a day for three days.

During treatment you need to double the amount of fluid you drink. You should also definitely do warm-moist inhalations with soda or any alkaline mineral water, with a decoction of the herb sage, eucalyptus leaves, with essential oils of juniper, cypress, pine or thyme (thyme). Heat and moisture help maintain moisture in the mucous membranes of the trachea and bronchi and help fight cough.

Alternative treatment of acute tracheobronchitis

External folk treatment used includes hot (+38-40°C) foot baths with mustard powder, compresses with black radish juice on the upper chest, rubbing the chest with melted goat fat, warming the chest with boiled hot potatoes in their jackets.

You should take honey and lemon internally (with warm tea); viburnum ground with sugar (a tablespoon of boiled water, twice a day); at night - warm milk with alkaline mineral water (1:1) or put a quarter teaspoon of baking soda on 200 ml of milk.

You can cook this folk remedy for a severe dry cough: boil a whole lemon in water for 10 minutes, cut it and squeeze the juice into a glass, add two tablespoons of glycerin and 150 g of natural honey, stir thoroughly. Take a teaspoon three times a day (before meals), and also at night.

Another recipe is for children. Pour a tablespoon of honey, two tablespoons of anise seeds and salt (a quarter of a teaspoon) into 200 ml of water, bring to a boil, strain and cool. It is recommended to give your baby a teaspoon of water every two hours.

Herbal treatment of acute tracheobronchitis is carried out using the leaves of coltsfoot, plantain, oregano, black elderberry flowers, sweet clover, tricolor violet. For dry cough, thyme infusion helps well (a tablespoon per glass of boiling water, leave for 30 minutes, take 50 ml several times a day). A decoction of licorice root, tricolor violet, and pine buds dilates the bronchi. For sticky sputum, use the root of istod, cyanosis or elecampane.

Homeopathy for acute tracheobronchitis

Considering that homeopathy involves fairly long-term use of drugs, their prescription, especially in severe forms of the disease, may be ineffective. However, the arsenal of homeopathic remedies for treating cough is extensive: Arnica (mountain arnica), Aconitum (turnip borer), Apis (honey bee), Argentum nitricum (silver nitrate), Belladonna (belladonna), Bryonia (white treadmill), Dulcamara (sweet nightshade), Echinacea (Echinacea angustifolia), Cephaelis ipecacuanha (ipecacuanha), Pulsatilla (lumbago or sleep grass), Kalii bichromicum (potassium dichromate).

Some medicinal plants, on the basis of which these expectorants are made, are also used in herbal medicine. For example, mountain arnica, growing in the Carpathians, is used in the treatment of nocturnal enuresis, colitis and flatulence. And the poisonous white step (bryonia or Adam's root) helps with rheumatism and radiculitis.

The complex homeopathic drug Broncho-Gran (Ukrainian production) relieves cough, promotes mucus discharge and reduces inflammation of the respiratory tract.

Mucosa compositum restores damaged mucous membranes; Umkalor is intended to relieve productive cough.

More information about treatment

Prevention of acute tracheobronchitis

Hardening, good nutrition with a sufficient content of vitamins, trace elements and minerals support the immune system, and a high level of the body’s defenses is, in fact, the prevention of this respiratory disease. And it is necessary to carry out timely and adequate treatment for all diseases of the upper respiratory tract - from influenza and acute respiratory infections to tonsillitis and pharyngitis.

The prognosis of acute tracheobronchitis - complete recovery without complications - will be positive with timely and correct diagnosis of the disease and appropriate therapy.

Many people face such a problem as bronchitis, most often against the background of a cold or acute respiratory viral infection. One of the existing forms of bronchitis is a disease that occurs with symptoms of bronchial obstruction. This nosological form has its own characteristics both in pathogenesis and in treatment.

Obstructive bronchitis (hereinafter OB) is a pathological process in the bronchial tree, accompanied by inflammation, cough with sputum and obstructive changes in the anatomical structure of the bronchi. This disease in the International Classification of Diseases, 10th revision (ICD-10) belongs to class 10 and has code J20 or codes J40 and J44 (depending on the characteristics of the disease). Bronchoobstruction can manifest itself both acutely (mainly bronchospasm and hypersecretion, severe edema, especially in childhood) and chronically (mainly against the background of degenerative and proliferative changes).

As a result of bronchial obstruction, bronchial patency deteriorates. In acute obstruction (usually observed in children), the pathogenesis of the development of broncho-obstructive syndrome involves hypersecretion and excessive accumulation of sputum in the bronchial lumen, pronounced swelling of the bronchial wall (due to this the bronchial lumen narrows), and reduction of smooth muscle cells in the bronchial wall (an even greater narrowing of the lumen). To understand this process clearly, carefully study the picture below.

The air passing through such narrow tubes during the act of breathing contributes to the formation of pathological wheezing with prolonged exhalation, and particles of sputum participate in the formation of wheezing, most often dry, audible at a distance.

In chronic obstructive bronchitis (COB), a restructuring of the cells of the mucous membrane occurs, and proliferative processes in the wall and the replacement of normal tissue with connective tissue are observed, while the functions of the bronchus are reduced or lost.

Classification

According to ICD-10, obstructive bronchitis is classified as a respiratory disease (class 10). It is either an acute respiratory disease (ICD code J20) or has a chronic status (ICD 10 code J40 and ICD 10 code J44).

OB can occur with the release of mucus, pus and mucopurulent secretion, affect the proximal and distal bronchi, and be diffuse. An acute (ICD-10 code J20) or chronic (ICD-10 code J40) course of this pathology is possible. A specific diagnosis of the disease is made based on the diagnosis of sputum secreted, the general condition of the respiratory system and the patient’s medical history. Thus, chronic disease status is assigned if the total duration of bronchitis is at least three months a year for two years.

Obstructive bronchitis has a wide etiology of occurrence. There are secondary and primary bronchitis depending on the cause of the disease. Primary OB is not associated with other pathologies. And secondary OB is associated with other diseases of the respiratory tract, cardiovascular system or renal failure.

Risk factors for the development of OB can be grouped into the following groups:

• lifestyle (active and passive smoking, alcoholism);
• ecology (polluted air, climatic conditions);
• professional activity (occupational hazards, work in a dusty room, quarry, mine);
• chronic diseases (rhinitis, sinusitis, tonsillitis, pharyngitis, dental caries, renal or heart failure, congestion of the pulmonary circulation);
• genetic factor;
• age (obstructive bronchitis occurs especially often in young children, as well as in old age).

Smoking is one of the causes of OB development based on statistical data, scientific research and studies of the pathological effect of tobacco smoke on the respiratory system. According to statistics, more than three million people die every year due to smoking.

This effect of cigarettes on the respiratory system is due to the fact that tobacco contains more than 1,900 different substances. Among them you can find polycyclic aromatic carbohydrates, which are carcinogens that cause the development of tumors. Tobacco also contains polonium, a radioactive substance, toxic phenol and cresol. Heavy metals in tobacco smoke, such as cadmium, destroy the structure of the cells of the bronchial tree.

Particular harm to the respiratory system occurs if a person smokes more than 15 cigarettes per day. In this case, during the day after each cigarette smoked, the efficiency of the ciliated epithelium, which consists of cells with special cilia, gradually decreases. Normally, the cilia of the epithelium are in motion and remove accumulated debris from the lungs through the bronchi: dust, mucus, dead cells or purulent products in other diseases. If the speed of movement of the cilia decreases, then all harmful products remain in the lungs, causing obstruction of the bronchi, a favorable environment for the development of infections and mutagenic processes. That is, all the garbage accumulates in the lungs and bronchi.

The bronchial epithelium is also damaged by the chemical component of smoke. The concentration of neutrophils in tissues (granulocyte leukocytes) increases. These blood cells begin to protect the respiratory system and secrete a special proteolytic enzyme (elastase), which is aimed at destroying accumulated chemicals. As a result, elastase significantly damages the ciliated epithelium of the bronchi.

Pathological changes in the bronchi due to tobacco smoke substances lead to many diseases, including OB. In this case, chronic obstructive bronchitis usually develops against the background of smoking. Smoking, in turn, provokes the development of the disease and worsens its course.

Polluted air has similar effects on the respiratory system as smoking. It contains pollutants - hazardous substances of various natures that cause damage to tissue structure. Air pollution is indicated by an increased content of sulfur and nitrogen dioxide, the presence of hydrocarbons, aldehydes and nitrates. These substances damage the bronchi and cause OB.

Climate has a negative impact on the respiratory system. Low temperature and high humidity can contribute to exacerbation of COB and decreased immunity in the fight against ARVI (for children with acute OB).

Occupational hazards include dust, toxic and temperature exposures. Dust irritates the surface of the bronchi and causes “dust bronchitis.” Inhaled toxins destroy the ciliated epithelium. High temperatures cause burns of bronchial tissue, and low temperatures provoke the development of bronchitis. According to statistics, the incidence of obstructive bronchitis in enterprises with these factors ranges from 12 to 45%.

A genetic predisposition to the development of OB is observed in the presence of a family history of the disease. Most often the disease manifests itself in women. Also, according to the results of certain studies, people with the third blood group, negative Rh factor or the first type of haptoglobin are more likely to develop the disease. It is important to understand that genetic predisposition cannot cause the disease. It only increases the likelihood of developing OB in the presence of other etiological factors.

Infections are the main etiological factor in the development of OB. In most cases, the above conditions for the occurrence of bronchitis create favorable conditions for microorganisms. The main pathogens are the following microorganisms:

• parainfluenza, influenza, respiratory syncytial viruses, less commonly adenovirus and rhinovirus;
• hemophilus influenzae (up to 40% of cases);
• pneumococcus (up to 25% of cases);
• mycoplasma and chlamydia;
• Pseudomonas aeruginosa (up to 10% of cases);
• Staphylococcus aureus (up to 10% of cases);
• Klebsiella, Moraxella.

These microbes, with the help of the toxins and enzymes they produce, disrupt the functioning of the ciliated epithelium, disrupt the cell membrane and cause cell death. Therefore, infections serve as a factor in exacerbation of the disease, the occurrence of acute bronchial obstruction syndrome, and contribute to the transition of the disease to a chronic form.

The listed reasons for the development of OB most often act in combination with reduced human immunity. Eliminating the causes is the prevention of obstructive bronchitis.

Only a therapist or pulmonologist can determine the presence and type of bronchitis, but it can also be suspected at home. Diagnosis of obstructive bronchitis is difficult due to the fact that the symptoms of bronchitis may not be noticed by the patient or doctor.

Simple (catarrhal) bronchitis (ICD-10 code J20) has symptoms that are also observed in OB, but cannot be involved in differentiating one type of bronchitis from another:

• moist cough;
• annoying and exhausting coughing attacks;
• wheezing;
• general weakness;
• low-grade fever.

But if obstructive bronchitis is present, the symptoms will necessarily include shortness of breath, difficulty breathing, mainly exhalation, participation of auxiliary muscles (in severe cases), wheezing with prolonged exhalation (auscultatory sign), the predominance of dry wheezing, prolonged cough and often sweating.

Dyspnea is an important symptom indicating bronchitis with obstruction. It is expiratory in nature, that is, it is observed during exhalation, less after coughing up sputum, physical activity is limited. During shortness of breath and there is a hacking cough (tense, with anguish) and whistling breathing.

The cough in patients with obstructive bronchitis is prolonged. Sputum discharge is difficult. In most cases, in patients with OB, more than three cough impulses are required to expel sputum. In this case, sputum is released in small quantities, often mucous, in the chronic form it is mucopurulent or purulent.

Development of the disease in adults

OB in adults most often has a chronic nature due to smoking, ARVI and occupational hazards. At the onset of the disease, a dry cough without sputum discharge is observed. Patients have a lethargic state, a feeling of weakness, heaviness in the chest and low-grade fever.

As bronchitis develops, a dry cough turns into a wet cough, that is, a small amount of sputum begins to be produced. Its discharge is not difficult, the sputum has a mucous and watery structure. When bronchial obstruction syndrome appears, slight expiratory shortness of breath first appears. As the disease progresses, shortness of breath becomes constant. This is followed by a paroxysmal barking hacking cough.

One attack can last from five minutes to one hour. Sputum comes out with difficulty; several coughs are required before it appears. The amount of sputum discharge varies depending on the nature of the inflammatory reaction and the type of pathogen. Sputum of a mucopurulent nature (has a yellow tint and an unpleasant odor) indicates the progression of obstructive bronchitis.

With exacerbation of OB, shortness of breath intensifies, and respiratory failure appears. Sputum in most cases is purulent and viscous, released in small quantities; it can also remain mucous or mucopurulent, but at the same time more viscous and difficult to separate. In some cases, due to depletion of the mucous membrane of the bronchial tree and damage to the vessels passing through it, the sputum is hemorrhagic in nature (contains streaks of blood). In case of hemorrhagic sputum, a careful differential diagnosis must be made between obstructive bronchitis and lung cancer, tuberculosis and heart failure.

Additionally, exacerbation of bronchitis with bronchial obstruction syndrome is indicated by increased night sweats, constant low-grade fever and increased heart rate with low physical activity.

The most common complication of obstructive bronchitis is bronchiectasis, pneumonia (ICD-10 code J13-J18), right-sided heart failure, pulmonary emphysema, and increasing respiratory failure.

The acquisition of a chronic form of obstructive bronchitis (ICD-10 code J-44) occurs mainly due to constant exposure to etiological factors. According to statistics, people who smoke more than 15 cigarettes a day suffer from COB (chronic obstructive bronchitis) 35 times more often than non-smokers. Due to the constant influence of causative factors, chronic inflammation of the mucous membrane of the bronchial tree occurs.

Localization of inflammation in the bronchi and the influence of etiological factors is the trigger for the development of the chronic form of the disease. In this case, relapses of the disease are observed in patients at least three months a year for two years. In the initial stages of COB, all degenerative changes in the structure are reversible. But in the absence of proper systematic treatment, after five to fifteen years, depending on the general condition of the body and the strength of the influence of pathogenic factors, damage to the structure of the bronchi becomes irreversible.

In severe COPD patients, the chest becomes barrel-shaped and pulmonary emphysema develops. The neck veins are swollen, especially during exhalation. Respiratory and heart failure, acrocyanosis and swelling of the lower extremities develop.

The development of the disease in children is practically no different from the development in adults. Most often, OB has an acute form and rarely becomes chronic. Develops against the background of concomitant pathologies of the upper respiratory tract, for example, sinusitis, adenoiditis or pharyngitis.

The child experiences weakness, slight fever, decreased activity and rawness in the chest area. There is a wet cough, a small amount of sputum comes out. In severe forms of the disease, shortness of breath, severe weakness and paroxysmal cough appear. Symptoms begin to decrease by the fourth day from the onset of the disease. With a favorable course of the disease and proper treatment, the symptoms completely disappear by the seventh or tenth day.

It is important to understand that in a child, bronchitis can also become chronic. In order to avoid this, it is necessary to observe bed rest during the period of temperature reaction, complete the course of treatment and take plenty of warm drinks during illness. And after recovery, avoid hypothermia, take vitamins, harden yourself, get vaccinated in a timely manner, maintain ventilation and humidity, and be in the fresh air a lot and often.

During a medical examination, an important diagnostic factor for confirming obstructive bronchitis can be identified - slow, prolonged exhalation in relation to inhalation, wheezing, audible by the ear.

On auscultation, breathing is harsh or weakened (with COB), exhalation is prolonged, dry, whistling, medium- or fine-bubbly moist rales are present.

There are no significant changes in the general blood test. In severe cases of the disease and bacterial infection, neutrophilic leukocytosis is detected, that is, an increase in the number of neutrophils, a shift of the neutrophil formula to the left and a moderate increase in the erythrocyte sedimentation rate (ESR).

Microscopic examination of sputum is carried out for the purpose of differential diagnosis of the disease and identification of the bacterial pathogen. OB is indicated by a high content of neutrophils in the blood, bronchial epithelial cells and macrophages, Kurshman spirals and Leyden crystals. Bacterial culture determines the type of pathogen. The analysis also allows us to identify the sensitivity of the infectious pathogen to antibiotics for effective treatment of the disease.

Bronchoscopy is a diagnosis of the condition of the trachea and bronchi using an endoscope. As a result of the examination, the doctor receives an accurate picture of the internal state of the bronchi through photo or video recording from a bronchoscope. The resulting image is transmitted to the screen and decrypted by a specialist. Also, during bronchoscopy, biological material (sputum or bronchial tissue) can be collected. The intensity of inflammation is determined from the resulting image depending on the condition of the mucous membrane and blood vessels. There are three degrees of endobronchitis, determined by bronchoscopy.

Radiographic changes are observed only in patients with a chronic form of the disease, after the addition of pulmonary emphysema. When diagnosing acute bronchitis, radiography is used to exclude pneumonia, atelectasis, bronchiectasis and other pathologies.

An effective method for determining the state of the respiratory system is spirography. This research method allows, by graphically recording breathing, to determine the main indicators of the respiratory system. For example, vital capacity (VC), forced expiratory volume (FEV1), peak volume flow (PVF) or Tiffno index (ratio of FEV1 to VC). With obstructive bronchitis, a decrease in vital capacity, FEV1, and Tiffno index is observed. A test with bronchodilators in COB is negative, but in the acute form it can be positive.

It is important to distinguish protracted acute OB from chronic OB. With a protracted form of the disease, symptoms are observed for 3 to 4-8 weeks. In the chronic form, symptoms are observed for 3 months or more over the past 2-3 years.

In the presence of mucopurulent or purulent sputum, it is necessary to differentiate OB from bronchiectasis. With bronchiectasis, sputum is separated “a mouthful” in large quantities. Sputum production may be associated with a certain body position.

Only after a thorough diagnosis is it possible to establish the type of disease and the degree of its development.

How to treat obstructive bronchitis correctly and effectively can only be determined by an experienced specialist, based on the results of the examination and individual history. The general treatment regimen includes elimination of provoking factors, treatment in a hospital or at home, a special diet, antibacterial drugs, restoration of bronchial excretory function, detoxification and restoration of respiratory function.

Elimination of the etiological factor that provoked the development of the disease makes it possible to limit the development of OB and prevent the disease from becoming chronic. It is necessary to stop smoking, as tobacco smoke provokes further development of obstruction. If there is a source of infection in the upper respiratory tract (nasal passages, sinuses, tonsils), it is necessary to carry out sanitation. It is recommended to avoid inhaling cold or burning air in order to prevent irritation of the mucous membrane of the bronchial tree.

Hospital treatment is prescribed to patients with severe disease to monitor the course of the disease, carry out diagnostic measures and exclude the occurrence of complex exacerbations, such as pneumonia or spontaneous pneumothorax due to bronchial obstruction. Inpatient treatment lasts nine to fourteen days in most cases. If the disease is mild, then hospital treatment is not necessary. It is permissible to be an outpatient if all doctor’s prescriptions are fully followed.

In order to completely cure obstructive bronchitis (before irreversible consequences of the disease occur), it is recommended to follow a diet containing all essential substances (vitamins, amino acids, polyunsaturated fatty acids and minerals). Prescribing a high-protein diet to restore lost proteins due to excessive sputum production.

Antibacterial drugs for bronchial obstruction are almost always prescribed. Unfortunately, the doctor does not have time to correctly prescribe and culture the biomaterial for sensitivity to antibiotics (Mulder method). This is due to the patient’s rather severe condition, so antibacterial therapy for OB is empirical at the first stage.

The following groups of antibiotics can be prescribed: preparations of aminopenicillins, macrolides, cephalosporins, respiratory fluoroquinolones. Antiseptics are prescribed to eliminate infection, for example, phytoncides. The drugs are prescribed in various forms; aerosol, parenteral, endobronchial and endotracheal are acceptable. Application directly into the bronchi or trachea is effective and fast-acting, since the drugs go directly to the site of inflammation, but this is associated with the risk of acute respiratory failure in the patient during manipulation.

Among antiseptics, Dioxidin is the most widely used. It is usually administered endobronchially. For inhalation, use ten milliliters of a 1% solution per procedure.

In order to cure OB, it is necessary to restore the excretory function of the bronchi, that is, to improve the functioning of the ciliated epithelium. Expectorants are used for this purpose. The most widely used is "Mukaltin" - a drug of natural origin, used up to six times a day, three tablets. "Ambroxol" ("Lazolvan") is a mucolytic drug, administered orally or inhaled through a nebulizer (this method of administration is preferable). The following mucolytics-mucoregulators also have a good proven effect:

1. "Acetylcysteine" (ACC, "Fluimucil") - preferable in the form of inhalations, the drug of choice for purulent bronchitis.
2. “Carbocisteine ​​(“Fluditec”) is also best used in the form of inhalation through a nebulizer, it helps not only to remove mucus, but also to normalize the function of the mucous membrane. Drug of choice for chronic OB.
3. Erdostein is the drug of choice for COPD.

In case of exacerbation of purulent OB, an intravenous infusion of four hundred milliliters of hemodez is used to eliminate intoxication. Infusion of an isotonic solution, plenty of warm drinks, vitamin-containing decoctions and infusions have a good effect.

Bronchodilators help to significantly improve the patient's condition: the drug ipratropium bromide in combination with fenoterol (Berodual), Spiriva, Berotek, Atrovent, Salmeterol.

In case of a pronounced inflammatory process or a severe course of the disease, inhaled or, less commonly, systemic glucocorticosteroids are prescribed, which quickly stop the inflammatory reaction and help normalize respiratory function indicators:

• "Pulmicort" - budesonide;
• "Beclomet" - beclomethasone;
• "Flixotide" - fluticasone;
• "Asmanex" - mometasone.

Items 3 and 4 in this list are the most preferable, as they have minimal systemic effect on the body.

It is possible to cure bronchitis with obstruction syndrome only under the supervision of an experienced specialist. Otherwise, bronchitis with obstruction syndrome will cause irreversible consequences and become chronic.

First of all, it is important to understand the etiological causes of the development of obstructive bronchitis and fight them.

An important step is to maintain a good level of immunity. A comprehensive and regular intake of all essential vitamins is an excellent way to maintain a healthy immune system. Vitamin complexes such as Complivit, Supradin or Vitrum have a good composition. It is enough to take these vitamins in a course two or three times a year.

It has been proven that stopping passive and active smoking reduces the likelihood of developing obstructive bronchitis by twelve times. In this case, the bronchial mucosa is not damaged by tobacco smoke substances and functions normally.

Elimination of occupational hazards that affect the respiratory system is also highly effective in preventing OB. Small particulate matter or chemicals from factories literally destroy the bronchial mucosa, so changing your place of work or place of residence will keep your bronchi healthy.

Maintaining your health at the proper level is the best prevention of disease.