Obstructive bronchitis – inflammation of the bronchi with the syndrome of respiratory failure: shortness of breath, wheezing, shortness of breath, choking.
Most often, obstructive bronchitis in children occurs with ARVI. There is another important factor that can lead to airway obstruction – allergens. In this case, we are talking about allergic obstructive bronchitis. There may also be a mixed type of bronchial obstruction. Against the background of acute respiratory viral infections, the bronchial sensitivity to allergens increases significantly, then the doctor can make a difficult but adequate diagnosis of infectious-allergic bronchial asthma.
What is obstructive bronchitis?
What is the term “obstructive bronchitis”? Obstruction in Latin means “obstruction, obstacle, hindrance,” and bronchitis means inflammation of the bronchi. If the child is given this diagnosis, it is assumed that he has inflammation of the bronchi with difficulty breathing. In modern domestic medicine, obstructive bronchitis is not an independent disease. It is not even a diagnosis, but a syndrome that characterizes the child’s condition. Proper treatment begins only when the cause of the obstruction is established. Therefore, if the doctor makes a diagnosis of obstructive bronchitis, he must justify why breathing is difficult, what is a hindrance to the normal passage of air in the bronchi? It may be:
- accumulation of mucus;
- swelling of the wall of the bronchi;
- a tumor, an abscess that presses on the bronchi from the outside.
For accurate diagnosis will require additional studies: blood tests and radiography.
Signs of disease
Symptoms of obstructive bronchitis in children can appear both during SARS and after it. What is their feature?
- Hot fit, debilitating, dry cough, often troubling at night.
- Difficult breathing is accompanied by swelling of the chest, the intercostal spaces being drawn in while inhaling.
- Audible wheezing and wheezing sounds in the chest without a stethoscope.
- The frequency and depth of breathing is disturbed, shortness of breath appears.
When SARS is also observed fever, runny nose, weakness, headache, general intoxication of the body. In addition, a viral infection confirms the decoding of a blood test with high lymphocytes, changes in ESR.
What could be other causes of obstructive bronchitis?
- Allergy. If the child did not suffer from acute respiratory viral infection, and signs of bronchial obstruction appeared, it was probably caused by household allergens: dust, polluted air, wool items, animal hair, household chemicals, hygiene products and
On the verge of asthma
Parents are often worried about the question: how to distinguish the symptoms of obstructive bronchitis from bronchial asthma? The main difference is that bronchial asthma occurs as a sudden attack, the child begins to suddenly suffocate. Obstructive bronchitis develops slowly. There is difficulty breathing with it, but not so sharp. Can recurrent obstructive bronchitis go into asthma? Yes maybe. And doctors warn about it. If you do not eliminate the causes and factors affecting hypersensitivity and bronchial obstruction, the risk of developing asthma is high.
In domestic medicine, there are often roundabout, milder variants of the diagnosis of “bronchial asthma”: the same obstructive bronchitis or asthmatic bronchitis. This is due to our mentality: asthma is a terrible diagnosis, and for many parents sounds like a sentence. Meanwhile, abroad have learned to live fully with him. Asthma, like diabetes, is more likely not a diagnosis, but a way of life. With this approach, everything changes: the child does not impose consciousness of disability, and teach him to live fully with this chronic disease. Read more about bronchial asthma in children in our other article.
Principles of treatment
The algorithm of actions is always the same: first call a doctor and do not use any drugs (except for antipyretic if necessary) before his arrival. A pediatrician will adequately assess the condition of the child and take action. With mild and moderate obstructive bronchitis, treatment is carried out at home. If a child of any age has severe respiratory failure, high intoxication, there is a suspicion of pneumonia, the doctor insists on hospitalization.
On medical sites, there is often a note: the treatment of obstructive bronchitis in infants is carried out in the hospital. This requirement is understandable: infants respiratory failure develops rapidly, there is a risk of dehydration and suffocation, severe complications. How is treatment in the hospital?
- Emergency care for respiratory failure. In extremely severe cases, ventilation is carried out lung. Also used oxygen masks, medicinal inhalation to facilitate breathing.
- Hormone therapy. In severe conditions, hormones are administered intravenously to quickly relieve obstruction syndrome and inflammation in the bronchi. This is an effective and powerful method.
- Rehydration therapy. Often required babies with moderate and severe dehydration. Glucose-saline solutions are administered intravenously to quickly restore the water-salt balance.
In addition to methods of emergency care, carried out medication, as shown in obstructive bronchitis.
What can a doctor appoint
Drug treatment depends on the cause of bronchial obstruction.
- Antiviral drugs. Since obstructive bronchitis most often occurs on the background of acute respiratory viral infections, it is advisable to use antiviral drugs that are presented in different dosage forms: candles, drops, tablets, syrups. The most commonly prescribed drugs based on interferon. Also used homeopathic remedies to strengthen the immune system.
- Bronchodilator drugs. With the help of bronchodilators relieves spasms in the bronchi and symptoms of difficulty breathing. The most commonly prescribed syrups are Ascoril, Salmeterol, Clenbuterol. Positive feedback on the treatment with Erespal, which has a bronchodilator and anti-inflammatory effect, reduces the amount of sputum, effectively relieves obstruction. The drug is contraindicated in children under 2 years. Glucocorticoid inhalers may be prescribed for relief of difficulty breathing (most commonly “salbutamol” is used).
- Mucolytics. In obstructive bronchitis, the doctor also prescribes mucolytic agents. They contribute to the liquefaction of viscous sputum and its removal from the bronchi. The most commonly used: “Lasolvan”, “Ambroxol”, “Mukosol”, “Ambrobene”, “Flyuditek” and others. Expectorant drugs are used strictly according to the prescription of the doctor: “Gadeliks”, “Prospan”, “Doctor IOM”, “Bronhikum”, “Herbion” and others.
- Antispasmodics. Appointed to relieve spasms in the bronchi. Can be used in the form of tablets, inhalations using a nebulizer. In stationary conditions are administered intravenously.
- Antibiotics. They are prescribed only if bacterial infection after sputum is confirmed. Also a sign of a bacterial infection can be yellow purulent mucus when it is coughing, prolonged temperature, severe intoxication, elevated neutrophils in the blood. Penicillin antibiotics are most commonly used: Augmentin, Amoxiclav, Amoxicillin. Macrolides (Sumamed, Macropen) and cephalosporins (Cefazolin, Flexin, Cephalexin and others) are also used.
- Antihistamines. First of all, antihistamines are prescribed to children who are prone to allergic reactions. These medicines help relieve swelling and inflammation in the bronchi. Antihistamines of the new generation, which do not dry the mucous and do not have a sedative effect, are usually prescribed.
Unreasonable use of antibiotics for obstructive bronchitis leads to exacerbation of the disease and possible complications. Therefore, it is important to establish the cause of inflammation in the bronchi. In most cases, it is a viral infection or allergy. Also, doctors are very careful to prescribe immunomodulators for this disease. These drugs can aggravate obstructive bronchitis.
How to help your child at home
Does something in this situation depend on the parents? A lot of things! Because parents are able to provide proper care for a child with acute respiratory viral infections and prevent complications.
- Moist cool air. In the room of the child it is necessary to carry out wet cleaning daily. Ideal parameters of air temperature – from 18 to 20 ° C, humidity – from 50 to 70%. If possible, remove all “dust bags”: carpets, upholstered furniture, books on open shelves, heavy curtains.
- Plentiful warm drink. If the child is sick with ARVI, drinking regime should be strengthened. First, it will help avoid dehydration. Secondly, it contributes to the dilution of mucus in the bronchi. The less fluid in the body, the thicker the blood and mucus in the organs. Thick sputum adheres to the walls of the bronchi and narrows their lumen, which leads to difficulty breathing with bronchitis.
- Vertical body position. Bed rest is indicated for severe intoxication and temperature. But if a child with obstructive bronchitis wants to sit and move, it will be good for him. In an upright position, sputum coughs better. In the horizontal – accumulates in the bronchi and can cause pneumonia.
- Moderate exercise. If a child jumps and jumps with ARVI – it means that not everything is so bad. However, if there are signs of bronchial obstruction, motor activity may increase shortness of breath. This must be remembered and not provoke a child to active games.
- Folk remedies. Treatment of folk remedies should be balanced and deliberate. So, for example, with care it is necessary to apply chest collecting with expectorant effect. Hot inhalations are not recommended (breathing over potatoes or herbal decoctions), since hot steam can cause respiratory tract burns and laryngospasm (false croup). Rubbing, ointment with essential oils, mustard plaster are prohibited – these measures are especially dangerous for young children. If the child does not have a temperature with obstructive bronchitis, you can go out for a breath of fresh air (just not on the balcony that goes to the gassed avenue).
- Inhalation using a nebulizer. The nebulizer is an indispensable device for the provision of emergency care for breathing difficulties, as well as for prevention. Doctors recommend purchasing a nebulizer if a child is diagnosed with recurrent obstructive bronchitis or bronchial asthma. Most often, a glucocorticosteroid (hormonal) drug Pulmicort or a bronchodilator solution Berodual is prescribed to relieve an attack at home. The dosage and treatment prescribed by the doctor.
If the cause of obstructive bronchitis is in allergies, it is necessary to eliminate all possible home allergens. Otherwise, the treatment will be useless and meaningless. It is strictly forbidden to smoke in the house where there is a child. Tobacco smoke and passive smoking is one of the most common causes of bronchial obstruction in children.
Usually they are prescribed as prevention of obstructive bronchitis in children, as well as after stopping the obstructive syndrome.
- Physiotherapy. These include: electrophoresis, UHF, laser therapy.
- Speleoprocedures. The healing air of salt caves is indicated for various diseases of the respiratory organs. But if, after a successful speleotherapy, the child again gets into the apartment with allergens, then relief will not last long.
- Climatotherapy. For a child who has suffered obstructive bronchitis, it will be useful mountain and sea climate. Any stay in the fresh and clean air (in the woods, in the country, in the village) will strengthen the child’s immunity.
- Physical therapy and breathing exercises. Conducted by an instructor in exercise therapy. Also, physical and breathing exercises should be regularly performed at home. In this case, there will be a tangible effect of the procedures.
- Hypoallergenic diet. All allergenic products are excluded: red, orange vegetables and fruits (especially citrus), chocolate, smoked meats, spices, sausages, fish dishes, chicken meat. Highly allergenic products are considered with flavors and dyes.
- Percussion or drainage massage. Percussion massage helps cough up sputum stuck to the walls of the bronchi. It should be a professional masseuse. If desired, the mother can also learn the basic elements of this type of massage. The procedure will be effective if the air in the room is humid and cool, then the sputum is released naturally. In a dry and hot room, mucus will be thick all the time, and massage can be done for a long time and without result.
Obstructive bronchitis in a child is successfully treated and with adequate, timely treatment rarely leads to bronchial asthma. It is important to observe the hygiene of the room, the drinking regimen, the hypoallergenic diet, strengthen the immune system so that there is no recurrence of the disease.