Hello, dear parents. We have already dealt with a disease like bronchitis. Now it's time to more thoroughly understand what is the chronic form of this disease. After reading the article, you will learn what the symptoms and causes of this pathology, what methods of treatment and prevention.
What is this disease
The chronic form of bronchitis is an inflammatory lesion of the bronchi, which is chronic, and therefore proceeds with periodic exacerbations.
In infants, this form of the disease is rare. To a greater extent is a complication of neglected bronchitis.
Chronic bronchitis is diagnosed only after excluding diseases similar in symptoms:
- hereditary diseases of the respiratory system,
- cystic fibrosis,
- immunodeficiency pathologies,
- malformations of the respiratory system.
What happens in the body
- The course of this disease is characterized by functional impairment of the bronchi, the process of cleaning the bronchi from accumulated mucus is worsening.
- Under the influence of foreign aggressive agents, hyperfunction of cells of the secretory type appears. As the disease progresses, the secret gets harder and harder to separate, and when released it sticks to the ciliated epithelium of the respiratory system mucosa.
- The processes of inflammation negatively affect the composition of the contents of the bronchi: the level of neutrophils increases.
- The local protective function of the body is impaired.
- Bacteria and viruses colonize.
There are a number of reasons that directly affect the development of the chronic form of bronchitis:
- Reduced immune defense. Due to the weakened state of the child is more susceptible to the attack of microorganisms from the external environment.
- Hereditary factor or congenital anatomical defects of the respiratory system. The likelihood of developing bronchospasms, the production of mucus in large volumes.
- Infections. Chronic pathology is caused by viruses, bacteria, atypical cells. The primary sources may be infectious processes in the tonsils and teeth, which, with the exacerbation of the disease, descend down the respiratory system and penetrate the bronchi.
- Harmful vapors, gases, dust particles, penetrating into the body, respond with inflammation or spasm of the bronchi.
- Cigarette smoke. If the child constantly inhales the scent of tobacco - this is a prerequisite for the development of the chronic form of bronchitis in the toddler.
- Climatic factor. It may be a favorable background for the development of the chronic form, but rarely serves as the primary source of pathology. For example, very low or high air temperature, humidity, polluted air.
Chronic bronchitis in a child, symptoms
What are the signs characterized by the course of the disease:
- General intoxication of the body. The younger the child, the more pronounced. It is characterized by a deterioration in appetite, increased sweating, fever and lethargy.
- Cough, which is an attempt of the body to get rid of accumulated sputum. There are both dry and wet cough. Dry is the most painful for the baby, causes pain, scratches, irritates the throat mucosa. When the baby often has processes of exacerbation of the disease - cough can be quite long.
- During coughing up, sputum can be released, both transparent, which is serous, and with a green tint, of a purulent character. With the duration of the process, the amount of excreted sputum gradually increases. Parents are faced with the problem of how to explain to the little toddler the need to cough up and spit out sputum.
- If your child has obstructive chronic bronchitis, then he may be accompanied by specific wheezing wheezing. An experienced wheezing specialist will be able to determine in which section of the bronchus the maximum damage is present.
- Asthma attacks and shortness of breath can also characterize the obstructive form of chronic pathology. It occurs more often in the first half of the day, with the occurrence of asthma attacks during exhalation.
- When listening to the baby’s breast with a stethoscope, the doctor will be able to determine the type as well as the stage of chronic bronchitis. Possible weakening of the breath or its stiffness.
- A doctor, after conducting a series of studies, will be able to determine the presence of chronic bronchitis:
- complete blood count is characterized by reduced hemoglobin and high ESR,
- on the x-ray in the root section of the bronchial tree marked expansion.
- The exacerbation of chronic bronchitis is attributed to the changing seasons of the year. It lasts up to four weeks.
Young mummies may be interested in the question of how dangerous it is to communicate with a baby during the period of such a disease, since bronchitis can be triggered by various microorganisms or viruses, or be due to an allergic reaction. Except for the last option, the disease is contagious, but only during the incubation period, which lasts up to seven days from the day of infection.
The chronic form of this pathology is harmless and non-infectious for people who are nearby. Therefore, such babies can easily visit places where children gather.
You just need to remember that 30% of the toadstools can develop pneumonia as a complication of the chronic form of bronchitis.
When examining a baby, a number of studies are assigned that can accurately describe the current picture.
- General blood analysis. It will show an increase in ESR, a decrease in hemoglobin, an increase in the number of leukocytes (in the leukocyte formula you can see a large number of stab leukocytes).
- Biochemical study of blood. Important indicators for diagnosis are the level of sialic acid, fibrinogen, C-reactive protein and seromucoid.
- Cytological, biochemical examination of sputum. In the acute stage of the disease, purulent discharge is detected, accompanied by an increase in neutrophils, acid mucopolysaccharides, and a decrease in lysozyme levels.
- Bronchoscopy. Allows you to identify the nature of the process of inflammation: atrophic, purulent, hemorrhagic, catarrhal.
- The roentgenogram may show an expansion of the root system of the bronchi, and in the lung fields, the transparency may increase (if there is enphisema).
Treatment of chronic bronchitis in children
- Elimination of factors provoking the development of the disease. For example, cigarette smoke, a disease of the upper organs of the respiratory system.
- During the exacerbation period, antibiotics may be prescribed. In particular, Amoxiclav, Cefaclor.
- It is important the presence of drugs for expectoration of sputum. For example, ACC, Bromhexine.
- Inhalation. In particular, Chlorophyllipt, Dioxidin, Furacilin.
- Bronchodilators For example, Atrovent, Teotard.
- Antihistamines. For example, Diazolin or Suprastin.
- Physiotherapy procedures, in particular electrophoresis in the chest.
- Rubbing, massage, breathing exercises.
- Immunomodulators and vitamin complexes.
- Normalization of the daytime regime, walks in the fresh air (after a period of exacerbation), a sparing diet.
It is important to understand that you should not run the disease. Therefore, it is imperative to see a doctor. It is he who will say with precision that the baby has completely recovered. My friend had this situation. His son got a cold. They treated him at home. We decided that the baby fully recovered. Then they even went on a journey, and the disease was only cropped. Due to improper and inadequate treatment, a chronic form of bronchitis has developed. His son is stable four times, and sometimes five, in a year he gets into bed with bronchitis. And parents now blame themselves for the fact that in time they didn’t ask for help from a doctor. Therefore, I recommend that you contact a specialist in case of characteristic symptoms.
Traditional methods of treatment
- Inhalation of all sorts of infusions of herbs, drugs.
- Compresses. The most popular flour. Performs warming function. It will require mixing in equal proportions flour, mustard powder, alcohol and badger fat, everything must be thoroughly mixed and heated, as follows, the compress in gauze is applied to the child’s chest, covered with a towel or scarf, the procedure takes about 45 minutes.
- Warming up mashed potatoes. You will need to boil several tubers (in the process of cooking you need to add a teaspoon of soda), knead them until smooth, wrap in gauze or a bag, after reaching a comfortable temperature, attach to the baby's chest in the center, until cooled.
- Treatment with herbal infusions. Mint, linden and sage will work well. It is advisable to insist weed during the day. Take a teaspoon three times a day before meals.
- Herbal homemade ointment. You can use, when mixed in equal proportions, licorice root, pine buds and thyme. Apply it to the breast of the child.
It is important to purchase a home inhaler, if your family is faced with chronic bronchitis. To fill this device will suit the following means:
- Alkaline water (mineral) or soda solution (combined with a salt solution).
- Infusions of herbs. A special place is occupied by sage and chamomile.
- Bronchodilator drugs, for example, atrovent.
- Antiseptic, in particular, dioxidine.
- Means affecting the dilution of sputum, for example, Lasolvan.
It is important to comply with the correct dosage of the drug, filled into the inhaler, given the age of the baby and his weight.
Prevention of chronic bronchitis
- Drink plenty of water. Particular attention should be paid to alkaline mineral water, decoctions of herbs, for example, limes and mint, hot teas with currant leaves or raspberries.
- Dairy diet is important, as well as a high content of plant foods in the diet.
- It is necessary to regularly air the room in which the baby is located, to do wet cleaning.
- It is important to observe the optimum level of temperature and humidity (approximately 20 degrees and 70%, respectively).
- It would not be superfluous to vaccinate during a surge in the epidemic of viral diseases.
You have familiarized yourself with the clinical picture of the chronic form of bronchitis, learned what may be the causes of this disease. You have become known methods of treatment, including folk. Once again you have seen that it is better to prevent the disease than to treat it later, moreover, at the moment of illness, the child’s body suffers. Take care of the health of your kids and be happy!
Chronic bronchitis in children - symptoms and treatment
A common cause of bronchitis in children is infection.
The body of babies is not yet strong, the immune system is not developed and is powerless against harmful microorganisms.
But the pathogen does not stop, hitting the child’s bronchi, it spreads throughout the body. Malicious microorganisms are able to maintain viability for a long time.
After inadequate bronchitis therapy, the infection may subside., "fall asleep". It seems as if the kid recovered. But just a little hypothermia and the disease again makes itself felt. We have to deal with chronic bronchitis, dangerous and insidious pathology.
At three years old, the baby’s respiratory system changes and lung immunity strengthens. Such a restructuring significantly reduces the number of diseases. If this does not happen, the child is diagnosed with chronic bronchitis.
The main symptoms of chronic bronchitis in a child include:
- passive smoking,
- propensity for allergies,
- weakening of immunity
- unfavorable ecological climate
- individual features in the structure of the bronchi.
The presence of chronic bronchitis in children results immediately several provoking factors at the same time.
Chronic obstructive bronchitis in children - how to recognize the disease
In children, the symptoms of chronic bronchitis differ in comparison with adult patients.
At the initial stage of chronic bronchitis, the symptoms are similar to the manifestation of ARVI. - fever, weakness, runny nose, excessive sweating, irritability.
As the pathology progresses, the symptoms change slightly:
Cough. In chronic bronchitis in children, cough syndrome is protracted, the child begins to cough for 2-3 days of illness. Initially, the cough is dry and rough, accompanied by soreness. Soon, coughing becomes wet with a separation of viscous purulent sputum.
Sputum. Chronic bronchitis in children is accompanied by sputum when coughing. In the period of the weakening of the disease mucus is transparent. When exacerbated, expectoration becomes thick and purulent.
Wheezing. The accumulation of mucus in the bronchopulmonary pathways provokes the development of hoarse, wheezing. Wheezing occurs due to the difficulty of passing air masses through clogged bronchi.
Lethargy. The younger the child, the more aggressive his chronic bronchitis affects his health. Periods of agonizing exacerbations are replaced by remission. But the long-awaited relief brings only weakness, fatigue and a complete loss of appetite.
Dyspnea. One of the most important and major symptoms of chronic bronchitis in children. Difficulty in breathing occurs after active games, physical exertion, crying baby.
Some specific signs of chronic bronchitis can only be detected by a pediatrician:
- radiograph shows the expansion of the roots of the bronchial tree,
- a blood test reveals an increase in ESR and iron deficiency anemia,
- when tapping the sternum, specific pulmonary sounds, wheezing, and breathing hardness are heard.
How to treat chronic bronchitis in a child
Treatment of chronic bronchitis in children should be carried out in the period of relief (remission), and during exacerbation of the disease (relapse).
During the exacerbation of the most intensive therapy. If bronchitis is not particularly difficult, comprehensive treatment is allowed at home.
Council If a baby has a fever, he should be kept in bed during treatment.
A pediatrician after examining a sick baby develops an individual therapy with the following medicines:
Antibiotics. In chronic bronchitis, doctors recommend taking gentle antibiotics of the penicillin group, macrolides and cephalosporins. The main task of antibiotic drugs is to stop the development of infection.
Expectorants. These drugs that dilute phlegm and improve its output are divided into two types:
- Phlegm diluting: Mukopront, Mukaltin, Bronkatar, Stoptussin phyto, Bronhikum, Ambrogexal, Mukodin.
- Helping to remove mucus from the bronchi: Bronhikum S, Alteyka, Prospan, Doctor IOM, Coldrex broncho, Ambrobene, Lasolvan, Bromhexin, Pertussin, ACC.
The choice of drug depends on the stage of chronic bronchitis. Taking prescribed expectorant drugs can also increase cough, improving bronchial cleansing and speeding recovery.
Bronchodilators. Drugs that expand the lumen of the bronchi, which helps in the release of mucus and facilitate breathing.
For children with chronic bronchitis, it is better to treat with bronchodilators by inhalation using Lasolvana, Ambroxol or Bromhexine.
Antipyretic. They are used only when the temperature rises from + 38⁰ C. Paracetamol, Ibuprofen, Analgin are more often prescribed to children with chronic bronchitis.
Methods of traditional medicine help to effectively and safely fight chronic bronchitis in children.
Chronic bronchitis in children treatment of folk remedies
There are many ways of treating children's chronic bronchitis. The most effective include the following:
Inhalation. The best way to relieve an irritating cough at home. To warm up the airways of the baby well, remember the old ways of your grandmother: breathing, covering yourself with a towel over a container with hot remedy. What to use?
- honey with its high emollient properties
- onion decoction with antimicrobial and expectorant effects,
- iodine, stopping the spread of infection through the pulmonary tract (it is better to combine it with soda and eucalyptus oil).
Potato warming. One of the effective and quick methods of cough relief in chronic bronchitis in children.
Peel a few potatoes and boil them. When cooking, add soda. Mash the boiled potatoes and put them in a plastic bag.
As soon as the mass reaches a comfortable temperature, attach the bag to the baby’s chest, fix and hold until cool. Place the potato pancake in the center of the chest!
Flour compress. Such a tool has an excellent warming effect. Mix flour, alcohol, badger fat and mustard powder in equal proportions. Mix all ingredients and heat to achieve mass uniformity.
A healing compress is applied to the chest over a layer of gauze and fastened with a scarf. The procedure time is 50-60 minutes.
Herbal medicine. Medicinal herbs with expectorant effect are effective when the temperature of the baby and a strong cough. Healers recommend the use of mint, sage and lime blossom. Dry herbs in the same amount are mixed and steamed with boiling water.
After 1-1.5 days of infusion, the mass is filtered.The finished medicine is given to drink a baby a teaspoon three times a day on an empty stomach. To improve the taste of the infusion can be mixed with honey.
Herbal ointment. With this tool it is good to treat the smallest patients. Mix equal quantities of thyme, pine buds and licorice root.
Grass mass should be poured ½ cup of water and then simmered. Finally, add a little badger fat and cook for another 6-7 minutes. Rub the breast of the sick baby twice a day with the finished mass.
About home treatment we have a detailed article. All the methods described in it can be applied in the treatment of a child.
Massage in children with chronic bronchitis
To carry out a high-quality home massage for a sick baby, turn on the fantasy and use the game form. During the procedure, the baby is laid on the belly. Before the main procedures, the child’s back is heated and lubricated with massage oil.
Massage is carried out with light tapping. movements on the back of the child. Tapping combine gentle rubbing from the spine to the sides. This massage is called drainage, it helps relieve coughing and cleansing the bronchi. The procedure takes 3-5 minutes. Massage your baby for an hour before meals 2-3 times a day.
Mustard plasters. An ancient and effective means of heating the bronchi. But the child will be difficult to put a yellow card - this procedure is not particularly comfortable. Habitual "adult" mustard plasters for children can be replaced with a mustard foot bath.
In a small bowl, pour warm water and add 2-3 tbsp. l mustard powder. Let baby float legs for 15-20 minutes. When performing the procedure, wrap the upper part of the legs with a warm cloth.
In the treatment of children's chronic bronchitis, the tasks of physiotherapy include stopping the sluggish inflammatory process and increasing the drainage of the bronchi. The main direction of such procedures is the strengthening of immunity and the health of the whole body of the baby.
A common, one of the best methods of physiotherapy for the treatment of chronic bronchitis in children is ultraviolet radiation. After a course of UV therapy in a sick child, the following effects are noted:
- Improved sputum output.
- Enhance the immune forces of the body.
- Regeneration and restoration of metabolic functions in the body of the baby.
- Relief and a marked decrease in the inflammatory process of the bronchi.
In addition to UV therapy, it has proven itself well. KUF-therapy (short-wave ultraviolet radiation). During the procedure, KUF-irradiation completely destroys the cells of pathogenic fungi and bacteria. KUF-therapy is famous for its powerful bactericidal and mycicidal effects.
The power of professional massage
Therapeutic massage, performed by a professional, significantly speeds up the process of recovery of the child and increases the general well-being.
This procedure helps Faster removal of excess fluid from the airways and clears the bronchi. This effect is achieved using a variety of techniques.
More often when working with a child’s body, specialists use the following types of massage:
- Drainage This type of massage facilitates coughing and contributes to the rapid removal of sputum from the bronchi.
- Vibrating. This technique provokes the rapid cleansing of the bronchi and the removal of excess fluid from them.
- Canned. Improves the condition of the blood and lymph, providing regeneration of the bronchial tubes and easier breathing.
- Spot. With the help of this massage technique, the muscles in the area of the bronchi relax and their spasms are stopped.
But be careful! Massage in the treatment of chronic bronchitis has its own contraindications. It can not be carried out by the child with:
- heart problems
- increased pressure
- feverish condition
- chronic bronchitis in the acute stage.
Not recommended for massage and children under 3 years. In babies of this age, the breast muscles are still weak and the respiratory tract is actively developing. This serves as a serious obstacle to active therapeutic effects and massage does not bring the desired effect.
Who from the doctors will help
Problems of the bronchopulmonary system and treatment of bronchitis in all its manifestations in children engaged by a pediatrician. If necessary (if the bronchitis is in a complicated form and affects the nasopharynx), the doctor will recommend visiting the ENT.
If the child is diagnosed with chronic bronchitis, it should be put on the dispensary account. Such a kid will have regular check-ups of the following specialists:
- pediatrician (once every three months),
- Dentist and ENT (twice a year).
A child suffering from chronic bronchitis is exempted from physical education lessons in kindergarten and school.
Treatment of bronchitis with remission
When a child has chronic bronchitis goes into remission, treatment can not be stopped. Even in spite of the fact that during this period the disease proceeds without pronounced symptomatology. The main goal of therapy during this period is to strengthen the children's body in order to minimize the possibility of a relapse.
It is during the calm period that the treatment with folk remedies gives a very good result. The following procedures also become useful:
- Breathing exercises.
- Reflexology (a method of prophylactic treatment by affecting the bioactive points of the body).
A special place in the prophylactic therapy of chronic bronchitis is given immunocorrection. This treatment is carried out by taking the following drugs:
- Antiviral (adaptogens, immunostimulants). Such remedies include: Eleutherococcus root, honey ginseng, purpurea echinacea preparations (Immunal, Echinacea), royal jelly and pollen (Apilaktoza, Apilikvirit, Politabs, Cernilton).
- Bacteria lysate (antibacterial drugs similar in their effects on the body with vaccines). These include: Imudon, IRS-19, Ismigen, Reshibron, Ribomunil, Broncho-munal, Broncho-Vaks.
It is very useful to take children with chronic bronchitis during remission to health resorts, where there is a course of speleotherapy (visiting salt caves with a healing microclimate).
Chronic bronchitis inhalation - A good treatment method that helps to dilute and remove sputum. The baby's breathing is easier, the cough weakens, and the healing process is much faster. For bronchitis, it is helpful to inhale healing vapors:
- medicinal herbs: eucalyptus, St. John's wort, coltsfoot, wild rosemary, mint, plantain, sage, juniper, raspberry, linden (herbs can be used individually or mixed)
- essential oils: tea tree, bergamot, cedar, lavender, eucalyptus, sandalwood, juniper, fir, anise, lemon pine, orange (add 2-3 drops of ether in the solution for inhalation),
- medications: Salgim, Berotek, Salamol, Atrovent, Berodual, Astalin, Sterineb, Gensalbutamol, Chlorophyllipt, magnesium sulfate (2-4 ml of medication is enough for one procedure), it is better to use these drugs during nebulization with nebulizer.
Nebulizer. Special drug designed for inhalation at home. The device using a powerful air flow or ultrasound splits drugs into aerosol-type microparticles. Such substances better and faster penetrate into the bronchi and quickly suppress inflammation.
Inhalation procedures in the treatment of chronic bronchitis in children are recommended to be carried out 2-3 times daily.
Is chronic bronchitis contagious?
Bronchitis is caused by different types of infection - it can be bacterial, viral, or occur as a manifestation of allergy. Bronchitis is dangerous in case of infection with viruses, bacteria and only during the incubation period (1-7 days) from the moment of infection.
Bronchitis, which has already passed into the chronic stage, is not dangerous and not infectious to those around. So you can safely walk with the baby and attend children's institutions. But with caution! Indeed, the exacerbation of chronic bronchitis can cause dangerous complications, up to pneumonia.
According to statistics on the background of chronic bronchitis in children in 3 out of 10 cases pneumonia develops. Inflammation of the lungs is the most frequent complication of chronic bronchitis, against which the disease goes much harder and longer. Pneumonia in chronic bronchitis can lead to deadly situations.
In order to prevent the development of unpleasant events in children with chronic bronchitis, special attention is paid to preventive measures.
In chronic bronchitis, the baby should be given more to drink (especially during periods of acute illness) and follow a milk-vegetable diet. Include in the daily diet of alkaline mineral water, healthy broth hips, peppermint, linden.
Cranberry, lingonberry homemade fruit drinks will be a good help. It is good to drink hot tea from raspberry leaves, currants, strawberries. Pamper your baby with delicious blackberry jam, currants and raspberries.
In the nursery spend regular wet cleaning and airing. Introduce the kid with a pool, sports, exercises. Observe the correct temperature regime: in the room where the child lives, the air temperature should be no higher than + 20⁰ С, and the humidity around 70%. Do not refuse vaccination during the mass epidemics of influenza.
Remember - it is possible to cure chronic bronchitis! The main thing is to turn to the doctor in time and conduct a full course of medical therapy. Only with the help of qualified help can the disease be defeated completely.
Health to your baby!
Another type of children's bronchitis is viral.
Read about all types of bronchitis in adults and children in this section.
Chronic bronchitis in children - symptoms of the disease
The onset of the disease is gradual. The first symptom of chronic bronchitis in a child is a cough in the morning with the separation of mucous sputum, gradually the cough begins to occur night and day, increases in cold weather and becomes permanent over the years. The amount of sputum increases, it becomes mucopurulent or purulent. Dyspnea appears.
With purulent chronic bronchitis, purulent sputum is periodically released, but bronchial obstruction is not expressed. Obstructive chronic bronchitis is characterized by persistent obstructive disorders. Purulent obstructive bronchitis in children occurs with the release of purulent sputum and obstructive ventilation disorders.
Frequent exacerbations of chronic bronchitis in a child during periods of cold, wet weather: cough and shortness of breath increase, sputum increases, malaise, rapid fatigue appear. Body temperature is normal or subfebrile, can be determined by hard breathing and dry rales over the entire surface of the lungs.
Diagnostic symptoms of chronic bronchitis in a child
A small leukocytosis with a rod-nuclear shift in the leukocyte formula is possible. During exacerbation of purulent bronchitis, the biochemical parameters of inflammation (C-reactive protein, sialic acids, seromucoid, fibrinogen, etc.) change slightly. Sputum examination: macroscopic, cytological, biochemical. With a pronounced exacerbation of chronic bronchitis, the child has a purulent sputum, mainly neutrophilic leukocytes, an increase in the content of acidic mucopolysaccharides and DNA fibers, which increase the viscosity of sputum, a decrease in lysozyme, etc. purulent, atrophic, hypertrophic, hemorrhagic) and its severity (but only to the level of subsegmental bronchi).
The differential diagnosis of chronic bronchitis in a child is performed with chronic pneumonia, bronchial asthma, and tuberculosis. In contrast to chronic pneumonia, chronic bronchitis always occurs with the gradual development of common bronchial obstruction and often emphysema, respiratory failure and pulmonary hypertension (chronic pulmonary heart). Radiographic changes are also diffuse: peribronchial sclerosis, increased transparency of the pulmonary fields due to emphysema, expansion of the branches of the pulmonary artery.
Chronic bronchitis in children is distinguished from bronchial asthma by the absence of suffocation attacks.
Differences in chronic bronchitis in a child with pulmonary tuberculosis are associated with the presence or absence of signs of tuberculosis intoxication, mycobacterium tuberculosis in sputum, x-ray and bronchoscopic examination data, tuberculin samples.
Chronic bronchitis in children - treatment of the disease
In the phase of exacerbation of chronic bronchitis, therapy should be aimed at eliminating the inflammatory process in the bronchi, improving bronchial patency, restoring impaired general and local immunological reactivity.
In the treatment of chronic bronchitis in a child, bacterial therapy is prescribed, which is selected taking into account the sensitivity of sputum microflora, is administered orally or parenterally, sometimes combined with intratracheal administration. Showing inhalation.
Apply expectorant, mucolytic and bronchospasmolytic drugs, drink plenty of fluids to restore and improve bronchial patency. Herbal medicine using alteynogo root, leaves, mother and stepmother, plantain. They also prescribe proteolytic enzymes (Trypsin, Chymotrypsin), which reduce the viscosity of sputum, but are rarely used today. Acetylcysteine has the ability to break the disulfide bonds of mucus proteins and causes a strong and rapid dilution of sputum.
Bronchial drainage in the treatment of chronic bronchitis in a child improves with the use of mucoregulators, which affect the secret and the synthesis of glycoproteins in the bronchial epithelium (bromhexin). In case of insufficiency of bronchial drainage and the presence of symptoms of bronchial obstruction, bronchospasmolytic agents are added to the therapy: eufillin, holinoblokatory (Atropine in aerosols), adrenostimulants (Ephedrine, Salbutamol, Berotek).
Treatment of chronic bronchitis in children in the hospital
In the hospital, intratracheal lavage with purulent bronchitis in children is combined with rehabilitation bronchoscopy (3 to 4 rehabilitation bronchoscopy with a break of 3 to 7 days). Therapeutic exercise, chest massage and physiotherapy also contribute to the restoration of the drainage function of the bronchi in the treatment of chronic bronchitis in a child.
In the event of allergic syndromes, calcium chloride is administered orally and in / in antihistamines. In the absence of effect, it is possible to conduct a short course (before relieving the allergic syndrome) of the course of glucocorticoids (the daily dose should not exceed 30 mg). The danger of activating the infection does not allow us to recommend long-term administration of glucocorticoids for the treatment of chronic bronchitis in children.
In patients with chronic bronchitis complicated by respiratory failure and chronic pulmonary heart, the use of veroshpiron is shown (up to 150 - 200 mg per day). The diet should be high-calorie, fortified. Assign ascorbic acid in a daily dose of 1 g, B vitamins, Nicotinic acid, if necessary aloe, Methyluracil.
When complications of pulmonary and pulmonary heart disease are used, oxygen therapy, assisted artificial ventilation of the lungs is used. Anti-relapse and supportive therapy begins in the phase of a diminishing exacerbation, is carried out in local and climatic sanatoriums, it is also prescribed during medical examination.
Types of treatment of chronic bronchitis in children
It is recommended to distinguish three groups of dispensary patients who are characterized by a different type of treatment for chronic bronchitis.
In the first group include patients with severe respiratory failure, pulmonary heart and other complications of the disease, with disability, patients need systematic maintenance therapy, which is carried out in a hospital or local doctor. Examination of these patients is carried out at least once a month.
Second group are patients with frequent exacerbations of chronic bronchitis and moderate respiratory function disorders. Patients are examined by a pulmonologist 3-4 times a year, anti-relapse rates are prescribed in spring and autumn, and after acute respiratory diseases. An effective method of medication is inhalation. According to the testimony, reorganization of the bronchial tree is carried out by intratracheal washes, rehabilitation bronchoscopy. With active infection using antibacterial drugs.
Third group treatment of chronic bronchitis in a child consists of patients in whom anti-relapse therapy has led to the subsiding of the process and the absence of its recurrence for 20 years. They are shown seasonal preventive therapy, including tools aimed at improving bronchial drainage and increasing reactivity.
Physiotherapy in the treatment of chronic bronchitis in children
Let's talk about how the physiotherapeutic treatment of chronic bronchitis is carried out. Physiotherapy in the treatment of bronchitis involves the use of the following methods:
Противовоспалительные методы физиотерапевтического лечения хронического бронхита у детей: УВЧ-терапия, СУФ-облучение в эритемных дозах , ДМВ-терапия, низкоинтенсивная высокочастотная магнитотерапия, лекарственный электрофорез.
Mucolytic methods: inhalation therapy of mucolytics and mucokinetics, halo-aerosol therapy, therapeutic, vacuum, vibration massage, osillatory modulation of respiration, therapeutic percussion of the chest, prolonged aerotherapy.
Bronchodilatory treatment of chronic bronchitis in children: inhalation therapy with bronchodilators, hyperbarotherapy, peloid interferotherapy.
Antihypoxic methods: oxygen therapy, oxygen heliotherapy, long-term low-oxygen therapy.
Myostimulating method: transcutaneous stimulation of the diaphragm.
Immunostimulating treatments for chronic bronchitis
Heliotherapy - The therapeutic effect of solar radiation on a fully or partially naked body of the patient. The intensification of melanin synthesis processes and the migration of Langerhans cells into the dermis of this method of treatment of chronic bronchitis, caused by long-wave ultraviolet radiation, lead to compensatory activation of cellular and humoral immunity. Dosing of sunbathing is carried out according to the energy flux density of the total radiation. Depending on the geographic latitude, time of year and day, it is reached at various lengths of procedures, taking into account REET. This immunostimulating treatment of chronic bronchitis is carried out according to a weak, moderate, intensive regimen (Appendix 4), the course of this method of treatment of chronic bronchitis in a child is 12-24 procedures.
Contraindications to physiotherapy immunostimulating treatment of chronic bronchitis:
bronchitis, accompanied by pulmonary heart disease above stage II,
acute purulent inflammatory diseases of the lungs,
bronchial asthma with frequent and severe attacks,
solitary cysts of large size,
chronic lung abscess,
general contraindications to the appointment of physical treatments.
Anti-inflammatory methods of treatment of chronic bronchitis in children
High-frequency magnetic therapy. In a high-frequency magnetic field, uniform local heating of the irradiated tissues occurs by 2-4 ° C to a depth of 8 - 1 2 cm. In the area of inflammation, under the action of high-frequency magnetic therapy, the dispersion of cell autolysis products increases, and the phagocytic activity of leukocytes increases. This in turn leads to dehydration and resorption of the inflammatory focus. Ventilation and drainage functions of the bronchi are restored, sputum separation improves, its viscosity decreases, bronchospasm decreases, and inflammatory changes in the bronchopulmonary tissue dissolve. With exacerbations, chronic bronchitis affects the back area at the level of the projection of the roots of the lungs (inductor-disk) in a low heat dose of 10–15 (15–25) min daily or every other day, the treatment of chronic bronchitis in children is 10–15 procedures.
In the presence of broncho-obstructive syndrome, in addition to exposure to the roots of the lungs, it is necessary to prescribe inductothermia consistently on the area of the projection of the adrenal glands - at the level of TX-LIII1.
Induction of the adrenal region - an active stimulator of glucocorticoid synthesis. The magnetic field increases the circulation in the blood of the free fraction of 11-oxycorticosteroids, because it inhibits the function of the transcortin binding protein. This effect of the high-frequency magnetic field allows it to be widely used for treating children with obstructive bronchitis, bronchial asthma in order to reduce inflammatory changes, hormone replacement therapy during the period of withdrawal of glucocorticoid therapy, and also for desensitization of the body.
Contraindicated in children with hemodynamic disorders in the pulmonary circulation, severe pulmonary and cardiac failure, coronary heart disease. These patients are prescribed UHF-therapy.
UHF-therapy on the area of the roots of the lungs. Under the action of the microwave field of the decimeter range, the capillaries of the microvasculature expand and their permeability increases, regional blood flow increases and the inflammatory focus of the bronchial tree dehydrates, the functional activity and metabolism of the bronchopulmonary tissue are restored. Microwave therapy improves the patency of the small bronchi. The prescription of UHF-therapy in the physiotherapy treatment of chronic bronchitis is preferable in patients with concomitant disorders in the pulmonary circulation and angina pectoris.
Emitters set over the affected area. Use low-intensity exposure with a frequency of 460 MHz, for 10 minutes, daily, the course of treatment of chronic bronchitis in children is 5-10 procedures. In broncho-obstructive syndrome, it is advisable to influence this physical factor not only on the lung area, but also on the area of the projection of the adrenal glands.
Drug electrophoresis. Under the influence of an electric field in tissues, the polarization of cell membranes changes. In the tissues of the interpolar zone, the concentration of the drug increases. In the electric field, the ionization of medicinal substances occurs and their penetrating ability to the cells increases. Medicinal substances are used: antibiotics (after a preliminary test for this antibiotic, a single dose of the antibiotic is administered per procedure), Calcium chloride (2-5% solution), Potassium iodide (2-5% solution), Heparin (5000-10 000 IU), Euphyllinum (2-5% solution), Platifillin (0.05-0.1% solution), Magnesium sulfate (2-5% solution), Novocain (0.25-5% solution), Dikain (0.5-1 % solution). The procedure is carried out according to the transverse, longitudinal or three-electrode technique. Current strength is up to 10-15 mA, 15-25 minutes each, daily, the course of treatment of chronic bronchitis in children is 10-12 procedures.
Mucolytic treatment of chronic bronchitis
Prolonged aerotherapy (in remission) - prolonged (including sleep) exposure of the child to fresh air. The excitation of mechanoreceptors and heat-sensitive structures of the skin and mucous membranes of the upper respiratory tract with cool air leads to an increase in respiratory volume and alveolar ventilation, followed by an increase in PO2. There is an increase in heart rate, UO of the left ventricle. The result is an increase in the absorption of oxygen by the blood and acceleration of its delivery to the tissues. Long-term aerotherapy is carried out in weak and moderate regimens (Appendix 4), daily, the course of this method of treatment of chronic bronchitis in children is 10-20 procedures.
Inhalation therapy - This is the method of mucolytic treatment of chronic bronchitis. For inhalation use medicinal substances affecting sputum and mucokinesis.
- Humidifiers respiratory mixture: and zotonic solution of sodium chloride (0.9%), solutions of sodium bicarbonate (1-2%), glycerin (30%), mineral water.
- Mucolytic drugs: Sodium bicarbonate solutions (5%), Sodium chloride (3-5%), Potassium iodide (1-2%), Ambroxol, Acetylcysteine.
- Cough reflex stimulants: Sodium chloride solution (5-10%), propylene glycol.
Used for the treatment of chronic bronchitis in children ultrasonic inhalers, allowing to spray large volumes of fluid. For inhalation of suspensions of glucocorticosteroids (budesonide), 2-agonists, mucolytics, and mucoregulators (acetylcysteine, Ambroxol), only compressor inhalers are used, since the structure of these drugs is destroyed in ultrasound.
For inhalation apply 20 ml of sodium chloride solution, sodium bicarbonate, potassium iodide for one procedure. When several inhalations are performed on one ultrasonic inhaler, 100 ml of solution can be poured into the nebulizer chamber, dispensing the procedure for 10-15 minutes per patient (depending on the performance of the inhaler used). 1-2 inhalations per day, the course of 8-10 days.
Can for the treatment of chronic bronchitis in children use medicinal mixtures:
- Sodium bicarbonate 2.0 g, sodium chloride 1, 0 g, distilled water 1 0 0 ml,
- Sodium bicarbonate 2.0 g, Sodium chloride 1, 0 g, Potassium iodide 0.25 g, distilled water 100 ml,
- Sodium bicarbonate 1.0 g, Sodium tetraborate 1.0 g, Potassium iodide 0.25 g, distilled water 10 ml,
- mineral water, medical and medical-table bottling (Ekaterinburgof, Essentuki number 4, 17).
Benefits of inhalation treatment for children with bronchitis
The mechanism of action of an isotonic solution of sodium chloride and other moisturizers in the treatment of chronic bronchitis in children is associated with an increase in the volume of bronchial secretions (the effect on the "sol" layer) due to the moistening of the inhaled mixture. The main mechanism of action of the hypertonic solution is the osmotic effect: an increase in fluid flow into the lumen of the respiratory tract due to the osmotic gradient, increased vascular permeability and stimulation of the secretory activity of the mucous membranes of the glands.
As a result of the osmotic effect, an increase in the volume of secretions and a decrease in its viscosity, the mucociliary clearance is stimulated. With an increase in the concentration of inhaled solutions, another mechanism of activation of the drainage function of the bronchi joins - cough stimulation.
The action of sodium bicarbonate is associated with the attraction of water to the surface of the secretion (gel layer), its softening and decrease in adhesion. Potassium iodide also stimulates the breakdown of sputum proteins in the presence of leukocyte enzymes. More concentrated solutions in comparison with isotonic ones are more effective in terms of sputum induction, but their inhalations are associated with a significantly higher risk of bronchospasm in patients with bronchial hyperreactivity.
The therapeutic effect of Ambroxol in the treatment of chronic bronchitis in children is associated with a mucolytic effect (depolymerization of mucoprotein and mucopolysaccharide fibers) and an increase in the production of surfactant, which reduces the adhesion of the secretion. Since the effect of the drug is mainly associated with the stimulation of alveolar secretion of pulmonary surfactant, it should be used with caution in diseases of the bronchi with marked hypersecretion of mucus.
For inhalation of Ambroxol solutions (Lasolvan, Ambrobene, Ambrogeksal) used compressor inhalers. It should be remembered that for inhalation therapy can not use the dosage forms of these drugs in the form of syrup. Dosing of ambroxol solutions for inhalation (in 1 ml of 7.5 mg): 2-3 ml (40-60 drops) in 2 ml of isotonic sodium chloride solution 2 times a day.
Acetylcysteine is a direct-acting mucolytic agent. Due to the free SH-group, it breaks the disulfide bonds between the glyco-proteins of the bronchial secretion. This leads to a decrease in its viscosity and elasticity. Such a diluting effect sometimes (with reduced or normal viscosity and elasticity parameters) may be undesirable. Excessive dilution of the secret can lead to a violation of mucociliary transport and the occurrence of bronchorea, worsening respiratory parameters. Acetylcysteine is shown only with increased viscosity, elasticity and is contraindicated with a decrease in their parameters.
In addition to inhalations, endotracheal injections of the drug through a bronchoscope are also used, which are more effective. In severe patients with a reduced cough reflex, one should be prepared to carry out sputum suction, and reorganization bronchoscopy to prevent pulmonary flooding. For topical use of Acetylcysteine (5% solution of Fluimucil) for one procedure, use 3 - 6 ml of a solution diluted in an isotonic solution of sodium chloride. The frequency of injections is determined individually, usually 1-2 times a day, the course of treatment of chronic bronchitis in children 3 - 6 days.
For purulent bronchitis in children, bronchiectasis, endotracheal administration via a fibrobronchoscope (less commonly with inhalation) of the combined drug Fluimucil (Acetylcysteine + Thiamphenicol) is used. Dosage of the drug for local use: 5-10 ml once a day after the removal of purulent mucus through the bronchoscope, a course of 2-7 procedures.
Halo-aerosol therapy as a treatment for chronic bronchitis
Includes inhalation of dry sodium chloride aerosol (halotherapy, haling inhalation therapy). The halochambers simulate the basic parameters of the microclimate of underground caves (speleo-therapy). The main active therapeutic factor is dry highly dispersed sodium chloride aerosol. When the respirable aerosol fraction gets into the terminal parts of the bronchial tree, due to the osmotic effect, the drainage function of the bronchi is activated, and the amount of secreted sputum increases.
On the one hand, this method of treating chronic bronchitis in children contributes to the elimination of one of the components of bronchial obstruction (hypo- or discriminative), and on the other, the effectiveness of basic drug therapy increases significantly (inhaled drugs act directly on the purified mucous membrane of the bronchial tree). Anti-inflammatory and immunomodulating effects of dry sodium chloride aerosol have also been identified. All this contributes to the positive dynamics of clinical indicators in patients with chronic obstructive pulmonary diseases and consolidation of the achieved remission.
Halocameras are designed to carry out the procedure simultaneously in 4 to 8 people, the number of procedures for the course of this method of treating chronic bronchitis in children is 12-16.
The spraying of sodium chloride aerosol is carried out with the help of a halogenerator for 45 minutes and is accompanied by listening to music for relaxation. The use of halocomplexes is important, which allow creating and maintaining the required parameters of an aerodisperse medium (concentration of dry sodium chloride aerosol, temperature, humidity, etc.) throughout the entire procedure. Halocameras are equipped in hospitals and clinics in special rooms. Depending on the degree of impairment of bronchial patency, 4 halotherapy regimens with an aerosol concentration of 0, 5, 1, 1–3, 3–5, and 7–9 mg / m3, respectively, are used.
The first treatment regimen for chronic bronchitis is used in patients with emphysema and bronchial asthma of atopic form, the second is used for lung diseases with reduced OFD1 to 60% of the due, the third is for reducing OFD1 by more than 60%, and the fourth for bronchiectasis and cystic fibrosis. Inhalation of dry sodium chloride aerosol (halogen inhalation therapy) for mucolytic treatment of chronic bronchitis is performed through a mouthpiece or (with concomitant rhinitis) through a mask for 15 minutes, daily, a course of treatment of chronic bronchitis in children is 12-14 procedures.
Massage therapy as a treatment for chronic bronchitis in children
Therapeutic massage is a metered mechanical effect on the soft tissues of the naked body using special techniques performed by a trained person in a specific sequence. In order to stimulate the movement of viscous sputum from the deep sections of the bronchial tree, it is recommended to combine the elements of classical massage with one of the following methods (listed in decreasing order of effectiveness):
vacuum massage of the chest wall,
intrapulmonary oscillatory percussion (oscillatory modulation of respiration),
Parents can give the child special nursing fees, which are present in pharmacies at an inexpensive price, but in combination with medication, they give an excellent effect.
In the fight against bronchitis help home inhalation with various essential oils. Fir, eucalyptus and orange have a good effect on immunity and weakened airways. For inhalation is enough three drops of oil, diluted in boiling water. The head is covered with a towel over the pan and inhale the vapors for about 10 minutes.
- Be sure to read: how to relieve night coughing attacks
Obstructive bronchitis spreads significantly throughout the bronchial tree, and the symptoms worsen. Prolonged inflammation of the bronchi and its branches can lead to pulmonary emphysema. Obstructive bronchitis begins with clogging of the bronchi with sputum, and the symptoms worsen.
The lumen gradually narrows, which creates irreversible processes if the disease is delayed and not treated. The inflammatory course leads to the sclerotic state, the deformation of the muscle layer and the formation of polyps. Obstructive bronchitis makes the movement of the diaphragm limited, and the expiration time is extended.
With the running form, not only bronchial tissue suffers, but also the lungs, which are covered with fibers.
Obstructive bronchitis is dangerous for its complication in babies, as the progressive form is difficult to treat. Obstructive chronic bronchitis can be fatal if there is no treatment for a long period. According to statistics, mortality is a large percentage, as well as from cancer of the respiratory tract.
Chronic bronchitis: symptoms and treatment in children
Chronic bronchitis in children is considered to be one of the most common diseases faced by pediatricians. This condition is a sluggish, periodically exacerbating inflammatory process in the bronchi.
A chronic form of the disease can be diagnosed in a child if sputum cough is observed for at least three months a year for two years or more. При этом данный диагноз не ставят малышам до 3 лет. Даже если кроха болеет бронхитом несколько раз подряд, врач относит его к категории часто болеющих детей.
At the age of three, children experience changes in the respiratory system, and pulmonary immunity is strengthened. Often, this restructuring leads to a decrease in the frequency of diseases. But if this does not happen, then chronic bronchitis is diagnosed for the child.
The causes of the development of the disease in babies
The main causes of the development of this disease in children are the high frequency of viral or microbial respiratory diseases, as well as the constant collision with allergens (dust, toxic substances, tobacco smoke).
If the baby has a weakened immune system, then the body cannot neutralize the infection, it settles on the mucous membranes, and then with the blood is transferred to the lymphatic vessels.
This leads to the fact that the infection remains in the body of the baby even if the symptoms of the disease are eliminated and the treatment is completed. Accordingly, after the slightest hypothermia or contact with a new infection, the disease recurs.
The factors that provoke the development of chronic bronchitis in a child include:
- reduction of body defenses
- features of the structure of the bronchi,
- the presence of allergic reactions
- passive smoking,
- adverse climatic conditions in the region of residence.
Typically, chronic bronchitis in children occurs when there are several adverse factors at the same time.
The main manifestations of the disease
The disease manifests itself as intermittently recurring exacerbations that occur in the fall or spring, but can also occur in the winter. The average duration of exacerbation is 3-4 weeks.
Relapse at the initial stage is accompanied by signs that can be mistaken for symptoms of acute respiratory viral infections, fever, runny nose, weakness, sweating, irritability.
The main manifestation of chronic bronchitis is a lingering cough. It starts at 2-3 days of illness, is characterized by soreness, roughness, low productivity.
Then dry cough is replaced by a wet, accompanied by the release of mucus-purulent sputum.
Some symptoms of the disease in a child can only be identified by a doctor, in particular:
- when tapping the chest, a pronounced pulmonary sound is detected with a slight shortening between the shoulder blades,
- when listening to the lungs, unstable rales, hard breathing are detected,
- in the results of blood tests, elevated ESR indices are recorded, neutrophilia with leukocyte shift to the left, sometimes iron deficiency anemia is detected,
- on the radiograph, you can see enhanced bronchial pattern and expansion of the roots of the bronchi,
- bronchoscopy shows catarrhal-purulent or diffuse catarrhal bronchitis.
Differential diagnosis of chronic bronchitis should be carried out with diseases that occur with recurrent bronchopulmonary infections. This group of pathologies includes diseases of the upper respiratory tract, hereditary lung diseases, infectious processes, whooping cough, chlamydial and mycoplasma infections.
Methods of dealing with the disease in the acute stage
Treatment of chronic bronchitis in a child should be carried out as an exacerbation and in the period of remission. The most intensive therapy is given to the baby during relapse. If the disease is not very severe and protracted form, then the fight against the disease can be carried out at home. In the presence of fever it is recommended to observe bed rest.
At the reception, the doctor examines the child and, if necessary, prescribes treatment with the following types of drugs:
- Antibiotics (penicillins, cephalosnorines, macrolides). Their use is recommended even for children with allergic bronchitis, because they often have an infectious component that complicates the course of the disease.
- Expectorants (Bronhikum, Doctor IOM, Terpingidrate, Mukaltin, Prostak, licorice root extract, Herbion, ammonia-anisic drops, Licorin). They are of two types: providing a dilution of sputum and contributing to its removal from the body. The choice of a particular drug depends on the stage of the baby’s illness. Taking these drugs can increase the symptoms of the disease (primarily coughing), but it also clears the bronchi and speeds recovery.
- Bronchodilators (Ambroxol, Lasolvan, Bromhexin), which provide the expansion of the bronchial lumen, and, accordingly, accelerated excretion of sputum and easier breathing. Most often, treatment with bronchodilators is carried out using inhalers.
- Antipyretic drugs (Analgin, Paracetamol). They should be taken only if the child’s body temperature rises above 38 degrees.
- Antihistamine (antiallergic), hormonal agents (if necessary).
Treatment of the child must be accompanied by vitamin therapy. In parallel with the intake of medicines and treatment of folk remedies are held:
- distracting therapy, which includes rubbing calendula ointment, jars, mustard plaster, mustard wraps,
- chest massage.
During the period of exacerbation, it is desirable for the baby to follow a plant-milk diet and drink as much liquid as possible.
Tea can be replaced with alkaline mineral water or well-known folk remedies: milk with soda and honey, broth of rose hips, limes or mint, cranberry or lingonberry juice.
Prompt recovery is facilitated by teas from currant leaves, raspberries, lingonberries, strawberries. Useful raspberry, currant, blackberry jam.
The above means can improve the immunity of the baby, but folk remedies can also effectively and safely deal with cough. For example, cabbage juice with sugar is an excellent expectorant.
A similar effect in the broth prepared from plantain, thermopsis, coltsfoot, licorice root and althea (1 tablespoon of a mixture of herbs should be boiled in 200 ml of water and drink up to 20 ml 5 times a day).
Coughing can also be treated with nursing fees offered by the pharmaceutical industry.
Therapy in remission
Treatment of a child in the period between exacerbations is carried out primarily by folk remedies. During remission, the symptoms of the disease are almost absent, and the main task of therapy at this stage is to increase the resistance of the baby’s body so that the risk of relapse is minimized.
Treatment of the child without aggravation should include:
- Therapeutic and breathing exercises.
- Elimination of foci of chronic infection of upper respiratory tract.
- Immunotherapy. It is carried out three times a year for 2 months and includes taking drugs with antiviral activity, immunostimulants, adaptogens, lysates of bacteria (antibacterial drugs, which are similar in principle to vaccines).
- Speleotherapy (visiting caves with a microclimate, contributing to the fight against colds and bronchitis).
- Visiting recreational facilities (sanatoriums).
Treatment of chronic bronchitis in remission should continue until the adolescence is reached. With proper therapy, most children fully recover or begin to get sick much less often. The occurrence of obstruction in relapse of the disease is observed only in 13% of small patients, in 2% of them the pathology is transformed into bronchial asthma.
A kid suffering from chronic bronchitis must be registered with dispensary. A pediatrician examines it 1 time in 3 months, an otolaryngologist and a dentist - 2 times a year.
The child is exempt from attending physical education classes in the general group. In the room where the baby lives, it is necessary to conduct regular airing and to monitor the absence of allergens in the environment.
It is recommended to remove carpets, walkways, tablecloths from the children's room.
Chronic bronchitis in children: treatment, symptoms, causes, prevention, photo, video
Chronic bronchitis in children is an inflammatory process on the mucous membrane of the bronchi, manifested up to two - three times a year. The reason for the transition of the disease from the acute to the chronic form is the lack of response to symptoms, improper treatment, ignoring preventive measures and complications after colds.
Bronchitis almost never manifests itself as a solitary disease, but goes along with the inflammatory process in the nose, larynx or trachea. Obstructive bronchitis complicates the work of the heart muscle, which leads to the formation of pulmonary heart disease.
The cause of the exacerbation of the chronic form is pneumococci and mycoplasma. By reducing the protective functions of the bronchial membrane, the pathogens become more active. The development of the disease is significantly affected by:
- weakening of immunity
- chronic diseases of the pharynx and nose (tonsillitis, sinusitis),
- genetic predisposition
- aspiration syndrome,
- foreign bodies in the respiratory tract,
- some hereditary diseases
- abnormal development of the lungs and bronchi.
Chronic bronchitis in children develops faster and more often with high nerve loads, fatigue, exhaustion, inhalation of dust and smoke, or hypothermia. Symptoms can be aggravated by concomitant diseases.
Manifestations during exacerbation of the disease can be of different intensity. Timely assistance to the child and timely treatment reduce strong manifestations. Obstructive bronchitis has the following features:
- During the day, bouts of cough in a child are repeated many times, aggravated in the early morning and late evening (at night).
- Attacks are accompanied by discharge of mucus or purulent sputum.
The duration of cough is affected by wet and cool weather. Common symptoms are mild fever and malaise.
With exertion and high activity, shortness of breath increases, and in the sputum there may be streaks of blood, which causes severe panic in parents. When blood inclusions appear, a thorough examination of the child is recommended in order to rule out a malignant tumor or tuberculosis.
- In chronic bronchitis, there is a small sputum discharge (up to 50–60 ml / day). Cough supplemented whistling component, which is heard with a quick inhalation and exhalation.
- With the running form, symptoms in the form of wheezing are clearly manifested. Shortness of breath may have varying degrees of complications. The child is experiencing a weak air shortage or severe respiratory failure.
Treatment of the chronic form is a rather difficult problem for pediatricians and its solution takes a long time. Without careful consultation of a specialist in pulmonology, getting rid of the recurrence of pathological processes will be protracted and ineffective.
It is important for parents to indicate all signs of bronchitis and describe the full picture from the onset of the disease until the onset of complications.
Treatment of bronchitis is divided into several stages. Initially, the child is prescribed drugs that expand the bronchi. Antibacterial therapy is used to actively fight against microorganisms. It is also important expectorant, removing stagnant sputum.
The treatment is necessary to prevent further exacerbations, interferons and vitamins are prescribed.
If necessary, additional vaccination against infections caused by pneumococci and hemophilic bacilli is shown. Taking into account his age group, the child is optimized for physical activity.
Chronic bronchitis in children: symptoms and treatment
Bronchitis is a disease that occurs in both children and adults. Inflammatory processes affect the mucous membrane of the lungs, as well as the bronchial tree. Bronchitis can manifest itself in two forms: acute and chronic.
In Russia as a whole, 3.7 percent of the population is sick with chronic bronchitis. According to other experts, the percentage of Russians with this disease is even higher and reaches 10-20%.
Such discrepancies in the estimates are explained by difficulties in the diagnosis of chronic bronchitis. In both adults and children, the main symptom of this disease is coughing.
However, the cough occurs in other diseases, therefore, in order to confirm the diagnosis of chronic bronchitis, long-term follow-up is necessary.
Symptoms of chronic bronchitis in children
From the statistics it is clear that chronic bronchitis occurs in children quite often. The situation is aggravated by the fact that the child’s bronchitis is more severe than in adults, so every parent should know the symptoms and treatment of chronic bronchitis in children.
At the onset of bronchitis in acute form, its main symptom is a dry cough, in which sputum does not depart. If the sputum begins to depart, then, as a rule, this indicates that the treatment has been proven to be effective and the disease retreats.
The same symptom is present in the chronic form of bronchitis and is observed for a long time (3 months or more). Dry cough in chronic bronchitis in children most often appears in the morning (usually immediately after waking up).
One of the symptoms of this disease is also shortness of breath. The child may complain of lack of air, which increases with motor activity.
During periods of improvement, the child feels almost normal, having become accustomed to a slight cough in the morning. Remission is also determined by the nature of the discharge of sputum: during periods of improvement, it is transparent and does not have a strong odor. In remission, sputum discharge may not be observed, but simply a dry cough.
The periods of exacerbation of chronic bronchitis most often occur in the autumn-winter period (as a rule, they occur more than once a year).
Symptoms of exacerbation of chronic bronchitis include intense cough, which, as a rule, sputum abundantly departs. In some cases, the discharge are purulent.
A number of symptoms of chronic bronchitis does not occur in all cases. Their presence or absence depends on the individual characteristics of the child’s body and the severity of the inflammatory process. But you can highlight the signs that occur most often:
- progressive shortness of breath,
- bronchospasm (in such a condition, as a result of muscle contraction, the bronchi are narrowed, which leads to insufficient oxygen supply), which is characterized by heavy breathing, loud noise during breathing, an agonizing cough
- increased sweating,
- subfebrile temperature (i.e., temperature in the range of 37.1 - 38.0 ° C),
- general unsatisfactory state of health, weakness, fatigue,
- manifestation of rhinitis.
The treatment regimen for chronic bronchitis should be chosen by the doctor for each child individually.
Treatment should be comprehensive, acting in a number of ways:
- elimination of pathogenic pathogens,
- softening and relief of sputum discharge,
- reduction of sputum formation,
- temperature normalization
- stabilization of the patient's general well-being.
To resolve these problems, various drugs are prescribed. If indicated, antibiotics are used.
It is important for parents to know that the antibiotic prescribed by the pediatrician last time will not always be effective at the next exacerbation, since different pathogens are sensitive to different types of antibiotics.
Therefore, it is not worthwhile to self-treat chronic bronchitis in a child, even if you already know what medicines the doctor usually prescribes.
In chronic bronchitis are used:
- Drugs with anti-inflammatory effects.
- Drugs that stimulate the body’s own immune response,
- Glucocorticosteroids - usually prescribed for severe airway obstruction.
- Mucolytics - shown when coughing with sputum and are prescribed in order to liquefy it.
- Bronchodilators (for the expansion of the bronchi).
There are also various preparations of complex action, combining several of the listed effects at once.
Among the over-the-counter drugs, you can mention drugs like Dr. Mom, Lasolvan, ACC, Codelac Broncho.
Chronic bronchitis in children: causes and risk factors
Chronic bronchitis may occur as a complication of acute bronchitis not cured in a timely manner. Frequent infectious and viral diseases can also lead to chronic bronchitis. Especially dangerous in this regard is the flu.
There are also external risk factors. For example, parents are well aware of the situation when a child quickly falls ill while attending kindergarten. The close communication of a child in a team with other children increases the risk of various diseases. Bronchitis is no exception to this rule.
They can affect the bronchi and various irritating factors associated with insufficient purity of inhaled air. For example, smoking is a known risk factor for developing chronic bronchitis in adults.
But do not think that if we are talking about a small child, then smoking can not harm. Passive smoking is no less harmful than normal.
If you are a smoking parent, then consider the risk of developing chronic bronchitis in a child an additional incentive to get rid of this addiction.
It is more difficult to control the cleanliness of the air that a child breathes on the street. Может привести к возникновению хронического бронхита у ребенка и продолжительное негативное воздействие на органы дыхания таких вредных веществ, как диоксид серы, монооксид углерода, окись азота.
These atmospheric pollutants under natural conditions are contained in the atmosphere in small quantities, measured in fractions of a percent, but due to the impact of industrial production, their level in the atmosphere may increase.
This is especially true for cities with developed industry.
The climate in which he lives may also have a negative impact on the health of the child. Cold climate with high humidity, frequent fogs increase the risk of developing chronic bronchitis.
Genetic predisposition can also be a risk factor. According to statistics, children of patients with chronic bronchitis are three times more likely to suffer from lung diseases in comparison with those children whose parents do not suffer from this disease.
Small children have a risk of developing bacterial bronchitis after small objects get into the respiratory system. Foreign objects cause coughing, after which usually such objects are removed naturally. However, in this way, bacteria can enter the body, which then multiply and fall on the bronchial mucosa, causing inflammation.
Specialists of Buteyko Clinic (Moscow) offer 3 rules for combating coughing attacks:
- It is necessary to cough only with a closed mouth. It is recommended to limit the expiratory force by applying volitional control. In order to make it easier to do, just need to ensure that the child’s mouth was closed with coughing fits.
- Cough is a sharp reflex exhalation through the mouth, so after such a sharp exhalation, you should hold your breath for 3-5 seconds to prevent the appearance of bronchospasm.
- After a necessary pause after a coughing attack, you need to take a quiet breath through your nose to prevent an increase in the formation of sputum due to deep breathing, which is usually accompanied by a cough.
Breathing exercises are considered one of the safest therapeutic methods for diseases of the respiratory system, so they can be safely applied in chronic bronchitis in a child.
There are several systems of recreational gymnastics for the respiratory organs. One of them is treatment according to the method of Professor K.P. Buteyko.
The key postulate of this system is this: improper breathing leads to the occurrence of dangerous symptoms that accompany lung disease, namely, excessively deep breathing. “The deeper the breathing, the harder the illness and the closer the death of the organism,” said the founder of the methodology, KP Buteyko.
In the treatment of bronchitis, the greatest interest is the assertion of supporters of this method that the Buteyko technique allows to eliminate bronchospasm without the use of medicines. For this developed a set of exercises.
Doctors of the Buteyko Clinic who use this method, declare its high efficiency and the possibility of a complete cure for obstructive bronchitis.
In their opinion, in order to cure bronchitis, special breathing exercises, normalization of diet and sports are needed.
Effective breathing techniques
Another system of breathing exercises, which, as stated in a number of sources, is highly effective in treating bronchitis, is gymnastics according to the method of A.N. Strelnikova. Her student M.N.
Schetinin believes that intensive exercise for a month in case of bronchitis will cause the disease to recede, while allowing it to get by with the minimum amount of medication.
This gymnastics is also aimed at preventing the development of complications of bronchitis and general recovery of the body.
M.N. Schetinin recommends gymnastics according to the method of A.N. Strelnikova absolutely everyone, without exception, which means that it can be applied to children. M.N. himself Schetinin, allegedly, with the help of this system, returned a lost voice, restored disturbed nasal breathing, and got rid of bronchial asthma.
You may notice some similarities of this system with the Buteyko method. Gymnastics by the method of A.N. Strelnikova also excludes a deep breath. The exercises are based on a short and sharp inhale through the nose, followed by a silent passive exhalation.
Other folk remedies
Among non-pharmacological treatments can also be noted aromatherapy. It involves inhalation with the use of various essential oils (fir, eucalyptus, lemon, peppermint, cedar).
Inhalation is a gentle method of treatment, the side effects of which are minimal, so it is recommended for the treatment of chronic bronchitis in children. However, you should carefully monitor the child, controlling possible allergic reactions that can be triggered by intolerance to any component.
Among the most common causes, experts note hereditary diseases, unfavorable environmental conditions, abnormal development processes, diseases of the chronic form of upper respiratory tract, the presence of foreign bodies in the respiratory system.
Of the other common causes, it should be highlighted:
- involuntary inhalation of chemical vapors
- bacteria that penetrate into the children's organism, in contact with various objects and toys,
- constant irritation of the mucous coat of domestic animals,
- mechanical effects on the bronchi (in cases of dust and fine sand),
- the presence of a large number of parasites in the body of the baby,
- the presence in the air of tobacco smoke, various impurities and toxic substances.
Decreased protection functions of the bronchial mucosa, caused by a not completely cured cold or other factors, is the main cause of problems with the health of the baby.
The main signs of the disease
Irritability, moodiness, lethargy and general weakness should immediately alert the parents. Symptoms of possible bronchitis include shortness of breath with copious sputum.
Successful treatment of chronic bronchitis in children requires knowledge of the characteristics of the manifestation and course of a common illness:
- The main symptoms include, first of all, the systematic repetition of exacerbations, which occurs most often in spring and autumn (seasons of decrease in the immune functions of the body). Between outbreaks of the active phase, remission is observed when there are no signs of illness. The exacerbation period is observed about 4 weeks.
- The symptoms are very similar to the processes that occur in adults. Initially, there is a cough with subsequent sputum discharge, fever and wheezing in the lung area. But in children the process of intoxication occurs much faster. This feature requires a balanced approach to the use of antibacterial agents. Cough can turn into a chronic form, it becomes almost constant and especially to bother the baby in wet and cool weather.
- With the frequency of episodes of bronchitis more than three times a year, it becomes mandatory to visit an allergist and take the necessary samples. Cases of such a reaction of a weakened immune system to a stimulus of a certain type are not uncommon. The similarity of symptoms may cause an incorrectly prescribed therapeutic treatment.
- Pallor of the skin and increased, in comparison with the usual state, sweating baby. There is also a lack of interest in food.
The specificity of the manifestations and treatment requires constant inspections and consultations in specialized medical institutions. Trying to independently recognize the difference between allergies and chronic bronchitis is not worth it. Failure to diagnose can result in the development of the disease into asthma.
There is a need to carry out treatment both in the period of exacerbations and in the intervals between them. During remission, it is desirable to apply a set of measures aimed at improving the immune functions of the body. Recommendations of doctors usually include a visit to the course of reflexology, hardening, treatment in sanatorium-resort institutions with suitable climatic conditions.
The effect will be felt only in the case of a systematic approach, which will provide an opportunity to gradually get rid of relapses. Before adolescence, the cyclical nature of such a set of measures becomes imperative if the child has symptoms of chronic bronchitis. When performing such a course of therapy, the prognosis of the course of the disease will definitely be favorable.
The preventive measures during this period include:
- systematic wet cleaning in the room where the child is
- clean and fresh air - the guarantee of health of the baby. Smoking in his presence is out of the question,
- hypoallergenic diet provides for the elimination of the source of irritation. This may be dust, and animal hair, and food.
With distinct signs of the active phase and manifested malaise, treatment requires a completely different approach. We have to deal with such a form as chronic obstructive bronchitis in children.
At this stage there is obstruction - a violation of the patency of the bronchi and the manifestation of respiratory failure.
With constant relapses in not very severe forms, the full rehabilitation period takes about two weeks.
Antibiotics and antiviral drugs in combination with bed rest will help reduce the growth of pathogenic microorganisms and the inflammatory process.
All these activities should be carried out only after a medical examination and the appointment of adequate therapy to the patient, taking into account individual characteristics. The attending physician during this period always recommends a plant and milk diet.
A prerequisite is to drink large quantities of heated water, replacing it with other liquids perceived by the child:
- Any kinds of fortified teas.
- Alkaline mineral water.
- Cranberry or lingonberry juice.
- Weak black tea with lemon.
- Milk with honey and baking soda.
At a temperature of more than 38 degrees, you should give your child medicines that can quickly reduce fever, and such expectorants as infusion of licorice root, Dr. IOM syrup and various drops.
It is mandatory for the baby to take designated breast gatherings and, if necessary, stimulating, non-steroidal and anti-inflammatory drugs, preparations for expanding the bronchus and corticosteroids.
Distraction therapy includes the following measures:
- thorough rubbing with calendula ointment,
- the use of cans
- mustard wraps or direct use of mustard plasters.
Therapeutic and respiratory gymnastics in combination with a systematic massage will increase the body's resistance and accelerate the healing process.
Only constant and day-to-day monitoring of the course of the disease, timely consultation with a doctor, a complete rejection of attempts to make a diagnosis yourself and prescribe therapy will be able to protect your child from the insidious illness forever. It will take a lot of effort and time to do this, but it all pays off with the radiant smile of a healthy child.
The disease occurs with exacerbations, which usually last 2-3 weeks. The main symptom is a painful prolonged cough. During exacerbation, the cough is wet with sputum that is difficult to separate, and during remission it is dry. The nature of sputum, separated in the period of exacerbation, depends on the type of bronchitis. Rattles have fuzzy localization, are wet or dry. The number of wheezing increases significantly during the period of exacerbation. The temperature increases with bronchitis in children is intermittent. At the KLA, a shift in the leukocyte formula to the left with a moderate increase in the number of leukocytes, an increase in the erythrocyte sedimentation rate (ESR) is detected.
Indications and contraindications
The indications for the use of the preparations described are the diagnosis of chronic bronchitis on the basis of symptoms and additional methods of examination. The choice of drug depends on the stage of the disease. During periods of exacerbation and remission various drugs are shown.
Each drug has its own contraindications. On their basis, the selection of medicines is carried out individually for each child. Frequent contraindications are:
- peptic ulcer,
- fructose intolerance (for preparations containing fructose),
- glaucoma and hyperthyroidism (for many bronchodilators),
- severe kidney and liver disease,
- severe bradycardia (for b-blockers).
Criteria for the effectiveness of treatment
The main criterion is the disappearance of the symptoms of the disease, the improvement of the patient's condition. Additionally, you can evaluate the bacterial efficacy of treatment by detecting pathogenic microflora. Using bronchoscopy estimate the dynamics of changes in the conductivity of the bronchi. The quality of the therapy is indicated by the length of the remission period and the frequency of exacerbations.