Cough in acute, chronic and obstructive bronchitis

Bronchitis refers to the acute or chronic form of the disease of the respiratory tract, the trigger mechanism for development is a violation of microflora. Cough with bronchitis is one of the leading signs of pathology and indicates damage to tissues and congestion of mucus in the airways.

Any inflammation is always accompanied by a cough. This is explained by the fact that cough is a natural protective mechanism that occurs in response to irritation of the mucosa. Accumulated mucus and bacterial microflora serve as an irritating factor, which triggers a reflex mechanism. Cough is needed in order to push out from the respiratory tract accumulated mucus and release the airways. The nature and duration of the cough depends on the amount of sputum accumulated in the lumen of the bronchi.

[1], [2], [3], [4]

Causes of the cough with bronchitis

It occurs as a result of irritation of the mucous membrane with mucus and sputum. Inflammatory process occurs as a result of dysbacteriosis, the predominance of pathogenic microflora, the attachment of a viral infection. This can occur against a background of reduced immunity, activation of a chronic inflammatory process, hypothermia, overfatigue. Sometimes the development of the inflammatory process can provoke neuropsychic factors: stress, overstrain, neuropsychic shock.

[5],

Risk factors

People with reduced immunity, those with chronic bronchial and airway diseases, bacterial carriers and virus carriers are at risk. More at risk people with malnutrition, not receiving the required amount of vitamin, with metabolic disorders. Also at risk are people who are in contact with infectious patients, work with cultures of microorganisms and viruses, have increased stresses, stresses, and are often exposed to hypothermia.

[6], [7], [8]

Pathogenesis

The disease develops with weakened immunity, when the defenses of the body are weakened, and lose the ability to control the microflora. There is a sharp change in the ratio of pathogenic and conditionally pathogenic forms. Prevalent are the pathogenic forms, as a result of which the acute form develops.

Bronchitis is always accompanied by a cough. The main cause of cough in bronchitis is reflex irritation of the walls and mucous membranes of the bronchi, larynx. Mucus, formed during the inflammatory process, accumulates on the walls and causes irritation of the reflex zones. In response, a cough reflex is formed, during which the muscles contract sharply, trying to push the mucus outward.

[9], [10], [11],

Epidemiology

According to statistics, every third adult and every second child gets sick every year. In this case, all 100% bronchitis is accompanied by a cough. It can differ in form, degree of expression. So, a dry, unproductive cough worries about 23% of cases, a moist, productive cough accompanies the disease in 37% of people. 13% have suffocating cough, 7% have obstructive cough. In the remaining 20%, the cough is unstable and changes from one form to another. In this case, 12% of people cough lasts from 3 to 14 days.

[12], [13], [14], [15], [16], [17], [18]

Symptoms

In the early stages of a person may be disturbed by a dry, annoying cough, which is accompanied by soreness and lack of relief after a fit of coughing. He can drag on for a long time. Sputum discharge does not occur.

Wet cough is considered a more productive, progressive form, which significantly brings a person closer to recovery. Such a cough leads to the fact that sputum is gradually moving away from the mucous membrane, releasing the airways, and is discharged outside. As a result, inflammation is significantly reduced, recovery is accelerated.

With a chronic form of the disease, coughing is usually wet and strong. Sputum is well separated, but in insufficient quantities. Most of it thickens in the thickened form on the walls of the bronchi and lungs, preventing them from completely cleansing. Such a cough is most difficult to treat.

The most unpleasant form is the acute form of the disease. It is the most painful for a person, as often accompanied by a dry, unproductive cough, at which the sputum does not go away. Desires for coughing become more frequent, irritation of mucous membranes only amplifies. Gradually, other symptoms, such as pain in the sternum, in the intercostal muscles, perspiration and dryness in the throat, join the strong cough.

How long does the cough last for bronchitis?

Duration is determined by many factors. The average cough lasts from 5 days to 14 days. There are very rare cases when the cough is less than 5 days. But most often the cough does not last long, exhausts the person, requires special treatment. In some cases, cough can last for more than 14 days, even up to several months. The most difficult to cure is an obstructive and dry cough, while a wet cough is fastest. His appearance is a good sign, as it indicates a speedy recovery.

The earliest manifestation of bronchitis is a dry, less frequent moist cough, during which the sputum is separated. Even if the sputum is not separated, but just a person suffers from a dry, prolonged cough, a sore throat - this can indicate the development of bronchitis. You should see your doctor as soon as possible.

[19]

Dizziness when coughing with bronchitis

Often a strong cough that occurs on the background of bronchitis leads to dizziness. This is due to the fact that coughing too intensely irritates the walls of the bronchi and mucous membranes. It can also indicate excessive filling of the bronchi and alveoli with mucus, as a result of which gas exchange is disturbed. Inadequate amounts of oxygen are supplied to the blood, hypoxia (oxygen starvation) develops. The brain is most sensitive to the lack of oxygen, so it is the first to exhibit a reaction that occurs in the form of dizziness.

[20],

Cough in children with bronchitis

At the child a bronchitis enough long time is accompanied by tussis that is connected with features of anatomic structure of respiratory ways. Children develop a large amount of mucus that fills the airways. It is removed long enough, has a viscous consistency. Requires compulsory treatment.

[21], [22]

Cough for chronic bronchitis

In chronic bronchitis cough, as a rule, dry, unproductive. Mucus leaves badly, creates a viscosity in the bronchi and alveoli, which makes breathing difficult and creates additional irritation, increases inflammation. Such a cough occurs quickly enough, even with a slight effect on the body of adverse factors. For example, hypothermia can lead to the activation of the inflammatory process and its transition to chronic acute form.

[23], [24]

Cough with acute bronchitis

In acute bronchitis, a dry, nonproductive cough that often torments a person often occurs and does not last a long time. It is necessary to translate dry cough to wet. Only after that, a quick recovery is possible.

[25]

Cough with obstructive bronchitis

Obstructive coughing is a narrowing of the lumen of the airways. Characterized by the presence of wheezing. Inflammation is accompanied by swelling, hypersecretion. The danger of this condition is that the lumen of the bronchi can be completely closed by sputum, as a result of which there comes an attack of suffocation, an intensive spasm develops.

The risk of asthma increases. The reason for this reaction is the addition of allergies. In this case, treatment with antibiotics is not appropriate, since antibiotics cause additional sensitization and allergic organism.

Antibiotics for obstructive bronchitis are prescribed only in the most extreme case: when there is green sputum, high temperature, and also if the illness does not pass for a long time and the person is in serious condition. With a relatively light form, traditional, alternative means are sufficient. It is better to spend time at home, wrapped up in a warm scarf, under a warm blanket. It is recommended that you drink vegetable decoctions, hot tea, milk, aids that help liquefying and injecting sputum. The food should be balanced, you need rest.

Also, for acute bronchitis, it is recommended to perform steam inhalations and plant extracts and balms. You can put mustard and rub your chest and back with fat, oil, massage oil, balms of cough.

You need a generous drink, because the water is very dilute sputum. Breathe better with moistened air. You can use special humidifiers. Recommended essential oils that are soothing to the nervous system.

Cough for allergic bronchitis

With allergic bronchitis cough can occur as a reaction of the body in response to the action of irritants of an allergic nature. Such a cough has a long, spastic nature. No sputum is produced. Such a cough is dangerous because choking can occur. Need antihistamines. Antibiotics can not be prescribed, as they only increase allergies.

[26]

Severe cough with bronchitis

Bronchitis is often accompanied by a strong cough, which indicates a severe damage to the respiratory system. Strengthening of cough indicates the passage of infection from the respiratory tract and bronchial tree directly to the alveoli. This indicates that bronchitis has already passed into the next phase - bronchopneumonia. The risk of developing pneumonia increases. Requires immediate treatment. It is mandatory to use antibiotics and antitussive drugs.

A strong cough is usually accompanied by high fever, heat, weakness. The disease can last very long, up to 10 days or more.

Cough with bronchitis and pneumonia

When bronchitis cough is very strong, accompanied by a whistle in the bronchi. There may be pain in the sternum. Cough can be both dry and wet. The transition of bronchitis to pneumonia is indicated by the intensification of cough. It is often accompanied by pain in the apex of the lungs (above the scapula), as well as in the intercostal spaces. Also, whistles and wheezing in the lungs are heard.

[27]

Coughing attacks with bronchitis

With bronchitis, seizures happen quite often, especially in children. Most often, seizures occur with obstructive or allergic bronchitis, when the lumen of the bronchi closes with sputum, or spasm develops. The danger of such forms of bronchitis is that a person can suffocate. In addition, there may be a complication - bronchial asthma. Prescribe anti-allergic, antihistamines. Antibiotics are contraindicated, as they only increase sensitization and allergic organism.

[28], [29]

Cough at night with bronchitis

Cough intensifies at night due to the fact that at night, usually increases the amount of histamine, the inflammatory process increases. In addition, the smooth muscles of the bronchi and alveoli relax, as a result, mucus more freely enters the lumen of the bronchi, causing their reflex contraction. At night, enzymes, hormones, biologically active substances that promote muscle relaxation and liquefaction of sputum develop.

[30], [31], [32]

Stages

Cough with bronchitis passes in several stages. The first stage is a dry, unproductive cough. With this form, sputum is not secreted, but remains in the bronchi, intensifying the inflammation and not bringing relief to the person.

The second stage is the transition of dry cough to wet, productive. This cough promotes the spitting and excretion of the body. Accordingly, inflammation and the infection process are reduced. To achieve this particular form of coughing are sought in the treatment of bronchitis. The appearance of a wet cough is a good sign that indicates a quick recovery.

[33]

Forms

There are several types of cough, depending on the sign that underlies the classification. According to the nature of the cough, five main types are distinguished: dry, suffocating, moist and protracted. Isolate cough with blood.

[34], [35]

Dry cough with bronchitis

Most often bronchitis is accompanied by a dry cough. Its peculiarity consists in the fact that this form of cough reflex arises immediately after the inflammation has arisen. It develops within 2-3 hours and then lasts 3-4 days. Such a cough practically does not give in to treatment, it is very difficult to mitigate and eliminate it.

It differs in that with such a cough sputum is practically not separated. Nevertheless, it accumulates in the bronchi and alveoli, closing the lumen and thereby increasing inflammation. Practically always against this background there is a pain in the chest. With a strong cough that does not go away for a long time, vomiting may occur.

Pass cough can only if it goes into a wet form. To do this, take mucolytic drugs that promote lysis (dissolution of mucus and its further removal from the respiratory tract). Treatment is long, at least a week. In this case, you should not stop taking drugs even if the cough has already disappeared. Most likely, he simply moved from the active phase to the latent (chronic) one.

[36], [37]

Unproductive cough with bronchitis

By non-productive cough means an acute attack of dry cough, which is accompanied by an inability to clear your throat, a breach, and a stuffy throat. Sometimes seizures can be asphyxiating, may be accompanied by vomiting. The duration of the attack is from a few minutes to an hour.

In the end, a small piece of viscous sputum may separate. The release of the lungs and bronchi does not occur anyway, the person does not feel the relief of the condition. Often seizures are accompanied by vomiting and impurities of blood. Such a cough usually manifests itself at the very beginning of the disease, and gradually subsides, passing into a moist form as the inflammatory process decreases.

For treatment, mucolytic and bronchodilating drugs are used. Well-acting drugs designed to eliminate the inflammatory process in the bronchi. When the inflammation is removed, the signs of coughing decrease. Also apply a combination therapy.

Wet cough with bronchitis

With bronchitis, there is often a wet cough. It usually develops at the very end of the illness. This is a good sign that heralds a speedy recovery. With a wet cough, intensive separation of sputum occurs. It is excreted outward, accordingly, the inflammatory process is significantly reduced. Sometimes a wet cough can appear at the beginning of the illness, bypassing the stage of dry cough.

Sometimes it can be accompanied by vomiting and copious expectoration of phlegm. Vomiting occurs after 5-10 minutes. Can be accompanied by pain in the chest. For the removal of symptoms used mucolytic drugs, anti-inflammatory drugs. To remove the symptoms will also help physiotherapy. Well established acupuncture, massage, reflexology, warming of the chest. Sometimes drugs are injected with electrophoresis.

Cough with blood in bronchitis

It occurs very rarely. Blood can appear due to cracks in the bronchial mucosa, with increased pressure inside the bronchial tree. Blood is mixed with phlegm, forming veins of pink and red. When coughing intrabronchial pressure is only increased. Also often such cough is accompanied by attacks of vomiting and pain in the chest.

It is necessary to treat very carefully differential diagnosis, since often a cough with blood impurities is a sign of tuberculosis. The appearance of blood is an important diagnostic sign, on the basis of which many more additional studies are being prescribed.

If a person has blood in the sputum, you need to help him. First, you need a vertical position. The pulse and pressure are then measured. After this, it is important to ensure complete peace. If possible, you should use antitussive drugs that will allow a person to rest, sleep. Usually, such drugs temporarily alleviate the condition of the patient, eliminating the manifestations of cough. Operate 1-3 hours.

[38], [39]

Barking cough with bronchitis

Bark cough usually represents a late, protracted form of cough that occurs at the end of the disease, or after recovery. It can last a long time after the end of treatment. Accompanied by the allocation of a small amount of sputum. Sometimes there is pain in the chest area. Since such a cough is lengthy and occurs after the basic therapy has been completed, many specialists recommend that they be treated with alternative prescriptions and homeopathic remedies.

Diagnostics of the cough with bronchitis

At the heart of the diagnosis is the need to identify the main pathological processes occurring in the body and make the appropriate diagnosis, on the basis of which further selection of appropriate therapy will be conducted.

To do this, you need to see a doctor (therapist or pulmonologist), he will conduct an examination and appoint appropriate laboratory and instrumental studies. Important diagnostic information can be obtained during the examination and questioning of the patient. First the doctor collects the general information, then - carefully studies the anamnesis of a life and the anamnesis of illness.

At the general or common survey the special attention on a status of mucous membranes, a skin is paid. Thermometry is also carried out: the temperature can be increased. The frequency of heart rate and respiratory movements may remain normal, but may slightly exceed normal values.

A special study involves a thorough examination of the respiratory system. The most informative method in this case will be auscultation. Listening whistles and wheezing in the area of the bronchi, a few rattles can slip in the area of the apex of the lungs.

At a palpation there is an insignificant soreness of a thorax, a sternum. Cough also causes pain. There may be pain upon palpation of the lymph nodes. Nodules and lymphatic vessels are often enlarged, pulsating.

When percussion, a percussive box sound is heard in the area of the shoulder blades, the front of the sternum.

The results of clinical examination suggest the presence of acute bronchitis, chronic bronchitis, or other disease with similar features in a person. If one disease is different from another, it is quite difficult, differential diagnosis is carried out.

[40], [41]

Analyzes

First, standard tests are made: clinical analysis of blood, urine, feces. They can show a general picture of what is happening in the body. For example, increased ESR, leukocytes indicates an inflammatory process. There may also be signs of bleeding, bacterial, viral infection. The high content of eosinophils and basophils may indicate an allergic or tissue inflammatory response.

Additionally, an immunogram is given which can give a lot of useful information about the state of the immune system, the nature of the pathologies. Biochemical analysis shows the direction of the main biochemical processes occurring in the body, metabolic disorders, severity and localization of the inflammatory process.

Bacteriological examination of sputum, swabs from the throat and nasopharynx is also carried out. Bacteriological and histological examination of bronchoptata is less common. This makes it possible, by sowing on nutrient media, to determine the main causative agent of the disease. It is recommended additionally to carry out an antibioticogram - determination of the sensitivity of the isolated pathogen to antibiotics. This makes it possible to determine the most effective antibiotic and to select its optimal concentration.

[42], [43], [44], [45], [46], [47], [48], [49], [50], [51]

Instrumental diagnostics

Instrumental diagnostics can include a spirogram, by which the vital signs of the lungs and bronchi are determined, which leads to the conclusion about the degree of tissue involvement in the inflammatory process.

X-ray examination or fluorography may be required , which makes it possible to obtain a picture of the respiratory tract and to consider pathology.

Also, if necessary, bronchoscopy is performed , in which the bronchi are evaluated from the inside with a bronchoscope. If necessary, a biopsy is performed - take a piece of tissue for further histological examination. Histology is carried out with a suspicion of an oncological process in the bronchi and makes it possible, according to the nature of tissue growth, to conclude whether the affected area is benign, or malignant. It is also possible to choose a variant of therapy, having defined sensitivity to pharmaceutical preparations.

Differential diagnosis

When suspicion of tuberculosis is sowing on special selective media for growing mycobacterium tuberculosis. Active growth suggests that there are tuberculosis pathogens. An additional biochemical and immunological study, smear microscopy, which give the basis to finally confirm or disprove the diagnosis. The analysis is performed on average 30 days, determined by the rate of growth of bacteria.

If you suspect a cough of an allergic nature, additional allergological and immunological tests are performed. The most commonly used method of enzyme immunoassay, less often - polymerase chain reaction. A general and specific immunoglobulin E, mucosal immunoglobulin A, histamine (if necessary) is also determined.

When suspected of a viral infection, virological and serological tests are conducted. Venous blood serves as a material for the study. You may also need an analysis for hidden infections.

If a suspected cough caused by poisoning with strong substances, acids, with strong intoxication of the body, toxicological examination is carried out.

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Treatment of the cough with bronchitis

To begin treatment of a bronchitis it is possible only after the full inspection and the definitive diagnosis is established. Consult a doctor if the cough lasts longer than 2-3 days. Treatment can be done at home, but this requires strict adherence to all the recommendations of the doctor. If there is a temperature, it is necessary to comply with bed rest. In more severe cases, hospitalization is indicated.

The basis of treatment is medication. It is presented mainly by antibiotics, anti-inflammatory agents. Symptomatic therapy is also performed: with strong cough, mucolytics, antitussives, or expectorants are used. It is also recommended to take homeopathic remedies, alternative recipes. Physiotherapy may be required. Also, the patient should comply with dietary intake and drink as much liquid as possible.

How to relieve an attack of cough with bronchitis?

In order to quickly remove the attack, a number of measures must be taken. It is necessary to comply with bed rest, drink plenty of fluids. It is recommended to rub the back and thorax with anti-inflammatory ointment, or any other means containing fat in its composition. It is important to drink more hot tea, you can with the addition of fat or butter, honey. Good for inhalation with eucalyptus or fir oil. Also you need to ventilate the room well.

Treatment of dry cough with bronchitis

Treatment of dry cough is always aimed at its transfer into a productive form - in a wet cough. For this purpose, mucolytics have proved to be very useful, which contribute to liquefaction of sputum, and its release from the bronchi. Also these agents stimulate the activity of the bronchi, stimulating the movements of the cilia of the epithelium.

For the treatment of dry cough, ambroxol is well established, which is available in the form of syrup and cough syrups. Syrup is taken on a tablespoon three times a day, tablets - 1 tablet 3-4 times a day. Usually, the symptoms take place after 5-7 days. You can also try products such as flavamed, lazolvan, ambrol. They also quite successfully fight with a dry cough.

Treatment of a damp cough with bronchitis

Wet cough is considered productive and its appearance is a good sign. When wet cough occurs, it is necessary to use drugs that stimulate sputum evacuation, its removal from the respiratory tract. This will help expectorant. In no case should they be taken together with antitussive drugs, because they have the opposite effect. This is a common mistake that leads not only to worsening of the condition, but also to the development of various complications, including an attack of obstructive coughing, asphyxiation.

Antitussive drugs depress the cough reflex and thus reduce the cough. They force the receptors of the mucous membranes to not react to a large amount of mucus, which must be removed from the body. Expectorants, on the contrary, contribute to the sputum from the bronchi, contribute to its removal from the respiratory tract. When taking two drugs at the same time, mucus can clog the bronchus lumen, which will lead to an attack of suffocation.

Treatment of cough with obstructive bronchitis

Obstructive bronchitis is dangerous because mucus clogs the lumen of the bronchus, resulting in the development of choking and spasm. Apply antispasmodics, which reduce spasm, bronchodilators, which relax the smooth muscles located in the walls of the bronchi and, accordingly, dilate the lumen of the bronchi.

Also used antitussives, which have a direct effect on the cough center of the brain and thus reduce the manifestations of coughing. By action they are close to anesthetics, that is, they have no therapeutic effect, but only depress the cough center and block the manifestation of the reflex.

Assign only to temporarily stop the manifestation of cough, especially if the patient has pain behind the sternum, or a strong vomiting occurs against the background of a cough. Applied only with a strong and debilitating cough. Take no more than a week, since many of them in their composition contain narcotic substances. Symptoms are removed after a day. Children under 12 years of age, these drugs are not prescribed. Remember their toxic effects.

Codeine, code-terpin has proven itself well. Take 1 tablet twice a day.

Treatment of cough in asthmatic bronchitis

In asmatical bronchitis, there is acute pain in the sternum and suffocating cough, paroxysmal. To eliminate the symptoms used antiallergic and antihistamines. Also, inhalations conducted with the help of a nebulizer proved to be very good. Apply a variety of means to relax the smooth muscles, relieve spasm and eliminate allergic component.

With asthmatic bronchitis, sedatives and sedatives are used. Antibiotics should not be taken. It can be taken in a minimum concentration, only in extreme cases, for example, with the appearance of purulent sputum, high temperature. To remove attacks of a cough help the preparations removing or taking off attacks of a suffocating cough, for example, inspirations, erespal. Take 1 tablet twice a day. The result is noticeable after 4-5 days.

Treatment of cough with acute bronchitis

In acute bronchitis appoint drugs aimed at ensuring the productivity of cough. Well-proven means of expectorants, mucolytics. At a high temperature and a strong inflammatory process, antibiotics, anti-inflammatory and antipyretic agents are prescribed . Accept various alternative means. From a cough that is observed without a rise in temperature, inhalations with various anti-inflammatory herbs, essential oils help well.

Cough treatment for chronic bronchitis

With chronic bronchitis, sputum often goes away badly. It accumulates on the walls of the bronchi, in the alveoli, being a source of infection and a chronic inflammatory process. Sputum usually stagnates, concomitantly developing stagnant phenomena, there is a blockage of the bronchi.

For treatment, mucolytics are prescribed, which help to dissolve sputum and remove it from the respiratory tract.

Apply a variety of alternative and homeopathic remedies. The most effective remedy for cough in bronchitis is honey. It is used as a basis for the preparation of syrups and tinctures, added to tea, used for compresses and wraps.

Complications and consequences

Cough with bronchitis is dangerous because it can develop into obstructive bronchitis, in which sputum is not excreted from the body, but remains in the airways. Gradually the lumens become clogged, and a spasm and an increase in the inflammatory process occur. This can lead to suffocation and development of bronchial asthma.

Also the danger of bronchitis is that the infection can progress, gradually turning into bronchopneumonia, pneumonia. In the absence of necessary treatment, a complication can develop in the form of pleurisy, pulmonary edema, pulmonary insufficiency.

[53], [54]

Prevention

Prevention is reduced to proper nutrition, maintaining a healthy lifestyle. It is necessary to carry out the sanation of existing infections in the body, including dental diseases. When identifying associated diseases, they should be treated. When you have a cough, you need to see a doctor as soon as possible and start the necessary treatment as early as possible. Do not let hypothermia, overwork, avoid stress and nervous strain.

[55], [56]

Forecast

If the necessary treatment is started in time, the prognosis is favorable. In this case,  cough with bronchitis  can be completely cured. In the absence of proper treatment, he can move into a chronic form. Dangerous complications such as pneumonia, pleurisy, pulmonary edema.

[57], [58],