Dyspnea in obstructive and acute bronchitis: treatment with drugs and folk remedies

Various forms of inflammation in the bronchi are usually accompanied by dyspnea (shortness of breath). Moreover, dyspnea with this disease develops much more often in children than in adults. The feeling of acute oxygen deficiency, threatening to flow into suffocation, causes not only significant discomfort, but also poses a danger to the health, and sometimes the life of the patient.

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Causes dyspnea with bronchitis

The subjective feeling of lack of air appears as a result of the obstruction of its patency in the bronchi during their spasms or strictures and is aggravated by the accumulation of viscous secretions (phlegm) precisely in narrower places.

Risk factors for the development of dyspnea in bronchitis include chest pain when inhaling, preventing deep breathing, development of complications (pneumonia, pleurisy), chronic inflammation, presence of cardiovascular pathologies, pulmonary hypertension, emphysema, pulmonary heart disease and other complications.

In the risk group for developing respiratory diseases, smokers are second to none. Allergy sufferers are also a weak link, as are people with reduced immunity and a hereditary predisposition to respiratory diseases.

The reason that children with bronchitis almost always experience shortness of breath is the small diameter of the bronchi, which quickly fills with viscous secretions, insufficient development of elastic tissue in the walls of the bronchi, and weakness of the respiratory muscles.

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Pathogenesis

In the mechanism of dyspnea, the main pathogenetic links are a decrease in the partial pressure of oxygen and its content in the blood (hypoxemia), which occurs during bronchitis due to the difficult passage of air through the bronchi, which are spasmodically narrowed or blocked with viscous secretion. The threat of hypoxia causes reactive excitation of the respiratory center. The body tries to compensate for the lack of oxygen by more frequent and deep breathing, i.e. dyspnea. As a result, the heart rate and systolic blood volume, blood flow velocity, erythrocyte and hemoglobin levels increase, entailing other functional disorders.

In acute bronchitis, the main role in the pathogenesis of dyspnea development belongs to bronchial spasms, accumulation of viscous secretions and chest pain, in chronic processes – to obstructions, organic and functional stenosis, blockages of the bronchial lumen, development of pulmonary heart disease and hypertension, heart failure.

During an inflammatory process in the large bronchi, the reflex regulation of breathing in the inspiratory (regulating inhalation) section of the respiratory center is usually disrupted.

Expiratory dyspnea (difficulty exhaling) develops with changes in the small bronchi and lung parenchyma in chronic bronchitis; mixed dyspnea also occurs (in advanced diseases), when breathing regulation is impaired in both sections.

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Epidemiology

Acute bronchitis most often affects young (under 40) males. About 5% of adults visit a doctor for this reason every year. Among children, the incidence is up to 100 cases per 1000 children, especially children in the first three years of life. The disease is characterized by pronounced seasonality - more than 80% of cases occur in the cold season.

Chronic bronchitis, which is mainly accompanied by shortness of breath, affects approximately 10% of the population. More than half of them are people over 50 years old, there are five to six times more male patients than female patients, which is explained by such a bad habit as smoking, which is more common among men. However, if we compare male and female smokers, the incidence of bronchitis among them is the same.

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Symptoms

The first signs of dyspnea in patients usually appear under the influence of unusual physical activity (running, fast walking, climbing stairs). Subjectively, this is expressed in a lack of air, the person feels like he is suffocating.

Dyspnea in acute bronchitis in adults is rare. Its appearance should alert the patient, since, most likely, it signals the spread of the inflammatory process to the lung or pleural tissue. In a child, dyspnea develops quite quickly with acute bronchitis. This is facilitated by the anatomical and physiological features of children's respiratory tract.

The classic development of clinical symptoms of acute bronchitis is a sudden onset of severe coughing, usually dry at first; wheezing and/or gurgling sounds are heard when inhaling and exhaling; breathing becomes difficult (dyspnea); fever, weakness, sweating, hyperthermia.

Chronic forms of the disease are characterized by a long-term (at least three months a year for two years) cough, the patient quickly gets tired, sweats with the slightest effort, and may have a subfebrile temperature or it may rise in the evening.

Shortness of breath in chronic bronchitis is very common. Patients may experience it periodically (during exertion) or constantly (even at rest). The frequency of exacerbations negatively affects the quality of breathing; the more often the disease relapses, the worse the patient breathes. Sometimes dyspnea does not stop even during remission.

Shortness of breath always develops with obstructive bronchitis. This is facilitated by bronchial edema, narrowing their lumen and promoting its blockage with sputum, as well as spasms of their muscles. Expiratory dyspnea is typical for this type of bronchitis. Wheezing and whistling sounds accompany the exit of air from the respiratory tract. With obstructive bronchitis, wheezing is often clearly audible to others. Shortness of breath is especially severe in the morning, when the bronchi are clogged with sputum accumulated overnight. Relief comes after coughing.

Shortness of breath in the chronic form of the disease can progress, in advanced cases mixed dyspnea appears, both inhalation and exhalation are difficult. In this case, severe shortness of breath in bronchitis accompanies the patient even at rest. With a long course of the disease, hypertension develops in the pulmonary artery, which over time leads to an increase in the right ventricle of the heart and its failure (pulmonary heart). The development of pulmonary hypertension often proceeds unnoticed, especially against the background of chronic bronchitis, since its signs are shortness of breath and cough, weakness and rapid fatigue during physical exertion, hoarseness, tachycardia, dizziness and loss of consciousness. Symptoms of pulmonary heart overlap with symptoms of chronic bronchitis and pulmonary hypertension - the same shortness of breath, which increases not only during physical exertion, but also in a lying position or in the cold. Heart pain, cyanosis, hepatomegaly, and peripheral edema appear.

In allergic bronchitis, shortness of breath develops from contact with the substance that caused the reaction. Difficulty breathing can be either minor or serious, up to suffocation. It is possible to get rid of this type of bronchitis only by identifying and eliminating the allergen.

Atrophic bronchitis is also accompanied by shortness of breath, especially during periods of exacerbation. With atrophy of the bronchi, their mucous membrane is replaced by scar tissue. Early symptoms of the atrophic form of the disease are a sore throat, cough, hoarse voice, severe sweating, weakness, pain in the back muscles, shortness of breath during exercise. In the acute stage, shortness of breath accompanies the simplest and most common movements, headache appears, weakness and pain in the sternum and abdominal area increase, body temperature may rise.

Shortness of breath with bronchitis in adults is a must and is one of the first signs if it is asthmatic bronchitis. It differs from asthma by the absence of asthma attacks and is considered a pre-asthmatic condition. However, preschool and primary school children are most susceptible to this type of bronchitis.

Shortness of breath during bronchitis in a child develops much more often and faster than in adults, since even a small lump of viscous secretion can clog a narrow lumen. The younger the child, the more dangerous the consequences of delay can be.

Symptoms that require emergency care for adults and children:

• the appearance of sudden severe shortness of breath with increasing symptoms;
• chest pain;
• expiratory dyspnea with signs of suffocation.

Sometimes after treatment of bronchitis dyspnea remains, accompanied by pain and distension in the chest. These sensations usually indicate recovery processes and eventually disappear on their own.

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Diagnostics dyspnea with bronchitis

Examination of patients complaining of cough and shortness of breath begins with collecting information for the medical history and visual examination. The patient's age, heredity, appearance, working conditions and bad habits are taken into account.

Blood tests (clinical, biochemical, coagulation), urine and sputum tests are prescribed. Instrumental diagnostics are performed: X-ray examination of the chest organs, which allows to identify bronchitis and its complications, in particular, pneumonia, pleural effusion, pneumosclerosis and others; computed tomography or magnetic resonance imaging of the chest; scintigraphy of the blood supply and ventilation of the respiratory organs; pulse oximetry (to determine the degree of respiratory failure); spirometry (to determine the volumes of exhalation and inhalation). The inner surface of the bronchi is examined using bronchoscopy (endoscopic examination of the mucous membranes of the trachea and bronchi). If pleurisy is suspected, an ultrasound examination of the lungs may be prescribed.

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Differential diagnosis

Differential diagnostics of dyspnea in bronchitis is carried out with dyspnea in diseases of the parenchymatous tissues or vessels of the lungs, in pathologies of the respiratory muscles, chest. Tumor diseases, neurotic conditions, organic lesions of the respiratory center of the brain, heart pathologies are excluded.

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Treatment dyspnea with bronchitis

If a series of acute, increasing attacks of dyspnea develop, especially those of an expiratory nature and accompanied by pain, it is necessary to call an ambulance. Until it arrives, the patient's condition can be alleviated as follows:

• in case of an attack of allergic etiology, first of all, it is necessary to eliminate the irritating substance and give an antihistamine drug recommended by a doctor and available in the medicine cabinet of any allergy sufferer;
• if the provoking factor is unknown, place the patient in a semi-sitting position, creating an elevation from pillows and blankets;
• ease breathing by loosening constricting clothing (tight collar, corsets);
• provide access to fresh air in the room, if possible, humidify the air;
• If the patient has an aerosol with the drug (inhaler), help him use it.

Dyspnea with bronchitis may appear periodically, or it may be permanent. An ambulance is called in emergency cases. Basically, attacks are dealt with independently. How to relieve shortness of breath with bronchitis?

Currently, there is a wide range of conventional inhalers and nebulizers, in which the medicine is sprayed into tiny particles and, entering the respiratory tract, acts quickly and effectively.

In case of spasmodic contraction of the muscular layer of the bronchi, inhalation with Fenoterol is used. This drug is available in an aerosol package. The drug, by inhibiting the transport of calcium ions through cell membranes, reduces its concentration in muscle tissue, relaxing the bronchial muscles and promoting their expansion. The spasmolytic effect occurs quickly, stopping asthma attacks of various etiologies, and lasts up to eight hours. Contraindications to its use are severe atherosclerotic lesions of the heart vessels, heart rhythm disturbances. It can cause side effects in the form of tachycardia, anxiety, trembling in the fingers, as well as increased sweating, fatigue, migraine.

The drug is dosed individually; in case of acute dyspnea, patients from the age of six are recommended to take a single inhalation of 0.2 mg of the drug or twice 0.1 mg. If the first attempt is ineffective, the drug can be used again after five minutes. The next inhalation is carried out at an interval of six hours (not earlier!).

The prophylactic dosage is 0.2 mg. Adult patients do inhalations three times a day, children aged 6-18 years – twice.

For patients aged 4-5 years, an aerosol is recommended at a dosage of 0.1 mg of the active substance up to four times a day.

The maximum daily allowable number of aerosol applications for patients of all age categories is four times.

You can do inhalations with a preparation based on herbal ingredients - Solutan. It can also be used orally. It is not recommended for insomnia, high blood pressure, increased thyroid function, organic pathologies of the heart muscle and coronary arteries. In childhood, the dose is from five to ten drops and taken three times a day. Adult patients with bronchitis are recommended to take from ten to 30 drops. The number of doses is similar. The drug is taken after meals.

The anticholinergic drug Atrovent can also be prescribed as a means of relieving bronchial spasm that occurs against the background of colds and infectious diseases, bronchial obstruction and reducing the secretory activity of the glands of the bronchial mucosa. This drug is available in aerosol form and in drops for inhalation. The aerosol can be used in patients over five years old, and the solution - over four. The drug can be prescribed to pregnant women by a doctor from the second trimester.

Aerosol Atrovent N, as a means of preventing shortness of breath, is recommended to be used two or three inhalations three times a day, as a therapeutic one - up to five times. Children aged 6-12 years are given up to two inhalations with a break of at least six hours as needed.

For adult patients, 20 to 40 drops of the solution are added to the inhaler and three or four inhalations are made per day. The daily dose should not exceed 2 mg.

In pediatric practice, patients aged five to 12 years are given inhalations with 10 or 20 drops of solution. The procedure is performed as needed under the supervision of medical personnel. The daily dose should not exceed 1 mg.

When using a nebulizer, the required dose is diluted with saline solution to a capacity of 4 ml. A fresh solution is prepared before each inhalation.

Quite often prescribed tablets for shortness of breath during bronchitis are Theophylline. Its ability to expand the bronchi helps to stop attacks of shortness of breath. This drug is not recommended for long-term use, as it can provoke convulsions. Tablets are prescribed from the age of two, they can cause dyspeptic side effects. This can be avoided by using the drug in the form of rectal suppositories. Sometimes this form is more effective.

Children's dosage: from two to four years - a single dose of 10-40 mg, from five to six - 40-60 mg, from seven to nine - 50-75 mg, from ten to 14 years - 50-100 mg. Adult patients take 100-200 mg. The frequency of administration is twice or four times a day. The daily dose for adults should not exceed 15 mg per kilogram of body weight, in childhood - 20 mg.

The drug Salbutamol is available in various forms: regular and prolonged-release tablets, syrup, powders and inhaler solution, injection solution. Eliminates bronchial spasms for a long time (from five to eight hours), without having a significant effect on the cardiovascular system. It has no absolute contraindications, requires caution when prescribing to pregnant women, patients with toxic goiter and attacks of severe heart palpitations, hypertensive patients.

Orally, patients over 12 years of age can take a daily dose of 6 to 16 mg, divided into three or four doses. The maximum permissible daily dose is 32 mg. For children, the drug is dosed as follows: from two to six years old, 3-6 mg per day, divided into three doses; over six but under 12 years old - 6-8 mg per day, divided into three or four doses.

The aerosol form is dosed at 0.1 mg for children, 0.1-0.2 mg for adult patients – three to four inhalations per day.

The powder form is also used three or four times a day, dosed at 0.2 mg for children and 0.2-0.4 mg for adults.

The solution can be dosed at 2.5 mg (if necessary, the single dose can be increased, but not more than 5 mg) according to the same scheme.

These drugs alleviate the patient's condition and are included in the therapeutic regimen if the patient has dyspnea.

When treating bronchitis, the patient is prescribed vitamins to support the immune system and prevent complications. Vitamin therapy is prescribed by a doctor based on the patient's condition. Vitamin and mineral complexes may be prescribed, they should contain vitamin C and A, vitamins of group B, to prevent the development of anemia.

It often happens that people who have had bronchitis suffer from shortness of breath for a long time. It should be taken into account that the recovery period takes a long time. You should not return to bad habits after the disease, in particular, to smoking. It is necessary to lead a fairly active lifestyle, including walking in the fresh air, feasible physical exercises. Massage, special therapeutic exercise, physiotherapy are effective as rehabilitation measures. Thermal procedures can be useful - mud, paraffin, ozokerite applications; exposure to low-frequency current impulses; amplipulse therapy; ultra-high-frequency therapy; halotherapy.

Folk remedies

You can also get rid of shortness of breath with the help of traditional medicine recipes, adding them to the bronchitis therapy regimen with the permission of your doctor. During the rehabilitation period, residual effects in the form of shortness of breath can also be combated with the help of traditional medicine.

It is recommended to use regular turnips: finely chop or grate one root vegetable, pour water (400 ml), boil for a quarter of an hour, strain. Drink a glass of turnip decoction before bed until shortness of breath disappears.

People suffering from shortness of breath of any etiology should drink tea made from cranberry leaves.

Almost everyone has probably had to do inhalations with potatoes boiled in their skins, covered with a towel over a saucepan.

For shortness of breath that occurs during physical exertion, accompanying chronic diseases, you can take the following mixture in courses (three times a day before meals for a month): grind the cloves of two heads of garlic with a blender or grater and pour in unrefined vegetable oil. Mix and put in the refrigerator - the mixture is ready for use. Take by mixing a teaspoon of the mixture and freshly squeezed lemon juice. After a month of taking it, you need to take a break of the same length. You can take four health courses in a year.

Herbal treatment: shortness of breath due to bronchitis can be cured with the following infusion. Prepare a herbal mixture by taking one part oregano, two parts marshmallow and coltsfoot, and mix. Brew a tablespoon of the herbal mixture with boiling water (½ liter), leave for 20 minutes, and strain. Drink half a glass daily after breakfast, lunch, and dinner.

In the spring, drink an infusion of young birch leaves, two teaspoons of which are brewed with a glass of boiling water, infused for 30 minutes and consumed once a day.

You can take a tablespoon of lilac flowers and pour the same amount of boiling water over it. Leave it for four hours. Take the infusion for shortness of breath for three weeks, repeat the course at intervals of a week.

Shortness of breath in allergic bronchitis: mix eight tablespoons of viburnum flowers, five each of sage and celandine herbs, three each of chamomile flowers and mint leaves. Pour a tablespoon of the mixture into a thermos, brew with 250 ml of boiling water, leave overnight. Strain and drink before meals throughout the day, dividing into four doses.

Recipe for adults: dry crushed horse chestnut flowers (a teaspoon) are infused in medical alcohol (50 ml). The tincture is kept for a week in a cool place without access to light. The finished product, after straining, is taken 30 drops, diluted in 150 ml of water, before breakfast and dinner.

Homeopathy

Treatment of dyspnea in bronchitis with homeopathic remedies requires a doctor's prescription. The choice of drugs for treatment is quite wide. Patients are prescribed both constitutional and symptomatic remedies. One of the remedies used for acute dyspnea is Antimonium tartaricum (emetic tartar, a complex salt of antimony and potassium), this medicine is one of the constitutional remedies for patients with bronchopneumonia. Kalium carbonicum (potassium carbonate) is prescribed for dyspnea accompanied by severe pain, dry cough and tachycardia. Arsenicum album (white arsenic) is prescribed for nocturnal attacks of dyspnea. Curare (curare) - for bronchitis complicated by pulmonary emphysema.

Of the drugs that can be purchased at any pharmacy, Bronhalis-Heel and Tartephedrel N are intended for the treatment of dyspnea in bronchitis. These drugs directly affect the bronchial tree, relieving spasms, stopping the inflammatory process, facilitating the removal of sputum. The homeopathic dilutions included in their composition activate the patient's own defenses against the disease.

Bronhalis-Heel is a multicomponent drug that has the ability to cure acute and chronic inflammatory processes in the respiratory system.

Atropa belladonna (belladonna) is a first aid remedy for acute respiratory inflammatory processes;

Lobaria pulmonaria (lung lobaria) – stops coughing fits and hemoptysis;

Cephaelis ipecacuanha (vomit root), Kreosotum (beech tar) – help relieve acute coughing attacks in chronic processes of any etiology;

Lobelia inflata (bloated lobelia) – relieves shortness of breath, facilitates breathing, promotes relaxation of the muscles of the bronchi and other organs of the respiratory system, eliminates autonomic disorders associated with acute respiratory symptoms;

Hyoscyamus niger (black henbane) – especially effective for nocturnal coughing fits, eliminates dryness in the throat and larynx;

Bryonia (white bryony) – used as an expectorant, effective for pleurisy;

Antimonium tartaricum (tartar emetic) – clears the respiratory tract of viscous secretion of the bronchial glands, eliminates shortness of breath caused by its accumulation, inflammation and hoarseness of the voice;

It is available in tablet form for sublingual dissolution. Patients over six years of age are prescribed one tablet three times a day, a quarter of an hour before meals or an hour after.

For small patients aged 3-6 years, the tablet is crushed into a powder mass, which is dissolved in 20 ml of cool boiled water. The dose is 10 ml of solution per dose.

To relieve acute symptoms, the drug is taken at intervals of 15 or 20 minutes, but not more than two hours in a row.

The duration of treatment is individual (from two weeks to a month). A repeat course is prescribed by a doctor.

In case of sensitization to the components of the drug, an allergic reaction may be observed. It is not recommended for children under three years of age, pregnant and lactating women to use without a doctor's prescription. Contraindicated for people sensitized to the ingredients and with lactase deficiency. Can be taken in combination with other drugs.

The composition of the oral homeopathic drops Tartephedrel N echoes the composition of the previous remedy - Antimonium tartaricum, Atropa belladonna, Lobelia inflata, Cephaelis ipecacuanha are also in its composition.

The drops also contain:

Natrium sulfuricum (Glauber's salt or sodium sulfate) is prescribed for asthmatic bronchitis and asthma attacks, especially in the morning, coughing and chest pain;

Arsenum iodatum (arsenic iodide) is an expectorant for bronchitis, pneumonia, tuberculosis, pleurisy, and also for respiratory manifestations of allergies;

Blatta orientalis (black cockroach) is a constitutional remedy for diseases of the respiratory tract in people of dense build;

Naphthalinum (naphthalene) – dyspnea, difficulty breathing in bronchitis, infectious, cold and allergic, antispasmodic and expectorant, prescribed for pulmonary emphysema, bronchial asthma;

Illicium verum (star anise) is an antispasmodic.

Please note that the medicine contains ethyl alcohol.

Contraindicated in case of intolerance to one or more ingredients of the drug. People with thyroid diseases should take it only as prescribed by a doctor.

Before taking, dissolve ten drops in ½ glass of water, drink, holding the sip in the mouth, three times during the day. To relieve acute conditions, take a single dose at intervals of a quarter of an hour for the first two hours, then switch to the usual dose.

A long course of treatment (more than a month) is carried out as prescribed and under the supervision of the attending physician.

Surgical treatment

Conservative treatment is used in most cases to treat dyspnea in bronchitis. In cases of complications of long-term chronic bronchitis that have spread to the parenchymatous tissue of the lungs, operations are performed to excise atrophied areas of tissue.

Complications and consequences

Difficulty breathing with bronchitis is a common symptom, however, it should not be ignored. In an acute process, shortness of breath usually indicates the spread of inflammation to the lung parenchyma and the development of complications, the transition of the disease into a chronic form.

Protracted chronic processes affect not only the bronchi. The disease progresses. A prolonged inflammatory process irritates the mucous membrane of the bronchi, causing irreversible changes in it. Most often, chronic bronchitis is complicated by pneumonia, which does not go away for a long time and can also become chronic. The parenchymatous tissues of the lungs are subject to irreversible sclerotic changes.

The development of asthmatic syndrome or bronchial asthma most often becomes a consequence of poor treatment of obstructive bronchitis. The risk factor for asthmatic complications is the presence of allergies.

Expiratory or mixed dyspnea may be a sign of the development of pulmonary emphysema - irreversible stretching of the pulmonary alveoli and an increase in the size of the lungs in these areas. Gas exchange in the lungs is disrupted, the main signs of respiratory failure appear - dyspnea increases, cyanosis appears, the distance between the ribs increases and the so-called barrel-shaped chest appears.

The vessels and heart muscle are also involved in this process. Chronic pulmonary heart disease leads to the development of severe heart failure. Emphysema is also complicated by severe respiratory failure, and pneumothorax may develop.

With long-term chronic bronchitis, the immune system suffers. Advanced diseases are difficult to treat and can lead to disability and death.

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Prevention

It is much easier to prevent a disease than to cure it. A healthy lifestyle - physical activity, good nutrition, hardening, eliminating bad habits will help keep the immune system in working order, and timely treatment of viral infections, allergies and colds will not contribute to the development of chronic respiratory pathologies.

In the presence of chronic bronchitis, timely treatment of exacerbations, special breathing exercise techniques, other rehabilitation measures are necessary, and most importantly, the patient’s efforts and desire to get rid of shortness of breath and cure the underlying disease will definitely be effective.

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Forecast

Shortness of breath during bronchitis, especially in a child, should cause alertness in parents and encourage them to seek medical help. Growing attacks in adults, accompanied by pain and suffocation, also require emergency measures. Timely assistance will help maintain health, prevent serious complications and the development of respiratory failure. In general, the prognosis is favorable.

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