Bronchitis. Description, types, causes, prevention and treatment of bronchitis

General information

Bronchitis (Latin Bronchitis ) is a disease of the respiratory system in which the bronchi are involved in the inflammatory process, i.e. it is an inflammation of the mucous membrane of the walls of the bronchi. The bronchi, in turn, are a branched network of tubes of different diameters that conduct inhaled air from the larynx to the lungs. With bronchitis, air circulation to and from the lungs is disturbed, due to edema of the bronchi and a large separation of mucus.  

Bronchitis is one of the ten most common reasons for seeking medical help around the world.

Types of bronchitis

The “International Classification of Diseases” includes two forms of bronchitis – “acute” and “chronic”, but among specialists there is also another form – “obstructive” bronchitis. 

Acute bronchitis is an acute diffuse inflammation of the mucous membrane of the tracheobronchial tree, characterized by an increase in the volume of bronchial secretion with cough and sputum separation. 

Chronic bronchitis is a diffuse progressive lesion of the bronchial tree with the restructuring of the secretory apparatus of the mucous membrane with the development of the inflammatory process, accompanied by hypersecretion of sputum, impaired cleansing and protective function of the bronchi. 

Obstructive bronchitis is a form of bronchitis, when blockage of the bronchi develops due to swelling of the mucous membrane. 

Symptoms of bronchitis

The main sign of bronchitis, both acute and chronic, is coughing. 

Symptoms of acute bronchitis

In acute viral bronchitis (for example, during the flu) in the first days of the disease, the cough is dry, intrusive. Such a cough can often cause restless sleep, or vomiting in children. In the following days, the cough becomes wet – sputum begins to stand out (white-greenish color), which indicates the attachment of a bacterial infection. A wet cough is not as painful as a dry cough, and in most cases brings relief to patients. Unpainted or white tinged mucus secreted during coughing is not a sign of a bacterial infection. 

It is important to remember that coughing is one of the most important protective functions of the body. Its role is to cleanse the airways. However, only a moist, productive cough is useful, in which liquid sputum is easily removed.

Cough with acute bronchitis can last 1-2 weeks or slightly longer. If the cough does not go away after three weeks, this indicates a decrease in the body’s regenerative abilities and a high risk of bronchitis becoming chronic.

Important! Normally, bronchi produce about 30 grams of mucous secretion daily. 

The next symptom of acute bronchitis is a slight increase in temperature. In moderate and severe forms, if influenza or other acute respiratory infections are accompanied, the body temperature can also reach 40 ° C.

Quite often, acute bronchitis can occur as an independent acute respiratory infections of a bacterial nature. In this case, the disease (acute bronchitis) is accompanied by a slight fever, wet cough, headache, weakness. Many patients (especially adults) can suffer the disease, as they say “on their feet,” attributing cough and fever to a common cold. 

Usually, the course of acute bronchitis (especially with adequate treatment) is favorable. However, in some cases, acute bronchitis can be the cause of complications such as pneumonia, bronchiolitis and other diseases of the respiratory system.   

Symptoms of Chronic Bronchitis

It is customary to talk about chronic bronchitis in the case when a patient has a chronic cough (more than 3 months a year) for 2 or more years. Thus, the main symptom of chronic bronchitis is a chronic cough.

Cough with chronic bronchitis is deaf, deep, aggravated in the morning, and in the mornings there is an abundant secretion of sputum with coughing – this may be a sign of one of the complications of chronic bronchitis – bronchiectasis.

The temperature in chronic bronchitis rises rarely and slightly.

For chronic bronchitis, an alternation of periods of exacerbation and remission is characteristic. Exacerbations of chronic bronchitis are usually associated with episodes of hypothermia, acute respiratory infections, often appear in the cold season. 

Symptoms of Obstructive Bronchitis

Another common symptom of bronchitis is progressive shortness of breath. The occurrence of shortness of breath is associated with a gradual deformation and obstruction (obstruction) of the bronchi. At the initial stages of chronic bronchitis, bronchial obstruction is reversible – after treatment and mucus secretion, breathing is restored. In the late stages of development of chronic bronchitis (usually without any treatment), bronchial obstruction becomes irreversible due to deformation and narrowing of the walls of the bronchi. In chronic obstructive bronchitis, patients complain of shortness of breath, which appears during physical exertion. 

So, to summarize all the possible symptoms of bronchitis:

– Cough; – A slight increase in body temperature; – Labored breathing; – wheezing; – Soreness and sensation of spasm in the throat; – shortness of breath; – Headache. 


Causes of bronchitis

Viruses that cause acute respiratory infections or colds can also cause acute bronchitis, however, a feature of inflammation of the bronchial tree (as mentioned above) is the ability to attach a secondary bacterial infection.  

Sometimes the development of bronchitis is facilitated by the inhalation of tobacco smoke, dust, toxic gases, as well as hydrochloric acid, which with a disease such as gastroesophageal reflux enters the esophagus and larynx from the stomach.

Also, a hereditary predisposition may be the cause of bronchitis.

Bronchitis develops very quickly in cases where there is constant damage to the mucous membranes, bronchi by any particles in the air. Another cause of bronchitis is the climate, which is not very favorable for humans, namely: constant dampness, frequent changes in weather conditions, fogs.

When the mucous membranes and bronchi are constantly damaged by some kind of smoke, dust, other particles, this is a kind of “push” to a constant increase in sputum production, which means that there is a need to often cough in order to eliminate sputum from the respiratory tract of a patient with bronchitis. Smoking is the cause of bronchitis No. 1, because statistics say that smokers, regardless of gender, suffer from chronic bronchitis 3-4 times more often than free from this bad habit. Although, perhaps, no less harmful than smoking, work in hazardous production does: workers in woolen, chemical, and bakery plants are also highly susceptible to bronchitis.  

Diagnosis of bronchitis

A specialist usually listens to your bronchi and lungs with a stethoscope. To exclude a more serious disease, such as pneumonia, an x-ray may be prescribed.

Diagnosis of acute bronchitis

Often, the diagnosis is not difficult, based on the history and clinical symptoms. However, in some cases, analysis results are also needed.

Laboratory research:

1. General blood test – leukocytosis, a shift in the leukocyte formula to the left, increased ESR.
2. Biochemical studies – an increase in the blood level of acute phase proteins, a2- and y-globulins, an increase in the activity of the angiotensin-converting enzyme. Hypoxemia sometimes develops.
3. Bacteriological research – sputum culture.
4. Serological analysis – determination of antibodies to viruses or mycoplasmas.

Diagnosis of chronic bronchitis

Recognition is based on a characteristic clinical picture, including an analysis of symptoms, life history, elucidation of the “experience” of smoking, and the identification of occupational hazards.

When radiography in the lungs may not change, the development of pneumosclerosis is subsequently noted, the number of leukocytes in the blood during exacerbation may increase, neutrophilic leukocytes prevail in sputum.

To exclude lung cancer, pulmonary tuberculosis and other diseases having manifestations similar to chronic bronchitis, an X-ray examination is carried out. 

Using the methods of functional diagnostics (assessment of the size of pulmonary volumes, bronchial obstruction, gas exchange), the degree of decrease in pulmonary functions is determined. Sometimes clarification of the diagnosis requires bronchoscopy and the use of other methods.

Laboratory research

1. General blood test – in a quiet period without changes, with exacerbation – a small leukocytosis, a shift of the leukocyte formula to the left, a slightly increased ESR.  

2. Biochemical studies – an increase in the level of sialic acids, seromucoid, with exacerbation of chronic purulent bronchitis, SRV appears.

3. Sputum analysis – sputum is often mucous, less often purulent. With microscopy, there are many neutrophils in purulent sputum, bronchial epithelial cells, macrophages are detected. With obstructive bronchitis, Courshman spirals can be determined.

4. Bacteriological studies of sputum allow you to determine the type of various bacteria and their sensitivity to antibiotics. A reliable way to obtain material is flushing from the bronchi.

5. Immunological studies – a decrease in the number of T-lymphocytes, including T-suppressors, is possible in the blood.

Bronchitis treatment

Treatment of acute bronchitis

The treatment of acute bronchitis is symptomatic: bed rest, good ventilation of the room, plenty of warm drink, distracting procedures (hot foot baths at temperatures up to 40 ° C, mustard plasters, cans for older children).

Expectorants: marshmallow syrup, pertussin, ammonia anise drops. At high temperature – “Acetylsalicylic acid”, “Amidopyrine”, hyposensitizing and antihistamines – “Diphenhydramine”, “Suprastin”.

Antibiotics and sulfonamides are indicated for pneumonia. 

Chronic bronchitis treatment

In the phase of exacerbation of chronic bronchitis, therapy should be aimed at eliminating the inflammatory process in the bronchi, improving bronchial patency, and restoring impaired general and local immunological reactivity.

Prescribe antibiotics and sulfonamides in courses sufficient to suppress infection activity. The duration of antibiotic therapy is individual. The antibiotic is selected taking into account the sensitivity of the microflora of sputum (bronchial secretion), is prescribed orally or parenterally, sometimes combined with intratracheal administration.

Shown is the inhalation of volatile garlic or onion (garlic and onion juice is prepared before inhalation, mixed with 0.25% novocaine solution or isotonic sodium chloride solution in a proportion of 1 part juice to 3 parts solvent). Inhalations are carried out 2 times a day; on a course of 20 inhalations.

Simultaneously with the therapy of active bronchial infection, conservative sanitation of foci of nasopharyngeal infection is carried out.

Treatment for Obstructive Bronchitis

Since the narrowing of the bronchi plays the main role in the development and progression of chronic obstructive bronchitis, for the continuous treatment of the disease mainly drugs that expand the bronchi are used.

An ideal bronchodilator for the treatment of chronic obstructive bronchitis should meet the following requirements:

– high efficiency;
– the minimum number and severity of adverse reactions;
– maintaining efficiency despite prolonged use.

To date, inhaled anticholinergic drugs most of all meet these requirements. They have an effect mainly on large bronchi. Preparations of this group are characterized by a pronounced bronchodilator effect and a minimal amount of side effects. It includes Atrovent, Troventol, and Truvent.

These drugs do not cause tremors (tremors), do not affect the cardiovascular system. Atrovent treatment begins usually with 2 inhalations 4 times a day. Reduction of bronchial obstruction and, therefore, improvement in well-being occurs no earlier than 7-10 days after the start of therapy. It is possible to increase the dose of the drug to 16-24 breaths per day. Preparations of this group are used for basic long-term bronchodilator therapy. It is preferable to use a metered dose inhaler with a spacer.

Bronchitis Medicines

  • Expectorant

These include preparations of thermopsis, istoda, marshmallow, licorice, coltsfoot. When administered, drugs of this group have a moderate irritant effect on the receptors of the stomach, which reflexively enhances the secretion of the salivary glands and mucous glands of the bronchi. The action of these drugs is short-lived, therefore, frequent doses of small doses (every 2 to 4 hours) are necessary . From expectorants prescribed plentiful alkaline drink, infusions and decoctions of marshmallow, thermopsis – up to 10 times a day. Expectorants are used both during an exacerbation of the disease, and during remission.   

Resorptive drugs: sodium and potassium iodide, sodium bicarbonate and other salt preparations. They increase bronchial secretion, cause thinning of the bronchial secretion and thereby facilitate expectoration.

  • Mucolytic drugs

Ambrobene (Ambroxol). 30 mg tablets 20 pieces per pack. Retard capsules 75 mg in 10 and 20 pieces per pack. 40 and 100 ml oral solution in vials. Syrup 100 ml in vials. The usual daily dose of the drug in tablets is 60 mg. Take 1 tablet 2 to 3 times a day with food, washed down with a small amount of liquid. Extended-action capsules (retard capsules) are prescribed 1 in the morning. The solution for the first 2 to 3 days is prescribed 4 ml 3 times a day, and then 2 ml 3 times a day. The drug in the form of syrup is recommended for adults in the first 2 to 3 days, 10 ml 3 times a day, and then 5 ml 3 times a day.    

“Bromhexine.” Tablets and tablets of 8, 12, 16 mg. Potion in a bottle. Syrup. Solution for oral administration. Adults are prescribed 8-16 mg 4 times a day. 

Bisolvon. 8 mg tablets 100 pieces per pack. Solution for oral administration. Elixir. Assign 8 to 16 mg 4 times a day. 

“Lazolvan.” 30 mg tablets of 50 pieces per pack. 100 ml syrup in vials. Assign 30 mg 2 to 3 times a day. 

  • Combination drugs

“Dr. IOM, broncholithin, bronchicum, etc.

  • Bronchodilators

“Atrovent”, “Troventol”, “Truvent”.

  • Other remedies recommended in the treatment of chronic obstructive bronchitis

Short-acting inhaled B-2 agonists

This group of drugs also has a bronchodilating effect. These drugs for chronic obstructive bronchitis are less effective than anticholinergics. The drugs of this group are recommended to be used no more than 3-4 times a day or as a prophylaxis before exercise. The combined use of short-acting inhaled beta-2 agonists in patients with chronic obstructive bronchitis is more effective than therapy with bronchodilator drugs of the same group. 

Important! Caution is required in the use of drugs of the betta-2 agonist group for older people, especially in the presence of cardiovascular diseases. 

Side effects of the “B-2-Agonists” drugs: possible trembling of the hands, internal trembling, tension, palpitations, nausea, vomiting.   

The most common drugs in this group are the following:

“Berotek” (fenoterol). Dosage aerosol for inhalation. 300 inhalation doses of 200 mcg.

“Berotek-100” (fenoterol). (Beringer Ingelheim, Germany). A metered aerosol containing a lower dose of the drug is 100 mcg. 

Salbutamol Dosed aerosol of 100 μg in a single dose.

“Ventolin” (salbutamol). Aerosol inhaler 100 mcg in a single dose.

There is a drug that is a combination of drugs of these two groups.

“Berodual” (20 mcg ipratropium bromide + 50 mcg phenoterol). Two bronchodilator preparations contained in berodual have in combination a stronger effect than each of them individually. If the combined treatment with inhaled anticholinergics and short-acting beta-2-agonists is ineffective, the doctor may recommend another group of drugs.

  • Methylxanthines group

The main representative of the methylxanthines is theophylline. It has a weaker bronchodilator effect compared with inhaled anticholinergics and beta-2 agonists.

However, in addition to bronchodilating action, drugs of this group have a number of other properties:

– prevent or reduce fatigue of the respiratory muscles;
– activate the motor ability of the ciliary epithelium;
– stimulate breathing.

Side effects of the drugs of the methylxanthines group: irritation of the gastric mucosa, pain in the epigastric region, nausea, vomiting, diarrhea, agitation, insomnia, anxiety, headache, trembling, palpitations, arrhythmias, decreased blood pressure.     

  • Theophylline group

Of the drugs of the theophylline group, its extended forms are of most interest. There are a large number of drugs on offer in this group. They are prescribed by a doctor. The dose and treatment regimen depend on the severity of the disease and some other individual factors.

1st generation drugs (taken 2 times a day):

Theotard. Retard capsules of 0.1, 0.2, 0.3 g. 20, 60 and 100 pieces per pack.

Theopec. Tablets of 0.3 g. 50 pieces per pack.

“Retafil.” Tablets of 0.2 and 0.3 g. 100 pieces per pack.

“Slow philin.” Tablets of 0.1 and 0.2 g. 100 pieces per pack.

“Durofillin.” Capsules of 0.125 and 0.25 g. 40 pieces per pack.

2nd generation drugs (taken once a day).

“Eufilong.” Retard capsules of 0.375 and 0.25 g. 20, 50, 100 pieces per pack.

  • Glucocorticosteroid group

Another group of drugs that can be advised to be taken as basic therapy are glucocorticosteroids. In chronic obstructive bronchitis, they are prescribed in cases where airway obstruction remains severe and causes disability despite smoking cessation and optimal bronchodilator therapy. The doctor usually prescribes these drugs in tablet form against the background of ongoing therapy with bronchodilators. The most common of this group is the drug – Prednisolone. 

  • In conclusion, about medications for the treatment of bronchitis …

All of the above drugs belong to the means of basic therapy, that is, when prescribed, they should be taken regularly for a long time. Only in this case can we count on the success of therapy. We want to emphasize once again the need to stop smoking as one of the factors that significantly aggravate the condition and accelerate the progression of the disease.

In chronic bronchitis, methods are used to increase the nonspecific resistance of the body. For this purpose, adaptogens are used:

– Eleutherococcus extract 40 drops 3 times a day; – tincture of ginseng 30 drops 3 times a day; – tincture of aralia; – tincture of Rhodiola rosea; – tincture of pantocrine in the same doses; – saparal at 0.05 g 3 times a day.  

The action of these drugs is multifaceted: they positively affect the functioning of the immune system, metabolic processes, increase the body’s resistance to adverse environmental influences and the effects of infectious factors.

Folk remedies against bronchitis

Folk remedies for the treatment of acute bronchitis

Gogol-Mughal. Beat egg yolks with sugar and rum. Take on an empty stomach. 

Slices of radish. Thinly cut 8 pieces of radish, sprinkle with sugar. After 6 – 8 hours, juice will appear, which must be consumed in a teaspoon every hour. Cough passes for 3-4 days. 

Marigold flowers. 2 tablespoons of calendula flowers, pour a glass of boiling water and hold in a water bath for 15 minutes. Take 1-2 tablespoons 3 times a day 15 minutes before meals.   

Folk remedies for the treatment of chronic bronchitis

Orange syrup. Rinse 1-2 fresh oranges in water, cut into small pieces, place in a jar and sprinkle with malt sugar so that the oranges let juice. Add 1 cup of water and simmer for about 1 hour until a thick syrup is formed. Take 1 tablespoon daily every morning and evening after meals. syrup. 

Decoction of tangerine peels take 2 to 3 tbsp. l 3 times a day before meals.  

Blackcurrant juice with honey. Squeeze the juice of blackcurrant, dissolve honey in it to taste and drink ½ cup 3 times a day with a strong cough.   

Radish and carrot juice with honey. Mix in a glass of 100 ml of radish juice, carrots and 1 tablespoon of honey. Stir until honey dissolves. Take 1 tablespoon every hour. 

Apricot kernel decoction. When eating apricots, do not throw away the seeds, as they are a good remedy for chronic bronchitis. Remove the kernels from them, pour 20 g of them in an enamel bowl with a glass of boiling water, bring to a boil and boil for 5 minutes over low heat. Remove from the stove, after 2 hours strain and drink ¼ cup broth 3-4 times a day, and eat the nucleoli themselves. 

Garlic. Boil 1 head of garlic and 10 finely chopped onions in milk until soft. Add 1 tsp. peppermint juice and 1 tbsp. l honey. Take every hour during the day 1 tbsp. l 

Balm. Grind 500 g of onions, add 400 g of sugar, 50 g of honey, 1 l of water, mix and cook for 3 hours over low heat. Cool, strain and pour into a bottle. Take balm for 1 tablespoon 4-6 times a day. Keep refrigerated. 

Honey with olive oil. Mix honey and warm olive oil in equal proportions. Give to young children with cough 1 teaspoon 3-4 times a day. The drug is also effective in the treatment of whooping cough. 

Radish and carrot juice with honey. Mix in a glass 100 ml of radish juice, carrots and 1 tablespoon of honey; stir until honey dissolves. Take 1 tablespoon every hour. 

Honey with plantain juice. Mix 500 g of honey with 0.5 l of plantain juice and cook over low heat for 20 minutes. After cooling, the mixture is ready for use. In the form of heat, take 1 tablespoon in 20-30 minutes. 3 times a day before meals as an expectorant and emollient in acute, chronic bronchitis and whooping cough. They also take it at the indicated dose – for diseases of the stomach.   

Black radish with honey. Wash a large black radish, cut off the upper part and make a deepening so that it contains 2 tablespoons of liquid honey. Put the radish in an upright position in a bowl, cover with thick paper and leave for 3-4 hours. Take the resulting mixture of radish juice with honey when coughing for adults, 1 tablespoon, and for children 1 teaspoon 3-4 times a day for 20-30 minutes before meals (the last dose is preferable before bedtime). 

Decoction of elecampane root of 20 g per 200 ml of water, taken 1 – 2 tbsp. l 6 times a day.   

Infusion of coltsfoot with honey. A tablespoon of dried powdered leaves of coltsfoot pour a glass of boiling water in a small enamel pan, close the lid and let stand 15 minutes. in a boiling water bath. Then leave the infusion to cool at room temperature for 30-60 minutes. and strain. Drink 1/3 cup 2-3 times a day as an emollient, expectorant, anti-inflammatory, antimicrobial and diaphoretic with laryngitis, tracheitis, acute and chronic bronchitis, bronchiectasis, pneumonia, and flu.    

A decoction of leaves of coltsfoot from 10 g per 200 ml of water, is taken 1 tbsp. l in 2-3 hours. 

Guelder-rose with honey. Rinse 100 g of viburnum berries , pour 200 g of honey and cook over low heat for 5 minutes. Cool at room temperature. Take 2 tablespoons of the mixture, washed down with warm water, 4-5 times a day as an expectorant, anti-inflammatory and soothing cough for tracheitis, bronchitis, etc.  

Althea root in the form of infusion of 8 g per 200 ml of water, 1 – 2 tbsp. l 5 – 6 times a day. Included in the breast collection No. 1 (marshmallow root, coltsfoot, oregano grass). 1 tbsp. l collection pour 1 cup boiling water, insist for 30 minutes, take ¼ cup 6 times a day.   

Onions with honey. Grind 500 g of peeled onions, add 50 g of honey, 40 g of sugar and cook over low heat in 1 liter of water for 3 hours. Let cool, pour into dark glass bottles, cork and refrigerate. Take the mixture in a warm form, 1 tablespoon 4-6 times a day with severe cough, acute and chronic bronchitis. 

Infusion of thermopsis herb from 0.6 – 1 g per 200 ml of water, taken 1 tbsp. l after 2 hours 6 times a day.  

A decoction of the root of the source of 20 g per 200 ml of water is taken 1 tbsp. l 5 – 6 times a day.  

Infusion of the root of cyanosis from 6 – 8 g per 200 ml of water, taken 3 – 5 tbsp. l per day after meals.   

Licorice root is used as an infusion of 6 g per 200 ml of water, 1 tbsp. l 6 times a day. Included in the breast collection No. 2 (1 tbsp. L. Is brewed per 1 cup of boiling water, infused for 30 minutes, приним cup is taken 4 times a day). It is part of the breast elixir. 

Infusion of plantain leaves from 10 g to 200 ml of water, taken in 2 tbsp. l 6 times a day. 

The infusion of Ipecac herb from 0.6 g per 200 ml of water, taken 1 tbsp. l every 2 hours 6 times a day. 

Aerosol inhalations of 30-50% aqueous solution of honey. At home, for inhalation, it is better to use a kettle, drenched in water at ¼-1/5 part. Bring the water to a boil, stop heating and add 1 tablespoon of honey. Inhale vapors through a rubber tube worn on the spout of the kettle. Duration of inhalation is 20 minutes. The procedure is performed 2 times a day. The course of treatment is 20-30 days. 

Additional treatments for bronchitis


Microclimate of salt mines and caves located underground:

– pos. Solotvino in Transcarpathia (Ukraine);
– Soledar, Donetsk region (Ukraine);
– Berezniki city, Perm region (Russia);
– Belaya cave in Tskhaltubo (Georgia).

Staying in these and similar salt caves positively affects the condition of patients. The effect of speleotherapy is associated with the special purity of the air in salt caves, the absence of bacteria, allergens, and industrial pollution in it. In this case, asthma attacks are reduced or disappearing, immunity indicators are normalized, sputum discharge is facilitated.

Recommended spa treatment (Kislovodsk, Crimea).

Hardening procedures, respiratory gymnastics, as well as some methods of physiotherapy are useful: vibration massage of the chest, electrophoresis of ascorbic acid , etc.  

Systematic anti-relapse treatment can significantly reduce the number of exacerbations. In the treatment of chronic obstructive bronchitis, an important place is occupied by the training of respiratory muscles – therapeutic respiratory gymnastics. There are various exercises offered by patients with chronic obstructive bronchitis. They are aimed at treating fatigue and tension of the respiratory muscles, including the diaphragm. There are also special exercises aimed at improving sputum discharge. These are the so-called drainage exercises. With prolonged airway obstruction, increased tension in all respiratory muscles becomes chronic. The treatment of fatigue of the respiratory muscles, including the diaphragm, is important along with the use of medications for the treatment of chronic bronchitis. Various workouts are widely used to ensure normal muscle function. 

Physiotherapy exercises aimed at decreasing muscle tone and improving bronchial patency give the best effect for bronchial obstruction.

Breathing exercises

The simplest, but very important exercise is breathing training by creating positive pressure at the end of exhalation. To carry out these exercises is simple. You can use non-corrugated hoses of various lengths through which the patient breathes, and create a water shutter installation (a can filled with water). After a deep enough breath, exhale as slowly as possible through a hose into a jar filled with water.

To improve the drainage function, special drainage positions and exercises with forced extended expiration are used.

Positional (postural) drainage is the use of a certain body position for better discharge of sputum. Positional drainage is performed in patients with chronic bronchitis (especially with purulent forms) with a decrease in the cough reflex or too viscous sputum. It is also recommended after endotracheal infusions or the introduction of expectorants in the form of an aerosol. 

It is performed 2 times a day (morning and evening, but it can be more often) after preliminary administration of bronchodilator and expectorant drugs (usually infusion of thermopsis, coltsfoot, rosemary, plantain), as well as hot linden tea. In 20-30 minutes after this, the patient alternately takes up positions that contribute to the maximum emptying of certain segments of the lungs from sputum under the action of gravity and the “draining” of sputum to cough reflexogenic zones. 

In each position, the patient initially performs 4 to 5 deep slow respiratory movements, inhaling air through his nose, and exhaling through his compressed lips. Then, after a slow deep breath, he produces a 3–4-fold shallow cough 4–5 times. A good result is achieved by combining drainage positions with various methods of chest vibration above the drained segments or compressing it with your hands on the exhale, with a massage done quite energetically.   

Postural drainage is contraindicated in hemoptysis, pneumothorax and the occurrence of significant shortness of breath or an asthma attack during the procedure.


Massage is part of the complex therapy of chronic bronchitis. It promotes sputum discharge, has a bronchodilator effect. Used classic, segmented and acupressure.

The latter type of massage can cause a significant bronchodilator effect. The following techniques of acupressure are most accessible to a layman: light touch and stroking, light pressure with a finger and deep pressure. The finger pressure during acupressure should be strictly vertical, without displacement. The movement of the finger should be rotational or vibrating, but always non-stop. The stronger the impact on the point, the shorter it should be.

Most of the points used are processed with the thumb. Acupressure is recommended for no more than 10 minutes. During pressing, a person should not experience unpleasant sensations. In chronic bronchitis, the massage of the following points is used:

“Hagu” – one of the most popular points, known in acupressure as the “point of a hundred diseases.” Located in the fork between the thumb and forefinger on the back of the hand at the top of the muscle tubercle; 

“Dazhui” – in the recess under the spinous process of the seventh cervical vertebra; 

“Tiantu” – in the center of the recess above the middle of the jugular notch; 

Massage can be completed by kneading the terminal phalanges of the thumbs on the hands.

Important! Acupressure is contraindicated in any tumors, acute febrile conditions, peptic ulcer of the stomach and duodenum, blood diseases, active forms of tuberculosis, pregnancy.      

Can massage

Cupping massage helps sputum discharge when coughing. A 200 ml jar is applied to the skin lubricated with petroleum jelly. A suction jar makes sliding massage movements from the lower back to the cervical spine. Duration 5 – 15 minutes. Then the patient is wrapped in a blanket, give him a glass of tea with lemon or raspberry. This procedure is carried out every other day.   


Physiotherapy is used in patients with chronic bronchitis in order to suppress the inflammatory process, improve the drainage function of the bronchi.

Physiotherapeutic procedures recommended for exacerbation of chronic bronchitis:

1. UHF currents – for 10 – 12 minutes to the area of ​​the roots of the lungs every other day in an oligothermic dosage. 2. Microwave therapy (decimeter waves with the Volna-2 apparatus) – to the area of ​​the roots of the lungs daily or every other day, 10-15 procedures (improves bronchial patency). 3. Inductothermia or short-wave diathermy on the interscapular region for 15 – 25 minutes, daily or every other day (a total of 10 – 15 procedures).  

With a plentiful amount of sputum – UHF alternating with electrophoresis of calcium chloride on the chest, with a dry cough – electrophoresis of potassium iodide.  

4. Electrophoresis with heparin on the chest.
5. With a subsiding exacerbation of chronic bronchitis, you can use applications of mud, ozokerite, paraffin on the chest, UFO in the warm season in a phase close to remission; coniferous, oxygen baths.

Inhalation aerosol therapy

In chronic bronchitis, inhalation aerosol therapy is prescribed. This treatment method is carried out with the help of individual (home) inhalers (AIIP-1, “Fog”, “Monsoon”, “Heyseo-6”, etc.) or in hospital and sanatorium inhalations.

Expectorant combination

Combinations of several expectorants are used, for example, first diluting sputum (acetylcysteine, mystabron), and then stimulating its coughing up (hypertonic solutions of potassium and sodium iodide, sodium bicarbonate, mixtures thereof). The duration of one course of treatment is 2-3 months. Inhalations are prescribed 2 times a day.

1. Bronchodilator mixture with adrenaline:

a) A solution of adrenaline 0.1% – 2 ml, a solution of atropine 0.1% – 2 ml, a solution of diphenhydramine 0.1% – 2 ml. 20 drops per 10-20 ml of water. b) 2.4% aminophylline solution – 1 ml, 0.1% adrenaline solution – 1 ml, diphenhydramine solution 1.0% – 1 ml, sodium chloride solution 0.9% – up to 20 ml 20 ml per 1 inhalation.   

2. Alkaline expectorant mixture:

a) Sodium bicarbonate – 2 g, sodium tetraborate – 1 g, sodium chloride – 1 g, distilled water – up to 100 ml. 10 – 20 ml per 1 inhalation. b) Sodium bicarbonate – 4 g, potassium iodide – 3 g, distilled water – up to 150 ml. 10 – 20 ml per 1 inhalation.     


Collection number 1. The dominant property of the collection is antiseptic. 

Plantain leaves – 1 part; Licorice root – 1 part; Sage leaves – 1 part; Buds of pine – 1 part; Black elderberry flowers – 1 part. 

From collection No. 1, an infusion or decoction is prepared. For this, 1.5 – 2 tbsp. l the collection is placed in an enameled dish, pour 200 ml of boiling water, cover with a lid and insist for 15 minutes (wrapped) or put on a boiling water bath for 30 minutes with frequent stirring, then filter, the residue is squeezed out, the resulting extract is brought with boiled water to 200 ml . Take 1 tbsp. l after 1.5 – 2 hours, that is, 8 – 10 times a day.   

Collection number 2. The dominant property of the collection is bronchodilating.  

Leaves of coltsfoot – 1 part; Oregano grass – 1 part; Licorice root – 2 parts; Ledum grass – 2 parts. 

It is mainly used for obstructive chronic bronchitis; it is prepared as collection No. 1.

Collection number 3. Anti-inflammatory and expectorant effect. Elecampane root – 1 part; Althea root – 2 parts; Oregano grass – 1 part; Buds of birch – 1 part; 

Collection No. 3 is used in patients with a mild exacerbation of chronic bronchitis and in the absence of exacerbation (as a predominantly expectorant). Preparing, as well as collection number 1.

Collection number 4. For each patient, the collection must be selected individually. If the patient has a strong cough and bronchospasm, then celandine grass, thyme grass , mint, valerian root, oregano are added to the collection . With a strong annoying cough with hemoptysis in the collection, the amount of mucus-forming raw materials increases (marshmallow root, mullein flowers, coltsfoot leaves).     

Althea root – 2 parts; Leaves of coltsfoot – 1.5 parts; plantain leaves – 2 parts; Pharmacy chamomile flowers – 2.5 parts; Licorice root – 1.5 parts; Sushnitsa grass – 2 parts; The roots of the spring primrose – 2 parts; Buds of pine – 1 part; Leaves and fruits of black currant – 5 parts; Oat seeds – 5 parts. 

2 tbsp. l collection number 4 pour 500 ml of boiling water, leave for about an hour, drink during the day.

Collection number 5

Ledum grass – 10 g; Leaves of coltsfoot – 10 g; Plantain leaves – 10 g; Pharmaceutical chamomile flowers – 10 g; Licorice root – 10 g; Tricolor violet grass – 10 g; Calendula flowers – 10 g; Elecampane root – 10 g; Anise fruits – 10 g. 

2 tbsp. l collection number 5 put in an enamel bowl, pour 200 ml of water, close the lid, bring to a boil in a water bath, boil for 15 minutes, cool for 45 minutes at room temperature. Squeeze out the remaining raw materials. The volume of the resulting infusion is brought to 200 ml with boiled water. Take ¼ cup 4 times a day (mainly with chronic obstructive bronchitis).

Collection number 6

Licorice root – 15 g; Cyanosis root – 15 g; Pharmaceutical chamomile flowers – 20 g; Valerian root – 10 g; Motherwort herb – 10 g; Peppermint herb – 10 g; St. John’s wort grass – 10 g. Cook, as collection No. 5. Take ¼ cup 4 – 5 times a day after meals (mainly with chronic obstructive bronchitis). 

Collection number 7

Leaves of coltsfoot – 20 g; Pharmaceutical chamomile flowers – 20 g; Oregano herb – 10 g. 2 tbsp. l collection pour 500 ml of boiling water, insist for 6 hours, drink ½ cup 4 times a day before meals in a warm form. Brew better in a thermos. 

Collection number 8

Leaves of a plantain – 20 g; St. John’s wort grass – 20 g; Linden flowers – 20 g. Cook as collection No. 7. Take ½ cup 4 times a day. 

Collection number 9

Elecampane root – 30 g; Marigold flowers – 30 g; Plantain leaves – 50 g; Thyme herb – 50 g; Leaves of coltsfoot – 50 g. 2 tbsp. l collection number 9 brew 200 ml of water, insist for 40 minutes. Take ¼ cup 4 times a day. 

Collection number 10. The collection has an expectorant and soothing painful cough effect. 

60 g (3 tbsp.) Of chopped flaxseed is poured into 1 liter of hot water, shaken for 10 minutes, filtered. To the resulting liquid add 50 g of licorice root, 30 g of anise fruits, 400 g of honey and mix thoroughly. The mixture is brought to a boil, insisted to cool, filtered and taken in ½ cup 4 – 5 times a day before meals. Not recommended for honey intolerance. 

Collection number 11. The collection has an expectorant and antioxidant effect. 

Alder cones – 50 g; Tricolor violet grass – 50 g; Grass series – 50 g; Grass of the mountaineer of the stingy – 50 g; Black elderberry flowers – 50 g; Hawthorn fruits – 50 g; Helichrysum flowers – 50 g; Blackcurrant leaves – 50 g; Plantain Leaves – 50 g. 

Mix 10 g of the mixture, pour 300 ml of boiling water, heat in a water bath for 15 minutes, insist 45 minutes, squeeze. Take 100 ml 3 times a day 15 minutes before meals.

Bronchitis prophylaxis

First of all, in order for bronchitis to no longer recur, it is necessary to immediately stop smoking by a patient with bronchitis. If the work of a patient with bronchitis includes unhealthy factors, then they must either be eliminated or employment of a patient with bronchitis should be undertaken. Moreover, the new work should exclude such risk factors for bronchitis as the presence of numerous dust in the air, temperature extremes, and severe air pollution.

When a patient with bronchitis comes in remission, it is quite possible for a doctor to prescribe a course of treatment and prevention with various tonic and strengthening the whole body means. These include, for example, tincture of ginseng, Methyluracil, Pyrogenal, Prodigiosan, some vitamins from groups A, B, K and minerals. Also, physiotherapy procedures may be indicated to a patient with bronchitis.     

In order for the prevention of chronic bronchitis to be effective, it is necessary in case of acute or not very inflammation of the respiratory throat and lungs to try to cure such diseases as quickly and correctly as possible. Special attention should also be paid to childhood diseases such as whooping cough and measles. Timely cleansing of the nasopharynx from sputum is also important in the prevention of bronchitis. Of course, if a person goes in for sports or just physical education, he is much less likely to get bronchitis.   

For the prevention of bronchitis, it is also necessary to timely detect and eliminate various diseases of the ear, throat and nose. For example, rhinitis (runny nose), sinusitis, tonsillitis, polyps, adenoids and other diseases that are not cured in time, increase the risk of getting bronchitis, because, firstly, they represent a source of infection in the body, and secondly, increase its sensitivity to future diseases, for example, to bronchitis.     

It is necessary to remove polyps (if any), to treat the curvature of the nasal septum to improve breathing.

The prevention of chronic bronchitis is also successfully carried out by staying in sanatoriums. Of course, warm sea edges are the best way to prevent bronchitis, and resorts with mountain or steppe landscapes are also a good option. When you choose the place for the prevention of bronchitis where you will rest, it should be borne in mind that a sharp change in air temperature during rest can, on the contrary, cause an attack of acute bronchitis.

Significant in the prevention of chronic bronchitis are constant breathing exercises, hardening procedures (preferably with the participation of water, for example, a cool shower every day or rubbing), physical education in general and physical therapy in particular. If a person is sick with chronic bronchitis, then he should always be in the field of vision of a local clinic.

Risk Factors in the Development of Bronchitis

The risk of developing acute bronchitis or becoming chronic increases several times if you smoke or passively inhale tobacco smoke. This is especially true for children whose parents smoke. In this case, in addition to bronchitis, children have an increased risk of ARVI, bronchial asthma and pneumonia. In cases where your immune system is weakened by an acute or chronic disease, the risk of developing bronchitis also increases.   

If you work in places with a high content of dust in the air, such as cotton, as well as chemicals, acids, alkalis, peroxides, the risk of developing bronchopulmonary diseases increases.

Bronchitis in children
Bronchitis in children most often develops as a complication of rhinopharyngitis, tracheitis, laryngitis, and also as a symptom of acute respiratory viral infection. A prolonged or repeated disease process often occurs in young children. There are frequent cases when bronchitis can be asthmatic. Of great importance in the occurrence of inflammatory processes in the bronchi is the general state of the child’s health, immunity.

Symptoms of bronchitis in children

The disease develops in children slowly. The onset of the disease can be inflammation of the upper respiratory tract. The child begins weakness, fever. Then a cough appears – first dry, then with profuse sputum. Young children are unable to cough up and swallow mucus, which may cause vomiting. In the case of the inflammatory process in the small bronchi, the condition of the child worsens, shortness of breath appears. As a rule, acute bronchitis lasts from seven to fourteen days.

Treatment of bronchitis in children

Treatment for acute bronchitis in most cases is symptomatic.

– Bed rest until normalization of body temperature.

– Dairy and vegetable, vitamin-enriched diet.

– Drink plenty of tea (tea, fruit drink, broth of wild rose, alkaline mineral water, hot milk with Borjomi in a ratio of 1: 1). 

– Restoration of nasal breathing. Various vasoconstrictor drugs are used: Oxymetazoline, Tetrizolin (tizin), Xylometazoline, including combined ones (with antihistamines, glucocorticoids). The use of drops, especially vasoconstrictors, should not be long, as it can lead to atrophy or, conversely, hypertrophy of the mucous membrane.

– Antipyretic drugs in an age-related dosage with an increase in body temperature above 38.5 – 39.0 ° C. The drug of choice is Paracetamol. A single dose of paracetamol is 10-15 mg / kg orally, 10-20 mg / kg in suppositories. Amidopyrine, antipyrine, phenacetin are excluded from the list of antipyretic drugs used. Due to possible side effects, it is not recommended to use acetylsalicylic acid (aspirin) and metamizole sodium (“Analgin”).  

– Antitussive drugs: “Butamirat” (synecode), “Glaucin”, “Prenoxdiazine” (libexin) are used only in case of dry, obsessive cough. Hypersecretion of mucus and bronchospasm are contraindications to the appointment of antitussive drugs. 

– Expectorant (preparations of thermopsis, marshmallow, licorice, essential oils, terpinghydrate, sodium and potassium iodides, sodium bicarbonate, saline solutions) and mucolytic (“Cysteine”, “Acetylcysteine”, “Chymotrypsin”, “Bromhexin”, “Ambroxol”) shown for all clinical variants of the course of bronchitis. Sputum evacuation agents are usually prescribed orally or by inhalation using a nebulizer or aerosol inhaler. Currently, there are a large number of effective combined drugs that have a multidirectional effect: muco- and secretolytic, expectorant, anti-inflammatory, reducing swelling of the mucous membrane (Bronchicum, etc.).

– Bronchodilators are used for clinical signs of bronchial obstruction in the form of inhalation (via a nebulizer, with the help of spacers), inside, less often rectally. Ss-adrenergic agonists, anticholinergics have a bronchodilator effect: ipratropium bromide (Atrovent), ipratropium bromide + phenoterol (Berodual) and methylxanthines (theophylline preparations, including prolonged ones). They use Salbutamol, Fenoterol, Clenbuterol, Salmeterol (Serevent), Formoterol (Oxis turbuhaler, Foradil). Fenspiride (Erespal) is also prescribed, which has a bronchodilating, anti-inflammatory effect, reduces bronchial reactivity, reduces mucus secretion, and normalizes mucociliary clearance.

– The rehydration of the respiratory tract is carried out with moistened aerosols, steam inhalations with alkaline solutions, including mineral ones, to which, in the absence of allergic reactions , essential oils can be added.  

– Drainage and sputum removal using therapeutic exercises, vibration massage, postural drainage.

– They also fight dehydration, acidosis, heart failure, and prescribe vitamins. 

Antibacterial and antiviral therapy is prescribed only for strict indications:

– febrile fever for 3 days or more;

– An increase in signs of infectious toxicosis and respiratory failure;

– pronounced asymmetry of physical data;

– inflammatory changes in the analysis of peripheral blood (neutrophilic leukocytosis, increased ESR).

Prevention of bronchitis in children

Preventive measures of bronchitis in children include hardening of the body, summer trips to the sea, balanced nutrition, walks in the fresh air, observing the daily regimen. If the child is sick often, vitamins and adaptogenic drugs are recommended. When a chronic disease of the nasopharynx is the cause of frequent diseases of bronchitis, it is imperative to reorganize the foci of infection in the summer. In addition, weakened children are recommended breathing exercises and a set of exercises to strengthen the shoulder girdle.

Important! In all cases, for the diagnosis, treatment and prevention of bronchitis in children, you need to contact your doctor, and in no case do self-medication. 

Bronchitis in pregnant women
Bronchitis, like any other disease in pregnancy should be treated with extreme caution, because with a standard approach, you can harm not only yourself, but also to your child. Therefore, in case of any health abnormalities, immediately contact your doctor! Thank you !!!

Symptoms of bronchitis during pregnancy

Bronchitis begins just like a cold. A slight increase in body temperature occurs (usually up to 38 ° C, but in some cases the temperature can remain normal), weakness, malaise, fatigue, cough – first dry, then with a small amount of mucous or mucopurulent sputum. On the 2-3rd day, sore sensations appear behind the sternum. If the above symptoms appear, the expectant mother should consult a doctor to prescribe treatment. This is very important, since changes in the body that are natural for pregnancy, such as swelling of the bronchial mucosa (this is due to the hormonal background), high standing and low mobility of the diaphragm (it is pushed up by the pregnant uterus), make it difficult to discharge the formed sputum. Sputum in the bronchi can support inflammation for a month or more. It is harmful to both the mother and the fetus.  

If the disease lasts no more than 2 weeks, then we are talking about acute, and if up to 1 month or more – about a protracted course of bronchitis. Usually acute bronchitis does not adversely affect either the fetus or the course of pregnancy. However, protracted bronchitis in rare cases can lead to intrauterine infection of the child. Therefore, the treatment of bronchitis must begin from the very first days. 

Diagnosis of bronchitis during pregnancy

Diagnosis of bronchitis is based on the identification of characteristic complaints from examination and laboratory examination data. A radiographic examination is prescribed to pregnant women only if the doctor has doubts about the diagnosis, the disease has acquired a protracted course, or complications have arisen.

Treatment of bronchitis during pregnancy

The main drugs in the treatment of acute bronchitis are antibiotics. But for pregnant women, they are still undesirable, especially in the first trimester of pregnancy. Usually, doctors try to do without antibacterial drugs and use them only in extreme cases, if there is a threat of pneumonia – pneumonia, intrauterine infection of the fetus or in severe protracted bronchitis. 

In the case when it is not possible to avoid taking antibiotics, penicillin preparations are prescribed: Ampicillin, Amoxicillin, Flemoxin solutab. These drugs are approved for use during pregnancy, do not harm the fetus.

From the second trimester of pregnancy, the use of antibiotics from the group of cephalosporins is possible . 

For the treatment of acute infectious processes in the respiratory tract, the bioparox inhalation antibiotic (fusafungin) is also intended. This drug has an exclusively local effect and does not have a systemic effect, that is, it acts only in the respiratory tract, not penetrating the placenta, which is important for a pregnant woman. A feature of Bioparox is a combination of antibacterial and anti-inflammatory activity. Bioparox is taken every 4 hours for 4 inhalations in the mouth and / or 4 in each nasal passage.

Without antibacterial drugs, the treatment of acute bronchitis is to relieve intoxication and restore impaired bronchial function.

Other treatments for bronchitis in pregnancy

Cough Relievers

1. Frequent warm drink:
– hot tea with honey and lemon; – lime tea. 

2. Expectorant drugs that enhance secretion of sputum (with dry cough):
– essential oils of camphor, thyme, thyme (inhalation);
– mixture of thermopsis (used at any time);
– potion from Ipecac Root – irritates the gastric mucosa, is not used for early toxicosis; “Sinupret.” 

3. Mucolytics – sputum thinning (with viscous, difficult to discharge sputum): – “Bromhexine” – a single dose of 50 mg, daily 200 mg; – “Ambroxol” – a single dose of 16 mg, daily 64 mg; – “Mukaltin” – a single dose of 30 mg, daily 90 mg; – “Chymotrypsin” (solution for inhalation) – a single dose of 10 mg, daily 20 mg; 

The effect is achieved with a sufficient single and daily dose of drugs, with underestimated effectiveness decreases sharply.

4. Antitussive drugs – with a constant excruciating cough: – mucous broth of the root of the marshmallow, or the drug “Altheika”; “Tonsilgon.” 

5. Relieving bronchospasm (asthmatic component of cough, wheezing, difficulty exhaling):
– “Zufillin” – pills and inhalations. 

6. Physical warming – local: – mustard plasters; – banks. 

It is strictly forbidden!

During pregnancy, it is forbidden to take the following antibiotics:

– “Levomycetin” (chloramphenicol);
– “Aspirin”;
– Preparations of a tetracycline series;
– Fluoroquinolones;
– “Streptomycin;
– “Biseptolum”;
– Sodium iodide and potassium iodide;
– Sulfanilamides.

These drugs have a damaging effect on the fetus.

Expectant mothers should not use such antitussive drugs as: Codeine, Ethylmorphine hydrochloride, because these substances can pass through the placenta and inhibit the baby’s respiratory center.

When to see a doctor

Medical help should be sought in the following conditions:
– Severe, constricting chest pain, which gradually intensifies.
– Attacks of suffocation.
– Cough with profuse spotting.

Call your doctor in the following cases:

– Shortness of breath, even at rest.
– You notice new or amplified whistling sounds during breathing (whistling breathing), hoarseness, or suffocation experienced during rest.
– When coughing from the lungs, sputum of yellow or green color is often released (not after drainage of the nasopharynx). The condition lasts more than 2 days at high temperature.
– Cough up spotting.
– You begin to experience symptoms of acute bronchitis and still suffer from a chronic lung disease such as asthma or chronic obstructive pulmonary disease (COPD).

Contact your doctor within 1 – 2 days if you:

– You notice increased shortness of breath with any physical activity.
– You cough and often feel nauseous.
– Have a cough that lasts more than 4 weeks.
– Take a course of treatment for acute bronchitis, and after 14 days of treatment your condition has not improved.

event_note June 14, 2020

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