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Asthmatic bronchitis is an allergic disease that affects the respiratory organs with predominant localization in the medium and large bronchi. The disease has an infectious-allergic nature, characterized by increased secretion of mucus, swelling of the bronchial walls and their spasm.
It is incorrect to associate asthmatic bronchitis with bronchial asthma. The main difference between bronchitis is that the patient will not suffer from asthma attacks, as with asthma. However, the danger of this condition should not be downplayed, as leading pulmonologists consider asthmatic bronchitis as a disease that precedes asthma.
According to statistics, children of preschool and early school age are more susceptible to asthmatic bronchitis. This is especially true for those patients with a history of allergic diseases. It can be rhinitis, diathesis, neurodermatitis of an allergic nature.
Causes of Asthmatic Bronchitis
The causes of asthmatic bronchitis are diverse, the disease can provoke both infectious agents and non-infectious allergens. Infection with viruses, bacteria and fungi can be considered as infectious factors, and various allergens to which a particular person has sensitivity can be considered as non-infectious factors.
There are two large groups of causes of asthmatic bronchitis:
Infectious etiology of the disease:
Most often, staphylococcus aureus becomes the cause of the development of bronchial pathology in this case. Similar conclusions were made on the basis of the frequency of its inoculation from the secretion separated by the trachea and bronchi.
It is possible to develop the disease against the background of a respiratory viral infection, as a result of the flu, measles, whooping cough, pneumonia, after tracheitis, bronchitis or laryngitis.
Another reason for the development of asthmatic bronchitis is the presence of a disease such as GERD.
Non-infectious etiology of the disease:
As allergens that irritate the walls of the bronchi, house dust, street pollen, and inhalation of animal hair are more common.
It is possible to develop the disease when eating foods containing preservatives or other potentially dangerous allergens.
In childhood, bronchitis of an asthmatic nature can develop against the background of vaccination if the child has an allergic reaction to it.
There is a possibility of manifestation of the disease due to medication.
The factor of heredity should not be excluded, since it is often traced in the anamnesis of such patients.
Polyvalent sensitization is another risk factor for the development of the disease, when a person has an increased sensitivity to several allergens.
As doctors observing patients with asthmatic bronchitis note, exacerbations of the disease occur both during the flowering season of many plants, namely, in spring and summer, and in winter. The frequency of exacerbations of the disease directly depends on the cause that contributes to the development of pathology, that is, on the leading allergic component.
Symptoms of Asthmatic Bronchitis
The disease is prone to frequent relapses, with periods of calm and exacerbation.
Symptoms of asthmatic bronchitis are:
Paroxysmal cough. They tend to increase after physical exertion, while laughing or crying.
Often, before the patient begins another attack of coughing, he experiences a sudden nasal congestion, which may be accompanied by rhinitis, sore throat, mild malaise.
During an exacerbation of the disease, an increase in body temperature to subfebrile levels is possible. Although often it remains normal.
A day after the onset of the acute period, a dry cough transforms into a wet one.
Difficulty breathing, expiratory dyspnea, noisy wheezing – all these symptoms accompany an acute attack of coughing. At the end of the attack, sputum is separated, after which the patient’s condition stabilizes.
The symptoms of asthmatic bronchitis recur stubbornly.
If the disease is provoked by allergic agents, then the coughing attacks stop after the action of the allergen stops.
The acute period of asthmatic bronchitis can last from several hours to several weeks.
The disease may be accompanied by lethargy, irritability and increased work of the sweat glands.
Often the disease occurs against the background of other pathologies, such as: allergic neurodermatitis, hay fever, diathesis.
The more often a patient has exacerbations of asthmatic bronchitis, the higher the risk of developing bronchial asthma in the future.
Diagnosis of asthmatic bronchitis
Identification and treatment of asthmatic bronchitis is within the competence of an allergist-immunologist and pulmonologist, since this disease is one of the symptoms indicating the presence of a systemic allergy.
During listening, the doctor diagnoses hard breathing, with dry whistling or moist rales, both large and finely bubbling. Percussion over the lungs determines the box tone of the sound.
To further clarify the diagnosis, an x-ray of the lungs will be required.
A blood test is characterized by an increase in the number of eosinophils, immunoglobulins E and A, histamine. At the same time, complement titers are reduced.
In addition, sputum or washings are taken for bacterial culture, which makes it possible to identify a possible infectious agent. To determine the allergen, scarification skin tests and its elimination are performed.
Treatment of asthmatic bronchitis
Treatment of asthmatic bronchitis requires an individual approach to each patient.
Therapy should be complex and long:
The basis of the treatment of asthmatic bronchitis of an allergenic nature is hyposensitization by an identified allergen. This allows you to reduce or completely eliminate the symptoms of the disease due to the correction in the work of the immune system. In the process of treatment, a person is injected with allergen injections with a gradual increase in doses. Thus, the immune system adapts to its constant presence in the body, and it ceases to give a violent reaction to it. The dose is adjusted to the maximum tolerated, and then, for at least 2 years, maintenance therapy is continued with the periodic introduction of the allergen. Specific hyposensitization is an effective method of treatment to prevent the development of bronchial asthma from asthmatic bronchitis.
It is possible to perform non-specific desensitization. For this, patients are given injections of histoglobulin. This method is based on sensitivity to the allergen as such, and not to its specific type.
The disease requires the use of antihistamines.
If a bronchial infection is detected, then antibiotics are indicated, depending on the sensitivity of the detected mycobacterium.
Reception of expectorants is shown.
When the effect of complex therapy is absent, the patient is prescribed a short-term course of glucocorticoids.
Auxiliary therapeutic methods are the use of nebulizer therapy with sodium chloride and alkaline inhalations, physiotherapy (UVR, drug electrophoresis, percussion massage), it is possible to perform exercise therapy, therapeutic swimming.
The prognosis for identified and adequately treated asthmatic bronchitis is most often favorable. However, up to 30% of patients are at risk of transforming the disease into bronchial asthma.
Prevention of asthmatic bronchitis
Preventive measures include:
Elimination of the allergen with the maximum adaptation of the environment and diet to the patient (getting rid of the room from carpets, weekly change of bed linen, exclusion of plants and pets, rejection of allergenic foods);
The passage of hyposensitization (specific and nonspecific);
Elimination of foci of chronic infection;
hardening;
Aeroprocedures, swimming;
Dispensary observation at the allergist and pulmonologist in case of asthmatic bronchitis.