The child is sick with bronchitis. The situation is not uncommon, because this particular respiratory disease is considered one of the most common in children. It has many faces - bronchitis has an extensive classification and a host of different symptoms. There are also plenty of treatment regimens for this ailment, which is why parents often have questions related to the causes of the disease, the approach to treatment and prevention. The well-known children's doctor of the highest category Yevgeny Komarovsky answers them often. We tried to collect in one article the maximum of useful information from this specialist.
About the disease
Bronchitis is an inflammatory process in the bronchi, both in the mucous membrane and in deeper tissues. The disease is more common in children than in adults, and babies from one to 3 years old are most susceptible to the disease. But even in older children, this disease is not at all uncommon. So, according to a study by the Ministry of Health, during a mass examination of children aged 8-10 years, bronchitis was found in 9% of all young patients. Boys are almost 3 times more likely to develop bronchitis than girls.
More than 80% of cases of the disease are caused by viral pathogens. Most often these are respiratory viruses, much less often - bacteria, also mycoplasma and chlamydia. Often, bronchitis becomes a complication of influenza, parainfluenza, measles and whooping cough, as well as a consequence of bacterial lesions by staphylococci, pneumococci and streptococci.
Only 3% of all diseases are associated with exposure to the bronchi of inhaled poisons, toxic compounds, acid vapors and gases. In children with allergies, the reaction to angigen passes into the stage of bronchitis in 10% of cases.
Among children from 3 to 12 years old (according to the World Health Organization) 97% have had bronchitis at least once, about 60% of children have suffered from this ailment several times, about 20% suffer from it in a chronic form.
Kinds
There are several types of ailment, which depend on the origin of the disease:
- Infectious... This type of bronchitis is the most common and is caused by bacteria and viruses.
- Non-infectious... This ailment is caused by allergens, harmful gases, vapors of toxic chemical compounds.
- Mixed (combined). The doctor will make such a diagnosis if it turns out that the causes of bronchitis are multiple (for example, an allergic reaction to something with a recent flu).
- Abnormal (idiopathic). This is bronchitis, the causes of which cannot be established.
In addition, the disease is different in duration, form and manifestation:
- Acute bronchitis. The most common type of disease. Usually caused by viruses or bacteria, it has pronounced symptoms. Often accompanied by bronchospasm.
- Chronical bronchitis. This form of the disease occurs when the acute form of the disease was cured incorrectly or, at all, was not treated. In the chronic course of the disease, the child experiences seizures at least once every three months, the peak of manifestations occurs in autumn and spring, as well as during periods of mass incidence of viral infections. Cough in chronic bronchitis does not respond well to drug therapy.
- Obstructive. This form of bronchitis is fairly well distinguishable. With it, the child has difficulty breathing, when exhaling-inhaling, a characteristic whistle and wheezing in the bronchi is heard, the baby suffers from severe shortness of breath. This disease can be associated with a genetic predisposition, with a severe viral infection, and severe air pollution.
According to the degree of inflammation, bronchitis can also be different:
- Catarrhal.
- Hemorrhagic.
- Combined.
- Purulent.
- Fibrous.
Sometimes bronchitis is deployed not only in the bronchi, but also captures the trachea area, such an ailment is called tracheobronchitis.
According to the severity of the course, the disease is divided into three main forms - mild, moderate and severe.
Doctors' predictions for bronchitis depend on the type and form of the disease. With timely access to a doctor and the correct approach to treatment, acute bronchitis can be completely cured in 99% of cases. Only 40% of chronic and obstructive cases are curable. Allergic bronchitis by itself is not treated until the cause of the reaction is eliminated. It usually goes away on its own after the antigen has been identified and eliminated.
Symptoms
If the exact cause of the disease can be established only with the help of doctors and laboratory techniques, then it is quite simple to suspect bronchitis in a child at home. The symptoms of this disease are quite typical. These include a severe cough, in which a large amount of bronchial secretions (sputum) are released from the child. Less commonly, the cough is unproductive, without phlegm. With a debilitating cough, the child will complain of chest pain. Shortness of breath is often noticeable even after minor physical activities.
In some cases, the child has cyanosis of the skin, pallor, and small blotches of blood may appear in the sputum. Every second baby with bronchitis has an increase in temperature, and all, without exception, have headaches of varying intensity and pronounced general weakness, lethargy, and increased sweating.
Causes
Initially, the bronchi perform an important protective function - to block pathogenic microorganisms and viruses. When the immune defense is weakened, and the number of pathogens is large, more mucus is produced in the bronchi, and if it is difficult to exit, an inflammatory process develops. This is the typical mechanism of bronchitis.
Among the reasons for the development of such an ailment, doctors consider the most common infections, concomitant hypothermia (colds). Bronchitis often develops in children who breathe in too dry, excessively humid or polluted air. Sometimes the disease is provoked by defects and diseases of the nasopharynx (if the nose "does not breathe", if the child had pharyngitis, sinusitis or tracheitis not so long ago).
The opinion of Dr. Komarovsky
Komarovsky does not advise blaming himself for the child's illness, as many parents do, because few people manage to raise a child who has never had bronchitis in his life. So, this is a typical "childish" disease, and moms-dads just need to know more about it.
And now the main issue of Dr. Komarovsky dedicated to childhood bronchitis.
Bronchitis, according to an authoritative doctor, can have three main manifestations - bronchospasm, bronchial edema and excessive mucus production. These processes start some time after the child has breathed in allergens or viruses-bacteria with the air. The above three manifestations interfere with the normal passage of air through the bronchi.
All these processes cannot be seen, the doctor can hear them by listening to the child with a phonendoscope, and only if he hears that the passage of air in the bronchi is impaired, breathing is "hard", wheezing, gurgling, then he will have the first good reasons for diagnosing bronchitis ...
Evgeny Olegovich emphasizes that considering hypothermia as the cause of bronchial inflammation is the main parental mistake, which is caused by insufficient knowledge of mothers and fathers in the field of children's health.
Acute bronchitis, according to Komarovsky, in 99% of cases is a consequence of an acute respiratory viral infection, which infects children by airborne droplets. Influenza A and B viruses cause bronchitis more often than other viruses, because bronchial cells are the most favorable environment for their existence. Therefore, the doctor does not believe that the child's immunity, his state of health, or something else affects the development of the disease. Whether or not there will be bronchitis depends only on the type of virus that has entered the baby's respiratory tract.
The remaining 1% is bacterial bronchitis. It is difficult to distinguish it from the usual, but it is possible. The main thing, says Komarovsky, is to objectively assess the child's condition. If the inflammation of the bronchi is caused by bacteria, he will feel not just bad, but very bad. He will have the highest fever, vomiting, severe intoxication, in the complete absence of a cold. This condition cannot be treated at home in principle, because the child needs to call an ambulance as soon as possible and take him to the hospital.
The most insidious Evgeny Komarovsky considers obstructive bronchitis, it is he who most often gives serious complications - pneumonia or, as it is also called, pneumonia and bronchopneumonia. With such diagnoses, he advises to be treated in an inpatient setting.
According to Evgeny Komarovsky, all self-respecting parents should know the causes, symptoms and mechanisms of bronchitis. But not in order to arbitrarily practice in various ways of folk and non-traditional treatment, but only in order to be able to consult a pediatrician in a timely manner.
Treatment
It is absolutely impossible to treat bronchitis on your own, without referring to a specialist, with home recipes, which are abundant in the arsenal of most grandmothers. Evgeny Komarovsky urges parents to be prudent and, with each discussion of this topic, reminds that acute bronchitis, which was treated with traditional medicine and respiratory gymnastics, becomes chronic in 99% of cases, which means that it can hardly be cured.
At the other extreme, when parents immediately rush to the pharmacy and buy up everything they can "from a cough." Medications are not always appropriate, for example, in case of bronchitis with dry cough, which was the result of a cold in a child, the mucous membranes of the bronchi simply dried up, since the baby breathed through his mouth for several days due to rhinitis. In this situation, it is enough to simply humidify the air in the house, give the child more to drink. And probably no other treatment is needed.
However, the final word in the choice of therapy rests with the doctor. If the disease is not complicated, then you can be treated at home, if the baby is too small, and bronchitis is quite severe, accompanied by respiratory and heart failure, then Komarovsky insists on treatment in a hospital. Bronchitis in infants - should always be treated in a hospital, with the constant supervision of specialists.
The use of antibiotics for acute bronchitis is often not the best way out, says Yevgeny Komarovsky. Since the overwhelming majority of the causes are not in bacteria, but in viral pathogens, and antibiotics are useless against them. And apart from harm to the child's body, they will not bring absolutely any benefit.
If the causes of bronchitis are not reliably known, as well as in the first days of the disease, you should refrain from taking antibiotics. If a viral infection is to blame, the child's condition will not worsen, there will be no point in antibacterial medicines. If the baby begins to feel worse, Komarovsky strongly advises to hospitalize him and treat him in a hospital setting.
There they will take tests for a bacteriological culture and find out if the bronchitis is caused by bacteria or fungi. This, although rare, is possible. Only then will it be possible to discuss the possibility of antibiotic treatment. In all other cases, antimicrobial drugs for bronchitis only increase the risk of developing pneumonia.
As for antiviral agents, it is also better not to get carried away with them, says Komarovsky. Especially the advertised drug "Bronchovax", which mothers love to buy "in case of bronchitis" for children. This remedy is an immunostimulant and is useful only for children with severe immunodeficiency. The immunity of an ordinary, average child is able to activate on its own, Komarovsky emphasizes.
To the logical question of how to treat bronchitis correctly, Komarovsky will answer that the scheme should include expectorants, which will allow you to quickly remove phlegm from the bronchi. There will be no stagnation of secretory fluid - inflammation will subside. In the acute form of the disease, especially if the child has a high body temperature, the doctor advises against resorting to massage, inhalation and various compresses. All these methods have their time, they usually work great in the later stages, accelerating the recovery of the child.
Allergic bronchitis is treated similarly to bronchial asthma, relying on anti-allergy drugs (hormonal corticosteroids). Antihistamines in this situation will only worsen the baby's condition, since they additionally dry the mucous membranes, which is extremely dangerous with bronchitis.
Commentary of Dr. Komarovsky about allergic bronchitis.
About home supportive care
Massage
With bronchitis, Komarovsky advises using a special type of massage aimed at improving the drainage functions of the bronchi. For this, the child is put on his knees with his face down so that his butt is at a level above the head. The baby's arms should hang down. With their fingertips, adults make tapping movements on the child's back in the region of the lungs.
After this, the child should be dramatically put on his knees and asked to cough. The release of sputum will occur immediately and more intensively. This method, of course, is not suitable for treatment in infants.
Another massage technique according to the Komarovsky method is to put the child on his knees with his back to him. Ask him to take a deep breath and cough hard as he exhales. At the moment when the child begins to cough, the adult makes light movements squeezing the chest with both hands in the region of the ribs.
And here is the video of Dr. Komarovsky about the correct massage for bronchitis
Inhalation
Komarovsky recommends to all mothers and fathers who are very fond of treating a child's cough with warm steam inhalations to remember what happens to a dry zest when it is treated with steam or boiling water. Yes, it grows in size. The same thing happens with a dried crust of phlegm in the bronchi. This is the main danger of inhalation, and you should be aware of it.
A child who is more than 5 years old is able to cough up with an increase in sputum during inhalation. But a baby under five may feel much worse. Therefore, Komarovsky categorically forbids inhalation of hot steam for children.
And now let's listen to Dr. Komarovsky about whether inhalation helps with bronchitis
If, nevertheless, you really want the child to breathe medicine, you can do inhalation with great care using a special device - a nebulizer. It disperses the drug solution into small particles, which quickly reach the destination by inhalation. This method has nothing to do with hot steam, but it cannot be considered completely safe either.
Komarovsky reminds that it is unacceptable to use antibiotics in the form of solutions for a nebulizer, because a child with bronchitis simply does not need them. It is better if the baby breathes in solutions with herbs that facilitate the removal of phlegm (licorice root or anise, for example).
Swimming and walking
Refusing to swim and walk during the treatment of bronchitis is the greatest delusion, according to Evgeny Komarovsky. Bathing is not prohibited, provided that the child does not have a high fever. As soon as it has dropped, you can take water procedures, this is useful for improving blood circulation. However, Evgeny Olegovich advises to do this with caution, giving preference to a shower, rather than hot baths. And walks with inflammation of the bronchi are necessary, since fresh air to sick bronchi is like a balm for wounds.
Tips
- If your doctor diagnoses "bronchitis" and immediately prescribes antibiotic treatment, the "savvy" mother can (and should!) Object. Komarovsky allows him to refer to himself, they say, the doctor said that bronchitis is a viral infection, and with it antibiotics are inappropriate.
There is no need to be afraid of causing displeasure at the attending physician, says Komarovsky. Usually all pediatricians are well aware that bronchitis and antibiotics are completely incompatible concepts, but they prescribe such medications to “play it safe”. After all, if this is not done, the parents will blame the doctor for a possible complication - pneumonia.
- Komarovsky does not advise rubbing the chest and back of a child with bronchitis with a high temperature. Any rubbing contributes to an increase in body temperature. And if a child is smeared with fats (badger, for example), then such actions of adults reduce sweating in the child, and such treatment will not be beneficial.
- For successful treatment and prevention of bronchitis, the environment plays a role in the future. Evgeny Komarovsky recalls that the bronchial mucosa will not dry out and become inflamed if the air in the apartment is sufficiently humidified (up to 50-70%). To achieve this, he advises buying a dedicated humidifier. And actively use it. Especially in winter, and especially if the house includes heaters that mercilessly dry the air.
If the financial capabilities of the family do not allow purchasing such a device (it is not cheap!), Then you can get by with the means at hand. To humidify the air, you can hang wet sheets and towels in the apartment, put basins of water in the corners and start an aquarium with fish, and do wet cleaning more often.
- The air temperature in the apartment, ideally, should be no more than 18-20 degrees. If it is customary in the family to tightly close the vents in winter, overheat, wrap up the child, believing that heat and stuffiness will protect him from bronchitis, then the result will be diametrically opposite.
- When treating bronchitis in a child, Komarovsky attaches great importance to an abundant warm drink. It helps prevent the mucous membranes of the nasopharynx, trachea and bronchi from drying out. It will be good if the mother, after the doctor's diagnosis sounds, does not run to the nearest pharmacy for antibiotics, but to the market for dried fruits. It is best, according to Komarovsky, to give the child such a compote, tea, rosehip decoction, berry fruit drinks are also suitable.
If you change the family's lifestyle, taking into account all the above points, create an optimal environment for the child for healthy and normal growth, bronchitis will cease to be an urgent problem, and even the chronic forms of this disease, when the baby coughs for several months a year, will gradually recede. The authoritative specialist Evgeny Komarovsky guarantees.
