Diseases of the respiratory system in children are more common than other ailments. Among them, one of the leaders in prevalence is acute bronchitis. Not everyone knows how to distinguish it from other respiratory diseases, what it is and how to properly treat such a disease.
About the disease
Bronchitis in children is acute and chronic. The disease can acquire a chronic form if the acute illness was treated incorrectly or not at all. That is why it is important to timely identify bronchitis in its initial form and cope with the problem in time.
With bronchitis, the bronchial tree becomes inflamed, the production of bronchial secretions (mucus) increases, and the patency of the bronchi is impaired. This condition can arise as an independent ailment or be a complication after another disease - for example, acute respiratory viral infections so common among children.
Most often, bronchitis is caused by viruses. When foreign agents enter the bronchi, the mechanism for the formation of abundant mucus is triggered, it performs an important immune task - to bind and neutralize virus particles. At this stage, it is important to prevent thickening of mucus, because thick bronchial secretions no longer save, it is now dangerous, since it is almost an ideal breeding ground for bacteria. Bacterial damage to the bronchi is a rather severe pathology.
Bronchitis can be localized only in the bronchi, or it can spread to the trachea, and then the disease will be called somewhat differently - tracheobronchitis. Depending on the state of bronchial mucus, the disease can be:
- catarrhal (acute course, moderate amount of liquid mucus);
- slimy (acute course, a large amount of mucus of high viscosity);
- purulent (complicated course, the addition of a bacterial infection due to dry or heavily thickened mucus or microbes from outside).
The inflammation can be insignificant, spread only to the bronchial membrane, or it can be deeper, when the inflammatory process goes to the submucosa and muscle layer.
Causes
The most common cause of bronchitis in a child is viral infections. Children's doctors note that bronchitis is often a complication of influenza, parainfluenza, rubella, and sometimes measles. Rarely enough, bronchitis is initially bacterial in nature (associated with contact with the bronchial mucosa of pneumococci or staphylococci). If the fact of bacterial bronchitis is ascertained, it is a secondary infection that has joined.
Non-infectious bronchitis can be caused by:
- inhalation of dust, smoke, chemicals, chlorine vapors;
- gassed or too dry air;
- allergens.
In childhood, the appearance of bronchitis in the acute stage is influenced not only by the unfavorable environmental situation and the presence of a virus or bacteria, but also by the state of immunity, which is much weaker in babies than in adults. Children who are poorly nourished, lack vitamins, often suffer from a runny nose and have a chronic infection in the nasopharynx, bronchitis occurs more often, and the number of complications and the transition of the disease to the chronic stage increases markedly.
The likelihood of complications increases if the thinning of bronchial mucus is not prevented. In the thickened secretion, bacteria multiply quite quickly, and already 2-3 days after the onset of bronchitis, it can become complicated. The affected mucous membranes usually recover on their own, if this does not happen, doctors put another diagnosis - chronic bronchitis.
Allergic bronchitis usually develops in children with a strong genetic predisposition to allergic reactions. One contact with an allergen is not enough for this, the child must experience such an effect for a long time.
Symptoms
The onset of bronchitis is always closely related to the symptoms of the underlying disease - it can be fever, fever, rhinitis, nasal breathing disorder. However, the main symptom of acute bronchitis is the appearance of a cough. At first, it is unproductive and dry in nature. At night, this cough intensifies, which does not allow the baby to sleep normally. During the day, you can notice severe shortness of breath, especially after physical activity or active games.
After 3-5 days, the cough changes to a moist, productive one. It is easy to hear, because there are characteristic "gurgling" sounds, and coughing attacks always end in sputum (excess abundant bronchial mucus). During this period, the child may have a low subfebrile temperature - 37 degrees. The child becomes lethargic, drowsy, apathetic. Older children may complain of headaches.
These accompanying symptoms usually go away quickly enough, within a week, but the cough can remain for a long time, since the healing process of the affected bronchial membrane is very slow. It is this feature of the bronchial tree that sometimes causes such severe consequences as asthma. It is important to understand that recovery will not be quick, but prolonged bronchitis lasting more than a month should alert parents and be sure to cause a visit to a pulmonologist.
Toxic or allergic bronchitis is always accompanied by painful prolonged attacks of dry cough, sometimes hoarseness (due to the development of edema). This condition is very dangerous for babies under one year old. In infants, the already narrow airways, spasms and swelling can lead to death by suffocation.
Diagnostics
Parents, by the totality of symptoms, can only suspect bronchitis, while the final diagnosis should be made exclusively by a pediatrician. To do this, the doctor will evaluate not only the symptoms and signs, but also the characteristic features of breathing.
With the help of a phonendoscope, the doctor will be able to detect in a child with bronchitis, hard breathing and scattered dry wheezing. In the second stage, when the cough becomes productive, wet, the doctor, while listening, will be able to identify gurgling sounds that disappear immediately after the coughing attack. Allergic bronchitis is accompanied by hard breathing and mild wheezing.
In addition, the doctor prescribes a number of tests - a general analysis of urine and blood, bacterial sputum culture, a blood test to determine viruses and antibodies to them. The doctor may send the child for an X-ray of the lungs to rule out tuberculosis and pneumonia, and also perform bronchoscopy. The same two studies are necessarily prescribed for protracted bronchitis to find out if there are signs of another infection.
Treatment
Acute bronchitis is usually treated at home. The need for hospitalization sometimes arises only for young children and children with a severe course of the disease. Viral acute bronchitis does not need special treatment, as a rule, it goes away in 7-10 days on its own - if the parents provide the right conditions. The baby should breathe with clean, sufficiently humidified air (a relative humidity of at least 50% can be created using a humidifier or by hanging wet towels).
While the temperature lasts, the child should lie more, rest. As soon as it decreases, it is important not to spend time in bed, but to move as actively as possible.
Drinking plenty of fluids will speed up the process of sputum formation, and drainage massage and an active motor regime in the second stage of the disease will facilitate its timely discharge. In no case should viral bronchitis be treated with antibiotics, since they are ineffective against the pathogen of a viral nature, and the risk of complications does not decrease, as many think, but significantly increases.
It is customary to treat bronchitis complicated by bacterial infection with antibiotics, although recently doctors have been trying to prescribe antimicrobial therapy in far from all cases. With allergic bronchitis, antihistamine therapy is prescribed.
The temperature with bronchitis rarely rises above 38.0 degrees. If this happens, children are given antipyretics. At the initial stage of the disease associated with a dry, painful cough, mucolytic expectorants may be recommended. In no case should you give your child antitussives. They suppress the cough reflex itself - and can thereby create an obstacle to the discharge of sputum, which will lead to the most sad consequences.
At the stage of recovery, children are shown physiotherapy and physiotherapy sessions.
Treatment of bronchitis is always a set of measures, which includes the creation of favorable conditions for recovery, and medicines, and drugs are not the main ones in this complex. If a baby is wrapped up, he sweats, if he breathes dry air and lives in an apartment where heaters work, if he is hot, then no syrups and tablets will help.
Medication
To bring down the high temperature in acute bronchitis, if it has risen above 38.0 degrees, drugs approved for use in childhood will help. This is "Paracetamol" and all means based on it ("Nurofen", "Tsefekon D" (candles), "Panadol" and others). Nonsteroidal anti-inflammatory “Ibuprofen” effectively lowers temperature and relieves inflammation.
With a strong dry cough, the formation and further discharge of sputum will be facilitated by such drugs as Alteika syrup, Mukaltin. Children from 3 years old can be given "Codelac Broncho", and children 2 years old and older - syrups "Herbion" and "Libeksin Muko". Everyone, including babies in the first year of life, can take Lazolvan, and babies after 6 months are allowed Bromhexin. Perfectly liquefies phlegm and even nasal mucus in case of viral infection "ACC".
The antibiotics given for severe bacterial bronchitis are most often of the penicillin group. The specific drug is prescribed by the doctor after the sputum culture analysis is ready - depending on the type of microbe found in it. The most active against most of these pathogens is "Amoxicillin".
In case of allergic bronchitis, treatment is aimed at finding the allergen that caused the disease and at eliminating it. It is not always possible to find it, so it is recommended to remove all potential allergens from the children's room - soft toys, books, carpets. To reduce the negative impact, the doctor may recommend "Loratadin" or "Suprastin".
Inhalation
Inhalations should not be administered independently, this is a big parental mistake. The fact is that with bronchitis, these procedures are very useful only if they are done with the use of special medicines that the child will breathe through a nebulizer. The device creates small particles of medication that easily enter the lower respiratory tract and act exactly where it is needed. Inhalation with a nebulizer is needed when bronchitis has a severe course, if it is complicated, or (according to the doctor's assessment) the risk of developing such complications is very high.
It is very important that the child inhales the medicine, and not the decoction of chamomile or plantain.
Most often, children are prescribed inhalations with "Lazolvan", "Berodual", "Fluimucil". However, you should not choose the medicine yourself, because this can greatly harm the child.
Steam inhalers that produce steam are excellent for moisturizing nasal mucus and mucus in the larynx, but this steam does not reach the bronchi, and therefore carrying out such procedures (like the folk procedure "breathe over potatoes") has no therapeutic benefit for bronchitis. They can do harm, and quite often this is exactly what happens.
Caring parents who give a baby with bronchitis to breathe steam, then turn to a doctor who finds burns of the mucous membranes of the respiratory system in the patient, purulent congestion that begins with bacterial inflammation, repeatedly intensified by heating and steam inhalations.
Breathing exercises
At the stage of formation and discharge of sputum, when the cough becomes wet, the child is shown drainage massage and breathing exercises. The massage is based on light tapping movements with your fingertips along the ribs, chest and back. Breathing exercises are a fairly simple way to speed up your recovery.
Most often, doctors recommend that parents use Strelnikova's technique. The child should take an intense quick breath through the nose and a relaxed slow exhalation through the mouth. To carry out such inhalation and exhalation should be rhythmically.
Such exercises are very useful closer to the stage of recovery, when there is no temperature, and the child should walk more in the fresh air. It is the breathing exercises performed on the street according to the Strelnikova method that usually give the best results.
The simplest and most interesting exercise for children is performed with a ball. The kid should take it in his hands, take a sharp breath, press the ball to his stomach - and as he exhale, begin to bend forward, as if hugging the ball with his chest. At the end of the exhalation, the arms with the ball are extended forward and then lower. The exercise should be repeated at least 8-10 times in one approach.
Babies who are unable to repeat breathing exercises should receive more frequent drainage massage. Usually it is enough for recovery.
Prevention
Prevention should be based on timely and correct treatment of viral infections. The child does not need to be given antibiotics at the first symptoms of influenza or ARVI, this only increases the risk of complications, which is bronchitis.
In case of a viral respiratory disease, at a high temperature (no matter what they are caused), you should give the child as much warm drink as possible, this will help keep the bronchial mucus in a normal consistency, prevent it from thickening and drying out, clogging the bronchi.
The cleaner and fresher the air in the apartment, the less often children get bronchitis, and in general, these children get sick less. Favorable conditions are considered to be an air temperature not higher than 20 degrees and humidity in the range of 50-70%.
Walking in the fresh air, if they are sufficient in duration, at any time of the year contributes to the formation of normal local respiratory immunity. In addition, walks will help the baby recover faster if bronchitis does happen to him.
The child should definitely do all the vaccinations required for age. At the first signs of beginning bronchitis, it is imperative to call a doctor or take the child to the clinic for examination. It is dangerous to treat acute bronchitis with folk remedies.
You can learn more about acute bronchitis in children in the next video.
