Bronchitis

Symptoms

The main symptom of any bronchitis is coughing. It may be dry at first, but sputum appears after a few days, which may be coughed up with chest pain. Narrowing (obstruction) of the airways causes shortness of breath.
Infectious bronchitis is often accompanied by intoxication syndrome. It occurs when pathogenic microorganisms begin to secrete into the blood the products of their vital activity - toxins, to which the body reacts with general inflammation.
The main symptoms of intoxication in bronchitis:
•    Weakness,
•    Chills,
•    Muscle and joint pain,
•    Headache,
•    Elevated temperature (over 37-38 ° c).
Differences between bronchitis and tracheitis
An infection of the trachea's mucous membrane is referred to as tracheitis. This is the main airway that connects the nose, mouth, and lungs. Bronchus extends from the trachea into each lung. So, if we consider all the bronchi as the crown of a tree, then the trachea is its trunk.
Tracheitis and bronchitis are almost identical in symptoms, and often combined (tracheobronchitis).
With tracheitis, pain from coughing does not occur throughout the chest, but exactly in the middle - behind the sternum. The cough itself turns out to be stronger and “barking” than with bronchitis.
A doctor can distinguish tracheitis from bronchitis using a phonendoscope and after collecting anamnesis.
Differences between bronchitis and pneumonia
In general, the symptoms of infectious pneumonia and bronchitis are similar, but not the same.
The onset of pneumonia is usually sudden, with no prior symptoms such as a sore throat, runny nose, or cough.
Also, with inflammation of the lungs, wheezing and shortness of breath appear. Breathing can be painful and labored, and in some cases the level of oxygen in the blood is reduced.
To distinguish pneumonia from bronchitis, a doctor may order an x-ray or ct scan of the chest.
Differences between bronchitis and whooping cough
Whooping cough is a disease caused by the bacterium bordetella pertussis. The disease differs from bronchitis by obsessive sore throat and paroxysmal cough, sometimes followed by vomiting. The temperature, as with bronchitis, rises to 37–38 ° c. The disease lasts from 7 weeks to 3 months.
If whooping cough is suspected, the doctor may prescribe targeted studies.
 

Causes

Causes of infectious bronchitis:
The most common cause of bronchitis is acute respiratory viral infections (arvi). They may be related to the same viruses that cause colds and flu.
Bacterial bronchitis is less common. It can be caused by streptococci, pneumococci and staphylococci. In some cases, bacterial bronchitis joins the viral form of the disease as a complication.
Infectious agents - causative agents of bronchitis - are transmitted by airborne droplets through close contact with sick people. When coughing and sneezing, they spread by aerosol - at a distance of up to 3 meters. 
In addition, pathogens can remain on fabrics, dishes, children's toys and other household items if an infected person has come into contact with them.
2.    Causes of non-infectious bronchitis:
Non-infectious bronchitis is often observed in smokers and production workers who inhale various dusts and fumes, as well as in allergy sufferers. If you eliminate the main irritant of the bronchi, the disease quickly passes.

Possible causes of non-infectious bronchitis:
•    Tobacco smoke - both with direct and passive smoking;
•    Chemical fumes - ammonia, chlorine, vapors of paint and varnish products and others;
•    Industrial dust - wood, grain, textile;
•    Various allergens - pollen, mold, dust mites, animal hair.
The mechanism of development of bronchitis:
Infectious bronchitis begins to develop when a virus or bacterium enters the mucous membrane (epithelium) of the bronchi. The infectious agent penetrates into it, multiplies and damages the cells.
The immune system reacts to the invasion, and immune cells move into the bronchi with the blood stream. They destroy the virus along with the epithelial cells that have been infected, and also trigger the inflammatory process. Inflammation leads to swelling and causes the mucous membrane to secrete more mucus for protection - this is how phlegm appears.
Non-infectious bronchitis occurs when particles that irritate the epithelium enter the bronchi: smoke, dust, allergens.
The cause of bronchial inflammation can be irritation of the mucous membrane with various dust, chemical damage to epithelial cells, or an allergic reaction.

Treatment

Treatment for bronchitis depends on the cause, duration, and severity.
Treatment of acute bronchitis
Acute infectious bronchitis can be treated at home in most cases. Bed rest, rest, good nutrition and plenty of fluids are recommended.
If the sputum is too viscous and does not come out well, the doctor may prescribe expectorants. With severe intoxication and fever, anti-inflammatory and antipyretic drugs are prescribed.
If necessary, bacterial bronchitis is treated with antibiotics, viral bronchitis with antiviral drugs.
Antibiotics do not kill viruses, but in some cases a doctor may prescribe them to prevent a bacterial infection from attaching.
In case of narrowing of the lumen of the bronchi, bronchodilator inhalers may also be prescribed.
In acute non-infectious bronchitis, it is necessary to eliminate the cause of its occurrence - it can be smoking, harmful fumes, contact with dust or chemicals.
If the cause of bronchitis is an allergic reaction, antihistamines, regular wet cleaning and indoor air purification are recommended.
Treatment of chronic bronchitis
In chronic bronchitis, maintenance therapy is prescribed with drugs that expand the lumen of the bronchi, relieve inflammation and swelling. It is also important to give up bad habits, especially smoking.
Timely treatment helps relieve symptoms and prevent or slow down the progression of the disease.
Prognosis for bronchitis
Acute bronchitis does not last long - from 2 to 4 weeks, if you follow the doctor's prescriptions and take the necessary medications.
Chronic bronchitis lasts for years. Subject to the doctor's recommendations, the remission of the disease can be long-term, but periodic exacerbations are not ruled out.
Chronic bronchitis cannot be completely cured.

Tests Required for Diagnosis

The diagnosis is made by a general practitioner or pulmonologist based on examination, listening to the lungs with a phonendoscope and patient complaints. 
Collection of anamnesis-
The doctor will pay attention to cough, wheezing, symptoms of concomitant sars, data on contact with the allergen.
Physical examination-
The presence of bronchitis will be indicated by the absence of changes in lung sound during percussion (tapping), the absence of pronounced toxicosis and the locality of wheezing when listening to the lungs. If pneumonia is suspected, x-rays are taken.
Laboratory diagnostics-
It is carried out according to indications, usually includes a clinical blood test, an analysis of c-reactive protein (CRP), procalcitonin (a biochemical marker for early diagnosis, monitoring the severity of sepsis and assessing systemic inflammatory response syndrome - sirs). If an atypical etiology of bronchitis or whooping cough is suspected, a serological examination and PCR diagnostics are performed. These examinations often reveal the causative allergen, but the accuracy of the studies does not reach 100%.
Saturation control-
To exclude hypoxia (lack of oxygen in organs and tissues), especially with bronchiolitis, it is recommended to control saturation - oxygen saturation of the blood. This is done with a device called a pulse oximeter.
 

Useful info

Pneumonia
Without treatment, acute infectious bronchitis can turn into pneumonia - inflammation of the lungs, or more precisely, the alveoli.
The alveoli are the main tissue of the lungs, in which gas exchange occurs: the absorption of oxygen into the blood and the release of carbon dioxide. If the alveoli are inflamed, their function is impaired.
The disease is often accompanied by high fever (above 38 °c), cough, and decreased oxygen concentration in the blood. Pneumonia is dangerous due to its severe course and often requires hospitalization.
Sepsis
In some cases, such as immunodeficiency or severe course without treatment, infectious bronchitis can lead to sepsis  - blood poisoning. In sepsis, pathogens spread throughout the body and cause inflammation in other organs.
Emphysema
Chronic bronchitis with a long course can lead to permanent obstruction and changes in the bronchial mucosa. This, in turn, can cause emphysema, a severe chronic disease that gradually “stretches” the lung tissue. The alveoli lose their elasticity and swell, as if they are constantly in the inhalation phase, and then begin to collapse.
Chronic obstructive pulmonary disease
The combination of chronic obstructive bronchitis and emphysema is called chronic obstructive pulmonary disease (COPD). Because of it, it becomes very difficult for a person to breathe, and most often the condition is steadily progressing.
Bronchial asthma
If bronchitis is chronic and it is caused by allergies, bronchial asthma may develop against its background .
With asthma, the bronchi swell due to increased sensitivity to the allergen and their lumen narrows. During an asthma attack, a spasm of the muscles of the respiratory tract occurs, the lumen of the bronchi becomes very small and the patient loses the ability to breathe freely - suffocation begins.