Bronchitis is an inflammation of the mucous membrane that lines the bronchi. It is a common respiratory disease in children and adolescents. Especially in the winter months, when many viruses circulate and the airways are attacked by the cold air, bronchitis often occurs. Such infections usually do not last longer than two weeks. Chronic bronchitis is when a child has bronchitis more frequently during a year or over a longer period of time.
Children with bronchitis should drink a lot (© Serhiy Kobyakov – Fotolia.com)
The general rule for mucous airways is to drink plenty of fluids. This makes the mucus liquid and makes it flow away more easily. Also make sure that no one smokes around the child, so as not to cause additional damage to the mucous membranes.
The main preventive measures are aimed at keeping the mucous membranes of the respiratory system healthy. Make sure that heated rooms are not overheated, if possible, and that there is a comfortable humidity level. This can be z.B. This can be achieved by hanging damp cloths over the radiators and carrying out "shock ventilation" at regular intervals.
Causes
Acute bronchitis is mainly caused by viral infections (respiratory viruses such as adenovirus, coxsackie virus, echovirus or myxovirus). Bronchitis can also occur with a cold (flu), which is also caused by viruses. In most cases, the trachea is also affected by the inflammation (tracheo-bronchitis). In addition, bronchitis can occur in the context of other diseases, z. B. for measles, whooping cough (pertussis) or typhoid fever. Fungi such as Candida albicans can lead to so-called soorbronchitis in immunocompromised patients. Inhaling poisonous gases or smoke can also cause acute bronchitis, which may result in additional damage to lung tissue.
Chronic bronchitis can have different causes. Pre-damage of the mucous membrane due to toxins in the air we breathe, z.B. Cigarette smoke, congenital malformations of the respiratory tract, congenital metabolic disorders with increased susceptibility to infections (e.g. B. Cystic fibrosis, certain enzyme deficiency diseases (a1 antitrypsin deficiency) or allergies can be responsible for this.
Symptoms& clinical picture
The trachea splits in the chest into the main bronchi, which pull into the lungs and branch out there. At the end of the finest and smallest bronchial branches are the alveoli, or air sacs, called alveoli. These are surrounded by blood capillaries. Gas exchange takes place in the alveoli. The passing blood absorbs oxygen from the inhaled air and releases carbon dioxide into the exhaled air.
The mucous membrane of the bronchial tubes is covered with small, mobile cilia, which continuously flicker in the opposite direction to the inhaled air and have the task of removing dust particles or other foreign bodies and the constantly formed mucus from the respiratory tract. Thus, the mucous membrane constantly cleanses itself. If inflammation of the mucous membrane occurs, this sensitive balance is disturbed; secretion accumulates and respiratory problems or. subsequent respiratory diseases can be the result.
Different forms of bronchitis are distinguished according to their course. In the case of acute bronchitis The child initially has a dry (non-productive) cough, later sputum is added, which can become mucopurulent. Respiratory distress and typical rales occur, while elevated temperature or fever usually occur only in the early stages.
The chronic bronchitis The child’s bronchitis shows signs similar to those of acute bronchitis, but lasts for a long time and comes back again and again.
It is not uncommon for children to contract sog. obstructive (constricting) bronchitis. It is caused by viruses and is accompanied by shortness of breath, which can be very severe or even threatening. When exhaling, a typical whistling sound occurs (wheezing). Children have difficulty exhaling due to inflammatory mucus formation in the bronchi – comparable to asthma patients, in whom bronchial constriction occurs due to contraction of the muscle sheath surrounding the bronchi on an allergic basis. Due to the damage to the bronchial mucosa, the wall of the bronchial tubes becomes thinner. As a result, the small bronchi can no longer withstand the pressure in the chest cavity during exhalation and collapse. Closure (obstruction) of the smallest pulmonary bronchi occurs. The air in the alveoli can therefore no longer be exhaled, and the alveoli become inflated and overinflated. This stage is called chronic obstructive bronchitis. These changes affect the absorption of oxygen into the blood. Increasing shortness of breath, initially only during exertion, but then also at rest, and a general drop in performance are the consequences.
Effects
The lungs, which are already damaged by acute or chronic bronchitis, are more susceptible to additional infections. A frequent complication is therefore purulent bronchitis caused by bacteria. Visible sign is purulent, cloudy, yellowish-green sputum. If the inflammation progresses further, pneumonia can also occur. If pneumonia is suspected, you should definitely consult your pediatrician and adolescent doctor.
Some of the children who develop obstructive bronchitis later develop bronchial asthma.
Diagnosis
If your child coughs and you suspect that he or she is suffering from bronchitis, you should take him or her to the doctor. The doctor can often determine the nature of the disease by listening to the typical sounds. An X-ray examination can be used to delineate obstructive bronchitis. If there is evidence of chronic bronchitis, further investigation must take place to pinpoint the exact cause. In addition to allergy test, sweat test, may then be an endoscopic reflection of the airways (bronchoscopy), the removal of a tissue sample or an X-ray examination with contrast medium (bronchography) is required.
Therapy
The therapy of acute bronchitis in a purely viral infection is the administration of expectorant drugs (cough suppressants, expectorants). The active ingredient acetylcysteine, for example, changes the structure of mucus, making it less viscous and thus facilitating its removal. Agents such as ambroxol or bromhexine stimulate the production of a thin mucus. Expectorants are available – depending of course on the active ingredient – in a wide variety of dosage forms as juice, capsules, effervescent tablets or granules for dissolving. The latter preparations have the advantage that, in addition to the active ingredient, liquid is also consumed. Antibiotics are only useful when bacteria have settled on the mucous membranes of the bronchi. The doctor will decide if their use is necessary with your child.
If obstructive bronchitis is present, additional medications that lead to a dilation of the small bronchial tubes (b2 sympathomimethics) may be necessary. These drugs are usually inhaled and can thus act primarily locally.
When treating chronic bronchitis, the main thing is to eliminate or treat the triggers of the disease.