Spastic bronchitis

Spastic bronchitis: description

In spastic bronchitis – as in normal acute bronchitis – the mucous membrane of the bronchi is inflamed and produces more mucus. The bronchi are the highly branched “channels” connecting the trachea to the alveoli. In addition, bronchial tubes are narrowed in spastic bronchitis. That’s why she will be “obstructive bronchitis“(Obstruction = closure, narrowing) called.

The narrowing arises, on the one hand, because the inflamed mucous membrane is swollen. On the other hand, the muscles of the respiratory tract become cramped. Therefore, the name derives from “spastic” (= convulsive) bronchitis.

Baby bronchi are very tender and not fully developed. They are therefore particularly susceptible to spastic bronchitis. The same is true for toddlers. Spastic bronchitis in adults is rather rare. This is why we often speak of Baby Bronchitis or Toddler bronchitis.

Toddler and baby with spastic bronchitis show a whistling or wheezing during exhalation and can often breathe only with difficulty – even breathing difficulty. Because of these asthma-like symptoms sometimes called the spastic bronchitis “asthmatic” bronchitis (also asthmatiform or asthmoid bronchitis). This name is not correct.

Spastic bronchitis: symptoms

Because of the constricted, inflamed bronchi that is Breathing difficult, especially the exhale. Patients are short of breath or literally short of breath. Also, exhale breath sounds to hear something like a rustling, whistling or humming. Add to that spasmodic cough, Especially morning, intense cough is characteristic. This is because a lot of mucus has formed in the bronchi overnight. He triggers a violent coughing and must be coughed off.

The coughing mucus is mostly whitish, rarely bloody. If it turns yellowish-green, this often indicates that additional bacteria have spread to the inflamed mucous membrane (secondary bacterial infection).

The breathing problems and the many coughing are very exhausting. Therefore, those affected are quickly exhausted. The shortness of breath can be scary for both the patients themselves and their parents.

Often the spastic bronchitis (as well as the normal acute bronchitis) of Cold symptoms or flu-like symptoms accompanied. These are, for example, fever, throat, head and body aches.

What to do if you have a dangerous shortness of breath?

If the spastic bronchitis puts children into a state of dangerous respiratory distress, you should alert the Rescue Service (phone 112). Warning signs include bluish discolored lips, nails and skin. Even movement of the nostrils (nostrils) and rapid breathing may indicate a shortness of breath.

Spastic bronchitis or asthma?

The symptoms of spastic bronchitis may be very similar to those of bronchial asthma. Basically, in case of bronchitis the cough improves the condition. In contrast, coughing in asthma can signal an exacerbation. In the case of asthma, the cough is mostly dry. Especially in infants, however, the distinction between spastic bronchitis and asthma is often difficult. As a rule, spastic bronchitis should have significantly improved after one to two weeks.

Spastic bronchitis: causes and risk factors

Spastic bronchitis (like almost all forms of acute bronchitis) is caused by viruses. These are mainly Respiratory Syncytial (RS), Parainfluenza, Adeno and Rhinoviruses. The pathogens are easily transmitted, for example, when coughing, sneezing or by touch. Mostly they cause only a slight cold – without acute or spastic bronchitis.

risk factors

Especially with existing ones Lung diseases or allergies Emerges from an acute bronchitis often a spastic bronchitis. Babies and toddlers are particularly prone to it.

Another risk factor is the so-called “bronchial hyperreactivityIn affected people, the bronchial mucosa is particularly sensitive to infection and irritation, and as a result of hypersensitivity, the bronchi contract more quickly and their mucous membranes swell, favoring spastic bronchitis.

Also premature birth as well as one very early contact with viruses and pollutants (possibly already during pregnancy) are considered risk factors. This is observed, for example, in mothers who smoke near the children or during pregnancy. This increases the children’s for a spastic bronchitis or other respiratory ailments.

Is spastic bronchitis contagious?

Yes, spastic bronchitis is contagious. The triggers – viruses – are easily transferable from patients to the healthy.

Spastic bronchitis: examinations and diagnosis

The pediatrician is the first contact for suspected spastic bronchitis. Because bronchitis is generally very common, it has a lot of experience with it. So he can well assess whether there is actually a spastic bronchitis and how severe it is. He then decides on suitable therapeutic measures for spastic bronchitis.

Pediatricians and family doctors have also known the little patients for a long time already. You can therefore classify an acute illness well in the individual medical history of the patient. For example, they often know whether a child is prone to high fever or a severe infection.

The doctor will be first in Conversation (anamnesis) Obtain all the important information to help him diagnose spastic bronchitis and assess severity. For example, he may ask:

• Are you or your child more likely to suffer from infections (the respiratory tract)?
• Are pre-existing respiratory diseases known?
• What are the exact symptoms and how long have they been?
• Can you describe the cough more precisely (for example seizure, barking, in the morning, with mucus ejection etc.)
• Is there breathlessness?

After that follows one physical examination, In doing so, the doctor becomes the Listen to the lungs, Typical of spastic bronchitis breath sounds, A whistling sound, which mainly occurs during exhalation, is called wheezing. It indicates that the airways are misplaced. Humming breath sounds are an indication that there is an increased amount of mucus in the airways.

In addition, the doctor will be the Tap lungs, From the knocking sound he can close the condition of the lungs. In a normal air-filled lung, it sounds like a knock on a drum. In pronounced sites of inflammation, however, the knocking sound is damped.

In addition, the doctor scans the (neck) lymph nodes and takes a look into the mouth and throat.

For longer and more complicated illnesses is also a X-ray of the ribcage (Chest x-ray) made. For example, the doctor can tell if the inflammation is limited to the bronchi or if the spastic bronchitis is threatening to develop into pneumonia. In addition, the X-ray image gives indirect indications of airway obstruction (for example pulmonary emphysema).

A blood test is not necessary at the first, spastic bronchitis. When inflammatory parameters such as the number of white blood cells or the CRP are increased, this only indicates general inflammation in the body.

Exclusion of other causes

In children with suspected spastic bronchitis, the doctor must also always check whether the symptoms may not be resolved by one swallowed foreign bodies arise, which has stuck in the bronchi. Especially when listening to the lungs the conspicuous noises are heard only on one side, the respiratory tract could be misplaced by a foreign body.

If someone has spastic bronchitis more often, further investigation is advisable. This includes, for example, an allergy test and examination of the respiratory effort. In addition, a bronchial asthma must be excluded.

Spastic bronchitis: treatment

Spastic bronchitis is generally treated in the same way as other acute bronchitis. Patients should be save or with fever bed rest comply. It should be the Upper body slightly raised lie. This makes breathing easier than lying flat.

Important is also one adequate hydration (Tea, broth etc.). If a child is very anxious or restless because of difficult breathing, parents should try to calm it down. Internal restlessness can increase the respiratory distress.

In addition, necessarily on one fresh and pollution-free air be respected. The ambient air should be warm (but not hot) and humid. For example, you can breathe regularly or put a damp cloth on the heater. The patient should also be kept away from tobacco smoke. He can dangerously exacerbate spastic bronchitis.

Warning: rubbing the chest with essential oils or ointments in spastic bronchitis may irritate the bronchial mucosa. The breathing problems and coughing fits can increase. In addition, many essential oils (such as eucalyptus oil) are generally not recommended in toddlers.

Cough suppressants are rarely advisable

Medications that reduce coughing (cough suppressants or cough suppressants) should generally be used only when the cough is not productive (low secretions in the bronchi) and it interferes with the nighttime sleep. Coughing up is very important for bronchitis diseases: it clears the respiratory tract of mucus, pathogens and other pollutants.

Antispasmodic agents

The spasmodic constricted airways in spastic bronchitis can be using so-called sympathomimetic (β2 receptor agonists) relax like salbutamol. The active ingredients ensure that the airways expand. Usually they are given as an inhalation or spray. In this form, they arrive directly at their site of action (respiratory tract). For children, there are special inhalation devices, which facilitate the inhalation of the vaporized active ingredients.

Note: If the constriction of the bronchi is based primarily on a swelling of the mucous membrane, treatment with sympathomimetics usually has little effect.

Spastic (obstructive) bronchitis may also be treated with a so-called anticholinergic agent (such as ipratropium). This drug group also has an antispasmodic effect on the muscles of the bronchi. Again, the application is by inhalation.

Antibiotics and cortisone

Spastic bronchitis is caused by viruses. On the attacked mucous membrane of the bronchi but can additionally spread bacteria. The condition of the patient may deteriorate as a result. Then the doctor Antbiotika prescribe. They fight the bacterial infection, but do not work against the viruses.

If the spastic bronchitis takes a severe, protracted course, sometimes it can also be a short term treatment cortisone make sense. It causes the mucous membrane of the bronchi to swell. Especially for spastic bronchitis in children, in addition to cortisone tablets, there are also other dosage forms such as suppositories or juice.

Further measures

Sometimes a spastic bronchitis needs to be treated in the hospital. This is especially true for babies. The required medication and fluid can be administered to the little patient there by infusion. In addition, the oxygen supply is constantly monitored. If necessary, the child receives additional oxygen.

Physiotherapy can be helpful, especially if you have a long illness. With appropriate techniques, coughing and breathing work can be additionally supported. For example, the therapist may gently tap the patient’s thorax.

Note: The administration of mucus removers (cough removers) in spastic bronchitis is controversial.

Spastic bronchitis: course and prognosis

Many parents are worried about their child developing asthma after spastic bronchitis. However, this does not happen very often: only about 30 percent of children who had spastic bronchitis as an infant later develop bronchial asthma. Particularly at risk are children in whom asthma, atopic dermatitis or other allergic diseases in the family are already known. With them one should pay particular attention that they are not attached to any tobacco smoke (passive smoking). In addition, the air in the home environment should be free of pollutants (e.g., no mold attack) and not too dry.

In most cases it heals spastic bronchitis but complication and consequences.