Generality
Asthmatic bronchitis is the medical condition that results when, in the presence of asthma, a form of acute bronchitis is added.
Asthmatic bronchitis recognizes numerous causes, including, to mention the most important examples, viral infections affecting the bronchial tree, exposure to some allergen or excessive environmental pollution and smoking.
Asthmatic bronchitis triggers a fairly articulated symptomatology, which includes: cough with phlegm production, shortness of breath, wheezing during expiration, increased respiratory rate, chest tightness, etc.
The presence of asthmatic bronchitis requires the use of a combination of treatments: a treatment for the management of asthma, a treatment against the cause triggering the condition in progress (for this reason an accurate diagnosis is essential) and, finally, a treatment to alleviate the symptomatology of acute bronchitis.
Short review of the Bronchial Tree
Following the trachea and preceding the pulmonary alveoli, the bronchial tree is the complex section of the lower airways (or lower respiratory tracts), which includes, in order: primary bronchi, secondary bronchi, tertiary bronchi, bronchioles, the terminal bronchioles and respiratory bronchioles .
According to the most common anatomical view of the bronchial tree, the latter can be divided into two sections: the extrapulmonary tract (that is, external to the lungs), to which only the primary bronchi belong, and the intrapulmonary tract (ie, inside the lungs), which include the secondary bronchi, the tertiary bronchi, the bronchioles, the terminal bronchioles and the respiratory bronchioles.
What is asthmatic bronchitis?
Asthmatic bronchitis is the medical condition resulting from the simultaneous presence of asthma and a form of acute bronchitis .
As asthma and acute bronchitis affect the intrapulmonary bronchial tree, asthmatic bronchitis is to be considered a lung disease .
What are Asthma and Acute Bronchitis?
To fully understand what asthmatic bronchitis is, it is necessary to review what are asthma and acute bronchitis:
- Asthma is a chronic pulmonary disease of an inflammatory nature, which determines, after exposure to allergens (eg: pollen or animal hair) or due to respiratory infections, drugs (eg NSAIDs), physical exertion, excessive emotion, stress or smoking, the temporary narrowing of intrapulmonary bronchi and bronchioles, thus resulting in an obstacle to the passage of inhaled air.
In asthma, the author of the temporary narrowing of bronchi and bronchioles (the so-called asthma attack ) is an abnormal contraction of the smooth muscles of these ducts of the bronchial tree, an event that is called bronchospasm .
Currently, it is not clear what the precise cause of asthma is; on the subject, however, there are various hypotheses, including one - the most reliable - that attributes a genetic origin to asthma.
- Acute bronchitis is the inflammation of the bronchi with an abrupt and sudden onset, intense in terms of symptoms and lasting no more than 10 days .
Acute bronchitis recognizes several causes, including: viral or bacterial infections affecting the respiratory tract, prolonged inhalation of irritating substances for the respiratory system, some chronic lung diseases (chronic bronchitis) and special conditions such as reflux disease gastroesophageal.
In light of the above, asthmatic bronchitis is the result of the combination of a pre-existing chronic affection of the bronchial tree - asthma - and a temporary acute suffering of the bronchial tree - acute bronchitis.
The main differences between asthma and acute bronchitis
- Asthma is a chronic inflammatory condition of the bronchial tree; acute bronchitis, on the other hand, is a temporary inflammation of the bronchial tree.
- Asthma would seem to be attributable to some genetic anomaly; acute bronchitis, on the other hand, recognizes its main causes in external factors, such as viruses, bacteria, environmental pollutants.
- Both in asthma and in acute bronchitis, there is a narrowing of intrapolmonary bronchi and bronchioles; however, while in asthma the aforementioned shrinkage is due to an abnormal contraction of the muscles of intrapulmonary bronchi and bronchioles, in acute bronchitis the same phenomenon is due to inflammation of the mucosa, which causes swelling and a large production of mucus.
Causes
Asthmatic bronchitis is a condition that normally affects only people with asthma.
Having said this, asthmatic bronchitis recognizes several triggering causes, including:
- Viral and bacterial infections affecting the bronchial tree;
- The smoking, that is the habit to the smoke of tobacco in the form of cigarettes, pipe, cigars etc .;
- Excessive exposure to pollution typical of large cities;
- Exposure to substances that can act as allergens (eg: mold, animal hair, dust, pollen, food, etc.);
- Excessive exposure to chemicals irritating the bronchial tree;
- Taking drugs for which there is a kind of intolerance. The drugs most commonly associated with asthmatic bronchitis are aspirin, NSAIDs and beta-blockers;
- Intense physical exercise ;
- A very cold climate ;
- A strong emotion . Experts have noted that, in people with asthma, there is a tendency to develop asthmatic bronchitis when they experience a situation full of emotion, such as to trigger a big cry, a big laugh, a lot of stress and so on.
Is asthmatic bronchitis contagious?
Asthmatic bronchitis is not a contagious condition ; however, it is worth pointing out that the people who suffer from it, if they have developed the condition following a viral or bacterial infection against the bronchial tree, can transmit this infection to anyone, spreading a form of acute bronchitis.
Asthma is not a contagious condition, so whoever is a carrier cannot pass it on to other people.
Symptoms and Complications
Symptoms of asthmatic bronchitis are a combination of asthma symptoms and symptoms of acute bronchitis. More specifically, therefore, those suffering from asthmatic bronchitis complain:
- Cough with white phlegm production, in the early stages, and yellow or green, in the most advanced stages;
- Shortness of breath ;
- Wheezing during exhalation;
- Increased respiratory rate ;
- Sense of constriction in the chest, which in severe cases results in real pain in the chest;
- Sneezing, runny nose ( runny nose) and sore throat ;
- Fever, chills and muscle aches . It is important to point out that these symptoms are present only when asthmatic bronchitis is related to a viral or bacterial infection of the bronchial tree.
Complications
If asthmatic bronchitis is particularly severe or not properly treated, the resulting bronchospasm can cause respiratory difficulties such as to cause the patient to die from asphyxia .
The classic symptoms of severe asthmatic bronchitis are dyspnea at rest (ie shortness of breath in the absence of physical effort) and cyanosis (especially at the extremities of the limbs).
Diagnosis
For the diagnosis of asthmatic bronchitis, the information coming from an accurate physical examination and a scrupulous anamnesis are sufficient; however, very often, diagnostic research also includes investigations such as spirometry, peak expiratory flow measurement and chest X-ray, with the aim of investigating the present situation and ensuring that conditions other than the suspected one are not in progress, but responsible for similar symptoms.
Objective examination and medical history
In a context of suspected asthmatic bronchitis, physical examination and medical history include:
- The patient's account of symptoms ;
- A medical examination, aimed at finding out what emerged from the previous story. This step relies largely on chest auscultation ;
- An in-depth inquiry into the health status and habits of the patient (eg: is he a smoker? Does he live in a particularly polluted town? Does he carry out work that exposes him to irritating chemicals? Etc.). This is a fundamental step to understand if the patient under investigation is at risk of asthmatic bronchitis and to identify possible triggers.
As you will see, understanding the causes of asthmatic bronchitis is essential when planning therapy.
Spirometry
Spirometry is the diagnostic test that measures the inspiratory and expiratory capacity of the lungs, and provides information on the patency (or opening) of the pulmonary airways.
Measurement of the Expiratory Flow Peak
The peak expiratory flow measurement is the diagnostic test that measures the force with which an individual expels the air from the respiratory system (ie exhalation), after a complete inspiration.
Chest X-ray
The RX-thorax is a radiological examination that provides fairly detailed images of the lungs and bronchial tree.
The RX-chest is the diagnostic investigation that allows the doctor to make sure that the symptoms present are not due to a condition other than asthmatic bronchitis.
Therapy
The treatment of asthmatic bronchitis involves a combination of treatments : a treatment aimed at the management of asthma, a treatment aimed at counteracting the triggering factor and, finally, a treatment focused on alleviating the symptoms produced by acute bronchitis.
Asthma therapy
Currently, asthma therapy is based on the use of drugs.
The drugs used in the management of asthma include:
- Bronchodilators . The bronchodilators are medicines that, acting on the muscles of the bronchi, have the effect of dilating the latter and favoring the passage of incoming and outgoing air with respect to the lungs.
There are two types of bronchodilators: short-acting bronchodilators and long-acting bronchodilators ; the first type has the peculiarity of entering into action in a very short time, resulting in this way ideal for the occurrence of an acute asthma episode; the second type, on the other hand, has the characteristic of acting longer, which is suitable for preventing future asthma attacks (remember that asthma is a chronic condition).
The list of bronchodilators useful for those suffering from asthma (and asthmatic bronchitis) includes the so-called antimuscarinics (or anticholinergic bronchodilators ), beta2-agonists and methylxanthines .
- Inhaled corticosteroids (or inhaled glucocorticoids ). Belonging to the pharmacological class of corticosteroids, inhaled corticosteroids are medicines used to reduce the inflammation that is triggered along the bronchial tree, during an asthma attack.
In those who need it, the use of inhaled corticosteroids determines an improvement in respiratory capacity and the general symptoms.
Like all other corticosteroids, inhaled corticosteroids, if taken in excessive doses or for long periods of time, also cause various side effects, some of which are also very serious.
- Antileucotrienes . Antileucotrienes are useful drugs in the management of asthma, as they block some receptors in the bronchi and lungs involved in episodes of bronchospasm.
Tripping Cause Treatment
Eliminating the cause that led to the onset of asthmatic bronchitis is essential to permanently stop the symptoms of the current condition. With an example, this means that, in the presence of asthmatic bronchitis due to a bacterial infection affecting the bronchial tree, the affected individual will need, in addition to treatment for asthma, ad hoc antibiotic therapy.
Symptomatic Therapy of Acute Bronchitis
As a rule, symptomatic therapy of acute bronchitis related to asthmatic bronchitis is based on:
- The rest ;
- Humidification of the air in the domestic environment;
- Taking cough medications (in the absence of contraindications or interactions with other drugs).
Prognosis
Asthmatic bronchitis is a condition that requires appropriate and timely treatment, since, if neglected in management and time, it can cause respiratory difficulties such as to cause the patient to die from asphyxia.
Therefore, the prognosis in the case of asthmatic bronchitis depends on the adequacy and immediacy of treatment.
Prevention
For an asthma carrier, avoiding contact with people suffering from some infectious disease affecting the bronchial tree, avoiding all potential allergens, not smoking and adequately protecting themselves from air pollution are the 4 main behaviors to be adopted in view of prevention of asthmatic bronchitis.
