CHRONIC BRONCHITIS AND HOMEOPATHIC TREATMENT

                                                            CHRONIC BRONCHITIS

DEFINITION:- 

                Chronic Bronchitis is a longstanding inflammatory disease of the tracheobronchial tree which is often associated with emphysema. Clinically it is defines as a condition associated with a history of productive cough for most days during three consecutive months in two successive years or more.

AETIOLOGY (or) CAUSES:-

        Males are more commonly affected in middle aged or elderly peoples. Presence of chronic disease of lungs or the heart or acute bronchitis will favours the incidence of chronic bronchitis.

-          Chronic irritation of the bronchial mucosa (dust, smoke, fumes and fog).

-          Climacteric changes mainly winter season.

-          Cigarette smokers.

-          Bacterial infections.

-          Exposure to damp weather, foggy or chilly weather.

PATHOLOGY:-

          There is chronic inflammation of the bronchial tree. The bronchial glands are hypertrophies secreting lot of mucus inside the bronchial lumen. The bronchial mucousa is oedematous due to congestion and collection of exudates. The lumen of the lower respiratory  tract is narrowed resulting in chronic airway obstruction. The goblet cells present inside the bronchioles proliferate and are over distended with mucus. This contributes to airway obstruction, Air can be inhaled during inspiration with the help of accessory muscles of respiration but expiration becomes difficult. This results in prolonged expiration and expiratory dyspnoea.Air remains trapped inside the lung alveoli which get ruptured.

The disease passes through 3 stages.

-          During the first stage the sputum is mucoid and white in co lour.

-          During the second stage infection supervenes and sputum becomes mucopurulent or yellow in co lour.

-          Third stage is that of chronic obstructive bronchitis associates with significant airway obstruction. This is crippling stage of the disease which persists and leads to death from respiratory failure with or without cor pulmonale.

SYMPTOMS:-

-          Cough with expectoration.

-          Cough leads to vomiting.

-          The sputum is scanty or copious, thin or thick, white or yellow.

-          Sputum with blood.

-          Dyspnoea is more on late hours of night or early morning.

-          Low grade fever.

  EXAMINATION:-

                The breath sounds are vesicular in character with prolonged expiration.Rhonchi (both sonorous and sibilant) are heard all over the chest bilaterally and symmetrically.Crepitations are present all over the chest. Presence of unusually coarse crepitations at one of the lung bases, signifies develops of bronchiectatic changes.

  INVESTIGATIONS:-

-          Pulmonary function tests -  The forced expiratory volume is reduced, the forced vital capacity is also reduced. The residual volume of the lungs is increased due to distension of alveoli and trapping of air inside them. The PaO2 falls and PaCO2 rises leading to respiratory acidosis.

-          Mild leucocytosis with increased polymorpho nuclear cell count.

-          X-ray.

   COMPLICATIONS:-

-          Emphysema and chronic cor pulmonale.

-          Bronchiectatic changes.

-          Bronchopneumonia and pneumonia.

   TREATMENT:-

-          Stop smoking.

-           Avoidance of dusty and smoke laden atmosphere.

-          Mechanical ventilation.

-          Tablets like salbutamol,terbutaline

-          Erythromycin, azhithromycin, ampicillin 2 times in a day.

  HOMEOPATHIC TREATMENT:-

1.       ACONITE:-

               Dry cough, worse at night, every inspirational seems to increase the cough, sleep disturbed due to cough which almost awakes him, onset will be sudden, chilly pt.

2.       ARSENIC UM ALBUM:-

                For any dryness, when due to some organic trouble, particularly of the heart, or with emphysema, the cough is violent and dry, with shortness of the breath and suffocative spells, worse at night.raipid emaciation and debility, restlessness,anguish and fear of death.

3.       BRYONIA:-

                 The cough is dry in  night, compelling one to spring up and assume and erect posture at once, patient dreads motion, cannot sit up as it causes nausea, the lips are dry and cracked, chilly pt.

4.       CALCAREA CARB:-

                  Secondary bronchitis, cough caused by sensation of plug, which moved up and down in the throat, cough is dry especially at night,violent,first dry, afterwards with profuse salty expectoration, with pain as if something had been torn loose from the larynx with rattling in the chest.

5.       KALI BICH:-

                 When there is an expectoration of tough, string mucus, irritability, chilly patient, anxiety about health.

6.       LYCOPODIUM:- 

                 The patient is quite emaciated, cough with excessive accumulation of mucus, the cough sounds loose, but the expectoration is easy. cough worse from 4-8 pm on alternate days, from exertion, when lying down on left side, from eating and drinking cold things, in the wind or in the warm room.

7.       SENEGA:-

                

                Particularly in old people, when there is an enormous accumulation of phlegm, with a loose rattling cough, tendency to diarrhea, chest is painful and sore.

8.       SEPIA:-

                       Particularly when reflex in women with some uterine trouble or from some stomach disease, cough at every evening, not ceasing until he coughs loose a little sputum, spasmodic dry cough from tickling in the chest.

9.       SULPHUR:-

                 This is our best remedy for cases of long standing profuse secretion of mucus. Cough with expectoration.

Some of other drugs are pulsatilla,arg nit, Kali sulph,carb veg etc.