Bronchiectasis

Bronchiectasis is a respiratory disease in which the bronchial tubes get permanently damaged, swollen, and thickened. Germs and mucus build up in the lungs due to clogged airways, thus increasing the risk of respiratory infection and airway blockages. Bronchiectasis is a chronic condition that worsens over time.
This pulmonary disease has no cure, but it is treatable. With treatment, patients should be able to lead a normal life. However, flare-ups must be managed as soon as possible to keep oxygen flowing to the rest of the body and prevent additional lung damage.

Bronchiectasis Overview

Symptoms

Bronchiectasis disease signs and symptoms develop and change over time. They are as follows:

The first common symptom is a continuous chronic cough and phlegm production; the excess mucus is normally clear but can become bloody if the bronchial wall is injured. Also, when an infection is present, mucus may become green or yellow.

Chronic coughing with mucus production increases as the condition worsens, and the person generally feels increasingly exhausted and has short breaths due to mild to moderate airflow obstruction as lung function declines.

Some people may develop wheezing, while others may lose weight due to increased breathing efforts.

In a few cases, the symptoms of a primary condition, such as pneumonia, hide the signs and symptoms of bronchiectasis, thus making it more difficult to identify this respiratory infection.


When to visit a doctor?

If a person has respiratory complaints such as a persistent cough that lasts three or more weeks, a new onset of shortness of breath, or coughing up blood (hemoptysis), seek medical attention.

Individuals who experience recurring attacks of pneumonia and increasing sputum production should also seek medical help.


Causes

Bronchiectasis disease is a lung condition mainly caused by chronic airway infection causing inflammation. It is characterised by any airflow limitation, due to growth or a noncancerous tumour. In a few cases, it develops in childhood after suffering from a severe lung infection or inhaling food particles or a foreign object.
Although it's mostly linked with cystic fibrosis, bronchiectasis can be caused by many other conditions, including:
Other causes of bronchiectasis include:

  • Autoimmune disorder
  • Immunodeficiency syndromes
  • COPD and alpha-1 antitrypsin deficiency
  • Diseases that impact the cilia, which are the tiny, hair-like coverings that cover the airways and have the primary function of mucus clearance.
  • Crohn's disease and ulcerative colitis.
  • Allergic bronchopulmonary aspergillosis
  • Chronic pulmonary aspiration

Risk factors

Bronchiectasis risk factors include:

  • Severe or recurring lung infections, such as pneumonia, tuberculosis, or whooping cough
  • Allergic bronchopulmonary aspergillosis
  • Alpha-1-antitrypsin deficiency
  • Cystic fibrosis
  • Conditions that impact the cilia, which are tiny hair-like growths in the bronchi that filter mucus.
  • HIV/AIDS and other immunodeficiency illnesses.
  • Crohn's disease and ulcerative colitis
  • Humoral immunodeficiency
  • Rheumatic disorders such as rheumatoid arthritis and Sjogren's syndrome Chronic pulmonary aspiration
  • Breathing in harmful substances like gases, smoke, pollutants, or coal dust.

Complications

Bronchiectasis complications include:

  • Recurring of infections
  • Pulmonary bleeding
  • Disruption of the respiratory system, resulting in low oxygen levels.
  • Atelectasis or a collapsed lung that makes breathing difficult.
  • Low oxygen levels in the blood cause heart failure.

Some of these complications are potentially fatal. If a bronchiectasis patient notices any of the above changes, they should consult a doctor.


Diagnosis

Bronchiectasis cannot be diagnosed with a single test. Even in its later stages, the disease's symptoms are similar to those of other conditions; therefore, it is important to rule out other conditions. The following are the most widely used diagnostic tests to detect bronchiectasis:

  • A chest X-ray of the lungs is performed to look for signs of infection and scarring of the airway walls.
  • Chest CT scan to provide a computer-generated image of the lungs, airways and other surrounding tissues.
  • Blood tests are used to diagnose diseases or conditions that might cause bronchiectasis.Sputum culture for bacteria, fungus, or TB detection
  • Lung function tests are used to determine how well the lungs breathe air in and out.Sweat test or other tests for cystic fibrosis

Treatment

Generally, there’s no cure for bronchiectasis disease, but treatment is important to help manage the condition. The main aim of treatment is to reduce respiratory infections and bronchial mucus secretions. The treatment options for bronchiectasis include:

Chest physiotherapy or chest physical therapy (CPT)

A high-frequency chest wall oscillation vest is used in chest physiotherapy to help eliminate mucus from the lungs. The vest gradually compresses and releases pressure from the chest, causing coughing to loosened mucus from the bronchial tube walls.

Antibiotics

Antibiotics are the main treatment options for recurrent lung infections due to bronchiectasis. Oral antibiotics are preferred to treat these infections. For serious infections, the doctor may prescribe intravenous (IV) antibiotics.

Draining secretions

Another treatment is gravity-assisted drainage of bronchial secretions. A respiratory therapist can teach patients coughing strategies to help get rid of the extra mucus.

Treating underlying conditions

If underlying illnesses such as immunological disorders or COPD are causing bronchiectasis, the doctor will treat those conditions also.

Hydration

The doctor may advise drinking plenty of fluids, especially water, to help stop airway mucus from becoming thick and sticky. Staying hydrated helps keep airway mucus slippery, moist, and easier to cough up.


Lifestyle and self-care

Making lifestyle modifications can help people to reduce lung infection symptoms and improve their health. Here are some steps to take:

Protect lungs

During cold and flu season, doctors recommend getting the flu vaccination every year to reduce the risk of infections. The flu vaccination can help prevent pneumonia, worsening of bronchiectasis and lung damage.

Stop smoking

Smoking inflames and irritates the lungs causing lung diseases and lung cancer.

Stay Active

Exercises help to maintain the heart and lungs in good condition. The doctor may advise patients to gradually increase daily aerobic activities, alone or under supervision. Exercise-related intense breathing can help the clear airways mucus more efficiently.

Stay Hydrated

Drink plenty of water to keep the body hydrated and reduce mucus thickening, making it easier to expel.


Do’s and Don’ts

Bronchiectasis, also known as chronic lung disease, is a disorder that happens when the airways in the lungs get damaged and have difficulties clearing mucus. Some mucus is healthy and necessary, but when there is too much mucus, germs can increase and cause infection. Repeated infections lead to even more damage to the airways, making breathing more difficult over time. However, it is possible to live a healthy life without severe complications if we follow the do's and don'ts listed below to help manage the condition.

Do’s Don’ts
Try to keep the chest clear of mucus Smoke cigarettes
Try to do regular exercises to keep yourself fit and active Get in close contact with sick people
Avoid air pollution as much as possible Eat food containing excessive salt, sugar, and saturated fats
Take medicines as prescribed by the doctor Drink cold and alcoholic drinks, and beverages
Drink lots of fluids and water to keep your body hydrated. Be obese

Manage the bronchiectasis symptoms and lead a healthy life. Seek timely treatment and keep following up with the doctor for better monitoring of the condition.


Bronchiectasis Disease Care at Medicover

At Medicover, we have the best team of pulmonologists who provide the most comprehensive pulmonology care and management. To treat various lung problems and disorders, our experts use the most advanced diagnostic methods and latest technology for accurate diagnosis and timely initiation of treatment. Our medical experts work closely with the patients to monitor their health and treatment progress to achieve a faster and more sustained recovery.

Citations

https://www.wikidoc.org/index.php/Bronchiectasis_risk_factors
https://www.lung.org/lung-health-diseases/lung-disease-lookup/bronchiectasis
https://www.nhs.uk/conditions/bronchiectasis/
https://www.nhlbi.nih.gov/health/bronchiectasis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094191/

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Frequently Asked Questions

1. What is bronchiectasis?

Bronchiectasis is a chronic lung condition characterised by the permanent widening and damage of the airways (bronchi) in the lungs. This can lead to a buildup of mucus, increased susceptibility to infections, and difficulty clearing airway secretions.

2. What causes bronchiectasis?

Bronchiectasis can be caused by various factors, including

3. Why do I need to see a Bronchiectasis specialist?

Consulting a Bronchiectasis specialist is essential because they possess expertise in diagnosing and treating this specific respiratory condition. Their experience ensures accurate diagnosis, personalised treatment plans, and effective management strategies.

4. Is Bronchiectasis curable?

While Bronchiectasis isn't completely curable, it is manageable. With proper medical care and lifestyle adjustments, many individuals can effectively control their symptoms, prevent exacerbations, and lead a fulfilling life.

  • Infections: Severe lung infections that damage the airways, such as pneumonia or tuberculosis.
  • Cystic Fibrosis: An inherited condition that leads to the production of thick and sticky mucus, which can clog airways.
  • Immune System Problems: Conditions that weaken the immune system's ability to fight off infections.
  • Allergic Bronchopulmonary Aspergillosis: An allergic reaction to a fungus called Aspergillus can lead to bronchiectasis in some cases.
  • Inflammatory Conditions: Conditions like rheumatoid arthritis or inflammatory bowel disease can also contribute to bronchiectasis.

5. Can bronchiectasis affect children?

Yes, bronchiectasis can affect children. Paediatric bronchiectasis is a less common but still significant condition. It may be caused by various factors, including recurrent lung infections, congenital lung abnormalities, or underlying medical conditions. Early diagnosis and appropriate treatment are crucial for managing bronchiectasis in children, as it can impact their lung health and overall well-being.

6. Is there a link between bronchiectasis and smoking?

Yes, smoking can increase the risk of developing bronchiectasis. Smoking damages the airways and impairs the ability of the lungs to clear mucus and fight infections. It is considered a risk factor for bronchiectasis, and quitting smoking is strongly recommended for individuals with this condition to improve lung health and reduce further damage.

7. What should I do if I suspect I have bronchiectasis?

If you suspect you have bronchiectasis or are experiencing symptoms such as chronic cough, increased mucus production, and recurring respiratory infections, it's essential to seek medical attention. A healthcare provider can perform diagnostic tests, such as chest imaging and lung function tests, to determine if you have bronchiectasis and develop an appropriate treatment plan.

8. Where can I find support and resources for bronchiectasis?

There are several resources and organisations that can provide support and information for individuals with bronchiectasis and their families:

  • Bronchiectasis and NTM Initiative: This initiative offers educational resources and support for individuals with bronchiectasis and related conditions.
  • Bronchiectasis Foundation: This organisation focuses on research, advocacy, and support for bronchiectasis patients and caregivers.
  • American Lung Association: They offer information and resources related to lung health and diseases, including bronchiectasis.
  • Online Support Groups: Various online forums and social media groups exist where individuals with bronchiectasis share their experiences and provide support to one another. However, always exercise caution and consult with healthcare professionals for accurate information and advice.