Bronchiectasis is a long-term condition, caused by damage to the airways of the lungs, which affects its ability to clear mucus. As a result we find accumulation of mucus, beginning the bacteria to grow and giving rise to repeated serious lung infections.
Bronchiectasis can develop at any age, but it is more likely to occur during childhood.
Inside the lungs, the tubes called bronchi form a structure in the form of a tree through which the air enters and exits. These line up with projections similar to tiny hairs called cilia, which work to push the mucus up into the lungs, allowing it to easily expel.
Bronchiectasis is a condition in which some of the bronchi become scars, enlarging permanently.
During the process of the disease the cilia are affected so that they are not able to effectively sweep away the mucus. As a result, it accumulates in the parts of the lung that are affected, increasing the risk of developing lung infections.
Recurrent infections can cause more scarring and bronchial enlargement thus perpetuating the condition.
Currently, bronchiectasis usually occurs as a result of a disease such as pneumonia (approximately 25% of all cases). Other causes include:
- Cystic fibrosis.
- Recurrent aspiration of fluid into the lungs (as with gastroesophageal reflux).
- Inhalation of a foreign body in the lungs (if not treated).
- Inhalation of harmful chemicals, for example: ammonia.
- In rare cases, it can be congenital (present at birth).
- In many cases, the underlying cause of the condition can not be identified.
Signs and symptoms
The main symptom of bronchiectasis is a cough that produces mucus. This is usually worse in the morning and is often caused by changes in posture. The mucus may be greenish-yellow with a bad odor, indicating the presence of infection.
Other symptoms may include:
- Cough with blood (more common in adults).
- Bad breath.
- Whistles in the chest. A characteristic crackling sound that can be heard with the help of a stethoscope.
- Recurrent pulmonary infections.
- Decreased health in general.
- In advanced bronchiectasis, dyspnea may occur.
The onset of symptoms often occurs slowly. As the disease progresses, the cough worsens and increasing amounts of mucus are produced.
An initial diagnosis of bronchiectasis is based on the patient’s symptoms, his medical history and a physical examination. Other diagnostic tests may include:
- Chest x-ray.
- CT scan (computed tomography).
- Blood test.
- Mucus test to identify any bacteria present.
- Checking the oxygen levels in the blood.
- Pulmonary function tests (spirometry).
Bronchiectasis is a chronic disease , where good management of the disease is vital to prevent permanent damage to the lungs and worsening of the condition.
The ultimate goal of treatment is to remove mucus from the chest and prevent further damage to the lungs. The two main types of treatments used are:
Some or all of the following groups of medications may be used:
Antibiotics are used to treat acute lung infections. When the infection is severe, hospitalization may be necessary and the patient may be managed with intravenous antibiotics.
Bronchodilators (as used in people with asthma) to improve the flow of air to the lungs.
- Corticosteroids to reduce inflammation in the lungs.
- Occasionally, medications can be used to thin mucus.
- Vaccination against influenza and pneumococcus.
- Physiotherapy and exercise.
Respiratory physiotherapy and postural drainage are used to eliminate secretions from the lungs. In addition, an individual program is developed in which they are usually taught exercise and breathing techniques to clean the lungs of mucus.
Other important factors in managing the condition include avoiding dust, smoke, other respiratory irritants and maintaining a balanced and nutritious diet.
It is also important to identify and treat any underlying conditions that lead to the development of bronchiectasis.
In some cases of severe bronchiectasis , surgery may be suggested to remove the affected portion of the lung. However, this is only an option if the disease is located in one or two small areas of the lungs.
- Do not smoke during pregnancy and have a smoke-free home.
- Breastfeeding their children.
- Eat a healthy and balanced diet.
- Detection and treatment of early chest infections.
- Immunization against diseases such as measles and whooping cough that can lead to bronchiectasis.