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What Is Bronchiectasis?
This is a disease that is caused by recurrent inflammation or infection
of the airways. It damages the muscle and elastic tissue of the airways in the
lungs. As a result of the damaged bronchial wall there can be permanent dilation of the
airways. This dilation can be a uniform enlargement or irregular and result in the
formation of pouches. These pouches of the airways are susceptible to infection. When
small infections accumulate, you may become very ill.
What Are The Causes?
You can be born with it or you can acquire it as an adult or child
through one or more of the following ways:
- Accidental inhalation of a foreign object into your lungs, causing inflammation.
- Obstruction of the airways due to a tumor.
- Gastroesophageal reflux (GERD, heartburn) is when the valve or sphincter connecting your
esophagus and stomach is relaxed; this allows a backward flow of stomach contents to enter
you lungs and irritate the airways.
- Having another chronic lung condition, such as cystic fibrosis, allergic aspergillosis,
tuberculosis, whooping cough (pertussis) or an immune deficiency disease or repeated
episodes of flu and pneumonia.
- Kartageners Syndrome is a rare genetic disease that comprises chronic sinusitis,
situs inversus (reversal of body organs so that what is supposed to be on the right side
of the body is now on the left), chronic saccular bronchiectasis, and loss of the
ability to clear mucus.
How Does Bronchiectasis Develop?
There is injury to the walls of the airways by recurrent inflammation.
The immune defenses of the respiratory tract weaken and lose ability to clear mucus,
therefore making the airways susceptible to infections. Having repeated lung infections
causes permanent damage to the elastic tissue within the bronchial wall and what finally
develops is chronic weakness and pouching of the airway walls.
What Are The Symptoms?
With bronchiectasis you have a recurring cough with mucus. The mucus
may be discolored and foul smelling, sometimes containing blood. You may also experience
fatigue, weight loss, shortness of breath and have abnormal chest sounds. Many people with
bronchiectasis will have chronic sinusitis.
How Is Bronchiectasis Diagnosed?
Diagnosing bronchiectasis involves the following:
- Complete history and physical exam
- Chest X-ray and / or CAT scan (diagnostic)
- Pulmonary function tests
- Practically never used anymore is a bronchogram (x-ray procedure that
tracks the distribution of dye into the airways, assessing the location and amount of lung
that is involved)
What Is The Treatment?
Bronchiectasis is best treated by treating the underlying cause.
Your doctor will recommend the best course of action for you. Here are some of the
- Sinusitis- corticosteroid nasal spray can be used to decrease swelling
and mucus production. Cromolyn sodium nasal spray may be helpful for allergy type
symptoms. Saline nasal washes also helps control sinusitis.
- Gastroesophageal reflux- elevate the head of your bed six to eight
inches and avoid eating or drinking alcohol, coffee, cola or tea for several hours before
bedtime. Antacids or other medications to control heartburn may be needed. Stomach acids
can irritate the lungs. In severe cases surgery may be needed to tighten the sphincter at
the base of the esophagus.
- Antibiotics- continuous treatment with antibiotics can help sometimes,
but drug-resistant organisms can develop in the lung. An antibiotic will be given based on
your signs and symptoms.
- Bronchodilators & Corticosteroids- bronchodilators will be used if
pulmonary function tests show improvements with the medication. Corticosteroids help to
reduce the inflammation in the airways.
- Chest physiotherapy- this is recommended if you are producing an
abnormally large amount of mucus or if you are having recurrent infections. You will need
an assistant or your doctor may prescribe an electric vibrator for this procedure. It is
done by using rhythmic clapping on your back to loosen the mucus and enables it to be
drained from the lungs.
- In severe cases, surgery to remove the affected parts of the lung.
Here are some steps you can take to better manage bronchiectasis:
- If you smoke, STOP, and avoid second-hand smoke
- Get your yearly flu shot and pneumococcal vaccine
- Exercise regularly to improve your muscle strength and breathe easier
- Eat a well balanced meal and drink plenty of fluids to help thin the mucus
Bronchiectasis is treatable with routine visits to your doctor and
taking medications as instructed. As with any illness always consult with your doctor
before doing any kind of treatment or taking any medications.