Bronchiectasis
What is Bronchiectasis?
Bronchiectasis is a lung disease characterized by irreversible enlargement of the lower lung airways and destruction of lung tissue. It is usually caused by repeated infections and inflammation, which can start a vicious cycle. Inflammation causes a partial obstruction of a part of the lung, causing secretions to collect, which sets the stage for infections to develop and persist, damaging the surrounding lung tissue. Bronchiectasis is not an independent lung disease, but is a consequence of some other disease process. A lung infection may be from tuberculosis, a fungus, or virus, or may result from obstruction by a tumor or an inhaled foreign object. Bronchiectasis can also follow lung injury from inhaling corrosive gases or one's own stomach contents. Other causes are cystic fibrosis and a syndrome of non-functioning cilia in the airways, both of which allow the collection of secretions in the airways of the lung. There may be anatomical birth defects in the lung, such as cysts or softening of the airways, which can begin the cycle of obstruction, infection, and bronchiectasis. Or, there may be an inborn immune deficiency leading to frequent infections. Over half of the cases of bronchiectasis in children and young adults in the US are specifically associated with cystic fibrosis.
Bronchiectasis signs and symptoms
- Frequent coughing with bad-smelling, green or yellow sputum (sometimes flecked with blood).
- Repeated lung infections.
- Shortness of breath; bad breath.
- General ill feeling.
- Frequent fatigue.
- Anemia (frequently).
Causes
Damage to the small bronchial tubes, which may develop
over years.
Common sources of damage include:
- Cigarette smoking.
- Repeated lung infections (pneumonia).
- Chronic bronchitis.
- Allergies; smoke or dust.
- Inhalation of a foreign object.
- Tuberculosis; lung cancer or lung abscess.
- Fungus infection.
- Cystic fibrosis.
Risk increases with
- Smoking.
- Poor nutrition.
- Obesity.
- Family history of tuberculosis.
- Fatigue or overwork.
- Exposure to allergens.
- Cold, humid weather.
Preventive measures
- Don't ever smoke.
- Obtain medical treatment for lung infections.
- Avoid as many risks as possible.
- Get immunization against influenza and pneumonia.
Predicted outcome
The prognosis of an individual with bronchiectasis varies with the amount of lung destruction. Prognosis declines with multiple successive pulmonary infections. Individuals who have had bronchiectasis from childhood generally have a shortened life expectancy.
Possible complications
- COPD (chronic obstructive pulmonary disease).
- Repeated pneumonia.
- Destruction of lung tissue.
Bronchiectasis treatment
- Medical tests for diagnosis may include X-rays of the lung, including a bronchogram, sputum culture, bronchoscopy.
- Don't smoke.
- Learn and practice postural drainage twice a day.
- Sleep with 3- to 5-inch blocks under the foot of the bed to prevent mucus from collecting in the lower lobes of the lungs.
- If you work around heavy air pollution, do everything possible to limit your exposure, including changing jobs.
- Install air conditioning with a filter and humidity control in your home.
- Avoid shouting, loud laughing, crying, exertion or sudden temperature changes, if these trigger coughing episodes.
- Keep the teeth and mouth in excellent condition.
- If you have an allergic background, avoid allergens.
- Surgery to remove isolated areas of damaged lung tissue (rare).
Additional Information
Medications
- Antibiotics for 10 days every month if bacterial infections have caused bronchiectasis or triggered episodes of pneumonia or acute bronchitis.
- Bronchodilators to enlarge airways.
- Expectorants to loosen secretions.
Activity
Remain as active as possible.
Diet
Increase fluid intake. Drink a minimum of 8 glasses of fluid a day. This thins lung secretions so they can be coughed out more easily.
Notify your physician if
- You or a family member has symptoms of bronchiectasis.
- After diagnosis, you have symptoms of a respiratory infection or bronchitis.
- Fever.
- Blood appears in the sputum, sputum thickens despite treatment or postural drainage reveals a change in color, amount or character of sputum.
- Chest pain increases.
- Shortness of breath occurs without coughing or when at rest.