What is bronchiectasis?
Commonly found in the women who are aged above 60 years, Bronchiectasis is a disease that affects the respiratory system, specifically the bronchi.
In this disease, the bronchial tubes of the lungs get widened and thickened than the normal width. As a result, the bronchial tubes allow bacteria and mucus to accumulate in the lungs of the patient.
This leads to permanent damage in most of the cases as one can get to see blockages and infections of the airways of the lungs.
Symptoms of Bronchiectasis
Since the disease affects the airways over a long period of time, hence it can take a few months to some years for the symptoms to start showing up.
In the earlier stages the symptoms could be:
- Shortness of breath or Wheezing
- More production of Sputum
- Some amount of discomfort or pain in the chest
- Reoccurring chest infections – considered as a sign of exacerbation
- A continuous daily cough
- Fatigue and tiredness
- Nails curving downwards or skin under nails getting thicker
Note – If any doctor tries to listen to the lungs using a stethoscope, they would hear a crackling sound.
But if the disease is diagnosed at a later stage, then the following symptoms may be seen:
- Weight loss
- Pale or blue skin color
- The slow rate of growth in children
- The smell in the breadth
- Excess fatigue
- Walking issues for short distances such as 100 meters
- Coughing blood
- Mucus containing blood
- Severe Chest Infections
If some diagnosis is done on the respiratory system, then the following results may come up:
- Extensive damage to both lungs
- Presence of fungus on the Sputum
Causes of Bronchiectasis
So, what exactly causes Bronchiectasis?
In order to understand this, you need to understand certain important facts about our respiratory system.
As you are aware that when we breathe, oxygen enters our respiratory system reaches our lungs and then goes back in the form of Carbon dioxide through the Bronchial tubes.
In normal cases, these tubes form a narrow shape towards the edges of the respective lungs.
However, when a person is diagnosed with Bronchiectasis, these bronchial tubes widen instead of narrowing. Now, cilia inside the lungs along with mucus, cover the linings of the bronchial tubes.
These cilia have a beating motion or a rhythmic wave in their function. The objective of the mucus that is present, is to protect our lungs from unwanted dust that try to enter our lungs during breathing.
In the case of Bronchiectasis, the cilia are damaged. This simply means that now they cannot remove the unwanted dust and excess mucus upward.
Therefore, as a result, the dust and mucus keep on adding inside. This results in another condition where the sputum becomes very sticky and it becomes difficult to move, even if the patient is coughing.
As time progresses, the sputum begins accumulating inside. This leads to an increase in the bacteria count leading to more infections.
As a result, the patient gathers more sputum inside and suffers from further damage to his respiratory system.
Speaking about Bronchiectasis, the reason why patients suffer from Bronchiectasis is not clear. However, it has been established that the damage to the bronchial tubes can happen due to a medical condition or an infection.
Also, lung injuries can cause Bronchiectasis. There are basically two sub-divisions in this:
1. Cystic Fibrosis (CF) – It is a disease that affects the secretory glands. This disease is genetic in nature and the mucus becomes very sticky and thick. This leads to infections and lung damage due to the blockage in the airways.
2. Non-Cystic Fibrosis (Non-CF) –This is not related to the CF. The commonly known conditions that lead to non-CF Bronchiectasis are as under:
- Allergic aspergillosis (an allergic lung reaction to fungus)
- Lung infections, for example, tuberculosis and whooping cough
- An abnormally functioning immune system
- Chronic obstructive pulmonary disease (COPD)
- Alpha 1-antitrypsin deficiency (an inheritable cause of COPD)
- Inflammatory bowel disease
- Autoimmune diseases
Let us check out the list of infections that increase the risk of Bronchiectasis
- Fungal infections
- Whooping cough early in life
- Tuberculosis (TB)
There are certain other medical conditions which can pave the way to Bronchiectasis, such as:
- Immunologic conditions
- Autoimmune diseases, For example- rheumatoid arthritis
- Underlying deficiencies due to genetic factors
- Genetic abnormalities
- Airway obstruction
Diagnosis of Bronchiectasis
Once the symptoms appear a doctor may recommend certain tests to the patient and also carry out a physical examination
- Laboratory tests on the sputum samples
- Certain Blood tests for checking the overall health
- A chest X-ray
- Cystic fibrosis – if required
- A high-resolution computed tomography (HRCT) scan
- Spirometry for measuring lung function
Note: Patients who are suffering from bronchiectasis may need continuous monitoring, to check for certain infections or any other worrying factors.
Treatment of Bronchiectasis
Even after so many path-breaking researches in the medical field, we have still not been able to find a 100 percent cure for bronchiectasis.
However, early-stage detection and proper treatment can go a long way in improving the lives of the patient by:
- Stopping the disease from spreading
- Reducing the complications
- Preventing exacerbations and infections
- Controlling the secretions
- Clearing the obstructions in the airways
So, how would a doctor treat an infection?
He may consider the following steps:
- In order to help in clearing the secretions, he would advise physical therapy and exercise.
- In order to relax the airways, he might prescribe bronchodilators for ease in the breathing of the patient.
- To prevent infections. S(he) may prescribe antibiotics.
- To avoid the mucous becoming sticky and thick, he would suggest drinking fluids.
- In order to clear the mucus, s(he) might prescribe mucoactive drugs.
Note – For patients who might have an underlying situation may receive particular treatment for that situation. Also, in order to increase the oxygen levels in the blood, sometimes oxygen therapy may be required for the patient.
Treating inflammation and mucus accumulation
Even though there is very little scientific proof that it is worth prescribing inhaled corticosteroids to reduce inflammation, yet some doctors do that to give some relief to the patient.
Electric Chest Clapper
Certain devices such as ECC that uses high-frequency airwaves may help in coughing out the accumulated mucus inside the lungs of the patient.
As a patient, if you can lay down or sit in certain prescribed positions then it can help you in clearing the mucus.
NoteSome amount of physical exercise in order to strengthen the muscle of the patient’s chest are also advisable for easy breathing.
Removing a bronchial obstruction
There have been cases where small items have been found stuck in the airways of the patient. In such cases, the doctor may use a bronchoscope – effective equipment to see and remove any kind of obstruction that may be present inside the patient and help him/her in breathing normally.
Depending upon the situation of the patient and the symptoms the doctor
Lung surgery and embolization
So, when is surgery suggested in the case of bronchiectasis?
Case 1 – If only a single lung or a part of a lung has been affected and the damage is big enough coupled with infections and other issues, the surgery is deemed to be the right path for recovery of the patient.
Case 2 – If the patient is suffering from cystic fibrosis and advanced bronchiectasis, s(he) may need immediate lung transplantation from a healthy donor so that their life can be saved.
Complications of Bronchiectasis
There are certain complications in bronchiectasis which have been described as under:
• Heart failure, reason being - low levels of oxygen
• Respiratory failure which would be leading to low oxygen levels
• Collapsed lung or Atelectasis, which makes it difficult to breathe
• Repeated number of infections
• Lungs Bleeding internally
Note – Patients suffering from bronchiectasis should immediately go and get diagnosed as some of these conditions are more likely to be fatal in nature.
Prevention of Bronchiectasis
‘Prevention is better than cure’. Hence in order to reduce the risk of bronchiectasis, one may consider taking vaccinations against particular types of diseases that might lead the patient towards bronchiectasis.
1. Vaccines for influenza and pneumococcus for all age groups.
2. Vaccines for Pneumonia, measles and whooping cough for kids.
Also, you can follow the following steps to avoid getting affected by bronchiectasis.
- Ensuring that kids do not inhale any hazardous objects or liquids
- Getting treatment for Asthma properly along with other lung issues, if any
- Completely avoiding breathing in polluted and toxic air
Note - There are certain instances when patients have responded to the treatment of the doctors. However, in order to be effective, the symptoms need to be identified as early as possible to increase the chances of recovery of the patient.
As far as the treatment of bronchiectasis is concerned, it is solely dependent on the precautions and timely medical treatment that has been given to the patient. This decides the chances of recovery of the patient.
The Diagnosis of any patient can result in very serious complications, if:
- S(he) is suffering from diseases such as emphysema or chronic Bronchitis – both of which are very critical if the person has bronchiectasis as well
- S(he) is suffering from pulmonary hypertension
- S(he) is delaying the treatment.
Note – Any patient, young or old, irrespective of the gender must immediately seek medical attention as soon as the symptoms of bronchiectasis appear. The sooner the treatment starts, the better are the chances of recovery of the patient.
1. What are the most common causes of bronchiectasis?
The most common causes of bronchiectasis can be aptly summed up as:
- Aspiration – stomach contents accidentally passing on to the lungs
- Immunodeficiency – because of a weak immune system
- Cilia abnormalities – unable to clear the mucus and unwanted dust upwards
- Connective tissue diseases – Diseases like rheumatoid arthritis, Sjogren’s syndrome, Crohn’s disease, and Ulcerative Colitis are certain medical conditions that are known to cause inflammation in other body parts. These conditions are linked to bronchiectasis
- Cystic fibrosis – lungs become blocked with mucus resulting in bacteria and infection
- Childhood infections – such as whooping cough, measles, Tuberculosis, severe Pneumonia
- Allergic bronchopulmonary aspergillosis (ABPA) – Individuals affected by the ABPA are allergic to aspergillus – a particular type of fungi
2. What are the best-considered treatments for bronchiectasis?
May ask the patient to go for the following things:
- Antibiotics prescriptions – either oral or IV depending upon the seriousness for repeated lung infections.
- Mucus Thinning Medicines & Expectorants - Mucus Thinning Medicines help in loosening up the mucus so that the patient can cough it out. Expectorants help the patient in loosening up the mucus inside the patient’s lungs.
- Hydration – Consuming lots of water would play an active role in not allowing the mucus to become sticky and thick and thereby making it easier to cough up.
- Chest Physical Therapy – using a Mechanical precursor or by manually pounding the chest & back of the patient repeatedly, helps in loosening up the mucus of the lungs so that the patient can cough it up.
- Oxygen Therapy – oxygen is let in through nasal prongs or a mask to increase the oxygen levels.
- Bronchodilators – A lot of them are taken using inhalers or nebulizers. This is a very effective method as the medicine reaches directly into the patient’s lungs
- Inhaled Corticosteroids – Prescribed by doctors only when the patient has asthma or wheezing with bronchiectasis.
- Surgery – In case, everything else fails, the doctor may recommend surgery to clear the part of the airway which is affected. In more serious cases, the patient might be asked to go for a lung transplant.
3. What is the life expectancy of someone with bronchiectasis?
If the patients are treated as per their present medical conditions properly, the patients who have been diagnosed with bronchiectasis can be expected to live a normal life.
However certain patients who have been affected by very serious cases of bronchiectasis could end up having a short life expectancy as compared to other patients.
4. Is bronchiectasis a progressive disease?
Yes, since there is no particular cure for bronchiectasis which has been developed, therefore it still remains to be a progressive disease in nature.
Normally, the treatments for bronchiectasis are focussed on prevention of additional infections and trying to control the symptoms.
But in case of serious bronchiectasis, the patients are advised to go through Medicines and surgery as the last resort.
5. Is exercise good for bronchiectasis?
Any kind of physical activity, that would make the patient a little bit uncomfortable about breath is considered as extremely beneficial as it helps in clearing out the mucus while improving the overall health of the patient.
Thus, a patient can also be expected to develop better immunity from infections.
6. What happens if bronchiectasis goes untreated?
It depends on the situation of the patient; in the earlier stages, it may result in the patient feeling tired and facing chest infections which are considered as a sign of exacerbation.
However, if the patient is in the advanced stage of bronchiectasis, it may even lead to heart failure or respiratory failure.
7. Does bronchiectasis worsen with age?
It depends upon the individual to individual. When the bronchial tubes continuously get clogged with mucus and dirt particles, it keeps on damaging the lungs.
For some patients, the speed of progression of bronchiectasis is on the lower side. While in certain cases, the condition may get worse quickly.
8. Do inhalers help bronchiectasis?
For some patients, the inhalers can be of some help. The reason being – even though bronchiectasis is not the same as COPD or Asthma, yet the lungs are affected in some of the similar ways.
Inhalers such as Salbutamol provides relief from breathlessness by opening the airways. The decision on whether to use inhalers by the patent, depends upon the patient’s symptoms, breathing test results and medical history as well.
9. Can bronchiectasis be seen on an X-ray?
No, it is not possible to see bronchiectasis in an X-ray. However, there are several other ways such as Spirometry, which involves blowing air inside the lungs onto the machine.
This is one way to ascertain whether there has been any damage to the lungs even though the spirometry device does not do the diagnosis of bronchiectasis.
10. What foods to avoid if you have bronchiectasis?
In the case of bronchiectasis, a patient is expected to bring up his/her weight to the desired level for healthy people. Therefore, one needs to avoid saturated fat, sugar, salt. Rather the focus should be on consuming lots of fiber in the form of vegetables, fruits, and whole grains.
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