Bronchiectasis is one condition among a group of lung diseases classified as chronic obstructive pulmonary disease (COPD). Bronchiectasis is characterized by damage to the airways, the tubes that carry air in and out of the lungs. The damage causes the larger tubes, called bronchi and bronchioles to widen and become flabby and scarred.
In a person with bronchiectasis, the airway slowly loses the ability to clear out mucus. Mucus is a substance that the airways normally produce to help remove inhaled dust, bacteria and other small particles. If mucus cannot be cleared, it builds up and bacteria multiples inside the lungs. This leads to repeated and sometimes serious lung infections.
With each infection, more damage and scarring occur in the airways. The more damage, the harder it is for the lungs to move air in and out of the body causing the person’s oxygen levels to drop. Vital organs need oxygen and when they do not get enough, critical health issues can arise such as respiratory failure (atelectasis) and heart failure.
If a child is born with this condition, it is called congenital bronchiectasis because it is present at birth and is a result of a problem with how the lungs formed in the fetus. Bronchiectasis can also be acquired in childhood and in adulthood and is usually the result of another health problem. This is the more common type of bronchiectasis (Merck.com, “Bronchiectasis,” accessed May 12, 2010).
Causes of Bronchiectasis
According to the American Lung Association, a condition called cystic fibrosis causes approximately 50% of all bronchiectasis cases in the United States. The other 50% include other underlying conditions that injure the airway walls or prevent the clearing of mucus (Cff.org, “About Cystic Fibrosis,” accessed May 12, 2010).
In the United States, the initial lung damage that leads to this lung condition often begins in childhood, although the symptoms may not appear until months or years after repeated lung infections. Common childhood illnesses such as whooping cough and measles were the main cause of bronchiectasis. These are less common causes now because of the effectiveness of vaccines and early intervention with effective antibiotics (Lungusa.org, “Lung Disease,” accessed May 12, 2010).
Sometimes, a weakened cough reflex can cause the inability to clear the airway effectively, which can lead to bronchiectasis. The cough reflex can be weakened from a surgery, or from other illnesses such as pneumonia, influenza, measles, ciliary dyskinesia or tuberculosis.
Bronchiectasis can affect one section of one lung or it can affect many sections of both lungs. Bronchiectasis occurring in only one part of the lung can be due to some obstruction or some kind of blockage of the airways rather than by infections and inflammatory illnesses. Airway obstruction can be caused by a foreign object such as inhaled food particles or from a growing tumor (Nhlbi.nih.gov/health, “Brochiectasis,” accessed May 12, 2010).
Symptoms of Bronchiectasis
Symptoms of bronchiectasis often develop gradually over months or sometimes even over years. Some of the symptoms include shortness of breath that worsens with activity, chronic cough that worsens when lying flat, wheezing, increasing weakness and fatigue.
Other symptoms include repeated respiratory infections and inflammation, thick, foul-smelling and even bloody mucus. Other common symptoms of bronchiectasis are weight loss and a condition called clubbing of the finger (“Bronchiectasis,” accessed May 12, 2010).
Treatment for Bronchiectasis
Bronchiectasis cannot be cured, but with effective care, it can be managed to the point that people who have it can enjoy a high quality of life. It is important that the condition is recognized early and that any underlying causes are treated as soon as possible.
The sooner treatment starts, the better the chances are of slowing and preventing further damage to the lungs. Treatment under the direction of a doctor may include medication therapy, hydration, chest physiotherapy, lung hygiene and postural drainage, oxygen or surgery.
The first line of medication that a doctor may order is an antibiotic to kill bacteria and stop infection. Another type of medication commonly used is a bronchodilator that works by relaxing and expanding the airways making it easier to breathe.
Another type of medication used is a type of cough medicine called an expectorant. This loosens mucus in the lungs making it easier to be coughed up and expelled so as to more effectively clear the lungs.
Adequate hydration helps to prevent thick and sticky mucus. It is easier to clear the airway when mucus is kept thin. Good hydration includes drinking plenty of fluids, especially water, on a daily basis.
Doctors will often recommend that all patients receive annual flu vaccinations to minimize or prevent viral lung infections. A pneumonia vaccine may also be recommended to prevent infection from the pneumonia virus or bacteria.
Other treatments for bronchiectasis are pulmonary hygiene measures. These include postural drainage, deep breathing and coughing exercises and chest percussion or chest physiotherapy. More information on pulmonary physical therapy can be found in this article on “percussion” (Cystic-l.org).
When blood oxygen levels are low, a doctor may recommend oxygen therapy. In severe cases and usually as a later treatment for brochiectasis, a doctor may recommend surgery to remove a section of the lungs. Surgery is used if other treatments are not helpful and if only one part of the airway is affected (Merck.com, “Bronchiectasis,” accessed May 12, 2010).
Mary Ann George - I am a registered nurse currently working as a case manager in the home health industry. My credentials include a BS degree in education, ...
