BRONCHIECTASIS

I’m writing this article in response to a question from one of our readers, specifically wanting to know about adult bronchiectasis, so here goes…

Firstly, let us have a look at this uncommon condition. Its a medical term which refers to damage of the walls of the bronchial tubes, or large airways of the lungs. Inflammation due to infection, or other causes destroys the smooth muscles that allow the bronchial tubes to be elastic and prevents secretions that are normally made by lung tissue to be cleared. The airways do not taper in a normal way, but become distorted. Secretions tend to pool in the distorted airways rather than be expelled, and these stagnant secretions are a breeding ground for bacterial growth. These bacteria can cause imflammation and irritation, which can result in pneumonia.

Bronchiectasis is what is referred to as Chronic Pulmonary Obstructive Disease (CPOD). CPOD includes, emphysema and chronic bronchitis. Bronchiectasis can be present alone, but usually more than one of the aforementioned components of COPD coexist in the same person.

Causes

As mentioned it is damage to the walls of the large intestine which in turn makes it difficult to clear any secretions out of the airways, which brings with it bacteria and infection. There are three primary types, but I am not going into the technicalities, but merely going to mention them:

• Cylindrical bronchiectasis
• Saccular bronchiectasis
• Cystic bronchiectasis

It can also be congenital or acquired (adult bronchiectasis).  Congenital causes may be:

• Cystic fibrosis
• Young’s syndrome
• Alpha-1-antitrypsin deficiency
• Kartagener Syndrome

Once again, just a mention as it is going to get too technical to explain each one. Acquired bronchiectasis can be caused by:

• Recurrent infection
• Inhalation of toxic gases like ammonia
• Alcohol and drug abuse
• Aspiration (inhalation) of foreign bodies or other materials
• Tubercolosis
• Inflammatory bowel disease

The symptoms will develop over a long period of time. Common symptoms include recurrent cough and sputum production. Usually the mucus is clear, but it may be bloody due to bronchial wall injury or green or yellow if infection is present. Shortness of breath and fatigue develop as lung function decreases. Wheezing may or may not be present. f the disease progresses or if it is poorly controlled, the amount of work required to breathe increases and weight loss and diminished quality of life may occur.

Treatment

Bronchiectasis is not a curable disease. Instead, the goal of treatment is control of secretions and preventing infections. In some situations, where the disease is limited to one area of the lung, surgery may be a possibility to remove the area affected by the disease. Those with the disease can control it better by doing the following:

• Keep your immunisations up to date to prevent infection
• Drink plenty of fluids to make the secretions less sticky
• Stop smoking, and also avoid secondary smoke
• Make sure you getting enough nutrition. Breathing heavier means the body needs to do more work, which means you need to feed it more

I hope that helps with the query?