An Overview of Bronchiectasis

What to expect with bronchiectasis

Doctor showing patient CT scan imaging
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Bronchiectasis is a lung disease characterized by coughing and wheezing. It can lead to health complications, such as lung infections and weight loss. The condition is one of the lung diseases classified as chronic obstructive pulmonary disease (COPD).

Bronchiectasis results from excessive dilation (widening) of the bronchi and bronchioles (airways of the lungs). There are several risk factors that can predispose you to develop bronchiectasis, including smoking and recurrent lung infections.

You may need several tests to identify bronchiectasis, including imaging tests and pulmonary function tests. And if you have the condition, you can benefit from a variety of medical treatments. Avoiding fumes from cigarette smoke is important if you have bronchiectasis.

Symptoms

Often developing gradually, symptoms of bronchiectasis may not be apparent until months or even years after the changes in your lungs have begun. You may initially experience intermittent effects of the condition. The symptoms tend to occur when the lungs are under more strain than usual, such as when you have a lung infection or during physical exertion.

Eventually, as bronchiectasis worsens, you may feel the effects more frequently—on a daily basis without any obvious triggers.

Common symptoms of bronchiectasis can include:

If you experience these symptoms, you should seek medical attention. Lung infections might not improve without treatment—if you have a fever, you may require treatment with antibiotics.

Hemoptysis is usually mild in bronchiectasis, but if you are coughing large amounts of blood, you could run the risk of severe lung damage and/or blood loss. Be sure to talk to your doctor if you are coughing up blood.

Complications

This condition may cause more serious health effects beyond the noticeable day-to-day symptoms. Over time, the effects of bronchiectasis can impact your quality of life and limit your overall ability to walk or get around without becoming severely short of breath.

Complications of bronchiectasis include:

  • Weight loss
  • Fatigue
  • Weakness
  • Pain when breathing

Causes

There are a number of causes and risk factors associated with bronchiectasis. The lung damage that leads to bronchiectasis can occur as a result of a congenital lung condition or it can be caused by respiratory illnesses.

Common causes of bronchiectasis include:

Cystic fibrosis: One common cause of bronchiectasis, cystic fibrosis, begins during childhood. It is characterized by abnormal mucus production in the lungs and digestive tract. The mucus build-up in the lungs damages the airways, leading to bronchiectasis.

Recurrent respiratory infections: Most respiratory infections improve without producing any long term consequences. But severe or repeated episodes of pneumonia or influenza, especially during childhood, can permanently harm the lungs. Having an immune deficiency can predispose you or your child to aggressive infections.

And measles or tuberculosis, which are typically more severe than usual respiratory infections, can also cause lasting lung damage, predisposing to bronchiectasis.

Inflammatory conditions: Allergies and asthma may cause thickening of your airways during flare-ups—and this thickening may not resolve after the flare-up resolves. Autoimmune conditions, such as rheumatoid arthritis or lupus, may cause inflammation anywhere in the body, including the lungs.

Ciliary disease: The cilia are tiny hairs lining your airways that help clear out mucus and infectious organisms. They can be damaged by airborne toxins, including cigarette smoke and environmental pollutants.

A genetic defect, primary ciliary dyskinesia, can make it difficult for you to adequately clear your airways, resulting in a build-up of mucus and inflammation, eventually causing bronchiectasis.

Large obstruction in the airways: Your airways can become blocked by an object or tumor. Obstruction can occur when you breathe in food particles while eating. You may be more prone to airway obstruction after surgery because a post-operative weakened cough reflex can make it hard for you to clear your airways effectively.

Lung Damage in Bronchiectasis

Bronchiectasis occurs due to dilation (widening) of the airways. Inflammation and infection can cause this to occur. When the airways become dilated, excessive mucus begins to pool in the enlarged areas.

Damage to the cilia, a common component of bronchiectasis, makes it difficult for you to clear out your airways. The pooling of mucus becomes a breeding ground for bacteria—which leads to further lung infections.

With bronchiectasis, you can experience repeated cycles of lung inflammation, infection, and worsening airway obstruction.

​Diagnosis

The process involved in the diagnosis of bronchiectasis involves a medical history, physical examination, and diagnostic testing. There are a number of causes of chronic coughing and wheezing, such as chronic bronchitis, and asthma. If you have these symptoms, your doctor will assess factors such as whether your condition has been gradually worsening and whether you have episodic flare-ups.

Your physical examination will include an assessment of your breath sounds, as well as your breathing rate, heart rate (pulse), blood pressure. Your doctor will also observe your breathing to determine whether you are struggling to breathe.

Diagnostic tests in the evaluation of bronchiectasis include:

  • Chest imaging, such as a chest x-ray or chest computerized tomography (CT) scan, provide a visual picture of the structure of your lungs
  • Arterial blood gas, a blood test that measures your blood oxygen, carbon dioxide, and bicarbonate levels
  • Sputum culture is used to grow and identify microbial organisms that could be causing a respiratory tract infection
  • Pulmonary function tests measure how much air volume you can inspire (breath in) and expire (breath out)
  • Lung diffusion test measures the ability of your lungs to absorb gases (such as oxygen and carbon dioxide) as you breath into a mouthpiece
  • Lung plethysmography involves breathing while sitting in a special booth so that the air inside the booth can be measured to assess your lung volume

Treatments

Although the disease can't be cured, most people who have bronchiectasis are able to live a normal and active life. There are several goals when it comes to the treatment of your bronchiectasis.

Treatment and prevention of infections is an important part of managing bronchiectasis. Maintaining comfort and drainage of excessive secretions from your lungs is another therapeutic target. And the prevention of further complications is a key feature of bronchiectasis treatment as well.

Lifestyle Approaches

Avoidance of respiratory irritants includes the avoidance of smoking and secondhand smoke. Additionally, air pollution and workplace exposure to toxins can exacerbate symptoms of bronchiectasis. Protecting your lungs from these airborne irritants, whenever possible, can help prevent worsening of your condition.

Respiratory Medications

A number of medications can help improve your breathing and decrease mucus build-up in your lungs. Bronchodilators, expectorants, decongestants, and mucus-thinning medications can make you more comfortable and can help prevent infections and other complications of bronchiectasis.

Management of Infections

You may need oral (by mouth) or intravenous (IV, through a vein) antibiotics if you have an infection. Having a yearly flu shot is important because bronchiectasis makes you more prone to infections, such as the flu.

Interventional Therapies

There are a number of procedures that can be used on a regularly scheduled basis to relieve mucus build up in bronchiectasis, including postural drainage and chest physiotherapy. Additionally, your doctor may prescribe oxygen therapy for you if you tend to have low blood oxygen levels.

Surgical lung resection is not a common treatment approach in bronchiectasis, but it may be necessary if you have severe lung disease.

A Word From Verywell

If you or your child has risk factors for bronchiectasis, it is important to get medical attention and treatment for respiratory infections because they can worsen the condition. With consistent medical attention and lifestyle strategies, you can minimize the effects and progression of bronchiectasis.

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