How Bronchiectasis Is Diagnosed

Understanding How Bronchiectasis is Diagnosed

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Bronchiectasis is among a group of lung disorders classified as chronic obstructive pulmonary disease (COPD). A diagnosis of bronchiectasis is sometimes difficult to make, as bronchiectasis symptoms are often mistaken for other lung disorders, such as chronic bronchitis, asthma, or pneumonia. However, specific tests, such as pulmonary function tests, chest X-rays, and sputum cultures can all help narrow down a diagnosis of bronchiectasis.

Self-Checks

Because the symptoms of bronchiectasis are so similar to numerous other lung conditions, such as bronchitis or asthma, at-home self-checks are not recommended. If you notice a chronic cough with thick mucus that's difficult to clear, wheezing, fatigue, weakness, or clubbing of the fingers, seek professional care immediately. It's important to pay attention to the signs and symptoms and see your doctor or a pulmonologist (lung specialist) as soon as possible to prevent further damage.

Labs and Tests

The first thing that your doctor is likely to do is take a thorough history and perform a physical examination. This includes asking questions about your health history and environmental exposures to airway irritants, such as cigarette smoke, air pollution and workplace exposure to chemicals and other airway irritants. A head-to-toe assessment will include listening to your lungs with a stethoscope and examining your chest wall for abnormalities. After these exams, if your doctor still suspects a diagnosis of bronchiectasis, the following tests may be ordered to confirm:

Pulmonary Function Test

The pulmonary function test helps your doctor assess your lung function and determine the amount of damage present in your lungs. It can determine how efficiently air flows into your lungs. There are three types of pulmonary function tests helpful in making a diagnosis of bronchiectasis and other types of COPD:

  • Spirometry, a noninvasive test that measures lung function as you breathe through a tube.
  • Lung Diffusion Studies, another noninvasive test that determines how much carbon monoxide you inhale versus exhale, to help assess how efficiently your lungs are performing.
  • Lung Plethysmography, a test that looks at your total lung capacity, or the amount of air you're able to take in as breath and how much is left over after you exhale (known as functional residual volume).

Sputum Culture

People with bronchiectasis are prone to frequent lung infections. A sputum culture is a lab test that analyzes a small amount of sputum or mucus in an agar dish (growing medium) that looks for bacterial growth. The test helps identify the specific bacteria strain(s) in the mucus, which can lead to more efficient treatment by successfully identifying which type of antibiotic to administer for best results.

Imaging

Two types of imaging tests may also be helpful methods to diagnose bronchiectasis.

Chest X-Ray

This noninvasive imaging technique uses electromagnetic waves to create a picture of your lungs and diaphragm.

Generally speaking, abnormalities in the lungs due to COPD do not show up until the damage is severe. So, while a chest X-ray does not provide a definitive diagnosis of bronchiectasis or other forms of COPD, it does help support one. X-rays are performed in some doctors' offices, medical imaging centers, or hospitals.

Chest CT Scan

A chest CT provides a more detailed image than an X-ray, as it takes numerous cross-sectional pictures (slices) of your lungs and chest and combines them to form a 3D image, in contrast to the 1D image created by an X-ray.

The test will usually be performed in a medical imaging center or a hospital and involves lying still on a table that is then electronically moved through a scanner tunnel, which takes the images. If you sometimes feel uncomfortable in confined or tight spaces, talk to your doctor before the scan about techniques to help you cope.

Although not routine practice in the diagnosis of bronchiectasis, your doctor may order a chest CT if you've had a change in symptoms, an infection is not resolving, or you are getting ready for surgery.

Differential Diagnoses

Before reaching a diagnosis of bronchiectasis, your doctor may also test you for associated conditions, such as cystic fibrosis or tuberculosis. This will help rule out or confirm a diagnosis of bronchiectasis. Other conditions your doctor will look into include:

  • Anemia: Limited airflow could be related to an iron deficiency in the blood.
  • Infection: Pneumonia or bronchitis could result in similar symptoms to bronchiectasis.
  • Cystic Fibrosis: This genetic condition affects the lungs and other organs and may result in increased mucus secretions.
  • Tuberculosis: Bronchiectasis may occur in conjunction with or be caused by tuberculosis, a disease caused by bacteria that usually attacks the lungs. Your doctor will perform specific lab work to rule out this disease.

A Word From Verywell

While bronchiectasis can be difficult to diagnose, there are several tests available to practitioners to help narrow the options. If you or a loved one have been diagnosed with bronchiectasis, know that several therapies have been shown to be helpful, including antibiotics and mucus-thinning medications, but also quitting smoking, staying hydrated, following a healthy diet, and keeping physically active. The most important thing is to seek treatment quickly to prevent further damage to the lungs and to identify your best treatment plan.

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