What is bronchiectasis?

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Bronchiectasis is a type of chronic obstructive pulmonary disease (COPD) where the large airways in the lungs are damaged and widened. The mucus can build up in these dilated airways which allows bacteria to grow, thus resulting to recurrent lung infections. The condition might be localized to a single region of the lung or generalized in which both lungs are affected.

The condition often starts due to repeated respiratory infections during childhood. These infections result to thickening, widening and scarring of the bronchi. Take note that the buildup of mucus in the dilated areas provides the right conditions for infections to develop. The infections can lead to worsening of the disease and further dilation and scarring of the bronchi.

Possible causes

The condition is often triggered by recurrent lung infections during childhood. The usual infections that can result to bronchiectasis such as whooping cough are uncommon due to immunizations, but the cases of bronchiectasis continue to increase.

Almost half of cases are due to hereditary conditions such as cystic fibrosis. The condition can also occur due to an obstructed airway by a tumor or a foreign body, immune suppression, allergic reaction or due to primary ciliary dysplasia.

Bronchiectasis
Chronic daily cough that is worst early in the morning and late at night

What are the signs and symptoms of bronchiectasis?

The usual signs and symptoms of bronchiectasis include the following:

  • Chronic daily cough that is worst early in the morning and late at night
  • Wheezing
  • Production of mucus that can be clear, yellowish, greenish or even blood-streaked
  • Coughing up blood
  • Indications of repeated infections such as fever and other respiratory symptoms
  • Clubbing is characterized by fingertips that take on the appearance of an inverted spoon
  • In severe cases, there is shortness of breath and evident fatigue

Diagnosis

A diagnosis of bronchiectasis starts with a thorough history and physical exam followed by imaging and lung function tests such as the following:

  • Chest X-ray
  • Chest CT scan
  • Pulmonary function tests
  • Bronchoscopy

Management

A vital step in treatment is to manage the underlying cause of bronchiectasis. Take note that infections are quite common and must be treated and closely monitored. There are airway clearance techniques that can help reduce the sputum and improve lung function. Oxygen therapy might be needed if the condition is severe and oftentimes surgery is also required to eliminate a severely damaged region of a bronchi.

What are the complications?

Aside from repeated infections, some individuals develop atelectasis which is a collapse of a region or the entire lung and even respiratory failure can occur. In some cases, the condition can also result to right heart failure.

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