Introduction
The bronchi or air passages are the tubes that carry air during the inspiration and expiration process. Thickening of these air passages results in lung damage. It is a long-term disease and becomes severe as the disease progresses. Smoking exacerbates the condition because patients with bronchiectasis are at higher risk. It usually affects older adults, mostly above 75 years old, with an autoimmune disorder. Younger people are the least affected. Women are more commonly affected by bronchiectasis than men.
What Are the Causes of Bronchiectasis?
Various underlying conditions are responsible for bronchiectasis. These include:
-
Cystic Fibrosis - It is the most common cause of bronchiectasis. The walls of the air passages or bronchial tubes thicken due to medical conditions like cystic fibrosis. In this condition, there is a reduced breathing capacity.
-
Idiopathic Bronchiectasis - Certain bronchiectasis occurs due to unknown causes. However, prolonged severe infections in the lungs interfere with breathing and make the condition worse. The individual with a weaker immune system is more likely to be affected.
-
Genetic Disorders - Genetic disorders like alpha 1 antitrypsin deficiency affects the lungs and their ability to breathe.
-
Aspiration - The involuntary actions like the aspiration of fluid or acids present in the stomach cause bronchiectasis.
-
Allergy - Certain individuals may be allergic to fungi. The allergic reaction causes bronchiectasis because it involves the lungs and air passages. This condition is known as aspergillosis.
-
Crohn's Disease - The irritation in the digestive tract leads to inflammation in the bowel. The swelling in the stomach and the lungs increases the risk of bronchiectasis.
-
Tumour - The proliferation of abnormal cells in the air passages blocks it and reduces the airflow. Eventually, it leads to bronchiectasis.
What Are the Symptoms of Bronchiectasis?
The symptoms of bronchiectasis depend on the progress of the disease. They are as follows:
-
Breathing Problems - The thickening of the tissues present in the bronchial tubes results in flare-ups. So the patient has trouble during respiration.
-
Cough - Since bronchiectasis affects the major part of the air passages, it induces cough along with excess phlegm. It also expels blood which is present in the form of red streaks.
-
Fatigue - The patient with severe bronchiectasis loses weight eventually and becomes exhausted. There is a frequent occurrence of respiratory infections due to bronchiectasis.
-
Chest Pain - The accumulation of abnormal fluid in the cavity present in the lungs causes chest pain.
-
Clubbing - The skin gets deposited in layers under the nails present in the toe and finger. This condition is known as clubbing.
-
Wheezing - The presence of fluid due to respiratory infection causes wheezing. Some individuals have a whistling sound during the respiratory mechanism.
-
Frequent Illness - The patient with bronchiectasis frequently becomes ill. There is an increase in temperature due to fever. Some individuals have chills, while others have night sweats.
What Are the Various Diagnostic Methods of Bronchiectasis?
Two to three diagnostic tests are necessary to confirm bronchiectasis. They are as follows:
-
Chest X-Ray - A chest X-ray is a radiographic image that covers the heart and lungs. The radiation passes through the lungs. Normal lung appears grey. But the changes, like a thickening in the air passages, can be observed in the image. The narrowing or obstruction of the bronchi can also be detected.
-
Culture Test - The sputum expelled due to bronchiectasis is collected. It is sent to the laboratory for a culture test. The presence of bacterial infection indicates bronchiectasis. During blood tests, the increase in white blood count, particularly in eosinophils, suggests infections.
-
Lung Function Test - Bronchiectasis has an impact on the lungs and causes respiratory illness. The lung function test is beneficial for observing the ability of the lungs. The restricted airways can be detected with lung function tests. Medical professionals can easily inspect the earlier changes due to lung impairment with the help of a pulmonary function test.
-
Bronchoscopy - The damage to the inner surface of air passages can be visualized using a bronchoscope. It comprises a tube, light, and camera. The blocks in the bronchial tubes or unwanted fluid secretions around the lungs can be removed with the help of a bronchoscope.
What Are the Different Types of Treatment Methods for Bronchiectasis?
The life expectancy can be increased in patient with bronchiectasis with maintenance therapy. It should be followed daily to prevent the worsening of respiratory illness.
-
Medications - The physician prescribes antibiotics to treat the underlying bacterial infections in bronchiectasis. It is available as both oral pills and inhalers. The medication is inhaled using a nebulizer. The inflammation of the air passages is treated with the help of Macrolides. Lozenges are prescribed to soothe the throat and help in clearing the mucus.
-
Airway Clearance Devices - The air passages blocked with phlegm are cleared with airway clearance devices. Positive expiratory pressure (PEP) is the most commonly used device. It also helps to breathe without any difficulty. The patient can carry it easily in their hands. Severe respiratory conditions require oxygen to support the breathing mechanism.
-
Physical Therapy - The chest physical therapy (CPT) is used to thin the mucus so that it can leave the air passages. The chest is physically pounded like clapping to clear the phlegm out of the lungs. The patient can also wear an inflatable vest. The mechanism of the vest is to generate airwaves and force the mucus above to expel.
Conclusion
Bronchiectasis is often left unnoticed unless the symptoms become severe. The individual affected by bronchiectasis does not recover completely. However, the condition can be managed with palliative care. The course of treatment takes several months to years because bronchiectasis is a prolonged condition. For a better prognosis, the underlying allergic conditions and infections must be treated at an earlier stage. So it is important to vaccinate against whooping cough and flu. Do not ignore the lung infection if it lasts for more than three weeks. Keep tiny objects away from children to prevent aspiration into the air passages. The individual must stay away from hazardous agents like fumes and gases. The individual should follow a healthy diet.
