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Bronchiectasis - Causes, Symptoms, Diagnosis, and Treatment

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The thickening of air passages leads to bronchiectasis. Read the article below to learn about the symptoms, diagnosis, and treatment of bronchiectasis.

Written by

Dr. Saberitha

Medically reviewed by

Dr. Kaushal Bhavsar

Published At September 6, 2022
Reviewed AtJune 6, 2024

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.

How Do Bronchiectasis and Bronchitis Differ From Each Other?

Bronchiectasis and bronchitis share symptoms like mucus buildup in the lungs and coughing. However, bronchiectasis leads to permanent widening of the airways, whereas bronchitis is a temporary infection that doesn't cause lasting harm.

What Different Types of Bronchiectasis Are There?

Healthcare providers classify bronchiectasis based on the appearance of airway damage: cylindrical (or tubular), varicose, or cystic. Cylindrical bronchiectasis is the most common and least severe, while cystic bronchiectasis is the most severe form. Bronchiectasis can also be categorized as focal, affecting a single area, or diffuse, affecting multiple areas throughout the lungs. Traction bronchiectasis occurs when lung scarring pulls the airways out of shape.

Which Medical Conditions Are Associated With Bronchiectasis?

Various factors can initiate the cycle of bronchiectasis, including:

  • Cystic fibrosis.

  • Infections such as mycobacterial infections (e.g., MAC infections or tuberculosis).

  • Autoimmune or inflammatory disorders like rheumatoid arthritis (RA), lupus (SLE), inflammatory bowel disease (IBD), and Sjogren's syndrome.

  • Obstructions caused by foreign bodies, lymph nodes, or tumors, that impede airway clearance.

  • Conditions that compromise immunity, raise the risk of infections (e.g., HIV and hypogammaglobulinemia).

  • Primary ciliary dyskinesia.

  • Alpha-1 antitrypsin deficiency.

  • Organ transplant, with transplant medications reducing immunity and potentially increasing infection risk and bronchiectasis.

  • Fibrosis (scarring) results from radiation.

  • Allergic bronchopulmonary aspergillosis (ABPA), is an allergy to a particular fungus.

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 in the bronchial tubes results in flare-ups. So the patient has trouble during respiration.

  • Cough - Since bronchiectasis affects most air passages, it induces cough and excess phlegm. It also expels blood, which is present in red streaks.

  • Fatigue—The patient with severe bronchiectasis eventually loses weight and becomes exhausted. Due to bronchiectasis, respiratory infections are frequent occurrences.

  • Chest Pain - The accumulation of abnormal fluid in the cavity in the lungs causes chest pain.

  • Clubbing - The skin gets deposited in layers under the nails on 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 this 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 for 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. A normal lung appears grey. But 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 and 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 impacts the lungs and causes respiratory illness. The lung function test is beneficial for observing the lungs' ability to function. Restricted airways can be detected with lung function tests. Medical professionals can easily inspect 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,a 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?

Maintenance therapy can increase the life expectancy in patients with bronchiectasis. It should be followed daily to prevent the worsening of respiratory illnesses.

  • Medications—The physician prescribes antibiotics to treat the underlying bacterial infections in bronchiectasis. The medication is available as both oral pills and inhalers. It is inhaled using a nebulizer. Macrolides treat the inflammation of the air passages. Lozenges are prescribed to soothe the throat and help clear the mucus.

  • Airway Clearance Devices—Airway clearance devices clear the air passages blocked with phlegm. Positive expiratory pressure (PEP) is the most commonly used device. It also helps the patient breathe without any difficulty. The patient can easily carry it in their hands. Severe respiratory conditions require oxygen to support the breathing mechanism.

  • Physical Therapy - 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.

Is Bronchiectasis a Potential Consequence of COVID-19?

Studies indicate that COVID-19 is not a prevalent factor in developing bronchiectasis. However, individuals who have experienced acute respiratory distress syndrome (ARDS) due to COVID-19 might exhibit pseudo bronchiectasis. Pseudobronchiectasis resembles bronchiectasis but typically resolves over time without leading to recurring infections and lung damage.

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. The underlying allergic conditions and infections must be treated earlier for a better prognosis. So, it is important to vaccinate against whooping cough and flu. Do not ignore the lung infection if it lasts over 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.

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Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)

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