Guide to Bronchiectasis

Bronchiectasis is a respiratory condition that causes the lung’s bronchial tubes, which allow air to enter the lungs, to become swollen and inflamed. This can lead to mucus build-up, bacterial infections, and difficulty breathing. There is no cure, but treatments are available that can help manage it.

Key Facts

  • Air travels through the lungs via passageways called bronchi. Bronchiectasis scars the bronchi, leading to inflammation, infection, and, eventually, loss of lung function.
  • There are multiple possible causes of bronchiectasis. One of the most common is cystic fibrosis, but other causes include chronic obstructive pulmonary disease (COPD), autoimmune diseases, and having recurrent lung infections.
  • There is no cure for bronchiectasis, but treatment options such as antibiotics and oxygen therapy can help manage the disease.

Causes

Bronchiectasis is most often caused by another condition that damages the lungs. One of the common causes of bronchiectasis is cystic fibrosis, a genetic condition that leads to mucus building up throughout the body. When this happens, it’s referred to as CF bronchiectasis.

Bronchiectasis caused by other conditions are called non-CF bronchiectasis. The following are some associated non-CF conditions:

  • Alpha 1-antitrypsin deficiency (which can lead to COPD)
  • Autoimmune diseases (e.g., rheumatoid arthritis or Sjogren’s syndrome)
  • Chronic obstructive pulmonary disease (COPD)
  • Immunodeficiency diseases (e.g., HIV)
  • Inflammatory bowel disease
  • Recurring infections (e.g., tuberculosis, whooping cough, or fungus)

Symptoms

Symptoms can emerge very gradually over several months or even years. They may include the following:

  • Chest pain
  • Chronic cough, commonly with sputum production
  • Difficulty breathing
  • Fatigue
  • Fevers and/or chills
  • Frequent respiratory infections

Diagnosis

The first step to diagnosing bronchiectasis is to review the patient’s family history and test for any underlying conditions that may have caused it. This can be done by taking a blood sample.

Other ways to diagnose bronchiectasis include the following:

  • Bronchoscopy: This test inserts a flexible, narrow tube with a light and camera through the mouth or nose and into the lungs, allowing doctors to see inside the lung. This makes it possible to identify any obstructions.
  • Imaging Tests: These take detailed pictures of the lungs so that doctors can accurately diagnose their condition. The most common imaging tests used for bronchiectasis are computerized topography (CT) scans and x-rays.
  • Pulmonary Function Tests: These measure the flow of oxygen from the lungs to the bloodstream. They may include a spirometer, which tests the airflow of the lungs, as well as plethysmography, which measures lung volume.

Treatment

While there is no cure for bronchiectasis, treatment can help minimize symptoms and prevent infections. Common treatments include the following:

  • Medications: These can include antibiotics to treat and prevent infections and medications called bronchodilators that help open up airways.
  • Expectorants: These are treatments that help break up mucus so it can be coughed out. They may include drugs, natural remedies such as steam, or physical therapy such as chest clapping.
  • Oxygen Therapy: This just involves giving the patient additional oxygen through a mask or breathing tube. While it cannot reverse or slow damage, it can help make it easier to breathe.
  • Pulmonary Rehabilitation: These programs involve a mixture of diet, exercise, and breathing techniques so that patients can better manage their condition.
  • Surgery: In severe cases, surgery may be necessary to remove infected bronchi and/or stop internal bleeding.

Outlook

Bronchiectasis is a long-term condition that must be treated and managed consistently for many years. However, most people with this condition are able to have a normal life expectancy if they take preventive measures. These include the following:

  • Avoid smoke, pollution, chemicals, and other irritants
  • Stop smoking. You may improve your chances of quitting with the help of nicotine patches or medications like varenicline or bupropion.
  • Stay up to date with vaccinations, which includes the flu vaccine for all adults and the pneumococcal vaccine (PPSV23) for adults over age 65 or younger with certain conditions or smoking.
  • Maintain a healthy diet and stay hydrated.
  • Take antibiotics and other treatments during flare ups.

Despite these measures, occasional flare ups and infections will occur. It’s vital to make regular appointments with doctors whenever this happens in order to avoid further lung damage.

Next Steps

We understand how frustrating it can be to live with a condition like bronchiectasis. This is why our goal is to help you not only reduce symptoms and manage this disease, but to ensure you lead a full and healthy life. Our multidisciplinary team does this by working closely with you, from diagnosis through treatment and management, so that you get consistent and effective care at every step.

If you need help for a lung or chest issue, we’re here for you. Call (212) 305-3408 for existing patients, (212) 304-7535 for new patients, or request an appointment online to get started today.

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