Bronchiectasis is a lung condition in which some of the bronchi and bronchioles have lost their elasticity and have expanded and filled with fluid. With bronchiectasis, these natural cleaning mechanisms have become damaged or destroyed. Although bronchiectasis can develop at any age, it generally begins during childhood. The mucus is then normally wafted away by the beating of tiny hairs called cilia which line the tubes see figure.Normally the airways in the lung are sterile – they are not infected. Also, inflammation and an increased number of blood vessels in the bronchial wall can result in a person coughing up blood. Blockage of the damaged airways can lead to abnormally low levels of oxygen in the blood. Typically, bronchiectasis causes widening of medium-sized bronchi, but often smaller bronchi become scarred and destroyed. Occasionally, a form of bronchiectasis affecting larger bronchi occurs in allergic bronchopulmonary aspergillosis, a condition caused by an allergic response to the Aspergillus fungus.
Causes of Bronchiectasis
The common Causes of Bronchiectasis :
Inhaling stomach acid which has been regurgitated back into the gullet
Healing of the tubes resulting in puckering and scarring, causing obstruction
Underlying genetic disease such as cystic fibrosis, where the mucus in the bronchial tubes is too thick, and primary ciliary dyskinesia, where the cilia lining the bronchial tubes do not beat properly
Immunodeficiency disorders, such as HIV infection and AIDS.
Cystic fibrosis, which leads to almost half of the cases of bronchiectasis in the United States.
Tuberculosis (TB) and other similar infections
Mechanical obstruction of the bronchial tubes by inhaled foreign bodies, for example, peanuts
Too little immunity to infection, for example after infantile pneumonia from whooping cough or measles, or lack of antibodies which occasionally occurs after a virus infection in adult life.
Symptoms of Bronchiectasis
Some Symptoms of Bronchiectasis :
Weight loss .
Shortness of breath worsened by exercise.
Coughing up blood .
Skin discoloration, bluish .
Cough worsened by lying on one side.
Breath odor .
Treatment of Bronchiectasis
If you are able, a daily exercise such as running, walking, swimming, dancing, aerobics, etc, helps to clear the mucus too.
Smoking makes symptoms worse and smokers are very strongly advised to stop.
Surgery may be an option if you have a small local area of lung damage causing symptoms. Cutting out the damaged airway may cure the problem. Surgery may be considered even if you have widespread bronchiectasis. This may be to cut out a particularly bad area of lung that is acting as a reservoir for mucus and infection. Occasionally, a lung transplant may be considered in severe cases.
Corticosteroids help reduce inflammation in your lungs. They work best when you take them with an inhaler.
Mucus thinners , such as acetylcysteine, loosen the mucus.
treatment of nose or sinus infection and runny nose using nasal drops and sprays.
If you have mild bronchiectasis, you may need a course of antibiotics every ‘now and then’ to clear chest infections as and when they occur. A change of the colour of your sputum to green and feeling unwell usually indicates that you have a chest infection. If you have severe bronchiectasis, you may find that chest infections return quickly once you stop taking antibiotics. In this situation you may be advised to take antibiotics every day to keep chest infections away.
Improvement of airflow through the bronchial tubes by anti-asthma treatment.