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Bronchiectasis Pathophysiology condition is a long-term lung disease where the bronchi are widened, thickened, and permanently damaged. The bronchi are passages that allow air movement to the lungs.
Mucus and bacteria build up and gather in the lungs due to the damaged bronchial tubes. In addition, the cilia, which are thin hair-like strands that allow the mucus to leave the lungs, are also damaged. This makes it easy for it to be infected and for blockage in the airway to occur frequently.
While there’s currently no cure for bronchiectasis, it can be managed with treatment. However, immediate treatment is needed to prevent further lung damage and maintain the body’s oxygen supply when exacerbated flare-ups occur.
Any condition, such as an infection or lung injury that damages or narrows the bronchial tubes can result in bronchiectasis.
Infections that cause bronchiectasis complication include whooping cough (pertussis), pneumonia, tuberculosis, and non-tuberculosis mycobacterium (NTM).
Other causes of the disease include:
Immunodeficiency disorders including diabetes and HIV (human immunodeficiency virus)
Aspiration (a disease that results in difficulty swallowing, causing solids or liquids to enter the airways)
Inflammatory bowel diseases (IBD), such as ulcerative colitis and Crohn’s disease
Primary ciliary dyskinesia (a condition that damage the cilia, which are protective hair-like strands, within the air passages)
Alpha-1 antitrypsin deficiency
Chronic obstructive pulmonary diseases (COPD)
Connective tissue disorders
Exposure to toxic gases
Typically, bronchiectasis symptoms can take months or even years to develop. They worsen as the chronic condition progresses. The main symptoms are daily mucus or sputum production and chronic daily cough.
Other bronchiectasis risk factor includes:
Coughing up blood
Wheezing or abnormal sounds in the chest when breathing
Shortness of breath that exacerbates during flare-ups
Chills or night sweats
Cubbing (abnormally shaped fingernails and toenails caused by thickening of the skin under the nails)
Recurring respiratory infections
Severe bronchiectasis can often induce weight loss. Medical experts suggest that the increased work of clearing and coughing up bronchial secretions can increase the body’s caloric requirements, causing bronchiectasis patients to lose weight.
Apart from that, other bronchiectasis symptoms such as fatigue, breathlessness, inflammation, and reduced appetite can increase weight loss risks.
It’s advisable to consult a doctor when symptoms consistent with bronchiectasis begin to appear. Catching the disease in its early stages improves chances of better management and prevents severe lung damage that could lead to lung transplant.
Doctors instructed the following tests:
CT scans and chest X-rays to look at the lungs
Pulmonary function tests to check breathing
Blood tests to check for infections
Tests on sputum, known as sputum culture, to check for the presence of fungi, bacteria, and mycobacteria
Genetic tests or sweat chloride tests to check for cystic fibrosis
50% of non-CF bronchiectasis cases have unknown causes, making it difficult to tell what to do to prevent the condition. Non-CF bronchiectasis is a type of bronchiectasis that isn’t caused by cystic fibrosis.
However, bronchiectasis is linked to medical conditions known to affect the lungs.
The best way to prevent the disease is to live a lifestyle that keeps the lungs healthy, such as avoiding smoking, cooking fumes, polluted air, and chemicals.
Taking vaccine shots for measles, flu, and whooping cough, especially during childhood, is another preventive measure. This is because these illnesses are known to cause bronchiectasis in adulthood.
Breathing exercises such as pursed-lips breathing and diaphragmatic breathing can improve lung health and keep certain conditions that could cause the disease at bay.
Generally, there’s no cure for bronchiectasis. However, treatment, especially the early ones, can prevent further liver damage, reduce the rate of infections, and make the condition easier to manage.
People with bronchiectasis can also lead normal lives with the disease.
Antibiotics will be administered to fight off infections. In addition, drugs like azithromycin and clarithromycin, known as macrolides, can ease inflammation. Inhaled corticosteroids are also prescribed to treat airway inflammation.
Bronchiectasis patients have also been prescribed expectorants, which help to thin mucus or cough them out to free the airways.
Bronchodilators like tiotropium and albuterol can be administered via inhalers and nebulizers to open up the airways.
Flu and pneumonia vaccines are often prescribed to prevent infections that can worsen the condition.
Doctors may suggest treatments such as chest physical therapy (CPT), percussion, or chest clapping to shake the mucus free. These therapies may involve physically pounding the chest and wearing inflatable vests that force mucus up using airwaves. Some devices can also be used to shake off mucus in the airways.
Respiratory therapists also teach techniques that can be applied to cough up excess mucus.
If the disease or bleeding is found in a part of the lung, it will be removed surgically. Patients with advanced and severe bronchiectasis may need a lung transplant.
NOTE: Bronchiectasis treatment is best offered by a team of skilled healthcare experts. Specialized clinics for patients with bronchiectasis are now available in several countries. Please consult your doctor if you think you need to visit a specialist.