Bronchiectasis

Bronchiectasis

Bronchiectasis is a relatively common condition where the bronchial tubes become permanently dilated as a result of damage to the airway wall from persistent infection.  This infection destroys the elastic structure, which maintains normal airway calibre.  This condition can develop after whooping cough, pneumonia, tuberculosis or blockage to a bronchial tube due to a mucus plug.

A diagnosis is confirmed by studying the shape of the airways on a CT scan of the chest.  Bronchiectasis can be localised involving only one or a few airways or may involve many airways, usually at the lung bases initially, then spreading to involve the middle zones.

The main symptom is a chronic cough, producing mucus (sputum).  Other important symptoms include:

• Sinusitis or nasal inflammation
• Fatigue
• Chest pain
• Shortness of breath
• Coughing up blood

It is common for bronchiectasis to have periods of acute worsening of symptoms (exacerbation).  These episodes may be initiated by a head cold however there is often no clear cause.

These episodes are usually associated with increased infection and inflammation in the airways.  The bacteria involved are usually low grade pathogens, which include Haemophilus influenza and Pseudomonas aeruginosa, although occasionally other bacteria may be involved.

Treatment consists of methods to cough up phlegm (exercise or devices which vibrate the airways – flutter valve and Aerobika), plus antibiotics directed against the causative bacteria taken short or long term.

Bronchiectasis causes progressive decline in lung function, which is proportional to the activity of the infection and the degree of mucus retention in the airways.  This is why it is very important to ensure that daily efforts to clear the lungs of phlegm will minimize lung damage in this condition.