Bronchiectasis
WHAT IS BRONCHIECTASIS? This condition is defined as an abnormal, irreversible dilatation (enlargement) of the bronchial tubes. It is not a disease in and of itself, but it represents a manifestation of other lung diseases, other systemic (generalized body) disorders or can be idiopathic (an abnormality that stands alone and is not linked to any other condition).
WHAT CAUSES BRONCHIECTASIS? The key element to the development of bronchiectasis appears to be inflammatory destruction of the muscle, elastic tissue and cartilage of the bronchial wall by infected mucous in close and prolonged contact with the bronchial wall. Bronchiectasis can occur anywhere in the lung. In fact, the causes of bronchiectasis can be divided into those causing focal (only specific area of lung) or diffuse (throughout both lungs). Focal causes usually involve obstruction of the bronchial tube from such things as a foreign body (like an inhaled piece of food), enlarged lymph nodes that squeeze the bronchial tube from the outside, a growth in the bronchial tube or thick secretions. Diffuse bronchiectasis is usually associated with previous illnesses that have caused widespread inflammation. These include:
- Pneumonias…either bacterial or viral (especially during childhood)
- Tuberculosis or similar slow-growing bacterial infections (but not tuberculosis)
- Fungal infections
- Sarcoidosis
- Immune deficiency conditions
- Genetic causes such as cystic fibrosis
- Rheumatologic disorders such as rheumatoid arthritis, Sjogren’s syndrome, ulcerative colitis and Crohn’s (which are inflammatory bowel diseases)
- Chronic bronchitis and Chronic Obstructive Pulmonary Disease (COPD)
WHAT ARE THE SYMPTOMS OF BRONCHIECTASIS? Chronic cough that produces thick, white or green sputum (discharge) is the most common symptom. The sputum may be foul-smelling and abundant and may contain blood. The individual generally coughs up large amounts of sputum after changing position (for example, after rising from bed). The patient may have recurrent pneumonia, weight loss, and anemia.
HOW IS BRONCHIECTASIS TREATED? Some treatments include breathing medications, antibiotics, breathing devices to help one cough up thick secretions, postural drainage and chest physiotherapy. It may be necessary to perform bronchoscopy (in which the airways are viewed via a tube inserted through the mouth) or, in rare cases, to surgically remove the affected portion of the lung.
WHAT CAN I EXPECT ON MY FIRST VISIT TO PCCS? We will perform full pulmonary function testing and an x-ray to evaluate the extent of the bronchiectasis. A full medical history will be taken and a physical exam will be done. Some additional tests may be needed including CT scan of the chest, sputum analysis, and blood work.
