What is Bronchiectasis ?
Bronchiectasis is a chronic airway disease in which the airways become damaged, scarred and permanently enlarged. These changes are irreversible and it causes large amount of sputum is produced in these damaged airways and it leads to recurrent airway infection and/ or inflammation.
Who gets it?
This can affect any age group, however it is more common in women and elderly.
What are the causes?
The exact cause for having bronchiectasis is unknown. However, having previous airway infections that damage the airways like pneumonia, whooping cough or tuberculosis particularly in childhood is believed to be a potential cause for bronchiectasis.
There are multiple reasons identified as risk factors such as following.
- Post infective
- post pneumonia
- Whooping cough
- Measles
- Tuberculosis
- Fungal infections
- Mucocilliary disorders
- Young’s syndrome
- Focal bronchial obstruction
- Foreign body
- Stenosis
- Tumor
- Enlarged Lymph Nodes
- Immune & inflammatory diseases
- Hypogammaglobulinemia
- HIV
- Allergic Broncho Pulmonary Aspergillosis (ABPA)
- Inflammatory Bowel disease
- Connective tissue disorders
- Rheumatic arthritis
- Sjogren’s syndrome
- Crohn’s disease
- Congenital disorders
- Cystic fibrosis
- Primary Cilliary dyskinesia
- Katagener’s syndrome
- Alpha 1 antitrypsine deficiency
- Chronic pulmonary aspiration
- Inhalation injuries
- Poor socioeconomic status/ malnutrition
- Air pollution
What are the symptoms?
- Cough
- Chronic productive cough
- Usually worsen in mornings
- Sputum often produced in large amounts
- Recurrent pneumonia
- causes fever, malaise, increased cough & sputum production
- Hemoptysis
- Usually associated with purulent sputum
- Poor general health
- Weight loss
- Anorexia
- Low grade fever
- Failure to thrive in children
How is it diagnosed?
The gold standard method of diagnosis is by High Resolution Computed Tomography (HRCT).
Other investigations include
- CXR
- FBC, CRP, ESR
- 6 minute walking test
- Spirometry
- Sputum for culture ABST
- Bronchoscopy
- Immunological screening
How is bronchiectasis treated?
The management of bronchiectasis is mainly consisting of attending to
- any emergencies
- early symptomatic care
- managing acute exacerbations
- physiotherapy
- antibiotic therapy
- pulmonary rehabilitation
What you should do if you have bronchiectasis?
- Clear your chest as advised by the physiotherapist
- Take your prescribed medication correctly
- Drink plenty of fluids
- Eat healthy, nutritious food as much as possible
- Do regular gentle exercise such as swimming, brisk walking and biking etc. according to medical advises
- Be aware of how much sputum you produce and its colour
- Avoid lung infections;
- Wear a mask when you go out
- Vaccinate yourself against the influenza annually and pneumococcal disease every 5 yearly
- Wash your hands often
What you should not do if you have bronchiectasis?
- Do not allow your medicines to run out
- Do not smoke
- Don’t allow others to smoke around you
- Don’t have close contact with anyone who is having a cold, flu or respiratory infection
- Do not expose yourself to environments highly polluted which are harmful to your lungs
What are the available specialized healthcare services for bronchiectasis?
- Government healthcare institutions
- District chest clinics
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