Updated 8 November 2023 | Approved By Dr. Umberto Russo
What is Bronchiectasis?Bronchiectasis is a chronic lung condition that affects the airways in the lungs. In this condition, the airways become damaged and wider than expected. This damage can lead to difficulty clearing mucus from your lungs. Mucus is a thick and sticky substance produced by your airways to help trap and remove irritants and germs. When your airways are damaged, this mucus can build up and get stuck. Second, the widening of the airways can lead to a higher risk of lung infections. So, people with bronchiectasis may experience more frequent and more severe lung infections.
Bronchiectasis CausesBronchiectasis is a long-term lung condition caused by a variety of factors. It results in the widening and damage of airways in the lungs, and these causes can include recurrent infections, genetics, and exposure to harmful substances. Common causes include :
- Infections: One common cause of bronchiectasis is recurrent lung infections. Imagine having multiple severe colds or lung infections over time. If these infections aren't treated correctly or if they keep coming back, they can damage your airways and lead to bronchiectasis.
- Genetic Factors: Sometimes, bronchiectasis is linked to genetics, especially if someone has a condition called cystic fibrosis. Cystic fibrosis is a genetic disorder that mainly affects the respiratory and digestive systems. For some individuals with cystic fibrosis, bronchiectasis can be one of the complications.
- Weakened Immune System: Our immune system helps protect us from germs and infections. When the immune system isn't working properly, it can't fight off infections effectively. This can make a person more susceptible to lung infections, leading to bronchiectasis.
- Breathing in irritants: Breathing in harmful substances is another way bronchiectasis can develop. This can happen if someone is exposed to things like cigarette smoke, dust, or chemicals at work or in their environment. These irritants can harm the airways and cause scarring and widening.
- Autoimmune Diseases: The immune system usually defends the body against harmful invaders, like bacteria and viruses. However, in autoimmune diseases, the immune system mistakenly attacks the body's own tissues. Some of these autoimmune diseases can affect the airways, leading to bronchiectasis.
Signs and Symptoms of BronchiectasisBronchiectasis is a chronic lung condition with a wide range of symptoms that significantly impact a person's daily life. These symptoms include:
- Chronic cough
- Excessive mucus and phlegm
- Recurrent Infections
- Shortness of breath and breathlessness
- Fatigue and low energy
Bronchiectasis Diagnosis and TestingProperly diagnosing bronchiectasis is essential because it guides how the condition is managed. These diagnostic methods  are used to make sure that a person's symptoms are due to bronchiectasis and not some other lung condition. Your GP or specialist may recommend the following:
- Medical History: Your doctor will ask you questions about your symptoms, past lung infections, and any factors that might have put you at risk for bronchiectasis. They'll pay close attention to your medical history because it can provide important clues.
- Chest X-rays and CT scans: Chest x-rays and CT scans are special types of imaging tests that help doctors see inside your chest. They can provide detailed pictures of your lungs and airways. By looking at these images, doctors can check for signs of bronchiectasis, such as widening or scarring of the airways.
- Pulmonary function tests: These tests are designed to measure how well your lungs are working. They can help doctors understand how bronchiectasis may be affecting your lung function.
- Sputum Culture: When you have a lung infection, the mucus you cough up can contain germs like bacteria. A sputum culture is a test where doctors take a sample of your mucus and check it in a lab to identify the specific germs causing the infection. This helps them choose the right antibiotics for treatment.
- Bronchoscopy: In some cases, doctors may perform a procedure called a bronchoscopy. It involves a thin tube with a tiny camera on the end that is inserted into your airways. This allows doctors to see directly inside and check for abnormalities or damage.
Bronchiectasis TreatmentOnce someone is diagnosed with bronchiectasis, your GP will help you coordinate treatment or refer you to a specialist. Treatments may include the following :
- Medications: Doctors often prescribe medications to manage the condition. These can include antibiotics to treat infections and mucus-thinning medications to make it easier to clear mucus from the airways. Another type of medication called bronchodilators may be recommended to help relieve airway constriction, making it easier to breathe.
- Airway clearance techniques: One of the essential aspects of managing bronchiectasis is learning techniques to clear mucus from the airways. This can involve physiotherapy and using special devices. Imagine it like regular cleaning for your airways, helping you breathe better.
- Pulmonary Rehabilitation: Some people with bronchiectasis may benefit from pulmonary rehabilitation programs. These programs include exercises to improve lung function, education to learn more about the condition, and support to enhance overall health and quality of life.
- Surgery: In severe cases of bronchiectasis or when complications arise, surgery may be an option. Surgery could involve removing damaged lung tissue or repairing the airways. This is usually a last resort and is carried out by specialists.
- Vaccinations and Prevention: Preventing infections is a significant part of managing bronchiectasis. In Australia, healthcare providers often recommend getting vaccinations to protect against certain diseases. For instance, the annual flu vaccine and the pneumococcal vaccine can reduce the risk of infection. Additionally, it's essential to avoid smoking and steer clear of respiratory irritants, like dust or strong fumes.
Bronchiectasis ComplicationsPeople with bronchiectasis need to be aware of potential complications.
- Recurrent lung infections
- Coughing up blood (hemoptysis)
- Respiratory failure
- Cor pulmonale can be caused by bronchiectasis when extra strain is placed on the heart. Eventually, the heart can't pump blood effectively, to the point where special care may be required.
- Psychological impact
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- Australian Institute of Health and Welfare. (2010). Asthma, chronic obstructive pulmonary disease and bronchiectasis in Australia: Their impact on health and wellbeing.
- King, P. T. (2009). The pathophysiology of bronchiectasis. International journal of chronic obstructive pulmonary disease, 411-419.
- Royal Australian College of General Practitioners. (2012). Bronchiectasis: Clinical update. Australian Family Physician, 41(11), 857-859.
- American Lung Association. (n.d.). Treating and managing bronchiectasis.