Introduction
Bronchiectasis is a chronic lung condition characterized by permanent enlargement and damage of the airways (bronchi). This structural change impairs the normal clearing of mucus, leading to frequent infections and inflammation. Bronchiectasis can affect people of all ages and often results in persistent respiratory symptoms that can impact daily life.
Causes
Bronchiectasis can develop as a result of various underlying conditions or events that damage the airway walls. Common causes include repeated respiratory infections, such as pneumonia or tuberculosis, and inherited conditions like cystic fibrosis. Other causes include immune system disorders, allergic bronchopulmonary aspergillosis, and obstruction of the airways by a foreign body or tumor. In some cases, the exact cause remains unknown (idiopathic bronchiectasis).
Symptoms
The main symptoms of bronchiectasis are a chronic productive cough and the daily production of large amounts of thick, sometimes foul-smelling mucus. Other symptoms include shortness of breath, wheezing, chest pain, and recurrent respiratory infections. Some individuals may experience fatigue, unintended weight loss, and, in severe cases, coughing up blood (hemoptysis). Symptoms often worsen during flare-ups or infections.
Diagnosis
Diagnosis of bronchiectasis involves a combination of clinical evaluation and imaging studies. A healthcare provider will review the patient’s medical history and symptoms, and perform a physical examination. High-resolution computed tomography (HRCT) scans are the gold standard for visualizing the characteristic airway changes. Additional tests may include sputum cultures to identify infections, lung function tests, and blood tests to check for underlying conditions.
Treatment Options
While bronchiectasis cannot be cured, treatment focuses on managing symptoms, preventing infections, and improving quality of life. Airway clearance techniques, such as chest physiotherapy and postural drainage, help remove mucus from the lungs. Inhaled bronchodilators and corticosteroids may be prescribed to reduce airway inflammation. Antibiotics are used to treat and prevent respiratory infections. In some cases, long-term or rotating antibiotics may be recommended. Pulmonary rehabilitation and regular exercise can also help maintain lung function. Surgery is rarely needed but may be considered for severe, localized disease.
Prevention
Preventing bronchiectasis involves reducing the risk of lung infections and managing underlying health conditions. Vaccinations against respiratory infections, such as influenza and pneumonia, are important. Prompt treatment of lung infections and avoiding exposure to lung irritants, such as tobacco smoke and air pollution, can help protect the airways. For individuals with known risk factors, regular monitoring and early intervention are key to preventing disease progression.
Takeaway
Bronchiectasis is a chronic lung disease that requires ongoing management to control symptoms and prevent complications. Early diagnosis, effective airway clearance, infection prevention, and regular follow-up with healthcare providers are essential for maintaining respiratory health and quality of life.