Bronchiectasis

Bronchiectasis is the destruction and widening of the large airways caused by mucous blockage. It is one of the chronic obstructive pulmonary diseases (COPD). It is often complicated by bronchitis and emphysema. You can be born with it (congenital bronchiectasis). It also may develop later in life.

When the lungs cannot get rid of mucus, it gathers in the airways. The blockage leads to infection. This causes a soreness (inflammation) in the air passageways. The inflammation causes the air passageways to weaken and widen. The weakened passages can then become scarred and deformed. This begins a cycle which may continue to worsen.

CAUSES

  • Bronchiectasis often begins in childhood and in the US about half of these cases come from cystic fibrosis.

  • Recurrent lung infections are another common cause.

  • Abnormal lung defenses a person is born.

  • Foreign bodies or other blockage in the lungs are other causes.

Breathing in food particles regularly while eating is an example.

It is also caused from a birth defect in the lining of the lungs.

SYMPTOMS

Symptoms vary from patient to patient but can include:

  • Coughing which is worse lying down.

  • Shortness of breath and wheezing.

  • Weakness, weight loss, and fatigue.

  • With infections the mucus may be discolored, contain blood and smell badly.

DIAGNOSIS

Tests for diagnosing bronchiectasis may include:

  • Chest X-rays or CT scans.

  • Breathing tests which tell your caregiver how your lungs are working.

  • Sputum cultures to check for infection.

  • Blood testing and tests for other related diseases or causes such as cystic fibrosis or tuberculosis may be done.

HOME CARE INSTRUCTIONS

  • Cough suppressants may be used if you cannot rest; however cough is a protective mechanism for clearing our lungs and is one reason for avoiding cough suppressants if able as they take away this protection.

  • Your caregiver may prescribe an expectorant to loosen the mucus to be coughed up.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • A cold steam vaporizer or humidifier in your room or home may help loosen secretions.

  • Cough is most often worse at night. Sleeping in a semi-upright position in a recliner or using a couple pillows will help.

  • Obtain rest as needed.

  • Make arrangements for a follow-up visit.

  • Avoid cigarette smoke and lung irritants. Smoking is a common cause of bronchitis and can contribute to pneumonia. Stopping this habit is an important self help.

  • Stay inside when pollution and ozone levels are high.

  • Stay current with vaccinations and immunizations.

  • Avoid sedatives and antihistamines which tend to thicken the mucus in the lungs.

  • Always try to stay well hydrated by drinking plenty of water.

  • Antibiotics are often given for infection. Take them as directed.

  • Medications called bronchodilators are often used to make the air passages larger.

  • Physical therapy methods should be learned so you can know how to clear mucus more easily from your lungs.

PROGNOSIS

  • Bronchiectasis varies in severity from patient to patient.

  • When lung infections are treated immediately, bronchiectasis is less likely to develop.

  • When it does develop, following the above instructions will help with the outcome.

  • Lung transplants or removing a portion of a lung are sometimes done for severe cases. Death is uncommon but can be caused by massive bleeding into the lungs.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop more pus like (purulent) sputum, have uncontrolled temperature, or become progressively more ill (debilitated). This is especially true if you are elderly or sick from another disease.

  • You cannot control your cough with suppressants and are losing sleep.

  • You begin coughing up blood.

  • You develop chest pain or increasing shortness of breath.

  • You develop pain which is getting worse or is uncontrolled with medications.

  • You develop an oral temperature above 102° F (38.9° C) or as instructed, after not having a temperature for one or more days (afebrile).

  • If any of the symptoms which brought you initially into the emergency room are getting worse rather than better.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.