Causes
Often caused by recurrent inflammation and infection of the airways, bronchiectasis may be congenital, meaning present at birth, or a person may be predisposed to it as a result of early childhood diseases, such as pneumonia, measles, influenza or tuberculosis.
According to the American Lung Association, cystic fibrosis causes approximately 50% of all cases of bronchiectasis in the United States today. Other pre-disposing factors include abnormal lung defenses and obstruction of the airway by a foreign object or tumor. Bronchiectasis can also be caused by breathing in food particles when you eat or after surgery because of a weakened cough reflex and the inability of the patient to clear their airways effectively.
Symptoms
Bronchiectasis causes an abnormal widening of the airways due to recurrent inflammation and infection. When the airways become dilated, extra mucus begins to pool in the enlarged areas. The pooling of mucus becomes a breeding ground for bacteria which leads to lung infections. This is further complicated by damage to the cilia, the tiny protective hairs that line the airways. When the cilia are unable to clear the airways of debris and extra mucus, airway obstruction occurs. The accumulation of mucus and subsequent bacteria lead to repeated cycles of inflammation, infection and obstruction of the airways and lungs.
Often developing gradually, symptoms of bronchiectasis may not appear for months or even years after the pre-disposing event that caused bronchiectasis to occur in the first place. Symptoms of bronciectasis include:
- Chronic cough that gets worse when lying down
- Thick, foul-smelling mucus
- Hemoptysis
- Dyspnea, worsened by exercise
- Weight loss
- Fatigue
- Weakness
- Clubbing of the fingers
- Wheezing
- Repeated lung infections
Visit Symptom Checker for more information about symptoms of bronchiectasis or other diseases.
Diagnosis
Bronchiectasis is not readily diagnosed, as the symptoms can be commonly mistaken for those of chronic bronchitis, asthma or pneumonia.
Doctors can evaluate bronchiectasis by doing the following tests:
Testing for other associated conditions such as cystic fibrosis or tuberculosis may also be helpful in making a diagnosis of bronchiectasis.
Treatment
The goal of treatment for bronchiectasis is to control infection, promote drainage of excessive secretions from the lungs and prevent further complications from occurring.
Treatment may include any of the following:
- Antibiotics
- Bronchodilators
- Expectorants
- Avoiding upper respiratory irritants (smoking, secondhand smoke, air pollution).
- Yearly flu shot
- Postural drainage
- Chest physiotherapy
- Surgical lung resection (for those who do not respond to treatment or for massive bleeding).
Prevention
The chances of bronchiectasis developing decrease with immediate treatment of lung infections. Other preventative measures include:
- Quitting smoking, if you are a smoker. Information on quitting is available at the Smoking Cessation Guide Site.
- Avoiding upper respiratory irritants, such as secondhand smoke or air pollution.
- Vaccinating against measles, influenza and other infections as recommended by your healthcare provider.
When to Contact Your Healthcare Provider
Call your doctor if any of the following occur:
- Your symptoms worsen or fail to improve with proper treatment.
- There is a change in the color or amount of your sputum.
- You develop hemoptysis.
- You develop chest pain or shortness of breath that is unrelieved by rest.
Sources:
American Lung Association. Bronchiectasis Fact Sheet. Janurary, 2005.
Smeltzer, Suzanne C. & Bare, Brenda, G. (1996). Brunnuer and Suddarth's Testbook of Medical-Surgical Nursing (8th Edition). Pennsylvania, PA: Lipponcott-Raven Publishers.
