Bronchiectasis

Bronchiectasis is an abnormal stretching and enlarging of the respiratory passages caused by mucus blockage. When the body is unable to get rid of mucus, mucus becomes stuck and accumulates in the airways. The blockage and accompanying infection cause inflammation, leading to the weakening and widening of the passages. The weakened passages can become scarred and deformed, allowing more mucus and bacteria to accumulate, resulting in a cycle of infection and blocked airways.

• Bronchiectasis is one of the chronic obstructive pulmonary diseases COPD )^* and it can be complicated by emphysema  and  bronchitis. The disease is commonly misdiagnosed as asthma or pneumonia.
• Bronchiectasis can develop at any age, begins most often in childhood, but symptoms may not be apparent until much later. Bronchiectasis can occur as part of a birth defect, such as primary ciliary's dyskinesia   or  cystic fibrosis.  About 50% of all cases of bronchiectasis in the U.S. result from cystic fibrosis. It can also develop after birth as a result of injury or other diseases, like tuberculosis, pneumonia and influenza. 
• There are three types of bronchiectasis that describe the severity of the condition:
  • Cylindrical - most common and refers to the slight widening of the respiratory passages. This type can be reversed and may be seen after acute bronchitis.  
  • Varicose - bronchial walls have both extended and collapsed portions. 
  • Cystic - most severe and involves irreversible ballooning of the bronchi.
• Symptoms include coughing (worsened when lying down), shortness of breath, abnormal chest sounds, weakness, weight loss, and fatigue. With infections the mucus may be discolored, foul smelling and may contain blood. Symptom severity varies widely from patient to patient and occasionally, a patient is asymptomatic.
• Doctors evaluate bronchiectasis with a chest x-ray, breathing tests, sputum culture or computed tomography (CT) scan. Testing for other associated diseases like cystic fibrosis or tuberculosis can also be helpful.
• Bronchiectasis patients are often given antibiotics for infection and bronchodilator medicines to open passages. There are also physical therapy techniques to help clear mucus. Lung transplants are also an option for severe cases. Fatalities are uncommon but may result from massive hemorrhage.
• If lung infections are treated immediately, bronchiectasis is less likely to develop. Bronchiectasis patients should avoid cigarette smoke and other irritants and refrain from using sedatives. Vaccinations against measles, influenza and other infections could also be a good preventative measure.