BRONCHIECTASIS

Bronchiectasis is a long-term condition where the airways of the lungs become widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection.

What Are the Symptoms of Bronchiectasis?

The most common symptoms of bronchiectasis include:

• a persistent cough that usually brings up phlegm (sputum)
• shortness of breath

The severity of symptoms can vary widely. Some people have only a few symptoms that do not appear often, while others have wide-ranging daily symptoms.

The symptoms tend to get worse if you develop an infection in your lungs.

Symptoms of bronchiectasis can take months or years to develop, and gradually become worse. Other symptoms typically include:

• Coughing up yellow or green mucus daily
• Shortness of breath that gets worse during flare-ups
• Fatigue, feeling run-down or tired
• Fevers and/or chills
• Wheezing or whistling sound while you breathe
• Coughing up blood or mucus mixed with blood, a condition called hemoptysis
• Chest pain from increased effort to breathe
• Clubbing, or the thickening of the skin under nails

How Is Bronchiectasis Treated?

The goal of bronchiectasis treatment is to prevent infections and flare-ups. This is done with a combination of medication, hydration and chest physical therapy. Oxygen therapy may be recommended to raise low blood oxygen levels. Surgery may be recommended in extreme situations where the bronchiectasis is isolated to a section of lung or there is excessive bleeding.

Antibiotics are the most common treatment for bronchiectasis. Oral antibiotics are suggested for most cases, but harder to treat infections may require intravenous (IV) antibiotics. Macrolides are a specific type of antibiotics that not only kill certain types of bacteria but also reduce inflammation in the bronchi. Though they may be beneficial for some people, they are only used in the most severe situations because they have extreme side-effects.

Mucus Thinning Medication may be prescribed to help bronchiectasis’ patients cough up mucus. These medications are often given through a nebulizer, where it is mixed with hypertonic saline solution, turned into a mist, and inhaled deep into the lungs. They are commonly used along with a decongestant.

Airway Clearance Devices: Some patients exhale into a hand-held device to help break up mucus. Some of these devices are Oscillating Positive Expiratory Pressure (PEP), Intrapulmonary Percussive Ventilation (IPV) and Postural Drainage. Chest Physical Therapy (CPT), or chest physiotherapy, is a popular respiratory therapist technique that involves clapping on the chest in a certain way that helps loosen mucus from the lungs so it can be expelled. Electronic chest clappers or vests are now available to make it easier to perform CPT at home.

How to Manage Bronchiectasis

Bronchiectasis is a long-term condition with symptoms that need to be managed over many years. Patients should work closely with a doctor to determine healthy habits that will limit flare-ups. Some suggestions may be:

• Quit smoking and avoid secondhand smoke.
• Maintain a healthy diet, low in sodium, added sugars, saturated fats and refined grains.
• Stay hydrated, drinking plenty of water to help prevent mucus build-up.
• Be diligent about taking oral and inhaled medications and performing mucus clearance techniques daily.
• Staying up to date on vaccinations.
• Take antibiotics for one to two weeks during flare-ups.

Despite maintaining a healthy lifestyle, occasional flare-ups may occur. This often happens because of a new respiratory infection or overgrowth of bacteria. Symptoms such as increased mucus (sputum) production that is bloody or a different color, fever, fatigue, weight loss and worsening shortness of breath may be a sign you’re experiencing a flare-up. In these instances, you should contact your doctor immediately.

References

American Lung Association 

NHS