Bronchiectasis

Bronchiectasis - What it is

Bronchiectasis is a chronic lung condition. There is abnormal dilatation of the airways with scarring and inflammation causing mucus or “phlegm” production.

Your airways become widened and unable to clear the phlegm properly. This results in mucus pooling, making your airways prone to infection, which can further damage your airways.

Once the damage has occurred, it is permanent.

Bronchiectasis - Symptoms

The most common symptom is coughing up phlegm, often in large amounts every day. Some people may feel tired, experience breathlessness or wheeze and may also have problems with their sinuses. Less common symptoms include coughing up blood and chest pain.

An important feature of bronchiectasis is periods of acute worsening of symptoms (also called exacerbation). It is thought that these episodes are due to increased infection and inflammation in the airways

Bronchiectasis - How to prevent?

Bronchiectasis - Causes and Risk Factors

For up to half of people diagnosed with bronchiectasis, there is no clear underlying cause. This is called idiopathic bronchiectasis.

Some illnesses which cause bronchiectasis include:

severe lung infection in the past
underlying inherited disease, such as cystic fibrosis or primary ciliary dyskinesia
lack of immunity to infection
gastric reflux
severe allergic response to Aspergillus (moulds)
blockage of the airways

Bronchiectasis can also be associated with other diseases such as inflammatory bowel disease or rheumatoid arthritis. Bronchiectasis is not caused by smoking but smoking can worsen bronchiectasis.

Bronchiectasis - Diagnosis

To confirm the diagnosis, you will need to have a computerised tomography (CT) scan.

Your doctor may also ask you to give a sample of your phlegm to find out what bacteria are present. You might also need to have blood tests to look for possible causes of bronchiectasis.

Occasionally, your doctor will suggest a bronchoscopy to look inside your lungs and take lung samples.

Bronchiectasis - Treatments

Bronchiectasis is a chronic condition and often requires life-long treatment.

Usually, the damage to your airways that causes bronchiectasis can’t be reversed.

General measures and lifestyle changes will keep you from falling sick too often. These include:

Balanced diet, increase protein intake
Regular exercise/physical activity
Avoid smoking/smoking cessation
Updated vaccinations against influenza and pneumococcus

The main stay of treatment includes prevention of infections which will further damage your lungs, and improving your symptoms. This can be done through:

Daily chest physiotherapy – to help to clear phlegm from your airways using various breathing exercises and techniques
Antibiotics – prompt antibiotic therapy when acutely unwell or worsening symptoms (“exacerbation”)
Bronchodilators – may help to open up your airways
Mucolytic/mucus clearance agents – to help expectorate the phlegm

Long term inhaled or oral antibiotics

Other Options:

You also have option of participating in clinical trials to see if new treatment or medications work. To find out more, you can call SGH Clinical Trails and Research Centre at +65 6321 3652 or send an email to grcctrc1@sgh.com.sg

Bronchiectasis - Preparing for surgery

Bronchiectasis - Post-surgery care

Bronchiectasis - Other Information

Overview

Article contributed by Respiratory ＆ Critical Care Medicine, Singapore General Hospital

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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