Bronchiectasis - Bronchiectasis Symptom, picture, Causes, Treatment

Bronchiectasis is the abnormal dilatation of the bronchi and bronchioles - the passages that carry air into the alveoli the air sacs in the lungs. This condition may be present from birth but most commonly is a complication of infection, smoking, or bran chial obstructions from any cause (such as tumours, inhaled foreign bodies, or thick mucus in cases of cystic fibrosis).

Bronchiectasis often begins in childhood, but evidence of disturbed lung function may not be apparentuntil much later in life. Bronchiectasis is a relatively rare condition that affects the Lungs. In this disorder the bronchial tubes become enlarged and distended forming pockets where infection may gather.

Symptoms of Bronchiectasis

Symptoms include a chronic cough that is worse in the morning; copious sputum, sometimes bloodstained; recurrentchest infections; wheezing and shortness of breath. Less common symptoms are coughing blood (haemoptysis), chest pain and joint pain. There may uncommonly be additional symptoms of associated conditions, for example bloody diarrhoea from ulcerative colitis, rheumatoid arthritis, and infertility (mainly in men). In longstanding bronchiectasis lung tissue may be destroyed around the affected air passages, making it harder for the right ventricle (lower chamber) of the heart to pump blood into the lungs. Persons with bronchiectasis sometimes have wheeze (whistling in the chest), like persons with asthma.

Cause of Bronchiectasis

Occasionally bronchiectasis can occur following inhalation of a foreign body - such as a peanut or other objects. If detected early these can be removed and any damage (including bronchiectasis) may be avoided. However there are several known causes including:

• underlying genetic disease such as cystic fibrosis, where the mucus in the bronchial tubes is too thick, and primary ciliary dyskinesia, where the cilia lining the bronchial tubes do not beat properly
• mechanical obstruction of the bronchial tubes by inhaled foreign bodies, for example, peanuts
• healing of the tubes resulting in puckering and scarring, causing obstruction
• inhaling stomach acid which has been regurgitated back into the gullet

Bronchiectasis is often caused by recurrent inflammation or infection of the airways. It may be present at birth, but most often begins in childhood as a complication from infection or inhaling a foreign object.

Treatment of Bronchiectasis

Bronchiectasis is not reversible but can be prevented from worsening by vigorous steps to eliminate infection, by not smoking, and by physiotherapy aimed at improving breathing efficiency and draining accumulated secretions. Children should be vaccinated against measles and whooping cough to prevent this damage to airways early in childhood. A cough (particularly a moist cough) that persists in a child, is a reason to take the child to the doctor.

Rarely patients inherit a primary abnormality of the hair cells or cilia that renders them more prone to develop Bronchiectasis. There are seven major components of treatment. The efficiency of treatment will be monitored to detect early progression of disease so as to enable treatment to be rapidly modified:

• if there is no underlying cause which might cause bronchiectasis to recur, and the bronchiectasis is localised to a single area of the lung which could be removed without impairing breathing, then removal by operation is one cure.
• the cause, if determined, must be treated (for example, antibody replacement for deficiency).
• regular daily self-administered physiotherapy, utilising gravity to drain the infected tubes.
• improvement of airflow through the bronchial tubes by anti-asthma treatment.
• treatment of nose or sinus infection and runny nose using nasal drops and sprays.
• antibiotics to treat infections, administered at regular intervals or continuously, by intravenous or inhaled routes.
• treatment of any associated disease.

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