Bronchiectasis is a very common illness you may not have heard of. Each year, between 350,000 to 500,000 people in the U.S. are diagnosed with this disease. It may cause coughing, shortness of breath, and mucus, to name just a few symptoms. Despite what you may think, however, bronchiectasis is not associated with smoking.

Sigfredo Aldarondo, MD, board certified in pulmonary, critical care medicine, and sleep medicine at the Pulmonary Care of Central Florida says, “Bronchiectasis is associated with environmental factors, mostly infectious types.” What is bronchiectasis and how can it be treated?

What is Bronchiectasis?

Dr. Aldarondo says, “Bronchiectasis means there’s enlargement (ectasia), fibrosis, and thickening of the airway walls.” 

The bronchi in the lungs are the tiny passages that allow air to flow into the lung. When the inside surfaces of the bronchial airways become damaged, rough, and thickened, that scarring causes malfunction in how normal secretions are drained out of the lungs. During this process, the tiny hairs in the bronchi that are there to catch and move mucus are destroyed. Scarring builds up and the bronchi becomes an effective warm, moist conduit for mucus and germs that get trapped in the airways. 

One person out of every 150 people gets bronchiectasis each year in this country. Most commonly, it is elderly people over 75 years old that are afflicted with bronchiectasis. However, you can be any age and experience these symptoms. Rarely, infants can even be born with the disease.

What Are the Symptoms of Bronchiectasis?

As you might imagine, bronchiectasis causes wheezing and coughing. Imagine a straw that has narrowed to the thickness of a spaghetti strand and you start to understand what it can be like to live with this disease. If you have bronchiectasis, you will experience:

  • Chest pain and tightness
  • Coughing and a good deal of mucus
  • Coughing up mucus with blood
  • Difficulty getting a deep breath
  • Wheezing or whistling when breathing

Because your body struggles to take in enough air to support normal tissue growth and oxygenate the blood, the chronic bronchiectasis patient can lose weight or have nails that are clubbed. During a severe case of bronchiectasis, you may experience fatigue and fevers or chills. You may even have night sweats or increasing difficulty catching your breath.

What Are the Symptoms of Bronchiectasis?

As you might imagine, bronchiectasis causes wheezing and coughing. Imagine a straw that has narrowed to the thickness of a spaghetti strand and you start to understand what it can be like to live with this disease. If you have bronchiectasis, you will experience:

  • Chest pain and tightness
  • Coughing and a good deal of mucus
  • Coughing up mucus with blood
  • Difficulty getting a deep breath
  • Wheezing or whistling when breathing

Because your body struggles to take in enough air to support normal tissue growth and oxygenate the blood, the chronic bronchiectasis patient can lose weight or have nails that are clubbed. During a severe case of bronchiectasis, you may experience fatigue and fevers or chills. You may even have night sweats or increasing difficulty catching your breath.

What Causes Bronchiectasis?

Pulmonary Care of Central FloridaTypically, bronchiectasis stems from cystic fibrosis (CF). CF is a genetic illness causing the reduced ability to breathe and long-term lunch infections. But there is also idiopathic bronchiectasis, for which the cause is not always known. Some of the non-CF related possible causes of bronchiectasis include:

  • A prior severe infection that ended up damaging the lung tissue
  • Aspirating, or breathing in fluids, foods, or even stomach acid into the lungs
  • Auto immune illnesses that make it harder to fight off common infections
  • Certain genetic illnesses such as alpha-1 antitrypsin or ciliary dyskinesia
  • Fungal allergies, such as allergic bronchopulmonary aspergillosis
  • Obstructed airways from a tumor or an inhaled object
  • Other conditions ranging from Crohn’s disease, rheumatoid arthritis, or Sjogren’s syndrome

The trick with bronchiectasis is to identify the underlying causes of the disease. Aldarondo says, “Bronchiectasis is the tip of the iceberg. Under the surface, there’s a lot of other illnesses that can be the underlying drivers. It is potentially treatable if you identify what kind of driver, what kind of infection.” The first step toward identifying the underlying problem is through a medical examination.

How is Bronchiectasis Diagnosed?

Bronchiectasis is much more common than you might imagine. Dr. Aldarondo says, “We see them all the time. There’s not a given day that we don’t see several patients in our practice with bronchiectasis.” 

Despite this, Dr. Aldarondo says, “It’s not well recognized until something shows up in an X-ray. It’s easily identifiable on a chest X-ray or even better on a CT.”

If your doctor believes bronchiectasis is the cause of your discomfort, he or she will likely order one or several tests, including:

  • A chest CT scan or X-ray of the lungs
  • Blood tests and sputum cultures to look for infections
  • Bronchoscopy to look inside the lungs with a tiny camera on a tube
  • Lung functioning tests to see how well your lungs are actually working

If a blockage of the airways is suspected, the bronchoscopy can also spot the disruption and possibly remove it. This test can also take lung secretion samples from inside the body. Lab work can help determine the underlying cause of the bronchiectasis flare-up.

How is Bronchiectasis Treated?

Dr. Aldarondo says bronchiectasis “cannot necessarily be eradicated but at least suppressed. You can actually influence the natural history of the disease.” 

While bronchiectasis can’t be cured, it can be efficiently managed by your doctor. Depending on the underlying cause, you may be prescribed medications to help with symptoms. 

Some of the choices for medications include:

  • Antibiotics to treat bacterial infections in the lungs caused by the mucus buildup 
  • Drugs that thin the mucus and help you expel it through coughing
  • Macrolides, which are drugs that treat inflammation and infections simultaneously

There are also treatments to help clear out the airways like:

  • Percussive vests to help break up mucus production in the lungs
  • Physical therapy exercises such as chest clapping to keep mucus draining
  • Positive expiratory pressure (PEP) devices, where you breathe through a handheld mouthpiece that pushes air behind the mucus to keep it from attaching to airway walls

Dr. Aldarondo says, “The important thing about it is that behavior modification can help, mitigating the effects of bronchiectasis.” This can include staying away from airborne pollutants that can cause the lung infection, such as second-hand smoke or chemical fumes. It’s also a good idea to vaccinate your children against whooping cough or measles, which are diseases that can weaken and scar the lungs.

Can I Live with Bronchiectasis?

Bronchiectasis can affect your quality of life, but with proper diagnosis and treatment, you can live with this disease. Primarily, do not smoke. Then be sure to exercise and eat a healthy diet  along with drinking plenty of water to thin mucus secretions. 

Dr. Aldarondo has good news if you’re experiencing this disease. He says, “It is not contagious. It is not passed from one individual to the other.” 

Patients experiencing signs of a bronchiectasis infection should see their doctor.

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