Bronchiectasis

Bronchiectasis: Description:BronchiectasisChronic dilation of bronchi or bronchioles as a sequel of inflammatory disease or obstruction often associated with heavy sputum production. Syn: bronchiectasia.Bronchiectasis is a condition in which damage to the airways causes them to widen and become flabby and scarred. The airways are tubes that carry air in and out of your lungs. Bronchiectasis usually is the result of an infection or other condition that injures the walls of your airways or prevents the airways from clearing mucus. Mucus is a slimy substance that the airways produce to help remove inhaled dust, bacteria, and other small particles.In bronchiectasis, your airways slowly lose their ability to clear out mucus. When mucus can't be cleared, it builds up and creates an environment in which bacteria can grow. This leads to repeated, serious lung infections.Each infection causes more damage to your airways. Over time, the airways lose their ability to move air in and out. This can prevent enough oxygen from reaching your vital organs.An estimated 110,000 people are living with bronchiectasis in the United States. Bronchiectasis can develop at any age. Overall, two-thirds of people who have the condition are women. However, in children, the condition is more common in boys than in girls.Bronchiectasis can lead to serious health problems, such as respiratory failure, atelectasis, and heart failure.If you have bronchiectasis, work closely with your doctor to learn ways that you can improve your quality of life. This involves learning as much as you can about bronchiectasis and any underlying conditions that you have.Taking steps to avoid lung infections is very important. Talk to your doctor about getting flu and pneumonia vaccines. Wash your hands often to lower your risk for viruses and bacterial infections.Follow a healthy diet and be as physically active as you can. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, beans, and fat-free or low-fat milk or milk products. A healthy diet is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar.It's also important to stay hydrated. Drinking plenty of fluid, especially water, helps prevent airway mucus from becoming thick and sticky.Also, try to be as physically active as you can. Activities, such as walking and swimming, can help loosen mucus so it can be coughed up. Talk to your doctor about what types and amounts of activity are safe for you.Other steps you can take to protect your airways include not smoking and avoiding lung irritants, such as secondhand smoke, dust, and fumes. If you smoke, talk to your doctor about programs and products that can help you quit.Symptoms:Symptoms often develop gradually, and may occur months or years after the event that causes the bronchiectasis.They may include:Bluish skin color.
  • Breath odor.
  • Chronic cough with large amounts of foul-smelling sputum.
  • Clubbing of fingers.
  • Coughing up blood.
  • Cough that gets worse when lying on one side.
  • Fatigue.
  • Paleness.
  • Shortness of breath that gets worse with exercise.
  • Weight loss.
  • Wheezing.
Causes and Risk factors:An injury to the walls of your airways usually causes bronchiectasis. A lung infection may cause this injury. For example, severe pneumonia, whooping cough or measles (now uncommon due to vaccination), tuberculosis, or fungal infections can injure the airways and lead to bronchiectasis.Often, people who have bronchiectasis have an underlying condition that damages their airways and increases their risk for lung infections. Examples of such conditions include:Cystic fibrosis: This disease leads to almost half of the cases of bronchiectasis in the United States.
  • Immunodeficiency disorders, such as common variable immunodeficiency and, less often, HIV and AIDS.
  • Allergic bronchopulmonary aspergillosis: This is an allergic reaction to a fungus called aspergillus. The reaction causes swelling in the airways.
  • Disorders that affect cilia function, such as primary ciliary dyskinesia. Cilia are small, hair-like structures that line your airways. They normally clear mucus (a slimy substance) out of your airways.
Other conditions, such as a blockage in your airways, also can lead to bronchiectasis. A blockage may be due to a growth, a noncancerous tumor, or something inhaled, such as a piece of a toy or a peanut that you inhaled as a child.Congenital bronchiectasis is the result of a problem with how the lungs form in a fetus. This condition usually affects infants and children.Diagnosis:Your doctor may suspect bronchiectasis if you have a daily cough that produces large amounts of sputum (spit).To find out whether you have bronchiectasis, your doctor may recommend tests to:Chest Computed Tomography Scan: The most commonly used test to diagnose bronchiectasis is a chest computed tomography scan or chest CT scan. This painless test creates precise images of your airways and other structures in your chest. It can show how much your airways are damaged and where the damage is. A chest CT scan gives more detailed pictures than a regular chest x ray.Chest X Ray: You also may have a chest x ray. This painless test creates pictures of the structures in your chest, such as your heart and lungs. A chest x ray may show areas of abnormal lung and thickened, irregular airway walls.Other Tests Include:Blood tests: These tests can show whether you have an underlying condition that can lead to bronchiectasis. They also can show whether you have an infection or low levels of certain infection-fighting blood cells.
  • A sputum culture: Lab tests of a sample of your sputum can show whether you have bacteria (such as the bacteria that cause tuberculosis) and fungi.
  • Lung function tests: These tests measure the size of your lungs, how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood. Lung function tests help show how much lung damage you have.
  • A sweat test or other tests for cystic fibrosis.
Bronchoscopy: If your bronchiectasis doesn't respond to treatment, your doctor may recommend a bronchoscopy. This procedure is used to look at the insides of the airways.During this procedure, a long, narrow, flexible tube with a light on the end is inserted through your nose or mouth into your airways. This tube is called a bronchoscope. It provides a video image of your airways. You'll be given medicines to numb the upper airway and to help you relax during the procedure.Bronchoscopy can show whether something is blocking your airways. If there is bleeding, this procedure can show where the bleeding is coming from.Treatment:The goal of treatment for bronchiectasis is to treat any underlying conditions causing lung injury, help remove mucus from the lungs and prevent further complications.Treatment may include:Bronchodilator Medications -- Inhaled as aerosol sprays or taken orally, bronchodilator medications may help to relieve symptoms of bronchiectasis by relaxing and opening the air passages in the lungs.
  • Steroids -- Inhaled as an aerosol spray, steroids can help relieve symptoms of bronchiectasis. Over time, however, inhaled steroids can cause side effects, such as weakened bones, high blood pressure, diabetes and cataracts. It is important to discuss these side effects with your doctor before using steroids.
  • Antibiotics -- Antibiotics may be used to help fight respiratory infections caused by bronchiectasis.
  • Mucus Thinners and Expectorants -- Mucus thinners and expectorants help loosen and clear mucus from lungs.
  • Respiratory Therapy -- People with bronchiectasis must clear mucus from their lungs on a daily basis. This may be done with chest physical therapy, which involves vigorously clapping the back and chest to dislodge mucus from the lungs. Airway clearance can also be achieved with mechanical devices that stimulate mucus clearance.
  • Surgery -- Lung volume reduction surgery, during which small wedges of damaged lung tissue are removed, may be recommended for some patients with severe cases of bronchiectasis.
  • Lung Transplant In very severe cases, lung transplantation may be an option for some patients.
Medicine and medications:Clarithromycin (Biaxin).
  • Azithromycin (Zithromax).
  • Trimethoprim and sulfamethoxazole (Septra, Bactrim).
  • Doxycycline (Doryx, Vibra-Tabs, Vibramycin).
  • Levofloxacin (Levaquin).
  • Tobramycin for inhalation (TOBI).
  • Gentamicin (Gentacidin, Garamycin).
  • Amikacin (Amikin).
Salmeterol (Serevent Diskus)Note: The following drugs and medications are in some way related to, or used in the treatment. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care. 

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