Bronchiectasis


Bronchiectasis is a lung condition that is estimated to affect one in every 1,000 adults and one in every 10,000 children in England. This long-term lung disorder is characterised by abnormally widened airways that leave the lungs vulnerable to a build-up of mucus and infection.

Treatment routes vary depending on the severity of the condition or resulting lung infection, and can include medication, physiotherapy and surgery.

Causes

There are a number of things that are believed to cause bronchiectasis. The most commonly reported are lung infections that cause damage to the bronchi and a problem with the immune system that can cause the bronchi to be mistakenly attacked. However, in the majority of cases there is no obvious or known reason why the bronchi widen. The condition tends to get progressively worse over time.

Symptoms

The most common symptom of bronchiectasis is a persistent cough. In three out of four cases the cough will bring up clear, pale yellow or pale green phlegm, while one in four have occasional or no phlegm. Other common symptoms of the condition include:

  • Shortness of breath
  • Chest pain
  • Fatigue
  • Coughing up blood
  • Feeling very unwell

Symptoms tend to get worse or occur more frequently if a person contracts a lung infection; this is known as infective exacerbation.

Diagnosis

The first step in the diagnosis of bronchiectasis is to understand the pattern of symptoms and any relevant lifestyle choices, such as whether or not the patient is a smoker. They will then listen to your lungs using a stethoscope and may take a sample of your phlegm for testing. Chest x-rays are commonly used in the first instance and may be followed up with an HRCT (high resolution computed tomography) scan. These build up a very clear and detailed picture of the lungs and will clearly show if the bronchi have widened. A blood test may be used to check the efficiency of the immune system and a pulmonary function test, which measures how quickly and forcefully air can be expelled from the lungs.

Treatment

In the majority of cases bronchiectasis is treated with medication usually administered using a nebuliser and specialist exercises to help clear the mucus that builds up and improve airflow. When lung infections occur – and sometimes as a preventative measure – antibiotics are usually prescribed. In a small number of cases, surgery may also be an option. Steroid-based inhalers can help reduce inflammation, making it easier for Bronchiectasis patients to breathe.