Understanding Bronchiectasis

Bronchiectasis (bron-kee-eck-tuh-sis) is condition affecting the airways in the lungs that causes cough, increased mucus production, and recurrent lung infections. The symptoms are caused by abnormal widening of the airways of the lung, also known as bronchi. The cells lining the airways become inflamed and swollen. These damaged airways can no longer effectively clear mucous and bacteria from the lung. This can lead to flare-ups of cough, mucus production, and shortness of breath.

Bronchiectasis is caused by one or more infections introduced into the lungs. People with bronchiectasis are more likely to get lung infections. Each lung infection can make the bronchiectasis worse. Therefore, early diagnosis and treatment of bronchiectasis is very important.

Symptoms of bronchiectasis  include:

  • chronic daily cough
  • coughing up blood
  • abnormal sounds or wheezing in the chest with breathing
  • shortness of breath
  • chest pain
  • coughing up large amounts of thick mucus every day
  • weight loss
  • fatigue
  • thickening of the skin under your nails and toes, known as clubbing
  • frequent respiratory infections

If you’re experiencing any of these symptoms, you should see your doctor immediately for diagnosis and treatment.

bronchiectasis cycle

Diagnosing Bronchiectasis

The first step in diagnosing bronchiectasis is a thorough evaluation. Your doctor may have you do a number of tests to evaluate your breathing. A multiple step process usually leads to the diagnosis of bronchiectasis. Many factors are considered.
BE ct scan

Bronchiectasis is diagnosed by x-ray imaging, almost always with a CT of the chest (CAT scan). The CT scan will show the location and severity and may give clues about its cause.

The evaluation for bronchiectasis often includes:

  • A complete medical history
  • A complete physical examination
  • A chest CT scan (a specialized X-ray which produces detailed slice-like pictures) of the lungs.
  • Breathing tests, called pulmonary function tests. These determine the presence and severity of abnormal airflow out of the lungs.
  • Specific screening or diagnostic tests for some of the possible underlying diseases that may cause bronchiectasis, based on the history and physical exam.

Your doctor may choose to have you seen by a specialist, such as a pulmonologist (lung specialist) to confirm a diagnosis and treat you bronchiectasis once it is diagnosed.

Treatment Options

The main goal of bronchiectasis treatment is to keep infections and increased mucus under control. It’s also critical to prevent further damage of the airways and minimize mucus buildup. Common methods of treating bronchiectasis include:

  • Airway clearance therapy such as breathing exercises and chest physiotherapy
  • pulmonary rehabilitation
  • antibiotics to prevent and treat infection
  • bronchodilators to open up airways
  • medications to thin mucus
  • expectorantsto aid in coughing up mucus
  • oxygen therapy
  • vaccinationsto prevent respiratory infections

Chest physiotherapy (CPT) is a cornerstone of airway clearance therapy. One form is a high-frequency chest wall oscillation (HFCWO) vest to help clear your lungs of mucus. The vest uses mechanical oscillation targeting the lungs through the chest and back, to help mobilize and thin secretions. This can help dislodge mucus from the walls of the bronchial tubes so that it can be coughed out.

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