Bronchiectasis - Irreversible Lung Disease

What is Bronchiectasis?

Bronchiectasis is a disease state defined by localized, irreversible dilation of part of the bronchial tree in the lungs. It is classified as an obstructive lung disease, along with emphysema, bronchitis and cystic fibrosis. Asthmatic bronchitis symptoms are similar.

Brochiectasis is the destruction and widening of the large airway. This disease can be present at birth and is called congenital brochiectasis, or it develops later in life making it an acquired brochiectasis. Acquired Immune Deficiency Syndrome (AIDS) is one of the major causes of brochiectasis. Kartagener syndrome which affects the ability of the cilia in the lungs aids in the development of the disease. Another common genetic cause is cystic fibrosis where a small number of people will develop severe localized brochiectasis. Young’s syndrome which is similar to cystic fibrosis is thought to contribute to the development of this disease.

Basically this is due to the occurrence of chronic, pulmonary infections. Another less common congenital cause is primary immunodeficiencies due to a weakened immune system that can’t fight against the infection. This would also hold true for someone with a weakened immune system due to chemotherapy, which can make cancer patients and patients with autoimmune diseases more susceptible to the disease.

Overview of Lungs

Photo Courtesy of Google
Photo Courtesy of Google

Books to Aid Understanding of this Disease

Bronchiectasis Associated with other Diseases

The primary cause of anyone acquiring this disease is due to tuberculosis. It is a particular common disease for children with HIV as well. This disease predisposes patients to a variety of pulmonary ailments, such as pneumonia and other opportunistic infections. Bronchiectasis can sometimes be an unusual complication of inflammatory bowel diseases, such as ulcerative colitis, and it can occur in Crohn’s disease as well. More recent evidence shows an increase in this disease for rheumatoid arthritis patients that smoke, with one study showing a 10 fold increase for these individuals. They have not proven that cigarette smoking is a primary cause of this disease.

Environmental exposures are also causes and include respiration infections, obstructions, inhalation and aspiration of ammonia and other toxin gases, pulmonary aspiration, alcoholism, heroin use, and various allergies. Another cause is allergic bronchopulmonary aspergillosis (ABPA) which is a condition characterized by an exaggerated response of the immune system to the fungus Aspergillus occurring most often in patients with asthma or cystic fibrosis.

Diseased Lungs

Symptoms

Symptoms of bronchiectasis often develop gradually and may occur months or even years after the causative event.

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
  • Chronic cough coughing up thick, white, or green sputum.

Lung Treatments

Treatment is aimed at controlling the infections and bronchial secretions, relieving airway obstruction and preventing complications.

Regular nebulizer treatments are used to clear the airway. A respiratory therapist can show the patient coughing exercising that will help. Inhaled steroid therapy is consistently adhered to and can reduce sputum production and decrease airway constriction over a period of time, plus it helps to prevent progression of the disease. Inhalers, such as albuterol, fluticasone (Flovent) and Atrovent may help reduce the likelihood of infections by clearing the airway and reducing inflammation. Antibiotics, bronchodilators and expectorants are often prescribed. Surgery to resect the lung may be necessary if medicine does not work or if the patient has massive bleeding.

Although not approved for use in the USA, Mannitol dry inhalation powder under the name Bronchitol has been granted “orphan drug” status by the FDA for use in patients with brochiectasis and with cystic fibrosis. These patients tend to be on antibiotics every couple of months as mucous gets caught in the pockets of the lung tissue caused by the disease and the patient is unable to cough them up effectively

Thyme a Great Healer

source flickr
source flickr

Thyme - a Healer of the Lungs

Thyme is an excellent herb for conditions of the lung as its properties have the ability to break down mucous, which makes it ideal for bronchitis and asthma. It is used as an expectorant by some people. Thyme is anti-microbial; it reduces the severity of the symptoms of respiratory infections and kills the micro-organism causing the infection. It is largely used as an aromatic oil, called Thyme Oil. This information is published by the British Herbal Medicine Association. There are other types of herbal medicines that treat lung diseases, but I would recommend talking with your doctor and someone that is well experienced in herbal medicine. I am not recommending any treatments.

Typical Causes of Bronchietasis

Bronchiectasis is often caused by recurrent inflammation or infection of the airways. It most often begins in childhood as a complication from infection, cystic fibrosis or inhaling a foreign object.

Cystic fibrosis causes about half of all brochiectasis in the United States. Recurrent, severe lung infections (pneumonia, tuberculosis, and fungal infections), abnormal lung defenses, and obstruction of the airways by a foreign body or tumor are some of the risk factors.

There are several tests the doctor does to diagnosis this condition. The doctor may hear small clicking, bubbling, wheezing, rattling or other sounds in the lower lobes of the lungs with a stethoscope as well.

Tests for Bronchietasis

Tests may include:

  • Aspergillosis precipitin test (to check for signs of the aspergillosis fungus)
  • Chest x-ray
  • Chest cat scans look for particular abnormalities
  • Sputum culture
  • Complete blood count (CBC)
  • PPD skin test to check for a prior tubercat ulosis infection
  • Serum immunoglobulin electrophoresis
  • Sweat test or other cystic fibrosis testing

The prognosis is better than you might think, and most people can live a fairly normal life with some disability. To prevent complications, lung infections must be treated promptly. Childhood vaccinations and an annual flu shot will help the chance of avoiding infection. People with this disease quite often get a lung infection following the flu or some other type of bacterial disease. Avoid smoke and pollution as much as possible.

There are possible severe complications, such as cor pulmonale, which is basically right sided heart failure, coughing up blood and low oxygen levels in severe cases, in addition to recurrent pneumonia.

Summary

Certainly call the doctor if the patient has chest pain or their shortness of breath gets worse; if there is a change in the color of phlegm coughed up or if it is bloody; if other symptoms get worse or do not improve with treatment. Bronchiectasis is a serious, irreversible lung disease, even though close monitoring by your physician will keep you in better health. It is important to contact your doctor for any signs of infection or difficulty breathing.

© 2010 Pamela Oglesby

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Comments 27 comments

Tom Whitworth profile image

Tom Whitworth 6 years ago from Moundsville, WV

Pamela,

Thank you for another well researched hub. At first I thought you were writing about bronchitis, which I had every year until puberty, after having pneumonia at 3 months of age.


Pamela99 profile image

Pamela99 6 years ago from United States Author

Tom, This is a disease that may not be that well known unless you happen to have it and I got it last year. I do pretty well however, but I am on antibiotics a lot. I didn't know if many people would be interested in this disease but it seems there is always someone who has the disease or who knows someone that has a disease, so I decided to write it. You must be careful with your lungs as well, since your history does involve lung problems. Thanks for the comments.


samsons1 profile image

samsons1 6 years ago from Tennessee

voted up & useful! Well written and researched, informative and concise. I have COPD & asthma, having had pneumonia 7 times and in constant fear of recurrence. Thanks for this information...


anglnwu profile image

anglnwu 6 years ago

Another well-researched hub. I've never heard of this before, so it's useful to me.Thanks.


Cagsil profile image

Cagsil 6 years ago from USA or America

Hey Pamela, that is one excellently written and researched hub you've created. I have not known anyone with, but I do know someone with COPD and a few other lung related problems. I do know that she does not suffer from Bronchiectasis. I have to admit I certainly learned something new and it is the second time today. Thank you for your due diligence and sharing. Much appreciated. :)


Pamela99 profile image

Pamela99 6 years ago from United States Author

Samson, I'm sure you've had the pneumonia shot but that only covers one type of bacteria. Best of luck with your health and thanks for your comment.s

Anginwu,Thank you for your comment.

Cagsil, I'm glad you learned some new information. Your fried with COPD could have it as it can attack just some small areas of the lungs. I appreciate your comments.


Hello, hello, profile image

Hello, hello, 6 years ago from London, UK

I am so sorry to read about your illness. Anything with chest and lund it horrible. I had bronchitis from the age 0 till when I was seven. I still can remember fighting for every breath. It is horrible. Then I had tonsilites. Thank you for your hub with well researched information.


Pamela99 profile image

Pamela99 6 years ago from United States Author

Hello, Thank you for your concern and I am lucky to this point as I have a mild case and it just started in this past year. It's a bit annoying as I have never been a smoker, who knows why these things happen. It sounds like you outgrew your lung problems, thank goodness. Thanks so much for your comments.


CYBERSUPE profile image

CYBERSUPE 6 years ago from MALVERN, PENNSYLVANIA, U.S.A.

Hi Pamela,

A very informative and a great research project on your part. So sorry to hear about your lung problem. I wish you the very best Pamela and May God Bless!


JY3502 profile image

JY3502 6 years ago from Florence, South Carolina

Pamela,

Sorry to hear you have that. But your article shows massive research. Something I don't have the patience for. Now,I write to entertain, although I was a news reporter for many years. I can do articles like this, but frankly I've gotten lazy. LOL. Hope you continue to feel OK.


Pamela99 profile image

Pamela99 6 years ago from United States Author

Cybersupe, Thank you so much for your comments and the blessing.

JY3502, Thank you for your comment. These article do take too much time and I think I need to lighten up if I'm going to learn all the new things coming my way.


akirchner profile image

akirchner 6 years ago from Central Oregon

I'm thinking you are going to medical school, Pamela - another informative hub!


katiem2 profile image

katiem2 6 years ago from I'm outta here

Pam, Thanks for the detailed facts on Bronchiectasis an Irreversible lung disease. I found this helpful, knowledgeablt and informative in the area of Lung Disease.


Pamela99 profile image

Pamela99 6 years ago from United States Author

Audry, I spent so many years as a nurse in many capacities that writing about medical issues comes kind of naturally. Thanks for your comment.

Katiem, Thanks for your comments.


Wendy Krick profile image

Wendy Krick 6 years ago from Maryland

Very informative hub about Bronchiectasis. Thank you.


LeanMan profile image

LeanMan 6 years ago from At the Gemba

Thank you for your hub Pam, my father is in the final stages of something very similar, i am not good with medical names or I would try to list it here. The problem however is hereditary and brought to the fore by smoking, my grandfather who was a heavy smoker died from lung disease and my father now is very close also a heavy smoker. Thankfully I have never smoked, I hope that neither I nor my children have to suffer from this!


Pamela99 profile image

Pamela99 6 years ago from United States Author

Wendy, Thanks for your comment.

LeanMan, I'm glad you haven't smoked and so sorry to hear about your father. If he doesn't have lung cancer than it might be COPD as that is common. Thanks for your comment.


Support Med. profile image

Support Med. 6 years ago from Michigan

Very thorough and well written. Voted/rated.


Pamela99 profile image

Pamela99 6 years ago from United States Author

Support Med, Thank so much for your comments.


nancy_30 profile image

nancy_30 5 years ago from Georgia

Thank you for this very informative hub. I learned a lot from it.


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