Understanding Bronchiectasis: Symptoms and Treatment Options

Bronchiectasis is a chronic lung condition that profoundly affects the breathing tubes, or airways, within your lungs. If you have bronchiectasis, the walls of the airways become wider and damaged due to persistent inflammation or recurrent infections, which may arise from various factors, including underlying health conditions or environmental irritants. This damage results in an increased production of phlegm, also known as mucus or sputum. In individuals with bronchiectasis, this phlegm can be thicker and more viscous, making it significantly harder to cough out, and if it is not cleared properly, it may lead to more frequent infections and further lung damage. Over time, the accumulation of mucus can create a breeding ground for bacteria, potentially exacerbating the condition and leading to a cycle of deterioration. Bronchiectasis can be localized, affecting only one or two areas in the lungs, or it may be more diffuse, impacting many areas throughout the respiratory system.

What are the causes of bronchiectasis?

• Infectious Diseases: Malaria, HIV, tuberculosis, measles, Pneumonia, yellow fever, whooping cough (pertussis)
• Chronic Diseases: Heart disease, stroke, diabetes, cancer, arthritis, asthma.
• Mental Health Conditions: Depression, anxiety, PTSD, bipolar disorder.
• Nutritional Deficiencies: Anemia, scurvy. Alpha-1-antitrypsin deficiency
• Other Conditions: Allergies, food intolerances, dental and gut health issues. 
• Organ transplant. Transplant medications decrease immunity and can increase risk of infection and bronchiectasis.

What are the symptoms of bronchiectasis?

• Shortness of breath
• Chronic productive cough
• Recurrent chest infections
• Weight loss
• coughing up blood
• atypical sounds or wheezing in your chest with breathing
• chest pain
• fatigue
• change in the structure of your fingernails and toenails, known as clubbing

Treatment for bronchiectasis

There’s no cure for bronchiectasis, but treatment helps manage the condition. The main goal is to control infections and bronchial secretions. Common treatments for bronchiectasis include:

• Chest physiotherapy. One form of chest physiotherapy is a high frequency chest wall oscillation vest to help clear your lungs of mucus. The vest gently compresses and releases your chest, creating the same effect as a cough. This dislodges mucus from the walls of the bronchial tubes, thereby improving lung function and facilitating easier breathing. Regular use of this therapy can help individuals with chronic respiratory conditions, as it assists in maintaining better airway clearance and overall respiratory health.
• Surgery. If there’s bleeding in your lung, or if the bronchiectasis is only in one part of your lung, you may need surgery to remove the affected area, which could involve a lobectomy or a wedge resection, depending on the severity and location of the condition. The decision for surgery should be carefully considered and discussed with a specialist, as it carries both risks and potential benefits for improving respiratory function and overall health.
• Draining secretions. Another part of daily treatment involves draining the bronchial secretions, aided by gravity. A respiratory therapist can teach you techniques to aid in coughing up the excess mucus.
• Treating underlying conditions. If conditions like immune disorders or COPD are causing your bronchiectasis, your doctor will also treat those conditions.
• Lifestyle changes. Things like exercise, eating a healthy diet, and drinking plenty of water may help improve the symptoms of bronchiectasis.

Can bronchiectasis be prevented?

Early identification and treatment of conditions leading to bronchiectasis are vital for prevention and mitigation. Recognizing underlying health issues, such as infections and genetic disorders, allows healthcare providers to improve patient outcomes.

Childhood immunizations against diseases like measles and pertussis have lowered bronchiectasis incidence by protecting respiratory health. Better living conditions, healthcare access, and nutrition also contribute to this decline. Specific vaccinations, including pneumococcal and COVID-19 vaccines, are crucial in preventing lung infections that could result in bronchiectasis, along with annual influenza shots.

Timely use of antibiotics for lung infections can prevent progression to chronic diseases. A holistic approach combining vaccination, improved living conditions, and prompt medical care can significantly reduce bronchiectasis incidence and severity.