Bronchiectasis

Bronchiectasis is a form of chronic obstructive pulmonary disease (COPD) where the bronchi become widened and damaged. The bronchi are the two large airways that branch from the trachea and lead to each lung. Inflammation of the bronchial tubes due to infection or allergy destroys the smooth muscles, reducing their elasticity and preventing secretions from being cleared. As a result, anatomical changes can occur causing the airway walls to become irregularly shaped. This leads to the trapping of secretions and bacterial growth, increasing the risk of spreading infection into the lungs, causing pneumonia.

Congenital bronchiectasis may occur due to genetic defects such as in cystic fibrosis, Kartagener syndrome, Alpha-1-antitrypsin deficiency, or Young’s syndrome. Defects in the airway cilia of an embryo can cause bronchiectasis. Acquired bronchiectasis is also possible by means of recurrent infections, long-term inhalation of toxic fumes, aspiration of foreign bodies in the respiratory tract, alcohol or drug abuse, and tuberculosis. Multiple and/or poorly treated pediatric lung infections can lead to lung damage and bronchiectasis later in life.

Prevention and treatment

Prevention is crucial, including proper treatment and avoidance of secondhand smoke and toxic fumes. Good respiratory hygiene makes a big difference in the development of a healthy respiratory system. Home salt therapy and seashore exposure are the best avenues in maintaining good hygiene and preventing respiratory problems. The salt aerosol helps to fluidize the mucus and clear the airway passages. It also helps to reduce inflammation and kill bacteria in the airways, preventing and stopping infections.

Bronchiectasis is characterized by an increased production and accumulation of mucus, numerous infections, and shortness of breath and fatigue due to poor lung functions. Wheezing may or may not be present. Sputum can sometimes be bloody due to damage to the bronchial walls or yellow, green with bacterial infection.

There are three primary types of bronchiectasis based on their anatomical appearance:

1. Cylindrical bronchiectasis – mildest form characterized by the accumulation of mucus and a chronic cough.
2. Saccular bronchiectasis – more severe than the first and characterized by more damage and distortion of the airway walls and more stagnant mucus and sputum.
3. Cystic bronchiectasis – the most severe form but least common today. It can appear in untreated lung infections, usually before antibiotics were discovered, and where the person survives but with permanent lung damage. There is productive chronic cough and lots of mucus production.

Treatment: Bronchiectasis is not a curable disease. The goal of treatment is to control secretions and prevent infections through basic respiratory hygiene:

• Stop smoking and avoid secondhand smoke
• Drink plenty of liquids to make the secretions less sticky
• Use natural mucolytics to fluidize the mucus and fight viral and bacterial infections – home salt therapy is the best to achieve this.
• Have good nutrition
• Physical therapy also helps in getting mucus out; mechanical devices such as chest clapper or vests may help, together with positions that allow gravity to loosen the mucus and expel it by means of coughing
• Classical medical treatment involves antibiotics, steroids, and bronchodilators
• If lung function decreases to the point that the patient does not get enough oxygen in the blood, oxygen supplementation is the only option