Bronchiectasis

Bronchiectasis is a long-term condition where the airways of the lungs become widened..

leading to a build-up of excess mucus that can make the lungs more vulnerable to infection.

The most common symptoms of bronchiectasis include:

  • Persistent cough that usually brings up phlegm (sputum)
  • Shortness of breath

Common causes in around half of all cases of bronchiectasis, no obvious cause can be found.

These are some of the more common triggers that have been identified.

  • Childhood infections: Around 1 in 3 cases of bronchiectasis in adults are associated with a severe lung infection in childhood, such as:
    • Severe pneumonia
    • Whooping cough
    • Tuberculosis (TB)
    • Measles
  • Cystic fibrosis: Cystic fibrosis is a genetic disorder, where the lungs become clogged up with mucus. The mucus then provides an ideal environment for a bacterial infection to take place, leading to the symptoms of bronchiectasis
  • Cilia abnormalities: Cilia are the tiny hair-like structures that line the airways in the lungs. They're designed to protect the airways and help move away any excess mucus.

Bronchiectasis can develop if there's a problem with the cilia that means they're unable to effectively clear mucus from the airways.

Conditions that can cause problems with the cilia include:

  • Young's syndrome – a rare condition only affecting males thought to be caused by exposure to mercury in childhood
  • Primary Ciliary Dyskinesia – a rare condition caused by inheriting faulty genes

Connective Tissue Diseases

Certain conditions that cause inflammation in other areas of the body are sometimes associated with bronchiectasis.

These include:

  • Rheumatoid arthritis
  • Sjögren's syndrome
  • Crohn's disease
  • Ulcerative colitis

These conditions are usually thought to be caused by a problem with the immune system, where it mistakenly attacks healthy tissue.

How is it diagnosed?

HRCT scan: Currently, the most effective test available to diagnose bronchiectasis is called a high-resolution CT (HRCT) scan.

How is it treated?

In most cases, treatment involves a combination of medicine, exercises you can learn, and devices to help clear your airways.

Surgery for bronchiectasis is rarely required. There are also a number of things you can do to help relieve the symptoms of bronchiectasis and stop the condition getting worse.

These include:

  • Stopping smoking (if you smoke)
  • Having the flu vaccine every year
  • Making sure you have had the pneumococcal vaccine to protect against pneumonia
  • Keeping yourself well hydrated
  • Eating a balanced diet
  • Exercising regularly: You can be referred to a physiotherapist, who can teach you these techniques.
    • Active cycle of breathing techniques (ACBT)
    • Postural drainage

  • Bronchodilators
  • Antibiotics
  • Vaccination

  • If you have 3 or more infective exacerbations in any 1 year or your symptoms during an infective exacerbation were particularly severe, it may be recommended that you take antibiotics on a long-term basis.
  • This can help prevent further infections and give your lungs the chance to recover.
  • This could involve taking low-dose antibiotic tablets to minimise the risk of side effects, or using an antibiotic nebuliser.
  • Using antibiotics in this way increases the risk that 1 or more types of bacteria will develop a resistance to the antibiotic. You may be asked to give regular phlegm samples to check for any resistance.
  • If bacteria do show signs of developing a resistance, your antibiotic may need to be changed.

Surgery is only recommended for bronchiectasis if:

  • It's only affecting a single section of your lung
  • Your symptoms are not responding to other treatment
  • You do not have an underlying condition that could cause bronchiectasis to come back

The lungs are made up of sections known as lobes the left lung has 2 lobes and the right lung has 3 lobes.

Surgery for focal bronchiectasis would usually involve removing the lobe affected by the bronchiectasis in a type of operation known as a lobectomy. Surgery will not be used if more than 1 lobe is affected, as it's too dangerous to remove so much lung tissue

Consult with experienced Doctors

JNU is home to some of the most eminent doctors in the world, most of whom are pioneers in their respective arenas and are renowned for developing innovative and revolutionary procedures
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