What is bronchiectasis? Bronchiectasis is a lung condition that causes your bronchi to permanently widen. Your bronchi are larger airways which help carry air in and out of your lungs. Your lungs make mucus to trap and remove germs and irritants that you breathe. In bronchiectasis, your lungs cannot clear mucus as it would normally. This may lead to infections, inflammation, and scarring in your lungs and may make it difficult to breathe.
What increases my risk of bronchiectasis?
Chemical damage: Gastroesophageal reflux (GER) from your stomach or breathing in harmful fumes may damage your airways.
Immune system problems: These include conditions such as allergies, rheumatoid arthritis (RA), inflammatory bowel disease (IBS), or HIV infection. These may increase the risk of infection or cause damage to your airways.
Genetic diseases: You may have been born with a health condition, such as cystic fibrosis, which makes it difficult to clear mucus.
Obstructions: Food may accidentally get stuck in your airways while you eat. Tumors in your chest may grow large and block your airway. This may lead to inflammation or infection.
- Past lung infections: Lung infections, such as measles, whooping cough, tuberculosis, and pneumonia, can cause damage to your airways.
What are the signs and symptoms of bronchiectasis? The following signs and symptoms may appear over time:
- A productive cough
- Foul-smelling sputum (mucus from your lungs)
- Weakness and fatigue
- Wheezing or trouble breathing
- Loss of appetite or weight loss
- Clubbing of your fingers or toes
- Chest pain
How is bronchiectasis diagnosed? Your caregiver will examine you. He will listen to your lungs and heart. He will ask you about other health conditions or medicines you take. You may also have any of the following tests:
Sputum sample: Sputum is collected in a cup when you cough. The sample is sent to a lab to find out if you have an infection.
Chest x-ray: This is used to look at your lungs and airways to check for the cause of bronchiectasis.
CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your chest and airways. You may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.
Bronchoscopy: This test is done to look inside your airways and lungs. Caregivers insert a bronchoscope (a tube with a light and magnifying glass on the end) into your mouth and down into your lungs. You may get medicine for pain or to help you relax during the test. Caregivers may also collect samples of sputum, fluid, or cells from your lungs for testing. This may help find the cause of bronchiectasis or see if you have an infection.
- Pulmonary function tests: Pulmonary function tests (PFTs) help caregivers learn how well your body uses oxygen. You breathe into a mouthpiece connected to a machine. The machine measures how much air you breathe in and out over a certain amount of time. PFTs help your caregivers decide the best treatment for you.
How is bronchiectasis treated?
Antibiotics: This medicine helps fight or prevent an infection caused by bacteria. Take this medicine as directed.
Bronchodilators: You may need bronchodilators to help open the air passages in your lungs, and help you breathe more easily.
Expectorants: Expectorant medicine helps thin your sputum (mucus from the lungs). When sputum is thin, it may be easier for you to cough it up and spit it out. This may make your breathing easier, and may help you get better faster.
- Steroid medicine: Inhaled steroids help decrease inflammation in your lungs and open your airways so you can breathe easier.
- Antibiotics: This medicine helps fight or prevent an infection caused by bacteria. Take this medicine as directed.
Oxygen: This may be given through a mask or nasal cannula to help you breathe easier. Oxygen can also decrease the strain on your heart and can help prevent further problems.
- Surgery: The part of your lung causing your symptoms may need to be removed. You may also need a lung transplant if your symptoms become severe. Ask for more information about the types of surgery.
How can I manage my symptoms? Your caregiver may show you airway clearance techniques (ACTs) that make it easier for you to cough up mucus. ACTs may help decrease your symptoms.
Controlled breathing: You do this by breathing gently, slowly, and deeply. You may also need to breathe out air as fast as you can, which will help force mucus out of your airways.
Chest expansion exercises: These help you completely fill your lungs with air by letting your abdomen swell as you breathe in.
Forced expiration technique: Coughing is a forceful response to something irritating your airway. Forced expiration, or huffing, is less forceful and tiring. You use muscles in your chest and abdomen to breath out, similar to breathing on a mirror.
Percussion: This involves having another person forcefully pat on your back with a cupped hand or soft plastic cup. It helps loosen mucus stuck in your airways. Percussion may also be done with an electric percussor.
- Postural drainage: This therapy is designed to help drain mucus from different parts of your lung. Your caregiver will show you the body positions used in this therapy.
- Controlled breathing: You do this by breathing gently, slowly, and deeply. You may also need to breathe out air as fast as you can, which will help force mucus out of your airways.
ACTs with equipment:
High-frequency chest wall oscillation: This uses a vest that you wear. It attaches to a machine that causes the vest to vibrate your chest.
Oscillating positive-end pressure therapy: This method uses a small, pocket-sized device that works by vibrating your airways as you breathe out through it. You breathe in until you fill your lungs, and then hold your breath for 2 to 3 seconds. You then put the device tightly to your mouth and breathe out normally through it.
- Positive expiratory pressure therapy (PEP): This therapy uses a device that keeps some air in your airways when you breathe out. This helps prevent mucus from getting trapped in your small airways, making it easier to cough it up.
- High-frequency chest wall oscillation: This uses a vest that you wear. It attaches to a machine that causes the vest to vibrate your chest.
What are the risks of bronchiectasis? You may bleed more than expected or get an infection after lung surgery. If bronchiectasis is not treated, your airways may become filled with mucus. This may make it difficult to breathe. As more airway damage happens you may get lung conditions such as emphysema (air trapped in tiny sacs). Pressure can grow in your pulmonary artery (blood vessel) and lead to heart failure. Respiratory failure or bleeding may be life-threatening.
How can I prevent bronchiectasis from getting worse?
Stay away from people who are sick: This decreases your chance of getting sick and getting an infection.
Vaccines: Get an influenza vaccine every year as soon as it becomes available. Get a pneumococcal vaccine every 5 years. These help to prevent influenza (flu) and pneumonia.
- Do not smoke: If you smoke, it is never too late to quit. Smoking can irritate your airways and make your condition worse. Ask your caregiver for information if you need help quitting.
Where can I find more information?
- National Heart, Lung and Blood Institute
Health Information Center
P.O. Box 30105
Bethesda , MD 20824-0105
Phone: 1- 301 - 592-8573
Web Address: http://www.nhlbi.nih.gov/health/infoctr/index.htm
When should I contact my caregiver? Contact your caregiver if:
- You have a fever.
- You cough more than usual or wheeze.
- Your medicines do not relieve your symptoms.
- You have questions or concerns about your condition or care.
When should I seek immediate care? Seek care immediately or call 911 if:
- You cough up blood.
- You have sudden or more severe trouble breathing.
- You are confused or feel faint.
- You have sudden chest pain.
- Your lips or fingernails turn gray or blue.
CARE AGREEMENT:You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.