Bronchiectasis

Bronchiectasis

Bronchiectasis is damage and abnormal dilation of the bronchi and airways. This condition causes the accumulation of mucus in the lungs. The most common symptoms that appear as a result of this condition are coughing up continuous phlegm, coughing up blood, and shortness of breath.

The respiratory tract has a protective mechanism to capture dust, bacteria, and dirt from the inhaled air by producing mucus. Under normal conditions, this mucus will be discharged from the respiratory tract and lungs.

In bronchiectasis, the defense function does not work well so mucus accumulates in the respiratory tract. Over time, the build-up of mucus can get worse and can trigger a bacterial infection. As a result, damage to the respiratory tract will worsen.

Causes of Bronchiectasis

Bronchiectasis is caused by damage or infection to the walls of the bronchi and respiratory tract. Sometimes, it is not known what caused the damage. However, in most cases, bronchial damage is triggered by a number of the following conditions:

  • Pneumonia or wet lungs
  • TB  (tuberculosis)
  • Whooping cough
  • Cystic fibrosis
  • Allergic bronchopulmonary aspergillosis
  • Primary ciliary dyskinesia  (abnormalities in the fine hairs in the respiratory tract)
  • Severe asthma
  • Aspiration
  • Autoimmune disease
  • Chronic obstructive pulmonary disease ( COPD )
  • Disorders of lung development since the womb
  • Connective tissue disorders, such as  Crohn's disease , rheumatoid arthritis, and  Sjögren's syndrome
  • Obstruction of the respiratory tract, for example due to a tumor
  • Weak immunity, for example due to HIV or diabetes
  • Measles

Symptoms of Bronchiectasis

Symptoms of bronchiectasis often only appear months or years after the sufferer has experienced recurrent respiratory tract infections. The most common symptoms are:

  • Cough with clear, pale yellow, or greenish-yellow sputum, which occurs every day
  • Coughing up blood (haemoptysis)
  • Recurrent respiratory tract infections
  • Moaning or whining
  • Shortness of breath
  • Chest pain
  • Muscle pain
  • Bad breath
  • Lost weight
  • The body feels tired
  • Fever and chills
  • Sweating at night
  • Changes in the shape of the fingernails ( clubbing fingers )

When should you go to the doctor?

Check with  a doctor  if you experience a persistent cough with phlegm accompanied by the symptoms mentioned above. You are also recommended to go to the doctor immediately if the complaint worsens and shows symptoms such as:

  • Coughing blood
  • Cough with sputum gets worse, accompanied by greenish sputum and bad smell
  • Severe chest pain that causes pain when coughing and difficulty breathing
  • The body feels very tired
  • Appetite lost
  • Bluish skin and lips
  • Breathing too fast
  • Bewildered
  • Fever

Diagnosis of Bronchiectasis

At the beginning of the examination, the doctor will ask about the symptoms experienced, for example how often the patient coughs and whether the cough is accompanied by phlegm. The doctor will also ask about the medication that is being consumed and whether there are any other diseases that are currently or have been suffered from.

Next, the doctor will listen to the sound in the patient's lungs using a stethoscope . Breath sounds produced by the respiratory tract in patients with bronchiectasis are usually abnormal.

In order to find out the cause of bronchiectasis and eliminate the possibility of symptoms caused by other diseases, the doctor will perform a supporting examination, which includes:

  • Blood test, to detect possible infection
  • Sputum examination, to find out if there are bacteria or fungi in the sputum
  • Examination of lung function, to measure the ability of the patient's respiratory tract by using spirometry
  • An autoimmune screening test, to determine if bronchiectasis is caused by  an autoimmune disease
  • Examination of sweat samples, to find out the possibility of bronchiectasis caused by  cystic fibrosis
  • X- ray  or CT scan of the lungs, to see the condition of the lungs and respiratory tract in detail
  • Bronchoscopy , to see if there is a blockage or bleeding in the respiratory tract

Bronchiectasis treatment

Bronchiectasis treatment aims to relieve symptoms, address the underlying cause, and prevent complications. The sooner treatment is given, the greater the patient's chance of avoiding further lung damage.

The types of treatment performed to overcome bronchiectasis include the administration of drugs, therapy, and surgery, as explained below:

Medicines

The doctor will prescribe a number of drugs to overcome the infection and reduce complaints, such as:

  • Antibiotics , which are available in oral or inhaled form
  • Bronchodilators , such as  beta 2-adrenergic agonists , anticholinergics, and theophylline
  • Expectorant (sputum thinner), which can be used as a single drug or combined with  a decongestant

Therapy

A number of therapies that patients can undergo to alleviate the symptoms of bronchiectasis are:

  • The use of a special vest
  • Chest clapping therapy
  • Use of breathing aids ( positive expiratory pressure )
  • Breathing therapy called  active cycle of breathing technique  (ACBT)

In addition to a number of methods above, bronchiectasis sufferers are recommended to do the following to help relieve symptoms:

  • Stop smoking
  • Exercise regularly
  • Wash your hands diligently
  • Drink plenty of water to keep your body hydrated
  • Consume balanced nutritious food
  • Get a flu vaccination every year
  • Get the pneumonia vaccine to prevent pneumonia

Operation

The doctor will recommend surgery if bronchiectasis only affects one lobe (part) of the lung, or if the patient's condition does not improve after being given medication or therapy. The operation is performed by removing the lobe affected by bronchiectasis.

It should be noted that the above treatment methods only prevent bronchiectasis from getting worse. This is because lung damage due to bronchiectasis is permanent and difficult to cure.

Complications of Bronchiectasis

Severe bronchiectasis can develop into a more serious condition and requires emergency action. These serious conditions include:

  • Coughing up large amounts of blood
  • Atelectasis
  • Lung abscess
  • short of breath
  • Heart failure

Prevention of Bronchiectasis

Bronchiectasis caused by birth defects is a condition that cannot be prevented. However, bronchiectasis that occurs as a result of a respiratory tract infection can be prevented by avoiding the triggering factor, namely by doing the following steps:

  • Avoid  air pollution , including factory smoke and vehicle smoke
  • Do not smoke and avoid exposure to cigarette smoke
  • Get vaccinated to prevent whooping cough, TB, pneumonia, measles, and COVID-19
  • Make sure that the child does not inhale things that can block the respiratory tract
  • Undergo regular treatment and check-ups if bronchiectasis is diagnosed early, so that the disease does not become more severe
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