Doctor Reza - The Bronchiectasis Specialist

Meaning of Bronchiectasis

Bronchiectasis is a permanent abnormal widening (dilation) in one or more of the lung’s airways (bronchi). It is an irreversible physical destruction of your bronchi caused by infection. Infection occurs when the tiny hairs (cilia) lining the airways are damaged and lungs fail to clear your mucus or sputum easily. Extra mucus tends to form and pool in the parts of the airways that are widened. Widened airways with extra mucus are prone to infection.

Understanding the airways

Air goes in to your lungs via the windpipe (trachea), which divides into a series of branching airways called bronchi. Air goes from the airways into millions of tiny air sacs (alveoli). Oxygen from the air is passed into your bloodstream through the thin walls of the alveoli.

Tiny glands in the lining of the airways make a small amount of mucus. The mucus keeps the airways moist, but also traps any dust and dirt in the inhaled air. There are many tiny ‘hairs’ (cilia) on the surface of the cells lining the airways. The millions of cilia lining your airways ‘sweep’ the mucus to the back of your throat to form sputum (phlegm) that you swallow. Coughing also helps to clear the airways.

The airways in Bronchiectasis

The extent of bronchiectasis can vary greatly. There may be only one section of one airway that is widened and abnormal. At the other extreme many airways may be widened.

The widened parts of the airways are damaged and inflamed. This causes extra mucus to form, which is less easily cleared. The severity of your symptoms depends on how many and how badly your airways are affected.

Causes of Bronchiectasis

The cause of Bronchiectasis is often not clear. No cause can be found in over half of the cases. Some conditions that affect or damage airways can cause bronchiectasis. So, an underlying cause is found in about 4 in 10 cases. Examples include the following: -

  • Some inherited conditions. For example, a condition called primary ciliary dyskinesia affects the cilia so they do not ‘beat’ correctly to clear the mucus. Cystic fibrosis is another condition that affects the lungs and causes ‘bronchiectatic’ airways
  • Inhaled objects, such as peanuts can become stuck and block an airway. This may lead to local damage to that airway. Acid from the stomach that is regurgitated and inhaled can also damage airways. Inhaling poisonous gases may also cause damage
  • Severe lung infections such as tuberculosis (TB), whooping cough, pneumonia or measles can damage the airways at time of infection. On going bronchiectasis may then develop.
Symptoms of Bronchiectasis
  • Coughing up lots of sputum is the main symptom. The amount of sputum can vary depending on the severity. It can be very tiring to cough up large amounts of sputum each day
  • Tiredness and poor concentration are common
  • Wheeziness is common
  • You may cough up some blood from an inflamed airway
  • About 1 in 3 people with bronchiectasis also have chronic (persistent) sinusitis.
Treatment of Bronchiectasis

In case you are a bronchiectatic patient, I will aim to clear mucus from your chest with some special treatment procedures. There are some ways to treat Bronchiectasis effectively, like:

  • Physiotherapy and exercise programs. Your physiotherapist can chart out a customised programme. This may include physiotherapy techniques such as:
    • Physical exercise
    • Postural drainage of the chest
    • Active breathing
    • Huffing and coughing
  • Support the exercise routine with the inhalation of a bronchodilator - a lung medicine that helps to open up your airways
  • If you contract acute bronchitis and pneumonia along with Bronchiectasis, then your sputum will become coloured and you may cough up blood. As your consultant Bronchiectasis specialist, I may need to admit you to a hospital and treat you with antibiotics. So, do not delay once you notice the first symptoms of Bronchiectasis. Consult me immediately. If you are not based in Kolkata, you can always email me or phone me for advice and appointment.
  • Stay away from people with coughs and colds.
  • Do your Physiotherapy regularly as shown.
  • Contact me immediately if there is any signs of infection.
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