Bronchiectasis – Symptoms, Causes, Treatment and Home Remedies

Overview

Bronchiectasis is a chronic condition where the airways (bronchial tubes) in the lungs widen and become flabby and scarred. This is caused by chronic inflammation and/or repeated infections. As a result, the airways slowly lose their ability to clear out mucus. Mucus is a slimy substance that the airways produce to help remove inhaled dust, bacteria, and other small particles. When mucus can’t be cleared, it increases and creates an environment in which bacteria can grow. This makes people more susceptible to lung infections. In addition, bronchiectasis can lead to other serious health problems, such as respiratory failure, atelectasis, and heart failure.

In the United States, more than 110,000 people have been diagnosed with bronchiectasis. While the disease can develop at any age, the risk increases with age. Fewer than 1 in 20,000 people ages 18 to 34 have the disease. But 1 in 350 have it by age 75. Moreover, two-thirds of people who have the condition are women. However, in children, the condition is more common in boys than in girls.

Currently, bronchiectasis has no cure. However, with proper care, most people who have it can lead a good quality of life. Therefore, it is important to diagnose and treat the condition as early as possible.

 

Symptoms

The initial airway damage that leads to bronchiectasis often begins in childhood. However, signs and symptoms may not appear until months or even years after you start having repeated lung infections. The symptoms of bronchiectasis may include:

  • a daily cough that occurs over months or years
  • shortness of breath that gets worse with exercise
  • feeling run-down or tired
  • fevers and/or chills, usually during flare-ups
  • wheezing or a whistling sound while you breathe
  • coughing up blood or bloody mucus, a condition called hemoptysis (less common in children)
  • chest pain from increased effort to breathe
  • thickening of skin under nails, known as clubbing (rare)

Causes

There are two kinds of bronchiectasis: cystic fibrosis (CF)-bronchiectasis and non-CF bronchiectasis. Between one-third and one-half of bronchiectasis cases in the United States are associated with CF.
The main cause of bronchiectasis is the damage to the walls of the airways. The conditions that may cause this damage can be divided into lung infections and other causes. Lung infections that can lead to bronchiectasis include:

  • Severe pneumonia
  • Tuberculosis
  • Fungal infections
  • Whooping cough or measles (uncommon in the United States due to vaccination)

Other causes that impair the airways include:

  • Cystic fibrosis. This disease leads to almost half of the cases of bronchiectasis in the United States.
  • Allergic bronchopulmonary aspergillosis. This is an allergic reaction to a fungus called aspergillus. The reaction causes swelling in the airways.
  • Immunodeficiency disorders, such as common variable immunodeficiency and, less often, HIV and AIDS.
  • Disorders that affect cilia function, such as primary ciliary dyskinesia. Cilia are small, hair-like structures that line your airways. They help clear mucus out of your airways.
  • Chronic pulmonary aspiration. This is a condition in which you inhale food, liquids, saliva, or vomited stomach contents into your lungs. Aspiration can inflame the airways, which can lead to bronchiectasis.
  • Alpha1-antitrypsin deficiency. This is the genetic cause of COPD in some people.
  • Chronic obstructive pulmonary disease or COPD
  • Connective tissue diseases, such as rheumatoid arthritis, Sjogren’s syndrome, and Crohn’s disease.

In addition, a problem with how the lungs form in a fetus may cause congenital bronchiectasis. This condition affects infants and children.

Diagnosis

The health care provider will perform a physical exam. When listening to the chest with a stethoscope, the doctor may hear small clicking, bubbling, wheezing, rattling, or other sounds, usually in the lower lungs.

Other tests to diagnose bronchiectasis and find the cause include:

  • Chest CT Scan, the most common test for diagnosing bronchiectasis
  • Chest x-ray to show areas of abnormal lung and thickened, irregular airway walls.
  • Aspergillosis precipitin test to check for signs of an allergic reaction to fungus
  • Alpha-1 antitrypsin blood test
  • Sputum culture to checks for growth of bacteria or other microbes
  • Complete blood count (CBC)
  • Genetic testing, including sweat test for cystic fibrosis and tests for other diseases
  • PPD skin test to check for a past tuberculosis infection
  • Serum immunoglobulin electrophoresis to measure proteins called immunoglobulins in the blood
  • Lung function tests to measure breathing and how well the lungs are functioning
    Bronchoscopy to find blockages and sources of infection and inflammation in severe or resistant cases

Treatment

Treatment is aimed at:

  • Controlling infections and sputum
  • Relieving airway blockage
  • Preventing the problem from becoming worse

The treatment options often includes medications, hydration, and chest physical therapy (CPT). Your doctor may recommend surgery if the bronchiectasis is isolated to a section of lung or you have a lot of bleeding. If the bronchiectasis is widespread and causing respiratory failure, your doctor may recommend oxygen therapy.

Medications

Antibiotics

Antibiotics are the main treatment for the repeated lung infections that bronchiectasis causes. Oral antibiotics often are used to treat these infections. For hard-to-treat infections, your doctor may prescribe intravenous (IV) antibiotics.

Macrolides

Macrolides are a type of antibiotic that not only kill certain types of bacteria but also reduce inflammation in the bronchi. Examples of macrolides include azithromycin, erythromycin, and clarithromycin. Marcolides may be beneficial for some people but also may have serious side effects, including:

  • diarrhea
  • nausea
  • hearing loss
  • dizziness
  • development of resistant bacteria in the lungs

Mucus-Thinning Medication

Mucus-thinning medications is also known as mucolytics. They help people with bronchiectasis get mucus out of their lungs. These medications are often given through a nebulizer, where it is mixed with hypertonic saline solution, turned into a mist, and inhaled deep into the lungs. Sometimes another inhaled mucus thinning medication called dornase alfa is given to patients with bronchiectasis who have non-CF bronchiectasis.

Hydration

Drinking plenty of fluid, especially water, helps prevent airway mucus from becoming thick and sticky. Good hydration helps keep airway mucus moist and slippery, which makes it easier to cough up.

Chest Physical Therapy

CPT is also called physiotherapy or chest percussion. A respiratory therapist or a trained member of the family can perform this technique. It involves the therapist pounding your chest and back over and over with his or her hands or a device. This helps loosen the mucus from your lungs so you can cough it up.

Oxygen Therapy

Supplemental oxygen can:

  • Make your breathing easier
  • Enhance your quality of life
  • Help you live longer
  • Improves sleep, mood, and mental alertness
  • Better allows the body to conduct everyday functions
  • Prevents heart failure

There are three types of oxygen:

  • Compressed gas oxygen in steel or aluminum containers of different sizes for home use and traveling
  • Liquid oxygen that changes into a breathable gas.
  • Oxygen concentrators, electrical devices that remove nitrogen from the air.

For this treatment, you’ll receive oxygen through nasal prongs or a mask. Oxygen therapy can be done at home, in a hospital, or in another health facility. Ask your health-care provider for more details.

Surgery

This is a last resort. Your doctor may recommend surgery if other treatments don’t help and only one part of your airway is affected. Surgery may involve:

  • Removal of part or all of a single lung.
  • Embolzation. This stops bleeding when a lot of blood is being coughed up.
  • Lung transplantation (in rare cases).

Lifestyle and home remedies

Early diagnosis and treatment of bronchiectasis is essential to prevent further damage to your lungs. People who have bronchiectasis should have ongoing care and try to follow a healthy lifestyle, including:

  • stop smoking
  • avoid secondhand smoke
  • avoiding toxic fumes, gases, and other harmful substances
  • have a healthy diet
  • staying hydrated
  • do some physical activities, such as walking and swimming

Supplements that can strenghthen the immune may help on bronchiectasis. These supplements include:

  • Vitamin C
  • Calcium phosphate
  • Milk thistle
  • Turmeric
  • Dandelion
  • Dong Quai

 

If you have any problem, please consult your health-care provider.

 

Related posts:

What are the Basics of Bronchiectasis?

What Can We Do to Deal With Bronchiectasis Disease?

Dong Quai – What is it & How to use

Milk Thistle – What is it & How to use

Turmeric – What is it & How to use

Dandelion – What is it & How to use

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.