Bronchiectasis is a common disease. Excessive phlegm production is the hallmark of this lung disease. Most patients develop this condition after a serious lung infection such as pneumonia or TB. This could have happened in childhood and is occasionally inherited. Patients who have inherited the disease sometimes have all organs in the body on the wrong side in left to right & vice versa. Apart from the inconvenience of this sputum volume disrupting their life, there are many other issues. Recurrent chest infections needing antibiotics, social embarrassment, and limited exercise tolerance also affect these patients.
Bronchiectasis is more common in women older than 60 years. In India, it is commonly a consequence of TB.
Why does it happen?
Any infection can destroy the airway tubes within the lungs. This results in the abnormal and permanent distortion of the airways.These tubes become big and carry lung secretions all the time. Infection is prevalent in the lung at all times.
How is it diagnosed?
Usually, the symptoms are adequate for a diagnosis. Sputum analysis helps. Chest radiography is useful although CT scan of the chest will accurately diagnose the condition. Once the condition has been identified, we look for the cause. Blood tests help to assess the patient's immunity. Pulmonary function test results may be normal or abnormal.
How can it be treated?
Antibiotics and chest physiotherapy are the mainstays. Chest physiotherapy to clean the secretions in the lung is very essential. If secretions are brought out regularly no further treatment is required.
Occasionally antibiotics are required. In very rare cases patients are given antibiotics every day either in a tablet form or inhaled therapy. Usually, courses of antibiotics are for 10-14 days' duration. Inhalers help with the breathlessness. Good nutrition is essential. Vaccinations to prevent pneumonia are also available and will help protect patients.
What is the prognosis for bronchiectasis?
In the pre-antibiotic era, mortality was high. Today with the widespread use of antibiotics the outlook is very good. In general, patients do well if they are compliant with all treatment regimens and practice routine preventive physiotherapy strategies.
Article by Dr.Supriya Sundaram
Pulmonologist, Kauvery Hospital