Bronchiectasis is a condition in which the bronchial tubes of the lung become damaged. Inflammation from infection or other causes destroys the smooth muscles of the bronchial tubes. Bronchiectasis is a form of COPD (which includes emphysema and chronic bronchitis). There are three primary types of bronchiectasis: 1) cylindrical bronchiectasis; 2) saccular bronchiectasis; and 3) cystic bronchiectasis. Bronchiectasis may also be acquired or congenital. The most common symptoms of bronchiectasis are recurrent cough and sputum production. There is no cure for bronchiectasis. Treatment is often geared toward controlling the symptoms of bronchiectasis.
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.
Bronchiectasis describes damage to the walls of the bronchial tubes with
loss of the smooth muscle and loss of elasticity of segments of the bronchi. The
resultant airway distortion prevents secretions from being adequately cleared
from the lung.
Bronchiectasis may be congenital or acquired. Cystic fibrosis is the most
common cause of congenital bronchiectasis.
Diagnosis is often made by history and confirmed by
CT scan of the chest.
Efforts may be made to find the underlying cause of bronchiectasis.
Complications include recurrent pneumonia, respiratory failure, and heart failure.
Bronchiectasis is not curable. The goal for treatment is to control
secretions and minimize the risk of infections.
What is bronchiectasis?
Bronchiectasis is a term that describes damage to the walls of the bronchial tubes, of the lung. Inflammation due to infection or other
causes destroys the smooth muscles that allow the bronchial tubes to be elastic
and prevents secretions that are normally made by lung tissue to be cleared.
Normal branching of the airways of the lung demonstrates a gentle taper that
occurs at each branch point, like the branches of a tree. This tapering results
in decreased resistance in the larger branches, enabling mucus or other objects
to be funneled to the larger airways and eventually, with a cough, ejected out
through the mouth. Loss of this normal anatomic tapering of the airways by
damage due to inflammation causes the walls of the airways to be irregularly
shaped. Secretions tend to pool in the distorted airways rather than be
expelled, and these stagnant secretions are a breeding ground for bacterial
growth. These bacteria, in turn, cause further irritation and inflammation,
airway damage, and hence more secretions, initiating a "vicious cycle" of
damage. This increases the risk of infections to spread directly into the
airspaces of the lungs resulting in pneumonia.
Bronchiectasis is a form of chronic
obstructive pulmonary disease (COPD)
which also includes emphysema and chronic bronchitis. Bronchiectasis can be
present alone, but usually more than one of the aforementioned components of
COPD coexist in the same person.
Congenital bronchiectasis may occur due to a genetic defect such as occurs in
cystic fibrosis. Usually, the disease Alpha-1 antiprotease (alpha 1-
antitrypsin) deficiency results in emphysema, but bronchiectasis can occur as
well in this condition. An embryologic defect in the airway cilia, so-called
immotile cilia syndrome, is another cause of bronchiectasis and is often
associated with situs inversus, in which the major organs are in a reversed
position (for example, the heart is on the right).
Pediatric lung infections may ultimately lead to lung destruction and
bronchiectasis later in life. Therefore prevention is an important part of
treatment, including adequate immunizations and avoidance of secondhand smoke
and other toxic fumes.
Bronchiectasis is characterized by an increased amount of sputum production
(mucus produced and coughed up from the lung), recurrent infections, and gradual
loss of lung function leading to shortness of breath.
Common symptoms of bronchiectasis include recurrent cough and sputum production. Usually the
mucus is clear, but it may be bloody due to bronchial wall injury or green or
yellow if infection is present. Shortness of breath and fatigue develop as lung
function decreases. Wheezing may or may not be present.
Bronchiectasis may occur due to another underlying disease. Symptoms of that
primary disease may also be present. For example, a patient with tuberculosis
may have bloody sputum, fever,
chills, and night sweats. A
Crohn's disease may have abdominal pain and diarrhea.
Congenital bronchiectasis often becomes apparent because of recurrent