Bronchiectasis
All the information about the causes, symptoms, and treatment for bronchial dilation.
Symptoms and Causes
Bronchiectasis occurs due to the irreversible dilation of the bronchi, which are the airways that carry air from the trachea to the lungs. It is a progressive disease that gradually destroys the internal muscular tissue of the bronchi.
There are two types of bronchiectasis depending on the extent of the area where bronchial thickening has occurred:
- Localized bronchiectasis: affects a single bronchus, or a small number of them, in a specific area of the lung.
- Generalized bronchiectasis: a large part of the bronchial tree is damaged, so it occurs in different areas or even in both lungs.
Bronchiectasis often appears during childhood, although it may remain asymptomatic and go undiagnosed. Over the years, it progresses slowly until symptoms appear, usually beginning with a respiratory infection that is difficult to control.
The prognosis for bronchiectasis varies, as it depends on underlying conditions and the degree of lung involvement. Nevertheless, most patients can lead normal lives without a reduction in life expectancy.
Symptoms
The most characteristic symptoms of bronchiectasis include:
- Recurrent bronchial infections that tend to become chronic.
- Chronic cough with expectoration. In severe cases, it may include blood (hemoptysis).
- Wheezing (whistling sounds while breathing).
- Shortness of breath.
- Fatigue.
- Pallor.
- Bad breath.
- Unexplained weight loss.
Causes
Bronchiectasis can be classified into two types depending on its main cause:
- Congenital bronchiectasis: babies are born with this condition.
- Acquired bronchiectasis: associated with one or more of the following factors:
- Recurrent inflammation or infection of the airways.
- Severe lung infection.
- Cystic fibrosis.
- Obliterative bronchiolitis: inflammation and obstruction of the bronchioles.
- Inhalation of foreign bodies, usually during childhood.
- Allergic lung disease: an exaggerated immune response to environmental allergens.
- Autoimmune disorders.
- Immunodeficiency.
Risk Factors
The main factors that increase the risk of developing bronchiectasis include:
- Cystic fibrosis.
- Chronic obstructive pulmonary disease (COPD).
- Asthma.
- Gastroesophageal reflux disease (GERD).
- Inflammatory bowel disease.
- Rheumatoid arthritis.
- Tuberculosis.
- Pneumonia.
- Smoking.
- Inhalation of pollutants.
- Genetic abnormalities.
- Airway obstruction.
Complications
The most common complications of bronchiectasis are:
- Pulmonary hemorrhage.
- Respiratory failure.
- Lung collapse (atelectasis).
- Heart failure resulting from low blood oxygen levels.
Prevention
Bronchiectasis cannot always be prevented. When possible, the following measures are recommended:
- Reduce the risk of infections, primarily through vaccination.
- Avoid smoking.
- Limit exposure to toxic substances.
- Maintain a healthy lifestyle:
- Drink plenty of water.
- Follow a balanced diet.
- Exercise regularly.
Which doctor treats bronchiectasis?
Bronchiectasis is diagnosed and treated by pneumology specialists.
Diagnosis
The diagnosis of bronchiectasis usually includes the following tests:
- Physical examination: includes lung auscultation to check for crackles, wheezing, or bubbling sounds.
- Computed tomography (CT) scan: provides detailed images of the lungs, allowing detection of bronchial damage.
To rule out other conditions with similar symptoms, additional tests may be performed, such as:
- Sputum culture: analyzed to detect the presence of bacteria or fungi.
- Chest x-ray: provides less detailed images than a CT scan but helps diagnose pneumonia, pulmonary fibrosis, heart failure, or lung cancer.
- Pulmonary function tests: evaluate the amount of air that can be inhaled and exhaled, as well as the lungs’ ability to deliver oxygen to the blood. These tests help determine the degree of lung damage.
Treatment
When bronchiectasis is mild and asymptomatic, only regular check-ups are necessary. However, more severe cases may require one or more of the following treatments:
- Antibiotics to treat infections.
- Bronchodilators to relax the muscles of the airways.
- Lobectomy: removal of the affected lung lobe in cases of localized bronchiectasis. Recovery in these cases is usually complete.
- Respiratory physiotherapy: helps drain accumulated mucus and therefore reduce the risk of infection.
