Bronchiectasis and its cause

Hello students and friends, today we are going to discuss bronchiectasis and its cause along with their symptoms, treatment, diagnosis, and pathogenesis.

So, let's discuss what is bronchiectasis?

Bronchiectasis is described as chronic permanent dilation and destruction of bronchi due to destructive changes in the elastic and muscular layers of bronchial walls.

In bronchiectasis, lung airways become damage. There is impairment of the drainage of bronchial secretions.

Pathogenesis

• In bronchiectasis, there is difficulty in clearing the secretions & recurrent infections with infection &  inflammation which results in airway injury and remodeling.
• It is the long-term condition in which cilia get damage and thus lungs become vulnerable to infections.
• In this, one or more of the conducting bronchi/airways gets damage{muscular and elastic component of bronchi damaged}.
• Abnormal dilation of bronchial tract leading to accumulation of the thick pool of purulent material and occlusion due to fibrosis thickening.
• Enlargement of the bronchial artery and increased anastomosis between them leads to an increase in vascularity.
• As infection increases, mucus gets increased along with microorganisms. Then this infection leads to damage to the airways.
• This is called a vicious cycle.

We can classify bronchiectasis according to the amount of sputum production-

If sputum is produced less than 10ml= mild

If sputum is produced 10-15ml= moderate

If sputum is produced more than 150ml= severe.

If we discuss how serious is bronchiectasis is, then we conclude that the complications are rare, but they can be serious(coughing with a large amount of blood).

Types of bronchiectasis

1. Cystic fibrosis- genetic condition; thick sticky mucus buildup in the lungs which results in recurrent pulmonary/lung infections.
2. Non-cystic fibrosis- if the person has asthma, COPD, cilia gets damage, and there is a problem in clearing mucus from the lungs then bronchiectasis occurs in that person.

Clinical features and symptoms

1. Chest pain
2. Dyspnea
3. Fatigue
4. Cough with mucopurulent sputum(mucus discharge+pus)
5. Weight loss
6. Blood in sputum
7. Weakness
8. Chronic cough
9. Fever
10. Wheezing
11. Decreased appetite
12. Cyanosis.

Causes of bronchiectasis

Some common causes are:

1. Immunodeficiency
2. Aspiration
3. Cystic fibrosis(a most common cause which gets worsen over time)
4. The disease of connective tissue
5. Abnormalities of cilia
6. ABPA(allergic bronchopulmonary aspergillosis)
7. Severe lung infections in childhood.

Signs/findings on physical examination

1. Crackle sound
2. Wheezing sound
3. Abnormal sounds
4. Bluish discoloration(cyanosis)
5. Loss of weight
6. Deoxyhaemoglobin>5gm.
7. Rhonchi(low pitched sound)
8. Digital clubbing.

Diagnosis

1. Pulmonary function test
2. X-Ray chest
3. Bronchoscopy
4. HRCT-scan
5. Respiratory function test
6. ABG
7. Sweat test(for cyanosis of cystic fibrosis).

Treatment

1. Physiotherapy
2. Antibiotics
3. Oxygen therapy
4. Bronchodilators
5. Penicillin
6. Steroids
7. Mucus reducing drugs.

If we discuss the best treatment for bronchiectasis, then we can prefer inhaled tobramycin(nebulized treatment) which is widely used nowadays. Gentamicin and colistin are also used.

Can bronchiectasis cure permanently or it can go away?

No this is not curable as well as there is no treatment of bronchiectasis which helps to cure it permanently.

It is a lifelong condition in which each cycle of infection lungs becomes more damaged.

Its symptoms can be prevented by removing mucus from the lungs.

Foods which are useful and foods which we have to avoid

We have to eat a healthy balanced diet and avoid food that has excessive salts, sugar, and saturated fats.

Hope you all find this helpful for you, if you have any query related to this topic or any other topic then you all are free to contact me via contact us or you can also ask your doubts on the comment box. Thank you! 

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