Bronchiectasis is a condition consisting on the permanent abnormal distortion of one or more of the conducting airways (bronchi), usually derived from an infectious process. It can be diagnosed based on a clinical history of chronic symptoms suggesting airway obstruction, like for instance the presence of persisting daily cough and the production of viscid sputum. It also can be diagnosed by using CT scanning. Bronchiectasis can be defined as a chronic obstructive lung disease in which airways are swollen and fragile, causing an air flow obstruction and difficulty to eliminate secretions.
Pathophysiology Of Bronchiectasis Bronchiectasis consists on an abnormal dilation of more than 2 mm of the proximal medium-sized bronchi due to the destruction of several components present in bronchial walls. It can be either acquired or congenital. The most common form of bronchiectasis is the acquired one. It affects mostly adults and older children, and can be caused by an airway obstruction or as a consequence of a previous infectious process affecting the respiratory system. This causes a moderate to severe damage to muscular and elastic tissues on bronchial walls, which is usually maximized by the host’s own response to the threat (the production of nitric oxide, neutrophilic proteases and cytokines, for instance).
Many patients also develop peribronchial fibrosis, what happens when the damage extends to the alveolar tissues. Additionally, bronchiectasis can be caused by several external agents, like corrosive gases and hot smoke, for instance on fires. The congenital type of bronchiectasis often affects infants and young children, and is a result of developmental arrest of the bronchial tree. Symptoms Of Bronchiectasis The most representative symptoms found on patients with bronchiectasis include the production of a purulent expectoration (which in severe and very rare cases can contain blood from dilated bronchial arteries), chronic cough, dyspnea, wheezing, pleuritic chest pain, hemoptysis, weakness, fever, and (rarely) weight loss.
Treatment Of Bronchiectasis Bronchiectasis treatment focuses mainly in controlling infections and bronchial secretions, relieving airways obstruction and stopping further damages. Bronchiectasis treatment usually requires regular drainage of bronchial secretions, helped by expectorants, bronchodilators and antibiotics. Prevention Of Bronchiectasis The main way to reduce the risk of pulmonary infections is to apply influenza vaccines on a yearly basis. Of course, as with all other lung diseases, avoiding the exposure to cigarette smoke and ambient pollution decreases the chances of infection and thus of acquired bronchiectasis.