Bronchiectasis - Causes, Symptoms, and Management

Causes of Bronchiectasis

Cystic Fibrosis

One of the most common causes of bronchiectasis is a genetic condition called cystic fibrosis. The condition mainly affects the lungs and becomes the cause of recurring infections in them. These recurring infections trigger an unusually high amount of mucus production, leading to bronchiectasis. The mucus also tends to be thick and sticky.

History of Respiratory Infections

Individuals who have previously had respiratory infections such as tuberculosis, whooping cough, or pneumonia are also at risk of developing bronchiectasis. This is because these infections can cause inflammation and damage to the airways, which then leads to bronchiectasis.

Autoimmune Diseases

Rheumatoid arthritis, lupus, Sjögren’s syndrome, inflammatory bowel disease, and similar autoimmune conditions, which cause inflammation, can also lead to bronchiectasis.

Weak Immune System

An individual whose immune system is not strong enough to fight infections is at a higher risk of sustaining lung damage and bronchiectasis caused by respiratory conditions. So, factors that can weaken the immune system can also increase the likelihood of developing bronchiectasis. Conditions such as HIV and hypogammaglobulinemia, for instance, are recognized as causes of bronchiectasis because they have a similar effect on the immune system. Apart from that, procedures such as organ transplantation can also cause a dip in immunity, which again increases the risk of bronchiectasis.

Obstructions

The blockage of airways due to foreign objects or growths, such as tumors or swollen lymph nodes, can block the mucus from draining out of the lungs. This trapped mucus can create an environment where bacteria can thrive, leading to repeated infections and inflammation. Over time, the continued damage to the airway walls from these infections can give way to bronchiectasis.

Other Genetic Conditions

Apart from cystic fibrosis, there is yet another genetic condition that can cause bronchiectasis, which is alpha-1 antitrypsin deficiency. This is a condition that causes a reduction in the number of AAT proteins, which are responsible for protecting the lungs. Consequently, alpha-1 antitrypsin deficiency can lead to lung (and liver) damage. The respiratory symptoms of the condition include coughing, wheezing, and shortness of breath.

Allergies

A specific allergic reaction known as allergic bronchopulmonary aspergillosis (ABPA) can also lead to bronchiectasis. This condition is triggered by an allergy to Aspergillus fungus, which causes lung inflammation.

Bronchiectasis Symptoms

Chronic Cough

Persistent coughing, usually daily that lasts for at least eight weeks, is a telltale sign of bronchiectasis. In this case, the coughing is not dry and involves the production of a lot of mucus, which is thick and yellow or green in color. In some cases, individuals may also cough up pus and blood.

Foul Breath and Mucus

In the case of bronchiectasis, the mucus that individuals cough up carries a foul odor. Sometimes, the condition can also be the cause of bad-smelling breath.

Recurring Cold

Colds that seem to come back repeatedly can also be a sign of bronchiectasis.

Wheezing

A shrill whistling or rattling sound produced when breathing is called wheezing. It usually occurs when the airway is partially blocked. Wheezing can point to several respiratory conditions, including allergies, bronchitis, asthma, pneumonia, and bronchiectasis.

Dyspnea

Shortness of breath, also called dyspnea, is another common symptom of bronchiectasis and is quite concerning. Bronchiectasis is a chronic condition, which means individuals may experience flare-ups every now and then. During these periods, they may notice an increase in breathlessness.

Fatigue

Bronchiectasis can also lead to extreme fatigue or tiredness, especially during flare-ups.

Clubbed Nails

Because of bronchiectasis, individuals may notice thick skin under their toenails and fingernails, making the fingertips and toe tips look swollen. Along with that, they may also notice their nails getting curved. This is a condition that is commonly known as nail clubbing.

Fever

During flare-ups of bronchiectasis, individuals may also experience fever, chills, and night sweats.

Chest Pain

Experiencing discomfort or pain in the chest is another symptom associated with bronchiectasis. This pain can result from frequent lung infections, coughing, and shortness of breath.

Frequent Infections

Bronchiectasis is a condition characterized by the accumulation of mucus in the lungs, which can create an environment for bacterial growth. This growth can lead to frequent infections of the lungs, often requiring prompt medical attention and treatment.

While these symptoms may indicate bronchiectasis, it is important to acknowledge that they can also be linked to other illnesses. Fever, for instance, is a common symptom that can occur because of a wide range of infections. This is why individuals should refrain from making hasty assumptions about bronchiectasis and instead seek medical attention to ensure an accurate diagnosis.

Likewise, symptoms such as chest pain and shortness of breath can also be triggered due to certain serious conditions, such as heart attacks. So, when individuals notice these symptoms flaring up, they must contact a healthcare professional immediately.

Bronchiectasis Management and Treatment Strategies

Mucus Thinning

Since mucus buildup causes bronchiectasis, doctors often suggest treatment options that help clear that mucus. One way to do it is by thinning it, which makes it easier for the body to drain it. Mucus-thinning treatments are often given through a nebulizer so they can be inhaled deep into the lungs.

Clearing Out Airways

Individuals with bronchiectasis may be advised to use specific handheld devices to help clear mucus and open up their airways. These devices include Oscillating Positive Expiratory Pressure (PEP), Intrapulmonary Percussive Ventilation (IPV), and Postural Drainage.

They may also be recommended to undergo chest physiotherapy, or CPT, to clear their airways. This therapy is only performed by respiratory therapists and involves exercises such as clapping on the chest in a specific way. In addition, the therapist might recommend at-home exercises. Some of these exercises may induce coughing, which is beneficial for helping the body expel excess mucus.

Based on the therapist’s recommendations, individuals can continue CPT at home with the help of devices like electronic chest clappers.

Breathing Techniques

Certain breathing exercises, such as the forced expiration technique and active cycle breathing, can help improve airflow by opening up the tubes in the lungs. Practicing these exercises can reduce shortness of breath and make breathing easier.

Staying Hydrated

Drinking plenty of water and staying well-hydrated are among the most important things individuals must do to manage bronchiectasis. Proper hydration helps thin the mucus in the lungs, making it easier for the lungs to clear it out of the system.

Making Lifestyle Changes

Certain lifestyle changes can support lung function and reduce inflammation. One of the simplest yet most effective lifestyle changes individuals can make is eating nutritious, well-balanced meals that help strengthen the immune system. Additionally, they should avoid eating foods unusually high in sodium, added sugars, and saturated fats. Some of these include store-bought sauces, frozen foods, and red meat. Exercising regularly can also help manage the condition by improving lung capacity. That said, before incorporating any lifestyle changes, individuals must speak to their healthcare professional. This is because not all exercises are suitable for everyone and every condition. Some exercises may exacerbate symptoms and worsen the condition.

While bronchiectasis is a chronic lung condition, its symptoms can be managed effectively. Understanding these symptoms and their causes can help individuals and healthcare professionals in developing a treatment plan. Individuals can manage bronchiectasis by following their prescribed treatment plan and incorporating certain lifestyle changes.

References:

https://my.clevelandclinic.org/health/diseases/21144-bronchiectasis#management-and-treatment

https://my.clevelandclinic.org/health/diseases/14770-aspergillosis

https://my.clevelandclinic.org/health/symptoms/15203-wheezing

https://my.clevelandclinic.org/health/diseases/21175-alpha-1-antitrypsin-deficiency

https://www.lung.org/lung-health-diseases/lung-disease-lookup/bronchiectasis/symptoms-diagnosis

https://www.lung.org/lung-health-diseases/lung-disease-lookup/bronchiectasis/treating-and-managing

https://www.healthline.com/health/bronchiectasis#treatment

https://www.medanta.org/patient-education-blog/bronchiectasis

https://pmc.ncbi.nlm.nih.gov/articles/PMC4332058/