Thursday, January 22, 2009

Bronchiectasis - how to manage it well

By Jason Croller

Bronchiectasis is uncommon. It is a disease of your bronchi or air tubes. They become permanently distorted and then don't work well. It can result in you getting breathless and having a really nasty cough. The cough is often productive of green, purulent sputum, which can, at times be blood stained.

The destruction of your airways can be triggered by a variety of causes. Some babies have a problem with the formation of their lungs and are therefore born with it. Some genetic conditions can affect children and young people. An example of these conditions are cystic fibrosis. The most likely reason for you to develop bronchiectasis is a bad lung infections, such as a pneumonia or childhood whooping cough.

There are probably about 100 000 Americans diagnosed with this condition, which isn't a hugh number. It is probably an underestimate as many cases will be undiagnosed. However, it will certainly be less than it was before we had ready access to antibiotics and immunisations - as infections are the major reason for people to have bronchiectasis.

The symptoms that you would have if you were unfortunate enough to have bronchiectasis would be a long history of a daily cough. You would probably be coughing up green muck from your chest. You may even have coughed up some blood.

Occaisionally patients present with less characteristic problems such as wheezing, difficulty breathing, shortness of breath, sharp chest pains which are worse on breathing in, tiredness and even weight loss.

Hopefully, your doctor will be suspecting this condition as a possibility. To help them work out what is wrong with you they will need to undertake some investigations. They may ask for some blood tests. They could organise for your sputum to be analysed by the microbiologist to see whether there is an infection there or not. They are likely to organise a chest x-ray and may well consider a chest CT scan.

Bronchiectasis tends to get worse with time and lead to a deterioration in your lung function. This can also impact on your heart.

Treating bronchiectasis is concerned with the reduction in symptoms, reducing complications and aggressively treating any complications.

Antibiotics and physiotherapy are the two mainstays of therapy. You also need to avoid tobacco smoke, improve your nutrition and diminish the chances of you developing additional investigations by getting immunised against influenza, pneumococcus, measles, german measles and whooping cough.

Sometimes your doctor may use inhalers, steroids and oxygen to help your lungs cope better. If you had an infection, your lung disease would get worse and so you should be admitted under a chest physician or pulmonologist for intravenous antibiotics.

Once in a while, cutting out a diseased portion of lung is a viable option. Clearly this is not entered in to lightly, but if you have localised disease and the medicines are helping because your disease is too aggressive, then surgery may be helpful.

There is no cure for this disease. However, if you are able to keep up with the treatment regime, your lung disease should be well controlled.

For personalised help, contact your local chest physician. - 15995

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