Bronchiectasis Treatment in Delhi, India

Any sort of lung injury can cause bronchiectasis. There are two types of this condition:

1. Cystic fibrosis-related Bronchiectasis: It is related to having cystic fibrosis (CF) and is known as CF bronchiectasis. Cystic fibrosis is a genetic condition that causes abnormal production of mucus.
2. Non-Cystic fibrosis-related Bronchiectasis: This condition is not related to CF.

The symptoms may take months or even years to develop. Some of the typical symptoms of bronchiectasis may be:

• Chronic daily cough with a large amount of sputum.
• Chest pain
• Coughing up thick mucus every day
• Abnormal sounds or wheezing in the chest with every breath
• Weight loss
• Frequent respiratory infections
• Fatigue
• Clubbing of the fingertips in which the tissue beneath the nail thickens, and the fingertips become rounded and bulbous

The most common symptom is a persistent cough resulting in large phlegm daily. The phlegm can be of different colours - clear, pale yellow, or yellow-greenish in colour. Some people may only occasionally cough up small amounts of phlegm or none.

Other symptoms may include:

• shortness of breath
• wheezing
• coughing up blood or bloodstained phlegm

Some of the common conditions that can cause bronchiectasis to include:

• An abnormally functioning immune system
• Autoimmune diseases
• Alpha 1-antitrypsin deficiency
• Inflammatory bowel disease
• HIV
• Chronic obstructive pulmonary disease (COPD)
• Allergic aspergillosis 
• Lung infections, such as tuberculosis and other chronic lung infections.

CF affects the lungs and other organs like the pancreas and liver. In the lungs, this results in repeated infections. In other organs, it causes poor functioning.

Bronchiectasis is diagnosed with the following tests:

• Chest CT scans or X-ray imaging tests are recommended to assess the state of the lungs.
• Blood tests and sputum cultures to look for the presence of any infections.
• Lung function tests to determine the patient's current breathing pattern and lung functioning.
• Bronchoscopy is a method to look inside the lungs. A light and camera on a tube are put through the nose or mouth, down the trachea, and into the lungs to view the lungs. In the case of blockages, a bronchoscopy can also find and remove the object blocking the airways. The procedure can also be used to obtain lung secretions.
• A sweat test to look for cystic fibrosis.

Because bronchiectasis worsens over time, diagnosing and treating it at an early stage is essential. That will prevent infections, slow the damage, and make the symptoms simpler to manage.

Depending on the case, treatment for bronchiectasis may include:

• Medications: Antibiotics are prescribed to prevent or treat any infections. Macrolides may be prescribed to reduce inflammation. Inhaled corticosteroids also ease inflammation within the airways. Medicines, called expectorants, may also be prescribed to make the mucus thinner or to cough it out. An inhaler or nebulizer machine can help breathe better the bronchodilation drugs that open the airways.

• Vaccines: Doctors usually suggest getting flu and pneumonia vaccinations to prevent certain infections.

• Oxygen therapy and chest physical therapy: They may also suggest oxygen therapy or methods and devices to shake mucus free. These treatments are chest physical therapy (CPT), chest clapping, or percussion.

• Postural Drainage: This form of physical therapy includes a specific position of the body to remove pooled mucus from the lungs to keep them infection-free.

• Surgery: In severe cases, one might need surgery or a lung transplant

Complications of bronchiectasis may include:

• Cor pulmonale
• Coughing up blood
• Low oxygen levels (in severe cases)
• Recurrent pneumonia
• Depression (in rare cases)

People with the following conditions are considered to have risk factors for bronchiectasis:

• Cystic fibrosis
• Chronic and inflammatory lung disease
• Chronic or severe lung infections, like tuberculosis, non-tuberculous mycobacteria (NTM), or pneumonia
• Deficits in the immune system
• Repeated aspiration (breathing in) of things other than air, such as food particles, that cause damage to the lungs
• Bronchiectasis shows female predilection.
• Recurrent lung infections such as tuberculosis, pneumonia, or whooping cough (pertussis)
• History of allergic bronchopulmonary aspergillosis
• Inflammatory bowel diseases such as Crohn's disease and ulcerative colitis
• Low levels of proteins in the blood 

The outlook is highly variable for people with bronchiectasis and usually depends on the underlying cause. Living with bronchiectasis can be frustrating, but most people have a normal life expectancy. However, for people with very severe symptoms, bronchiectasis can be fatal if the lungs stop working properly. The patient will have to deal with the exacerbation of disease symptoms when the condition worsens with time. The symptoms may be:

• More phlegm
• Nagging cough
• Different colours of phlegm
• Stronger cough
• Tougher breathing
• Blood in your phlegm
• Heavy fatigue
• Chest pain

One can consult a pulmonologist, who may prescribe medicines or other treatments that can open the airways and improve symptoms.