The dr. Eva Polverino, a pneumologist at the Hostafrancs Medical Center and at the Hospital Clínic in Barcelona, as well as CEO, founder and coordinator at the Italo-Catalá ItaCa Medical Center, explains the bronchiectasis and how to treat them. These are dilatations of the bronchi that cough and difficulty breathing, among many other symptoms.
Bronchiectasis is a chronic respiratory disease that is defined by the presence of permanent bronchial dilatations and is usually manifested by chronic cough and expectoration and frequent infections (bronchitis, pneumonia) that are an expression of chronic airway inflammation and bronchial infection .
Why bronchiectasis occurs
Bronchiectasis can occur due to a high number of different causes. These include:
- "poorly healed" or severe respiratory infections of the past- alterations of the immune system (antibody deficiency, etc.)- cystic fibrosis (rare genetic disease)- alterations in the cilia that line the airways- COPD (Chronic Obstructive Pulmonary Disease)asthma- Rheumatological diseasesinflammatory bowel diseases- many other less common pathologies
It is important to try to investigate the initial cause of bronchiectasis because some have a specific treatment or management that can greatly improve the prognosis of the disease.
Symptoms that alert the patient to bronchiectasis
Cough and chronic expectoration , as well as frequent infections (bronchitis or pneumonia) are the most common symptoms of bronchiectasis, but respiratory distress (dyspnea), hemoptysis (blood in the sputum), chest pain, fatigue, wheezing , etc.
Diagnosis of bronchiectasis
Although the medical history and the chest X-ray may greatly help the Pneumology specialist in suspecting the disease, only the high-resolution CT scan can confirm the diagnosis, that is, the presence of bronchiectasis. Apart from this test a number of other tests can be done (depending on each case) to look for the specific cause of bronchiectasis.
More suitable treatment for bronchiectasis
As it is a very heterogeneous disease due to causes and clinical presentation, the treatment is variable depending on each case. In general, the use of bronchodilators is indicated when there is bronchial hyperreactivity, whereas respiratory physiotherapy is indicated in all cases of abundant secretions or difficulty in expectoration. Finally, in case of fatigue and dyspnea, rehabilitation is recommended.. The use of antibiotics is quite frequent because the exacerbations of this disease are almost always of infectious cause and because up to more than half of the patients can have some type of chronic infection. In case of chronic bronchial infection and frequent exacerbations, antibiotics can be used prophylactically , either orally (a few days a week) or inhaled, in selected cases. In any case, the treatment must be valued and decided on a case-by-case basis.