Adrian Harrison - Respiratory Physician
Private Service, Respiratory
Bronchiectasis means "damaged breathing tubes". Sometimes this condition can be widespread, involving most or all parts of both lungs, and sometimes it is localised to one area. Consequently, symptoms vary considerably. Severe, widespread bronchiectasis causes a persistent cough and sputum, as well as prolonged and recurrent chest infections. Localised bronchiectasis may only cause occasional trouble - a prolonged chest infection requiring 2 or more antibiotic courses, for instance. Coughing up blood can be a symptom of bronchiectasis.
In bronchiectasis the breathing tubes are thin-walled, wider than normal, and they are floppy. The main problem is that coughing is likely to cause these airways to collapse or flatten, and this results in mucus being trapped. Impaired ciliary clearance also occurs in bronchiectatic airways. Mucus can sit in damaged breathing tubes for weeks, providing a wonderful home for all sorts of micro-organisms - bugs that just don't survive in the airways of people with normal breathing tubes. Too many antibiotics can make the situation worse.
So what causes bronchiectasis?
- People can be born with it.
- Viral infections in childhood are a potent cause.
- Foreign bodies inhaled into the breathing tubes are another classic cause - chicken bones, nuts and pills, to name a few.
- Aspiration of gastric contents occurring with reflux (gastro-oesophageal reflux).
- Damage caused by pneumonia or severe viral infections in adult life.
- Often, no recognisable cause is found.