🌬 Bronchiectasis

🧾 Introduction

• Definition: Chronic condition where the bronchi (airways in the lungs) become permanently widened, leading to mucus buildup and frequent infections.
• Nature: Irreversible airway damage, often progressive if untreated.

🔍 Symptoms

• Chronic productive cough (often with thick sputum)
• Recurrent lung infections / pneumonia
• Shortness of breath (dyspnea)
• Wheezing
• Fatigue
• Hemoptysis (coughing up blood, sometimes)
• Clubbing of fingers (in advanced disease)

⚠️ Causes / Risk Factors

Bronchiectasis can be post-infectious, congenital, or secondary to other conditions:

1. Infections: Severe pneumonia, tuberculosis, whooping cough, measles
2. Genetic disorders:
   • Cystic fibrosis (most common genetic cause in children)
   • Primary ciliary dyskinesia
3. Immune deficiencies: Reduced immunity leading to recurrent lung infections
4. Obstruction: Tumor, foreign body, or enlarged lymph nodes blocking airway
5. Inflammatory conditions: Autoimmune diseases like rheumatoid arthritis
6. Other causes: Chronic aspiration (inhaling food or gastric contents), alpha-1 antitrypsin deficiency

🧪 Diagnosis

1. Clinical history & physical exam: Chronic productive cough, recurrent infections
2. Imaging:
   • High-resolution CT (HRCT) scan – gold standard, shows dilated bronchi
3. Pulmonary function tests (PFTs): Assess airflow obstruction
4. Sputum culture: Identify bacterial infections (e.g., Pseudomonas, Haemophilus influenzae)
5. Blood tests / immune workup: Check for immune deficiencies or underlying conditions

💊 Treatment / Management

Medical Therapy

• Airway clearance techniques: Chest physiotherapy, postural drainage, devices like oscillating PEP
• Inhaled bronchodilators: Short-acting or long-acting for wheezing or obstruction
• Antibiotics:
  • Oral antibiotics for mild flare-ups
  • Intravenous antibiotics for severe infections
  • Long-term prophylactic antibiotics in selected patients
• Anti-inflammatory therapy: Sometimes inhaled corticosteroids, depending on inflammation

Surgical / Advanced

• Surgery: Resection of severely damaged lung segments (rare)
• Lung transplantation: For end-stage disease

Vaccinations

• Influenza and pneumococcal vaccines to reduce infection risk

🛡 Prevention / Lifestyle Measures

• Avoid smoking and exposure to pollutants
• Promptly treat respiratory infections
• Maintain good oral hygiene (reduces risk of bacteria entering lungs)
• Regular follow-up with pulmonary specialist
• Pulmonary rehab to maintain lung function

⚠️ Complications

• Recurrent pneumonia
• Respiratory failure in severe cases
• Hemoptysis (sometimes life-threatening)
• Pulmonary hypertension and cor pulmonale (long-term heart strain)

✅ Summary:
Bronchiectasis is a chronic lung disease with permanent airway dilation, leading to mucus buildup and repeated infections. Early diagnosis and treatment — including airway clearance, antibiotics, vaccinations, and lifestyle measures — are essential to slow progression and maintain quality of life.