Bronchiectatic disease or bronchiectasis is an inflammatory processes in the respiratory system. The disease is characterized by pathological changes, enlargement or deformation of the bronchi, as a result of which a large amount of pus is formed in them. This distortion of the internal organs is called bronchoectasia.
Bronchoectatic disease is an independent disease that can affect not only one lung or its part, but also spread to both sides of the organ. Since the structure of the respiratory system is disrupted because of the illness, it can lead to the appearance of an intrabronchial infection that can cause permanent hemoptysis.
The main risk group is children from the age of five and young people up to the age of twenty-five.
To date, in medicine, there is no exact information about the pathogens of this disease. It is known only that different bacteria can cause an exacerbation of the disease. But doctors agree that it can serve as a fertile ground for this disease. They distinguish the following etiological factors:
- genetic predisposition;
- congenital anomalies in the development or structure of the lungs
- Various respiratory tract infections transferred at an early age.
Acquired causes of the disease are several times more likely than congenital. The disease is most often found in children, because they can get pneumonia or have a severe illness with the flu, with multiple complications.
The pathogenesis of the disease is such that at first a strong cough is manifested, and the process of increasing the bronchi begins to develop within the body. All this entails changing the structure and density of the walls of the organ and increasing the pressure inside it. The transformation of the walls takes its origin from the inflammatory processes in the mucous membrane and ends with the disruption of the structure of the muscles that connect them to the organ. The growth of intrabronchial pressure is due to compression of the bronchi from the outside, for example, enlarged lymph nodes, or possible exposure from within a foreign body. Because of all these pathological processes, the lungs are not cleared sufficiently, and this serves as a favorable factor for the onset of infection.
The main condition for the classification of bronchiectasis is the form of organ enlargement, which happens:
- cylindrical. Often appear against the background of the infection in the body. At the same time, a large accumulation of purulent fluid is not observed in the organ, which makes the patient’s health not very difficult;
- clear-cut. Appear «rosary», when several oval cavities are formed on one bronchus, in which a large amount of pus or sputum is collected. The disease proceeds somewhat heavier than the previous form;
- Sacrum. This expansion is usually observed on one bronchus, and is a ball. This form is most often found in congenital defects in the structure of the lungs. A large amount of purulent fluid can accumulate in spherical sacs, from which the sizes increase. This, in turn, leads to a slight discomfort when breathing;
- spindle-shaped — at which the diameter of the bronchiectasis gradually narrows, with the transition into a healthy bronchus. This form does not give rise to the formation of fluid accumulation;
- mixed — when one patient may have bronchiectasis of various forms. Usually it is revealed against the background of inflammatory processes or diseases that lead to a change in lung tissue. The flow of this form of the disease is completely dependent on the number and size of bronchiectasis.
The disease is chronic, because the bronchiectasis does not pass with time. In such cases, the general condition of the patient depends on which phase the disease is in. There can be two in total:
- aggravation. At this phase, a sharp deterioration in the patient’s condition may occur, from a pronounced manifestation of the symptoms of the disease and the accumulation of a large amount of pus. You may need urgent hospitalization. When untimely seeking help, the disease is complicated by pneumonia. The frequency of exacerbations is purely individual and can be expressed one or two times a year, up to several times a month;
- remission. This phase is characterized by the absence of symptoms. The person feels absolutely healthy, is engaged in usual affairs and work. The deformity of the organ is present, but does not appear difficult breathing or discomfort.
Localization of bronchiectasis can be:
- one-sided, damaging only one part of the lung. Such are only congenital educations;
- two-sided — with spread across all parts of the lungs.
The severity of the course of the disease is divided into degrees:
- initial, in which the aggravation occurs at most twice a year, not more often. The patient does not complain of symptoms and leads a habitual way of life;
- medium — the deterioration of the course of the disease occurs up to five times a year. With exacerbations of this degree, the patient’s condition deteriorates sharply. In such periods, a person loses efficiency for some time. Abundant sputum is excreted and breathing is difficult. When remission, labor activity resumes, but there is a cough;
- Heavy. In this case, the exacerbations are observed about once every few months. The patient’s condition worsens greatly. When you cough, pus and blood are secreted. The skin is pale, with a bluish tint, which means insufficient oxygen supply to the tissue. People with this degree of severity are best hospitalized. The remission time is short, the work activity is not completely restored;
- very severe — there are no periods of retreat of bronchoectatic disease. The patient’s health does not come back. There are complications in the form of heart failure and pneumosclerosis.
The disease is not only a specific pathogenesis, but also a manifestation of symptoms. All the symptoms make themselves felt only during the period of exacerbation, against the backdrop of inflammatory processes. Because of the possibility of a parallel course of purulent bronchitis or pneumonia, the symptoms of bronchiectasis are very often confused with these diseases. During the period of the disease’s withdrawal, the symptoms do not make themselves felt, accordingly, the patient’s complaints are absent. The most common symptoms of bronchiectasis are:
- cough (present in all patients). Cough, in turn, depending on the degree of severity, can be with the release of sputum in both pure form, and with impurities of pus or blood. This symptom can appear spontaneously, for example, with a change in the position of the body;
- shortness of breath;
- painful sensations in the chest area
- increase in body temperature;
- weight loss
- loss of performance
- pallor of the skin
- intoxication of the body
- change in the shape of the chest
- some developmental lag, only in children
Bronchoectatic disease develops in the lungs, but complications occur:
The first group of complications are:
- bleeding in the lungs
- abscessed pneumonia (lungs filled with pus)
- organ gangrene
- violation of air passage through the bronchi. There is a constant shortness of breath, a feeling of lack of air;
The second category of complications were:
- ingestion of toxic bacteria (sepsis)
- Amyloidosis, in which the protein accumulates in the internal organs, which leads to disruption of their functioning.
The measures of diagnosis of bronchiectasis, in addition to a general examination of the patient, include:
- biochemical blood test
- general urine analysis
- cough, sputum assessment
- CT of the chest;
- study of breathing functions
- consultation with ENT.
Depending on the degree of manifestation of symptoms and the stage of the disease, the treatment of bronchoectatic disease includes:
- Drug therapy
- instrumental treatment
- folk remedies.
Drug treatment is done with antibiotics and directed:
- to clean the bronchi from purulent fluid or sputum
- normalization of breathing function
- elimination of bacteria;
- if necessary — lowering body temperature;
- cleansing the body of toxins.
The operation in some cases is able to completely cure a person of bronchiectasis. During the operative intervention, a cavity filled with pus is removed. Very rarely, mainly because of heredity, after surgery, bronchiectasis may reappear. The patient independently decides on the operation, having previously listened to the physician’s forecast regarding the state of health in the event of an operation or without an operation.
Folk remedies for the treatment of bronchiectasis are mainly aimed at lowering the separation of sputum during a cough. They can be combined with medication, but should not be used without first consulting a doctor. The most effective application is:
- flax seed powder
- garlic broth
- carrot juice
- tinctures from the leaves of aloe.
Preventive measures of bronchoectatic disease include:
- prevention of hypothermia
- a healthy lifestyle, without alcohol and nicotine
- timely treatment of not only lung diseases, but also of any inflammatory processes in the body
- eating foods that contain a lot of vitamins and nutrients
- receiving at least two liters of water per day;
- Complete a clinical examination at least twice a year.