Doctor's Notes on Bronchiectasis Symptoms, Causes, Complications, and Prognosis
Bronchiectasis is a term that describes damage to the walls of the bronchial tubes with loss of the smooth muscle and elasticity of the bronchi. Signs and symptoms of bronchiectasis include the following: increased sputum production, bloody sputum, shortness of breath, wheezing, weakness and fatigue. The sputum can be clear, bloody, and/or green or yellow.
Causes of bronchiectasis maybe congenital or acquired. Congenital causes of bronchiectasis may include cystic fibrosis, Alpha-1-antitrypsin deficiency, Kartagener syndrome (sinusitis, bronchiectasis, dextrocardia and infertility) and Young’s syndrome (like Kartagner syndrome without dextrocardia). Acquired causes may include the following: recurrent infections, aspiration of foreign bodies, inhaling toxic gases like chlorine or ammonia, alcohol abuse, drug abuse, tuberculosis and inflammatory bowel diseases (ulcerative colitis, Crohn’s disease).
Bronchiectasis Symptoms, Causes, Complications, and Prognosis Symptoms
Bronchiectasis develops over a prolonged period of time.
Common symptoms include recurrent cough and sputum production. Usually the mucus is clear, but it may be bloody due to bronchial wall injury or green or yellow if infection is present. Shortness of breath and fatigue develop as lung function decreases. The persson may experience wheezing.
If the disease progresses or if it is poorly controlled, the amount of work required to breathe increases and weight loss and diminished quality of life may occur.
Bronchiectasis may occur due to another underlying disease. Symptoms of that primary disease may also be present. For example, a patient with tuberculosis may have bloody sputum, fever, chills, and night sweats. A person with Crohn's disease may have abdominal pain and diarrhea.
Congenital bronchiectasis often becomes apparent because of recurrent pneumonia.
Bronchiectasis Symptoms, Causes, Complications, and Prognosis Causes
Bronchiectasis is caused by damage to the larger airway walls destroying the muscles and elastic tissue layers that allow normal bronchial tubes to contract. This damage decreases the ability of the lung to move and clear secretions that are normally produced in the lung. These pooled secretions cause increased potential for infection like pneumonia and bronchitis, which causes further damage to the bronchial walls. As mentioned above, this results in a vicious cycle in which increased damage leads to increased infection, leading to further damage.
There are three primary types of bronchiectasis. These types are described by their anatomical appearance.
- Cylindrical bronchiectasis is the mildest form and reflects the loss of the normal tapering of the airways. The symptoms may be quite mild, like a chronic cough, and usually are discovered on CT scans of the chest.
- Saccular bronchiectasis is more severe, with further distortion of the airway wall and symptomatically, affected persons produce more sputum.
- Cystic bronchiectasis is the most severe form of bronchiectasis, and fortunately it is the least common form. This often occurred in the pre-antibiotic era when an infection would run its course and the patient would survive with residual lung damage. These patients often would have a chronic productive cough, bringing up a cup or more of discolored mucus each day.
Bronchiectasis also may be congenital or acquired.
Congenital causes of bronchiectasis
- Cystic fibrosis
- Kartagener syndrome
- Young's syndrome
- Alpha-1-antitrypsin deficiency
Acquired causes of bronchiectasis
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COPD (Chronic Obstructive Pulmonary Disease) QuizQuestion
COPD (chronic obstructive pulmonary disease) is the same as adult-onset asthma.See Answer
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.