WHAT IS IT?
Bronchiectasis damages the tiny hairs (cilia) that cover the inside of our airways. Damaged cilia can’t do their job of removing dirt and mucus out of our lungs.
According to the website Breathe: The Lung Association, bronchiectasis, is a condition when the airways will be enlarged and stretched out.
In some places the airways are so stretched out they form little pockets. Germs, dust and mucus will collect in these pockets and get stuck.
After a while the germs, dust and mucus that are stuck in the airways will get infected.
Since tiny hairs (cilia) can’t sweep them away, the infections will constantly return.
CAUSES OF BRONCHIETASIS
Any lung injury can cause bronchiectasis. There are two main categories of bronchiectasis. One is related to having cystic fibrosis (CF), and is known as CF bronchiectasis. CF is a genetic condition that causes an abnormal production of mucus.
The other category is non-CF bronchiectasis, which is not related to CF. Some common known conditions that can lead to non-CF bronchiectasis include:
- an immune system that is functioning abnormally
- autoimmune diseases
- allergic aspergillosis (an allergic lung reaction to fungus)
- lung infections such as whooping cough and tuberculosis
Cystic fibrosis causes about one-third of all cases of bronchiectasis.
SIGNS AND SYMPTOMS OF BRONCHIETASIS
The most common signs and symptoms of bronchiectasis acccording to the National Heart, Lung and Blood Institute are:
- A daily cough that occurs over months or years
- Daily production of large amounts of sputum (kahak).
Sputum, which you cough up and spit out, may contain mucus (bahan berlendir), trapped particles, and pus.
- Shortness of breath (semput) and wheezing (bunyi siulan ketika bernafas)
- Chest pain
- Clubbing (isi di bawah kuku menjadi gelap)
The doctor may hear abnormal lung sounds when listening to a person’s chest who has bronchiectasis using a stethoscope.
Over time, a person may have more serious symptoms. He/she may cough up blood or bloody mucus and feel very tired. Children may lose weight or not grow at a normal rate.
Complications caused by bronchiectasis are rare, but they can be serious.
One of the most serious complications is coughing up large amounts of blood, caused by breaking of one of the many the blood vessels in the lungs.
This problem can be fatal and may require emergency surgery to treat it.
TREATMENT OPTIONS FOR BRONCHIECTASIS
Although there’s no cure for bronchiectasis, treatment is important to help patients manage the condition.
The main goal of treatment is to keep infections and bronchial secretions under control.
It’s also important to prevent further blockage of the airways and minimize lung damage. Common methods of treating bronchiectasis include:
- breathing exercises and chest physiotherapy to clear the airways
Patients may need the help of chest physiotherapy. This can be done using a high-frequency chest wall oscillation vest to help remove mucus from the lungs.
The vest gently presses and releases on an individual’s chest, creating the same effect as a cough.
This action help releases mucus from the walls of the bronchial tubes.
- pulmonary rehabilitation (pemulihan paru-paru)
- using antibiotics to prevent and treat infection — studies are currently being done to create antibiotics that needs to be inhaled.
- using bronchodilators like albuterol (Proventil) and tiotropium (Spiriva) to open up airways
- medications to reduce mucus
- expectorants to aid in coughing up mucus
- oxygen therapy
- vaccinations to prevent respiratory infections
If there’s bleeding in the lung, or if the bronchiectasis is only in certain parts of the lung, surgery may be needed to remove the affected area.
Another part of daily treatment involves removing the bronchial secretions, with the help of gravity.
A respiratory therapist can teach individuals’ techniques to aid in coughing up the excess mucus.
If a condition like immune disorders are causing an individual’s bronchiectasis, doctors may treat those conditions as well.
Avoiding smoking, polluted air, cooking fumes, and chemicals can help protect lungs and maintain lung health.
But usually when the cause is unknown, prevention is difficult.
Therefore, early identification of bronchiectasis is important so that steps can be taken to prevent further lung damage.
LIVING WITH BRONCHIECTASIS
Patients tend to have continous symptoms, but, these can generally be controlled with treatment and the vast majority of patients live active independent lives.
Because a small portion of patients develop severe disease, they therefore require more aggressive disease management and extra regular visits to their physicians.
A very important feature of bronchiectasis is that it is a chronic condition, however, with professional guidance, patients may become familiar with how to manage their lung conditions.
However, patients may know which treatment that is most suitable for them.