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Early diagnosis key to managing bronchiectasis

Bronchiectasis, a condition causing chronic coughing and lung damage, requires early detection and treatment to prevent permanent harm. Despite being as common as COPD and asthma, it remains underrecognized, making awareness and timely diagnosis critical.

Agencies and A News HEALTH
Published January 21,2025
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Persistent cough, heavy mucus, wheezing, and similar symptoms can lead to bronchiectasis, which, if not detected early, causes permanent damage to the lungs. Early diagnosis and proper treatment are crucial in controlling the disease's insidious progression.

Bronchiectasis, commonly known as "lung decay," is a disease that causes permanent damage to the lungs, severely reducing quality of life but can be controlled with early diagnosis. Unfortunately, this significant health issue is not widely recognized in society. Research has shown that bronchiectasis is as common as COPD and asthma. The disease, known to have a prevalence of between 1 and 5 per thousand in developing countries, poses a serious risk due to its insidious progression.

The disease often presents with mild symptoms in the early stages, which are frequently mistaken for other conditions, making bronchiectasis even more dangerous. What symptoms indicate bronchiectasis? Why is early diagnosis critical? What treatment methods are most effective? We sought answers to these questions from Dr. Caner Çınar, a pulmonologist at Marmara University Pendik Training and Research Hospital.

CAUSED BY LUNG DAMAGE

"Bronchiectasis is a health issue characterized by the irreversible dilation of the airways (bronchi) in the lungs, caused by damage from factors such as past lung infections," Dr. Çınar explains.

"In bronchiectasis, structural damage occurs in the bronchial structures that ensure airflow in the lungs. As the damage progresses, the bronchi enlarge and take on an abnormal structure. This leads to the accumulation of mucus produced by the bronchi. The accumulated mucus increases the risk of lung infections. Repeated infection attacks lead to more mucus production, eventually causing airway blockage."

BE AWARE OF BLOODY MUCUS

Chronic cough and mucus are present in every bronchiectasis patient. Dr. Çınar mentions that patients usually cough daily and produce significant amounts of mucus. "Sometimes, there may be traces of blood in the mucus, and in some cases, there can be heavy, bloody mucus. Bronchiectasis is one of the most common causes of hemoptysis (coughing up blood)," he says, listing additional symptoms as follows:

"Wheezing, fatigue, and difficulty breathing are also intermittent symptoms seen in bronchiectasis patients. During flare-ups of the disease, symptoms like fever, increased mucus production, thicker mucus, and worsened breathing difficulties may accompany the clinical picture."

Early Diagnosis Reduces Lung Damage
To diagnose bronchiectasis, imaging methods like chest X-rays and CT scans are used. The most accurate and preferred method for a definitive diagnosis is computerized tomography (CT), which provides clear results.

As with many diseases, early diagnosis is critical in bronchiectasis. Dr. Çınar explains, "If diagnosed early, the treatment process starts sooner, and infection and inflammation are kept to a minimum. This slows down and controls the damage to the lungs and bronchi."

While early diagnosis is crucial in bronchiectasis, it is sometimes detected late. Dr. Çınar attributes this to, "Patients not seeking medical help except during flare-up periods, receiving symptomatic treatment without detailed examination during visits, and the disease mimicking pneumonia during flare-ups, which can lead to a delayed diagnosis."

WHO IS AT RISK FOR BRONCHIECTASIS?

So, who is at risk for bronchiectasis? Dr. Çınar provides the answer:

"People who have had lung infections such as whooping cough, pneumonia, or tuberculosis are at higher risk. Additionally, conditions like foreign body airway obstruction, cystic fibrosis, autoimmune diseases, immune deficiencies, ciliary dysfunction, and alpha-1 antitrypsin deficiency can lead to bronchiectasis."

THE FIRST STEP: MEDICAL TREATMENT

"The first option in treating bronchiectasis is medical treatment. The most important issue in treatment is to use appropriate antibiotics when bronchitis or pneumonia attacks occur," Dr. Çınar explains, adding:

"Regular breathing exercises and chest physiotherapy help clear the airways, and pulmonary rehabilitation is another part of the treatment. Mucolytic drugs and inhaler treatments are used. Because bronchiectasis patients have a much higher risk of developing lung infections compared to the general population, influenza (flu) and pneumococcal (pneumonia) vaccinations are essential to reduce their risk of infection."

Moreover, underlying conditions that may cause bronchiectasis need to be carefully investigated and treated accordingly. Dr. Çınar emphasizes that "Surgical treatment may be applied in suitable patients with localized bronchiectasis resistant to medical treatment, repeated bleeding in mucus, and recurrent infections."

UNTREATED BRONCHIECTASIS LEADS TO RESPIRATORY FAILURE

Bronchiectasis is a serious disease that must be treated. If left untreated, it can lead to severe complications. Dr. Çınar summarizes the potential issues as follows:

"Without treatment, bronchiectasis can lead to respiratory failure, life-threatening hemoptysis (coughing up blood), and non-tuberculous mycobacterial infections."

To prevent the progression and development of this disease, childhood vaccinations against infections should be regularly administered. In addition to not smoking, regular mucus clearance and breathing exercises are also vital in managing the condition.