Bronchiectasis is a disease in which there is permanent enlargement of parts of the airways of the lung. Symptoms typically include a chronic cough productive of mucus. Other symptoms include shortness of breath, coughing up blood, and chest pain. Wheezing and nail clubbing may also occur, although clubbing is uncommon. Those with the disease often get frequent lung infections.
Bronchiectasis may result from a number of infective and acquired causes, including pneumonia, tuberculosis, immune system problems, and cystic fibrosis. Cystic fibrosis eventually results in severe bronchiectasis in nearly all cases. The cause in 10-50% of those without cystic fibrosis is unknown. The mechanism of disease is breakdown of the airways due to an excessive inflammatory response. Involved bronchi become enlarged and thus less able to clear secretions. These secretions increase the amount of bacteria in the lungs, result in airway blockage and further breakdown of the airways. It is classified as an obstructive lung disease, along with chronic obstructive pulmonary disease and asthma. The diagnosis is suspect based on a person's symptoms and confirmed using computed tomography. Sputum cultures may be useful to determine treatment in those who have acute worsening and at least once a year.
Worsening may occur due to infection and in these cases antibiotics are recommended. Typical antibiotics used include amoxicillin and in those who are allergic erythromycin or doxycycline. Antibiotics may also be used to prevent worsening of disease. Airway clearance techniques, a type of physiotherapy, are recommended. Medications to dilate the airways may be useful in some but the evidence is not very good. The use of inhaled steroids have not been found to be useful. Surgery, while commonly done, has not been well studied. Lung transplantation may be an option in those with very severe disease. While the disease may cause significant health problems many other people with the disease do well.
In the United Kingdom the disease affects about 1 per 1000 adults. The disease is more common in women and increases as people age. It was first described by Rene Laennec in 1819. The economic costs in the United States are estimated at $630 million per year.
We researched this topic for you and found the following best online resources. They are categorized into basic, advanced, and research level based on the extent of information you need. You will be taken to the respective websites by pressing on the links below.
http://memo.cgu.edu.tw/cgmj/2702/270206.pdf original article:bronchiectasis is a chronic progressive lung condition characterized by irreversible dilation of diseased bronchus by shen-hao lai, md; kin-sun wong, md; sui-ling liao chang gung med j vol. 27 no. 2 february 2004
http://jama.jamanetwork.com/article.aspx?articleid=1672240 effect of long-term, low-dose erythromycin on pulmonary exacerbations among patients with non–cystic fibrosis bronchiectasisthe bless randomized controlled trial by david j. Serisier, mbbs, dm, fracp et al.,jama. 2013;309(12):1260-1267. Doi:10.1001/jama.2013.2290