In modern medicine, cases of pathology called "bronchiectasis" are often recorded. This is a dangerous condition that develops against the background of various diseases of the respiratory system. Of course, patients who are faced with this diagnosis are looking for any information about the dangers, symptoms and methods of treating the disease.
Bronchiectasis - what is it?
Many diseases of the respiratory system are associated with a similar pathology . What should patients do with a diagnosis of bronchiectasis? This condition is accompanied by a strong expansion of the areas of the bronchi as a result of damage to the bronchial wall.
The disease can affect different parts of the bronchi, but most often there is an expansion of the walls of medium-sized bronchioles. The process is associated with loss of tissue elasticity. According to statistics, in men, such a pathology is recorded about 3 times more often than in women of the opposite sex. The left lung often suffers from an ailment, but bronchiectasis of the right lung is less common. Experts attribute such statistics to the fact that the lumen of the left bronchus is much smaller and forms a physiological narrowing at the site of inflection of the pulmonary artery.
Unfortunately, it is rarely possible to completely get rid of bronchiectasis, but with the help of correctly selected methods of treatment it is possible to stop the process of destruction of the bronchial walls.
Causes of the disease
Bronchiectasis can be either congenital or acquired. If we are talking about congenital pathology, then it is usually associated with the presence of genetic and physiological abnormalities. The expansion of the bronchi is often observed in children suffering from cystic fibrosis and immunodeficiency conditions, as well as a number of other diseases, including Young's syndrome, Marfan, Kartagener.
Acquired chronic bronchiectasis often develops against the background of diseases of the respiratory system, including pneumonia, tuberculosis, whooping cough. Risk factors include allergic ailments. Pathology may be associated with the presence of bronchial tumors, which impede the passage of air and sputum. The list of causes includes diseases of the immune system, including AIDS.
Bronchiectasis is not always associated with pathologies of the respiratory tract itself. The expansion of the bronchial wall may be the result of progressive ulcerative colitis, rheumatoid arthritis, Crohn's disease, staphylococcal infection, regardless of location, a hiatal hernia in the diaphragm. Risk factors include bad habits (alcoholism, smoking, drug use), poisoning with toxic toxic gases.
It is very important for the doctor to determine the cause of pathological changes in the bronchi, because in many respects the success of therapy depends on this.
The main symptoms of bronchiectasis
Bronchiectasis is a pathology that develops gradually. In the initial stages, some characteristic symptoms may be completely absent. Patients very often suffer from diseases of the respiratory system, including pneumonia and pleurisy. Bronchitis with bronchiectasis is also a common occurrence.
In addition, there is an increase in the amount of sputum produced, especially in cold, damp weather. Often you can see wheezing on inhalation and exhalation.
As the disease progresses, patients note the appearance of a cough - seizures are especially strong in the morning and are accompanied by the release of a large amount of mucopurulent sputum. Discharges often have an unpleasant odor.
Changes in the bronchial walls affect the amount of oxygen received by the body. Hypoxia is accompanied by a general weakening - patients complain of constant weakness, drowsiness, frequent dizziness. The patient's skin is pale, sometimes acquires a bluish color. Symptoms include shortness of breath, which at later stages of development becomes constant and worries a person not only during physical activity, but also at rest.
Stages of the development of the disease
Doctors distinguish three stages of the development of the disease:
- The first stage of bronchoetasis is accompanied by damage to the layers of the mucous membrane of the bronchi. Characteristic symptoms are practically absent, and the course of the disease is considered benign.
- At the second stage of development, the destructive process affects the entire thickness of the bronchial walls. Patients complain of private pneumonia and increased daily sputum production.
- At the third stage, the pathological process is observed not only in the bronchi - it spreads to neighboring lung tissues. Patients suffer from chronic inflammation, complain of profuse discharge of fetid sputum. Hemoptysis is often observed at this stage.
Classification of bronchiectasis
There are several classification schemes for this pathology. As already mentioned, bronchiectasis can be congenital or acquired. The destructive process sometimes covers only a small area of the bronchi, but can also extend to other parts of the respiratory tract (in this case we are talking about large bronchiectasis). Perhaps the appearance of several lesions in different parts of the bronchi.
Depending on the degree of manifestation of symptoms, mild, moderate and severe forms of pathology are distinguished. Depending on the pathomorphology, bronchiectasis can be hypertrophic or atrophic.
It is worth noting that if untreated, the disease can lead to dangerous consequences, including pulmonary emphysema, extensive bleeding, secondary amyloidosis, respiratory and heart failure.
Bronchiectasis: instrumental and laboratory diagnostics
Diagnosis of this disease is a long process. During a routine physical examination, the doctor may notice some changes in the patient’s appearance - the chest in shape resembles a barrel, the phalanges of the fingers are changed (if we are talking about the later stages of the development of the disease). During an auscultation examination, the specialist notes hard breathing and the presence of wet rales.
As for laboratory diagnosis, the patient is first prescribed a blood test. Against the background of bronchiectasis, an increase in the erythrocyte sedimentation rate, an increase in the number of leukocytes and anemia, which is associated with oxygen starvation of the body, are observed. In a laboratory study of sputum, you can notice that the discharge has a three-layer structure.
For the final diagnosis, various instrumental methods are used. Informative is a chest x-ray, which makes it possible to see areas of fibrosis, confirm the presence of cysts and bronchial extensions, determine the change in vascular pattern. Additionally, bronchoscopy is performed (internal examination of the bronchi with an endoscope), as well as computed tomography.
Drug therapy
Conservative treatment largely depends on the stage of development of the disease. As a rule, patients are prescribed medications to thin the sputum. Immunomodulators, multivitamin complexes are widely used. In the presence of pneumonia and other bacterial diseases, patients need to take antibiotics - macrolides (Azithromycin) and pneumotropic fluoroquinolones (Moxifloxacin, Levofloxacin) are most often used.
An important part of therapy is the rehabilitation of the bronchi, because it is impossible to prevent stagnation of sputum in the lungs - patients are prescribed periodic sessions of vibration massage. A correctly selected complex of physiotherapy exercises will also facilitate sputum production. Treatment of bronchiectasis necessarily includes breathing exercises. When clogging the lumen of the respiratory tract with purulent masses, microdrainage is performed using antibiotics and antiseptic agents. Sometimes mucolytic agents and proteolytic enzymes are introduced into the lumen of the bronchus, which dilute sputum and facilitate its discharge.
This is how bronchiectasis is treated. Reviews of doctors say that with the right treatment, you can restore the relatively normal functioning of the respiratory system.
Surgery and its features
Not always conservative methods of treatment help to cope with such a pathology as bronchiectasis. Operation is sometimes simply necessary. Depending on the degree of damage, the doctor may recommend complete removal of the lung or partial resection of the affected areas of the bronchi.
Surgical treatment for such a disease is quite complicated, after which the patient needs a long rehabilitation.
Diet for patients
Treatment of bronchiectasis necessarily includes the right diet. The diet should include a large amount of protein food, but the amount of fat is recommended to be reduced to 90 g per day.
The menu should contain more foods rich in B and A vitamins, as well as ascorbic acid. Patients are advised to eat more raw vegetables and fruits, to drink fresh juices. The menu should include the liver. For drinking, decoctions of wheat bran and rose hips are used.
Preventive actions
Unfortunately, there are no drugs that can prevent the development of the disease. But you need to understand that bronchiectasis is a serious pathology, the development of which is easier to prevent. Patients at risk are recommended to give up bad habits (in particular, smoking), monitor nutrition, strengthen the immune system and take preventive vaccinations against viral infections, including pertussis, influenza, measles and others.
Patients who have already undergone treatment should be registered with a doctor, passing examinations three times a year and passing tests. People with already existing bronchiectasis during remission need periodic bronchial sanitation, physiotherapeutic procedures, preventive spa treatment.