In order to raise awareness of bronchiectasis—and to support patients through diagnosis and care—we must first understand this disease state.
What is Bronchiectasis?
by Bryan Pearson, RRT
Frontier Home Medical Clinical Representative
The American Lung Association defines bronchiectasis as “A chronic condition where the walls of the bronchi are thickened from inflammation and infection. People with bronchiectasis have periodic flare-ups of breathing difficulties, called exacerbations.” We see two types of bronchiectasis, Cystic Fibrosis and idiopathic bronchiectasis. For those who suffer from non-cystic fibrosis bronchiectasis little is known to why this develops. Some people that may be at an increased risk for developing bronchiectasis are those with a history of lung infections, which have left scar tissue throughout the lungs, those who suffer from immune system conditions. Genetic diseases like alpha-1 antitrypsin deficiency or ciliary dyskinesia have been seen to develop bronchiectasis.
Bronchiectasis in Primary Care
In a “Journal of Community Nursing” article by Shirley Pickstock, she outlines the complexity of bronchiectasis and how it can, if left untreated, impair your patients’ quality of life. Better understanding of signs and symptoms can lead to diagnosis.
“It is important for clinicians to have an awareness of the possible causes and disease overlap in order to identify and treat patients with bronchiectasis effectively, with comprehensive history-taking being paramount. The majority of respiratory tract infections in primary care are self limiting, however patients presenting with persistent cough and daily production of a large volume of sputum with recurrent infections should alert clinicians to the possibility of bronchiectasis. Patients may also report breathlessness, chronic rhinosinusitis, haemoptysis, fatigue, pleuritic chest pain, and, in more severe cases, weight loss (National Institute for Health and Care Excellence, © 2018). On clinical examination, there may be coarse crackles, wheeze, large airway rhonchi (low pitched snore-like sounds) on auscultation of the chest, and finger clubbing may be present (Bourke and Burns, ‘Lecture Notes: Respiratory Medicine’, © 2015).”
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