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 this pathology. What to do for patients who are faced with a diagnosis of bronchiectasis? This condition is accompanied by a strong expansion of sections 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 a 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 suffers from the disease more often, but bronchiectasis of the right lung is less common. Experts attribute these statistics to the fact thatthe lumen of the left bronchus is much smaller and forms a physiological constriction at the junction of the pulmonary artery.
Unfortunately, it is rarely possible to get rid of bronchiectasis completely, but with the help of properly selected methods of treatment, it is possible to stop the process of destruction of the bronchial walls.
Causes of disease development
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. Bronchial dilatation is often observed in children suffering from cystic fibrosis and immunodeficiency conditions, as well as a number of other diseases, including Young, Marfan, Kartagener syndrome.
Acquired chronic bronchiectasis often develops against the background of diseases of the respiratory system, including pneumonia, tuberculosis, whooping cough. Allergic diseases are also risk factors. Pathology may be associated with the presence of bronchial tumors that 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. Expansion of the bronchial wall can be the result of progressive ulcerative colitis, rheumatoid arthritis, Crohn's disease, staphylococcal infection regardless of location, hiatal hernia in the diaphragm. Risk factors include bad habits (alcoholism, smoking, drug use), poisoning with dangerous toxic gases.
It is very important for a doctor to determine the cause of pathological changes in the bronchi, because the success of therapy largely depends on this.
Main symptoms of bronchiectasis
Bronchiectasis is a pathology that develops gradually. At 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 common.
In addition, there is an increase in the amount of sputum produced, especially in cold wet weather. It is not uncommon to notice wheezing as you inhale and exhale.
As the disease progresses, patients notice the appearance of a cough - the attacks are especially strong in the morning and are accompanied by the release of a large amount of mucopurulent sputum. The discharge is often foul-smelling.
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, and frequent dizziness. The patient's skin is pale, sometimes becomes bluish. Symptoms include shortness of breath, which becomes constant at later stages of development and worries a person not only during physical activity, but also at rest.
Stages of disease progression
Doctors distinguish three stages in the development of the disease:
- The first stage of bronchiectasis is accompanied by damage to the layers of the mucous membranebronchi. There are practically no characteristic symptoms, and the course of the disease itself is considered benign.
- At the second stage of development, the destructive process affects the entire thickness of the bronchial walls. Patients complain of partial pneumonia and increased daily sputum output.
- 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 copious discharge of fetid sputum. Hemoptysis is common 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 spread 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, there are mild, moderate and severe forms of pathology. Depending on the pathology, bronchiectasis may be hypertrophic or atrophic.
It is worth noting that if left untreated, the disease can lead to dangerous consequences, including emphysema, massive bleeding, secondary amyloidosis, respiratory and heart failure.
Bronchiectasis: instrumental and laboratory diagnostics
Diagnosing this disease is a lengthy process. During a routine physical examination, the doctor may notice some changes in the patient's appearance - the chest is shaped like a barrel, the phalanges of the fingers are changed (if we are talking about the later stages of the development of the disease). During auscultatory examination, the specialist notes hard breathing and the presence of moist rales.
As for laboratory diagnostics, the patient is first prescribed a blood test. Against the background of bronchiectasis, there is 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. In a laboratory examination of sputum, you can see that the discharge has a three-layer structure.
Various instrumental methods are used to make a final diagnosis. Informative is chest X-ray, which makes it possible to see areas of fibrosis, confirm the presence of cysts and bronchial extensions, and determine changes in the 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 medication to thin the sputum. Widely used immunomodulators, multivitamin complexes. In the presence of pneumonia and other bacterial diseases, patients need to take antibiotics - macrolides ("Azithromycin") and pneumotropic fluoroquinolones are most often used(Moxifloxacin, Levofloxacin).
An important part of therapy is the rehabilitation of the bronchi, because sputum stagnation in the lungs should not be allowed - patients are prescribed periodic sessions of vibration massage. A properly selected complex of physiotherapy exercises will also help to facilitate sputum secretion. Treatment of bronchiectasis necessarily includes breathing exercises. When the lumen of the respiratory tract is clogged with purulent masses, microdrainage is performed using antibiotics and antiseptics. Sometimes mucolytic agents and proteolytic enzymes are injected into the lumen of the bronchus, which thin the sputum and facilitate its discharge.
This is how bronchiectasis is treated. The doctors' comments suggest that with the right therapy, it is possible to 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. Surgery is sometimes 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, drink fresh juices. The menu should include the liver. For drinking, decoctions of wheat bran and rose hips are used.
Prevention measures
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 advised to give up bad habits (in particular, smoking), monitor nutrition, strengthen the immune system and get preventive vaccinations against viral infections, including whooping cough, influenza, measles and others.
Patients who have already been treated must be registered with a doctor, undergoing examinations and tests three times a year. People with existing bronchiectasis during remission need periodic bronchial sanitation, physiotherapy, preventive spa treatment.
