What is "bronchiectasis"

Modern Latin, from Greek bronkhia "the bronchial tubes" (plural; see bronchial) + ektasis "a stretching out, extension, dilation."

n. (context medicine English) Abnormal permanent dilation of the bronchial tubes.

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. 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, 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 most people with the disease do well.

The disease affects between 1 per 1000 to 1 per 250,000 adults. The disease is more common in women and increases as people age. It became less common in since the 1950s with the introduction of antibiotics. It is more common among certain ethnic groups such as indigenous people. It was first described by Rene Laennec in 1819. The economic costs in the United States are estimated at $630 million per year.