What is Bronchiectasis Respiratory Disorder?
Bronchiectasis is a lung disorder in which the bronchi are dilated abnormally. It often develops in childhood, resulting from obstruction and infection occurring in the air passageways. Obstruction may result from many causes, such as plugs of mucus chronically blocking airways. Childhood pneumonia commonly accompanies such mundane events as measles or the more distressing childhood complaint of whooping cough (now seen far less often than in earlier days). The disease may be confined to a small area of the lungs, often in their lower parts. Or it may involve entire segments, and he far more widespread.
These are usually longstanding, and come chiefly in the form of a productive cough with considerable amounts of sputum. Often pus is present in this thick, unpleasant phlegm. Additional acute respiratory infections tend to come and go over the years. Sometimes the volume of sputum production is excessive. There may be streaks of blood in the material coughed up. With severe attacks, breathlessness and respiratory distress may occur. Often the fingers show “clubbing,” a typical feature, once seen, always remembered. The ends of the fingers tend to be rounded and do not have the natural elongated appearance. The physical appearance of the patient is generally reasonable and the health otherwise usually satisfactory. The type of symptoms that may occur also include the onset of a cough in a child who has preciously appeared to be fairly well. The cough persists, gradually becoming worse, starting mostly at night, later being, present during the day also. The child may become breathless, especially when playing games and running about. Soughing may bring up a considerable amount of sputum.
Often other infections accompany bronchiectasis, such as recurring infections in other parts of the chest. a tendency to pneumonia, infected sinuses and pleuritic infections. The diagnosis is often made on the history of the infection, which frequently dates from early life. Although plain X-rays of the chest may appear normal, a special picture called a bronchogram is usually diagnostic and reveals the dilated affected bronchi.
Today, therapy usually gives good results, and can make living relatively normal for these patients. Physical treatment is often the most successful line of attack. For satisfactory results efforts must be made to remove the accumulating sputum and fluid debris from the lungs regularly. Postural drainage, with the patient lying over the side of the bed, and percussion applied on the back, usually results in copious amounts of fluid draining away. Breathing exercises, aimed at giving regular distension to the lung substance and sleeping on an inclined plane also are effective.
These cost nothing apart from time and a little effort both on the part of the patient and the parent or attendant who must cooperate in carrying out the routines regularly.
Antibiotic therapy is often reserved for upsurges of undercurrent infections, although opinion on this varies. It is best to be guided by the doctor’s advice in the particular case. If a sudden burst of infection takes place in the lungs, added to the chronic infection, then antibiotics will often assist materially.
In chronic cases that fail to respond to conservative measures, there is a place for surgical intervention and removal of the severely affected, diseased part of the lung tissue.