Bronchiectasis: Understanding the Causes, Symptoms, and Treatment Options

What Is Bronchiectasis?

Bronchiectasis is a chronic respiratory condition characterized by the abnormal widening and damage of the bronchial tubes in the lungs. It can be classified into two main types: primary and secondary bronchiectasis. Primary bronchiectasis often develops in early childhood as a result of severe lung infections such as whooping cough, measles, pneumonia, or asthma. Although symptoms may not appear until adulthood, imaging tests like CT scans typically reveal visible structural changes, including cystic and cylindrical dilation of the airways.

Symptoms of Primary Bronchiectasis

Individuals with primary bronchiectasis commonly experience persistent coughing, production of thick yellow or green mucus, and in more severe cases, hemoptysis (coughing up blood). Over time, this ongoing inflammation weakens the airway walls, making them prone to recurrent infections and further structural damage.

Secondary Bronchiectasis: Linked to Underlying Lung Conditions

Secondary bronchiectasis arises due to pre-existing pulmonary diseases. Common underlying conditions include bronchial asthma, chronic obstructive pulmonary disease (COPD), old tuberculosis lesions, pulmonary fibrosis, and lung abscesses. Even after the initial infection has resolved, scar tissue and permanent airway damage can remain, creating an environment where mucus accumulates and bacteria thrive.

Chronic Complications and Recurrent Infections

Patients with secondary bronchiectasis are at high risk for frequent respiratory flare-ups, marked by prolonged cough, discolored sputum, and occasional bleeding in the phlegm. These recurring episodes not only reduce quality of life but can also accelerate lung function decline if left unmanaged.

Diagnosis: Key Steps for Accurate Identification

To confirm bronchiectasis, physicians typically recommend a high-resolution computed tomography (HRCT) scan of the chest. This imaging technique provides detailed cross-sectional views of the lungs, clearly showing dilated bronchi and associated structural abnormalities. In addition, sputum culture tests are essential for identifying specific pathogens—such as Pseudomonas aeruginosa or Haemophilus influenzae—enabling targeted antibiotic therapy to control infection and prevent progression.

Treatment Strategies and Emergency Management

Effective management focuses on reducing infection frequency, clearing mucus buildup, and preserving lung function. However, one of the most serious complications is massive hemoptysis, where significant bleeding from the bronchial arteries can lead to airway obstruction and life-threatening asphyxiation.

Life-Saving Intervention: Bronchial Artery Embolization

In cases of severe bleeding, immediate medical intervention is crucial. Bronchial artery embolization (BAE) is a minimally invasive procedure that blocks the bleeding vessel, effectively stopping hemorrhage and preventing fatal outcomes. Alongside antibiotics, airway clearance techniques, and sometimes surgical resection, BAE plays a vital role in comprehensive care.

Conclusion: Early Detection Saves Lives

Bronchiectasis, whether primary or secondary, requires long-term monitoring and personalized treatment. Recognizing early symptoms, undergoing timely diagnostic testing, and adhering to a structured care plan can significantly improve prognosis and help patients maintain better respiratory health over time.