Diagnosis and Treatment of Bronchiectasis
How is bronchiectasis diagnosed?
How is bronchiectasis managed?
Available Medications and Treatments
Other Conditions That Should Be Treated
Techniques To Clear Mucus From the Lungs
Any Specific Condition Contributing to Bronchiectasis Should Be Treated
How is bronchiectasis diagnosed?
The evaluation for bronchiectasis often includes:
- A complete medical history and physical examination by a healthcare provider.
- Breathing tests, called pulmonary function tests. These determine the presence and severity of abnormal airflow out of the lungs.
- A chest CT scan (a specialized X-ray which produces detailed slice-like pictures) of the lungs.
How is bronchiectasis managed?
Bronchiectasis can be managed in a number of ways. Your healthcare provider will evaluate your history and recommend the best management plan for you.
Available Medications and Treatments
Inhaled Short-Acting Bronchodilator Medicine
A bronchdilator medicine opens the airways by relaxing the smooth muscles around the airways. This type of medicine is available in a number of inhaled forms. Commonly used inhaled short-acting bronchodilators include:
- Proventil®, Proventil® HFA, Ventolin®, Ventolin® HFA (albuterol)
- Maxair® (pirbuterol)
Inhaled Long-Acting Bronchodilators
Long-acting bronchodilators may also be used. They include:
- Serevent® (salmeterol)
- Foradil® (formoteral)
- Spiriva® (tiotropium)
Inhaled Steroid Medicine
Inhaled steroids reduce and prevent swelling inside the airways. Common inhaled steroids include:
- Vanceril®, Beclovent® and Qvar® (becolmethasone)
- Azmacort® (triamcinolone)
- Aerobid® (flunisolide)
- Flovent® (fluticasone)
- Pulmicort® (budesonide)
- Advair® is a combination medicine. Flovent® and Serevent® are the medicines combined in Advair®
- QVAR® (beclomethasone dipropionate HFA)
Antibiotics
If a specific infection, such as mycobacteria, is found to be the cause of the bronchiectasis, then antibiotics are tailored to the underlying cause. Antibiotics are also used for episodes of infection. Rotating antibiotics are not encouraged because this promotes the development of drug resistant organisms. Therefore, your healthcare provider will prescribe an antibiotic based on your signs, symptoms and appropriate sputum cultures. For example, you may need an antibiotic only when you experience increased shortness of breath, cough, blood in the mucus or an increase in the amount and thickness of the mucus.
Return to Top
Other Conditions That Should Be Treated
Sinusitis
There are four groups of sinus cavities within the bones of the skull. Sinusitis is an inflammation of the mucus membranes that line the sinus cavities. Postnasal drip often occurs with sinusitis. This can worsen infections in the lungs.
Actions you can take include:
- Salt water nasal washes help remove mucus and bacteria from the nose and sinuses. When done routinely, this can decrease postnasal drip.
- A prescription steroid nasal spray can decrease swelling and inflammation in the nose and sinus passages.
Gastroesphageal Reflux
In some people, the muscle between the esophagus and stomach may not work well. This can allow some backflow of stomach acid into the esophagus. This reflux response may aggravate lung problems.
Actions you can take include:
- Elevate the head of your bed at least six to eight inches or sleep on adjustable bed with the back at 35°.
- Avoid food or liquids 2-3 hours before bedtime.
- Avoid any caffinated beverage, chocolate, and fatty foods.
- Medications may be prescribed to help prevent GE reflux.
- If your case is severe, you may need surgery to tighten the muscle at the base of the esophagus.
Return to Top
Techniques To Clear Mucus From the Lungs
If you produce a large amount of mucus your healthcare provider may recommend techniques to help clear the mucus.
- Devices such as the Acapella DMTM, Acapella Choice®, or Flutter Valve® may help clear mucus from your lungs. These are small devices you exhale into.
- The Vest® is an inflatable vest that you put on. The vest shakes your chest to help clear the mucus.
- Postural drainage and clapping, uses gravity to promote drainage of mucus from the lungs.
Each technique can be prescribed and demonstrated by your healthcare provider.
Return to Top
Any Specific Condition Contributing to Bronchiectasis Should Be Treated
Examples include:
- Prompt removal of any foreign object in the lungs.
- Treatment of immune deficiency disorders with immune globulin if appropriate.
- Treatment of ABPA (allergic bronchpulmonary aspergillosis) with steroids and anti-fungal agents.
- Treatment of chronic infections such as non-tuberculous mycobacteria.
- Surgery is occasionally indicated – usually only if bronchiectasis is very localized in the lung and medical treatment and other therapies are not effective.
Return to Top
This information has been approved by Gwen Huitt M.D., (April 2006).
