Bronchiectasis (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
George Schiffman, MD, FCCP
Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.
In this Article
- What is bronchiectasis?
- What causes bronchiectasis?
- What are the symptoms of bronchiectasis?
- When should you seek medical care for bronchiectasis?
- How is bronchiectasis diagnosed?
- What is the treatment for bronchiectasis?
- What are the complications of bronchiectasis?
- What is the prognosis for bronchiectasis?
- Bronchiectasis At A Glance
- Find a local Doctor in your town
How is bronchiectasis diagnosed?
Diagnosis of bronchiectasis begins with history and physical examination.
The patient will complain of daily cough and sputum production that may or may not be bloody due to damage to the bronchial tubes or from infection. Shortness of breath with activity or at rest, wheezing, fatigue, and chest pain are all common complaints.
Physical examination may be relatively normal, or lung examination may reveal wheezing and crackles. Depending up on the severity of disease and how long it has been present, other findings may include weight loss, cyanosis (a bluish color of the skin and the mucous membranes due to an insufficient level of oxygen), and right heart failure (manifested by shortness of breath, leg swelling, and liver enlargement).
The history and physical exam may lead to the suspicion of the diagnosis and the health care practitioner may order a high resolution chest CT scan, which will confirm the diagnosis. The CT may also help in finding the underlying reason why bronchiectasis developed.
Plain chest X-rays may be used in helping make the diagnosis and help track the progression of the disease, but these findings are often much more subtle than those seen by CT scans.
Once the diagnosis of bronchiectasis is made, the underlying cause needs to be found. Blood tests and sputum tests may be indicated depending upon the clinical situation. Often a lung specialist (pulmonologist) will be consulted to help direct the investigation and testing.
Pulmonary function studies or pulmonary function tests (PFTs) may be helpful in assessing what kind and how much lung damage has occurred. Bronchiectasis is a form of chronic obstructive pulmonary disease (COPD), and this testing can help confirm this. These tests can help determine whether the lung tissue will respond to the use of bronchodilator treatment with inhaler medications (please see treatment section). Repeated over time, pulmonary function studies can help document the benefits of treatment or progression of the disease.
Less commonly, bronchoscopy is used to look inside the airways with a fiberoptic camera. This is sometimes done to look for tumors or foreign bodies that may have been seen on CT. In some cases, bronchoscopy can be used therapeutically to remove excessive retained secretions.
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