Bronchiectasis

WHAT YOU SHOULD KNOW:

• Bronchiectasis (bron-key-ECK-tah-sis) is a lung condition where your bronchi get too wide and mucus build up in them. Your bronchi are medium-sized airways (tubes that carry air in and out of your lungs). With bronchiectasis, your lung airways get damaged and cannot clear out the mucus the way they should. The mucus stays in the airways and germs grow in it, causing new and repeated lung infections. Over time, this can cause your airways to swell and to become stretched out and scarred. As your airways become damaged, it gets harder for you to move air through them when you breathe. This is permanent damage that may happen only in one part of your lungs or in many places in your lungs.
  
  
• Bronchiectasis is caused by having repeated infections and inflammation (swelling) in your lungs. Inflammation can be caused by diseases that affect the lungs, past lung infections, and immune system problems. Other causes include things that irritate or block your airways, but the exact cause may be unknown. You may have an ongoing cough, trouble breathing, or cough up large amounts of phlegm (lung mucus). You may feel tired and weak, wheeze when you breathe, and have sinus or nasal drainage and chest pain. A chest x-ray, computed tomography (CT) scan, and sputum samples can help caregivers learn more about your condition. Treatment includes medicines, airway clearance techniques (ACTs), and oxygen. You may also need surgery if other treatments do not work. Early treatment may help relieve your symptoms and prevent further damage to your airways.

AFTER YOU LEAVE:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not working as expected. Tell him if you are allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs you take. Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists.

• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Anti-inflammatory drugs: This family of medicine is also known as non-steroidal anti-inflammatory drugs or NSAIDs. They may help decrease pain and inflammation (swelling). Some NSAIDs may be given to decrease a high body temperature (fever). This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.
  
  
• Bronchodilators: You may need bronchodilators to help open the air passages in your lungs, and help you breathe more easily.
  
  
• Expectorants: Expectorant medicine helps thin your sputum (mucus from the lungs). When sputum is thin, it may be easier for you to cough it up and spit it out. This may make your breathing easier, and may help you get better faster.
  
  
• Immune globulins: This medicine is given as a shot or an IV infusion to make your immune system stronger. You may need immune globulins to treat or prevent an infection. It is also used when you have a chronic condition, such as lupus or arthritis. You may need many weeks of treatment. Each infusion can take from 2 to 5 hours.
  
  
• Steroids: Steroid medicine may help to open your air passages so you can breathe easier. Do not stop taking this medicine without your caregiver's OK. Stopping on your own can cause problems.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Activities:

• Airway clearance techniques: The mucus in your lungs can lead to infections and lung damage. Your caregivers may teach you special exercises to help remove mucus and let you breathe easier. These exercises may be used along with machines or special devices to help decrease your symptoms. Ask your caregivers for more information about these airway clearance techniques (ACTs).
  
  
• Physical exercise program: You and your caregiver can plan a suitable exercise program for you. Doing exercise and other physical activities can increase your energy. Exercising also makes the heart stronger, lowers blood pressure, and keeps you healthy. Physical activities can also help to loosen secretions in your airways and lungs, and help you breathe easier.

Diet:

• Drinking liquids: Men 19 years old and older should drink about 3 Liters of liquid each day (about 13 eight-ounce cups). Women 19 years old and older should drink about 2 Liters of liquid each day (about 9 eight-ounce cups). Follow your caregiver's advice if you must limit the amount of liquid you drink. Liquids help thin the sputum, which may make it easier for you to cough up.
  
  
• Eat a variety of healthy foods from all the food groups every day. Include whole grain bread, cereal, rice and pasta. Eat a variety of fruits and vegetables, including dark green and orange vegetables and legumes (dry beans). Include dairy products such as low-fat milk, yogurt and cheese. Choose protein sources such as lean meat and poultry (chicken), fish, beans, eggs and nuts. Ask your caregiver how many servings of fats, oils, and sweets you may have each day, and if you need to be on a special diet.

Oxygen:

You may need extra oxygen to help you breathe easier. It may be given through a plastic mask over your mouth and nose. It may be given through a nasal cannula, or prongs, instead of a mask. A nasal cannula is a pair of short, thin tubes that rest just inside your nose. Tell your caregiver if your nose gets dry or if you get redness or sores on your skin. Never smoke or let anyone else smoke in the same room while your oxygen is on. Doing so may cause a fire.

Preventing bronchiectasis from getting worse:

• Avoid the spread of germs:
  
  
  • Wash your hands often with soap and water. Carry germ-killing gel with you. You can use the gel to clean your hands when there is no soap and water available.
    
    
  • Do not touch your eyes, nose, or mouth unless you have washed your hands first.
    
    
  • Always cover your mouth when you cough. Cough into a tissue or your shirtsleeve so you do not spread germs from your hands.
    
    
  • Try to avoid people who have a cold or the flu. If you are sick, stay away from others as much as possible.
  
  
• Smoking: It is never too late to stop smoking. Smoking harms your heart, lungs, and blood. It can irritate your airways and make your condition worse. You are more likely to have a heart attack, lung disease, or cancer if you smoke. You will help yourself and those around you if you stop smoking. Ask your caregiver for more information about how to stop smoking if you have trouble quitting.
  
  
• Vaccines: To prevent influenza (flu), all adults should get the influenza vaccine. They should get it every year as soon as it becomes available. The pneumococcal vaccine is given to adults aged 65 years or older to prevent pneumococcal disease, such as pneumonia. People aged 19 to 64 years at high risk for pneumococcal disease also should get the pneumococcal vaccine. It may need to be repeated 5 years later.

For more information:

Having bronchiectasis can be hard for you and your family. Learning more about bronchiectasis can help you understand how to deal with your condition. Contact the following for more information:

• American Lung Association
  1301 Pennsylvania Ave. NW
  Washington , DC 20004
  Phone: 1- 202 - 785-3355
  Phone: 1- 800 - 548-8252
  Web Address: www.lung.org
  

• National Heart, Lung and Blood Institute
  Health Information Center
  P.O. Box 30105
  Bethesda , MD 20824-0105
  Phone: 1- 301 - 592-8573
  Web Address: http://www.nhlbi.nih.gov/health/infoctr/index.htm
  

• National Jewish Medical and Research Center
  1400 Jackson Street
  Denver , CO 80206
  Phone: 1- 800 - 222-5864
  Web Address: http://www.nationaljewish.org
  

CONTACT A CAREGIVER IF:

• You have a fever.
  
  
• You are coughing more than usual, wheezing, and have trouble breathing.
  
  
• You find it hard to do your daily activities because of wheezing, coughing, or other symptoms.
  
  
• Your medicines do not relieve your symptoms as well as they used to.
  
  
• You have any questions or concerns about your medicine, condition, or care.

SEEK CARE IMMEDIATELY IF:

• You are coughing up blood.
  
  
• You have trouble breathing all of a sudden.
  
  
• You have trouble thinking, are confused, or have just fainted.
  
  
• You have sudden chest pain.
  
  
• Your lips or fingernails are turning gray or blue.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Bronchiectasis (Discharge Care)