Of Edward Simonetta

It is a chronic respiratory disease characterized by the finding, on chest CT scans (computed tomography), of dilatation of the bronchi and by daily symptoms such as cough, tiredness, shortness of breath

My father was diagnosed with bronchiectasis: what are they?
and how are they treated?

He answers Edward Simonettareferent for the Bronchiectasis Program, Pulmonary Unit, Humanitas Institute, Milan

Bronchiectasis is a chronic respiratory disease characterized by the finding, on chest CT scan (computed tomography), of bronchial dilatation and from everyday symptoms such as cough, tiredness, shortness of breath, profuse production of phlegm and sometimes the presence of blood in the sputum. Patients with bronchiectasis may present
recurrent bronchitis or pneumonia
, which often require antibiotic treatment. The symptoms and frequency of bronchitis vary from case to case, so the impact of this disease on the quality of life is extremely heterogeneous.

In Italy there are more and more patients suffering from bronchiectasis, with an estimated prevalence of one person affected every 2,000 adults. In the presence of bronchiectasis, it is necessary to carry out various blood and instrumental tests to identify the cause, however, in about half of the patients, it is not possible to trace the etiology of the disease. Bronchiectasis can develop as a result of many conditions, including previous lung infections, immune deficiencies, and genetic disorders (such as cystic fibrosis) or they can be associated with pathologies such as chronic bronchitis from smoking, asthma, gastroesophageal reflux, rheumatoid arthritis, inflammatory bowel disease or other rarer causes. The natural history of bronchiectasis disease is characterized by a vicious circle, with a succession of bronchial infections of various kinds (bacterial, fungal or viral), inflammation of the bronchi, reduction of the defenses of the airways and consequently greater susceptibility to new infections.

The reduction of the defenses of the airways, the repeated respiratory infections and the frequent use of antibiotics facilitate the onset of chronic bacterial infections in the lungs, also due to multiresistant bacteria that are difficult to treat with common antibiotics. The clinical management of patients with joint bronchiectasis requires a specialist pulmonary evaluation and in the most complex cases it is necessary to have access to structures that have multidisciplinary groups dedicated to the treatment of pathology. We need an individualization of the treatment on a case-by-case basis, with paths of Respiratory physiotherapy and close clinical and microbiological monitoring to reduce symptoms, prevent episodes of bronchitis and improve patients’ quality of life.

June 2, 2023 (change June 2, 2023 | 07:00)

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