Bronchiectasis

[poolnoni]

I have MAI (mycobacterial avium infection) and I also have bronchiectasis. I continually cough up phlegm, yellow and white. The doctor has me on Albutol. My pulmonary doctor didn't really explain to me about bronchiectasis except that the small little hairs in the bronchial tree are destroyed. Are there other medications to decrease all this coughing up phlegm all day long.

[National Jewish]

Bronchiectasis can develop at any age.  Inflammation causes damage to the airways of the lungs.  When the airways become dilated this is called bronchiolectasis.  When the airways become distorted with areas where mucus can collect this is called bronchiectasis.  This can be due to a lung infection during childhood, but it can follow lung infections as an adult especially severe pneumonia or repeated lung infections such as bronchitis.  In fact, in recent years, a correlation has been found between a lung infection with the nontuberculous mycobacterium called Mycobacterium avium intracellulare (MAI) and the development of bronchiectasis primarily in post-menopausal women.  When a person’s immune system is compromised, then they may be more likely to develop bronchiectasis due to an otherwise unusual organism, such as fungi.

Usually these changes can be seen with a CT scan of the lungs.  It can be difficult to clear this mucus because of damage to the normal methods that the lungs use to clear mucus.  This can lead to episodes of infection.  Typically an ongoing infection can lead to inflammation.  So it is important that lung infections are treated.  Pulmonary hygiene is very important in preventing and controlling lung infections.  Using an inhaled bronchodilator, like albuterol, may help to loosen the mucus.  Many people find the routine use of a mucus clearance device to be very helpful in clearing the mucus from their lungs.  This is a small device that you exhale into causing a vibration in your lungs that loosens mucus so that you can cough it up easier.  The names of 2 types of devices are Acapella and Flutter Valve.  Bronchiectasis can result from airway blockage along with infection, so it may effect only one area of your lung.  If your recurrent lung infections are always in the same area of the lung, surgery to remove that portion of your lung may provide a cure.  Please read our information about bronchiectasis at http://www.nationaljewish.org/disease-info/diseases/bronchiectasis/index.aspx  and nontuberculous mycobacteria (NTM) at http://www.nationaljewish.org/disease-info/diseases/nts-mycobac/index.aspx to learn more.

A decision should be made as to whether to use long-term antibiotics to treat as well as to keep your condition under control.  Your pulmonary doctor might wish to consult with the doctors who specialize in the treatment of both of these conditions at National Jewish Medical and Research Center by calling or completing our Mycobacterial Consultation Form at http://www.nationaljewish.org/patient-info/progs/med/mycobacteria/consult.aspx.

[sylvia909]

A related discussion, bronchiectasis was started.