What is Bronchiectasis, and how can it overlap with COPD?
Posted on October 14, 2019 |
Recent research suggests that bronchiectasis is more common than previously thought1, and you or someone you know may be living with this condition. We hope that this article will help to increase your knowledge of bronchiectasis and how it can overlap with COPD. There is power in knowing more about the ways these conditions can be treated to help one live better. This knowledge can also help increase awareness and improve communication between families, friends, and health care providers.
In addition to the details contained in this article, here are a few places to find more information. The Healthy Body, Healthy Mind video series includes an educational program titled Solutions for COPD and Bronchiectasis Patients, which can be viewed by clicking the link. Resources from the COPD Foundation include COPD360social and BronchandNTM360social websites, which host online social communities for members to communicate, share experiences and ask questions. These sites also include many articles, helpful blog posts, educational materials, and information about the COPD Foundation’s research programs.
The name ‘Bronchiectasis’ is derived from the Greek term “bronkhia,” meaning branches of the lungs’ main bronchi (aka airways), and “ektasis,” meaning dilation. Recent research estimates that 340,000-522,000 adults received treatment for bronchiectasis in the United States in 20131. Bronchiectasis develops when the airways are dilated (widened). When this occurs, the lungs struggle to clear themselves of mucus. When mucus is not cleared from the lungs, bacteria can build up. This environment in the lung may lead to repeated lung infections and cause more damage to the already impaired lungs.
Symptoms of bronchiectasis may include frequent coughing, sputum (mucus) production, fatigue, repeated chest infections, shortness of breath, unexplained fever, chills, sweats, weight loss and in extreme cases, coughing up blood (hemoptysis). With the rare exception of a situation when a limited amount of bronchiectasis can be surgically removed, there are currently no cures for bronchiectasis, but there are treatments available.
Bronchiectasis can be caused by infections like tuberculosis or pneumonia, immunodeficiency (low antibody levels), autoimmune diseases such as rheumatologic disease, or genetic conditions such as cystic fibrosis or alpha-1 antitrypsin deficiency. Recent research shown that individuals with bronchiectasis may be more susceptible to developing nontuberculous mycobacterial (NMT) lung infections. Recent data has also found potentially 49%-59% of patients with moderate to severe Chronic Obstructive Pulmonary Disease (COPD) also had bronchiectasis.2(Read more on COPD below.)
Diagnosis of bronchiectasis typically requires a high-resolution computerized tomography (HRCT) scan. Pulmonary function testing (PFT) is often used to assess lung function, but PFTs alone cannot be used to confirm a diagnosis of bronchiectasis. Treating bronchiectasis involves treating infections and clearing mucus or sputum from the airways to help prevent repeated infections that can lead to further lung damage. There are many different methods of clearing the airways, from handheld devices, percussive vests to inhaled medications. To treat infections, oral or inhaled antibiotics are used, and sometimes, depending on the severity, intravenous antibiotics may be used. Oxygen is required in a small population of those with this lung disease.
COPD is another lung disease resulting in the obstruction of airflow. COPD is prevalent with 30 million people affected in the United States, many undiagnosed. Symptoms of COPD may include shortness of breath, coughing (with and without mucus), wheezing and tightness in the chest.
As mentioned earlier, many people with moderate to severe COPD may have bronchiectasis, and people with bronchiectasis may have COPD. COPD and bronchiectasis share some similarities, but therapies can differ for each disease, and for those who have both bronchiectasis and COPD. It is important to remember that effective therapies are available to help.
- Seifer et al. Health-care utilization and expenditures among patients with comorbid bronchiectasis and chronic obstructive pulmonary disease in US clinical practice. (2019). Chronic Respiratory Disease, Volume 16: 1–8. DOI: 10.1177/1479973119839961
- Kosmas E, Dumitru S, Gkatzias S, et al. Bronchiectasis in patients with COPD: an irrelevant imaging finding or a clinically important phenotype? American College of Chest Physicians. Elsevier Inc., 2016. DOI: http://dx.doi.org/10.1016/jchest.2016.08.994.