Definition of Bronchiectasis

Bronchiectasis: Permanent dilatation (widening) of the bronchi (the large air tubes which begin at the bottom of the trachea and branch into the lungs). Bronchiectasis can result in very serious illness including recurrent respiratory infections, a disabling cough, shortness of breath, and hemoptysis (coughing up blood).

Chronic respiratory infection and the inflammatory response to the infection play key roles in the pathogenesis (development) of bronchiectasis. Immunodeficiency, cystic fibrosis, and primary ciliary dyskinesia (hereditary dysfunction of the cilia) predispose to bronchiectasis. Rheumatoid arthritis and inflammatory bowel disease (IBD), particularly ulcerative colitis, are also associated with bronchiectasis.

The gold standard for the diagnosis of bronchiectasis is high-resolution computed tomography (CT). Bronchopulmonary hygiene is generally recommended and includes postural drainage, chest physiotherapy, thinning and loosening of secretions, and administration of a bronchodilator. Acute exacerbations of the disease must be treated promptly with antibiotics. Surgery may be indicated, for example, to remove parts of a lung that are the source of acute exacerbations or uncontrolled hemorrhage.