What Is Bronchiectasis?

Bronchiectasis is another chronic lung disease. It may present similar to COPD. Some people with COPD may also have bronchiectasis. So, here’s all you need to know about bronchiectasis.

What is bronchiectasis?

It is usually caused by a severe lung infection. This lung infection usually occurs early in life. It may be caused by either a respiratory virus or bacteria. It may also be caused by other diseases, like cystic fibrosis and even COPD. The exact mechanisms of how this happens remain unknown. But, somehow, it leads to airway walls becoming scarred and chronically dilated.^1-5

One theory is that this is caused by the immune response to the severe infection. Inflammatory chemicals are released by immune cells. These chemicals include cytokines, chemokines, and specialized white blood cells called neutrophils. This causes neutrophilic inflammation.^1-2

Neutrophilic inflammation is also common in COPD airways. It is responsible for a very aggressive sort of inflammation that persists over a long period of time. It persists because you are constantly exposed to harmful substances, such as cigarette smoke. Although, the harmful substance may also be respiratory viruses and bacteria.^1-2

How is bronchiectasis like COPD?

COPD airways produce lots of mucus. This mucus gets trapped in airways. This creates a breeding ground for germs. This increases the risk of lung infections like pneumonia.

Bronchiectasis is similar but also different.

With bronchiectasis, mucus becomes very thick and sticky. Normally, mucus is thin and it lubricates airways. Thick and sticky mucus is hard to bring up. It’s difficult to cough up. So, it tends to accumulate in airways. It creates a breeding ground for respiratory viruses and bacteria. Therefore, it increases your risk of respiratory infections.⁴

Respiratory infections cause flare-ups, just like COPD causes flare-ups. These flare-ups may be very similar to COPD flare-ups. Thick, sticky mucus obstructs airways. This causes airflow limitation. This causes symptoms such as shortness of breath, chest tightness, and coughing. Left untreated these symptoms may become severe.

Likewise, a genetic form of COPD may cause bronchiectasis. Genetic COPD is called Alpha-1 Antitrypsin Deficiency. Studies confirm that many people with Alpha-1 Deficiency also have bronchiectasis.²

So, this indicates the importance of screening people with Alpha-1 Deficiency syndrome for bronchiectasis. This is another very important reason to get tested for this if you have COPD. It also spotlights the need for screening people with bronchiectasis for Alpha-1 Deficiency Syndrome. This is important because controlling one means controlling the other.²

In either scenario, screening can lead to a proper diagnosis of bronchiectasis, COPD, or both. And, as we all know, a proper diagnosis can lead you and your physician to the best treatments for treating the symptoms you feel.

How are bronchiectasis and COPD related?

Researchers know about Asthma/ COPD Overlap Syndrome. Interesting, this “overlap” may also include COPD and bronchiectasis. Some like to refer to this as Bronchiectasis/ COPD Overlap Syndrome.

Although, there are various other names for it too. This may be due to poor diagnosis. It may be because people with bronchiectasis are improperly diagnosed with COPD. This may be due to the fact that thick sputum due to bronchiectasis obstructs airways. These airway obstructions cause airflow limitation and shortness of breath. Plus, bronchiectasis is a progressive disease just like COPD.

Of course, it may also be due to the fact that COPD may cause bronchiectasis. I already gave an example of how Alpha-1 Antitrypsin deficiency may cause this.

Here is another fact to consider. One study showed that about 40% of bronchiectasis patients also had a diagnosis of asthma. The same study showed that about 36% of bronchiectasis patients also had a diagnosis of COPD. So, this shows that bronchiectasis may have an impact on both the asthmatic as well as the COPD population.²

Analysis of these studies is confusing. This could mean that asthma and COPD are linked with bronchiectasis. But, it may also mean that some patients with bronchiectasis are being misdiagnosed with asthma and COPD. Or, it may mean that some patients with asthma and COPD are being misdiagnosed with bronchiectasis.²

Either way, this spotlights the fact that these chronic diseases present so similarly. This is why it’s so important to do a differential diagnosis. This means that other diseases must be considered, and ruled in or out when you present with COPD symptoms.

Similar symptoms but different treatment

Bronchiectasis is a chronic lung disease like COPD. It causes similar symptoms and presentation as COPD. But, the treatment is different. Sure, treatment does entail some COPD medicines, like bronchodilators and corticosteroids. But, it may also entail medicine to thin secretions. It also may involve strategies for thinning secretions and improving your cough. It may involve other medicines and treatments altogether.

And this is why it’s so important for doctors to be wary of all potential causes of shortness of breath. If you have COPD, you should be treated with COPD treatments. But, if you have bronchiectasis, your treatment options may be slightly different.