The initial lung damage that leads to bronchiectasis often begins in childhood. However, symptoms may not occur until months or even years after you start having repeated lung infections.
In the United States, common childhood infections—such as whooping cough and measles—used to cause many cases of bronchiectasis. However, these causes are now less common because of vaccines and antibiotics.
Now bronchiectasis usually is due to a medical condition that injures the airway walls or prevents the airways from clearing mucus. Examples of such conditions includecystic fibrosisand primary ciliary (SIL-e-ar-e) dyskinesia (dis-kih-NE-ze-ah), orPCD.
Bronchiectasis that affects only one part of the lung may be caused by a blockage rather than a medical condition.
Bronchiectasis can be congenital (kon-JEN-ih-tal) or acquired. Congenital bronchiectasis affects infants and children. It’s the result of a problem with how the lungs form in a fetus.
Acquired bronchiectasis occurs as a result of another condition or factor. This type of bronchiectasis can affect adults and older children. Acquired bronchiectasis is more common than the congenital type.
What Causes Bronchiectasis?
Damage to the walls of the airways usually is the cause of bronchiectasis. A lung infection may cause this damage. Examples of lung infections that can lead to bronchiectasis include:
- Severepneumonia(nu-MO-ne-ah)
- Whooping cough or measles (uncommon in the United States due to vaccination)
- Tuberculosis
- Fungal infections
Conditions that damage the airways and raise the risk of lung infections also can lead to bronchiectasis. Examples of such conditions include:
- Rheumatoid arthritis, Sjögren’s syndrome, and Crohn’s disease.
- Immunodeficiency disorders, such as common variable immunodeficiency and, less often, HIV and AIDS.
- Allergic bronchopulmonary aspergillosis (AS-per-ji-LO-sis). This is an allergic reaction to a fungus called aspergillus. The reaction causes swelling in the airways.
- Disorders that affect cilia (SIL-e-ah) function, such asprimary ciliary dyskinesia. Cilia are small, hair-like structures that line your airways. They help clear mucus (a slimy substance) out of your airways.
- Chronic (ongoing) pulmonary aspiration (as-pih-RA-shun). This is a condition in which you inhale food, liquids, saliva, or vomited stomach contents into your lungs. Aspiration can inflame the airways, which can lead to bronchiectasis.
- Cystic Fibrosis. This disease leads to almost half of the cases of bronchiectasis in the United Sates.
Cystic fibrosis (SIS-tik fi-BRO-sis), or CF, is an inherited disease of the secretory (see-KREH-tor-ee) glands. Secretory glands include glands that make mucus and sweat. “Inherited” means the disease is passed from parents to children through genes. People who have CF inherit two faulty genes for the disease—one from each parent. The parents likely don’t have the disease themselves. CF mainly affects the lungs, pancreas, liver, intestines, sinuses, and sex organs. Mucus is a substance made by tissues that line some organs and body cavities, such as the lungs and nose. Normally, mucus is a slippery, watery substance. It keeps the linings of certain organs moist and prevents them from drying out or getting infected. If you have CF, your mucus becomes thick and sticky. It builds up in your lungs and blocks your airways. (Airways are tubes that carry air in and out of your lungs.) The buildup of mucus makes it easy for bacteria to grow. This leads to repeated, serious lung infections.
Over time, these infections can severely damage your lungs. The thick, sticky mucus also can block tubes, or ducts, in your pancreas (an organ in your abdomen). As a result, the digestive enzymes that your pancreas makes can’t reach your small intestine. These enzymes help break down food. Without them, your intestines can’t fully absorb fats and proteins. This can cause vitamin deficiency and malnutrition because nutrients pass through your body without being used. You also may have bulky stools, intestinal gas, a swollen belly from severe constipation, and pain or discomfort. CF also causes your sweat to become very salty. Thus, when you sweat, you lose large amounts of salt. This can upset the balance of minerals in your blood and cause many health problems. Examples of these problems include dehydration (a lack of fluid in your body), increased heart rate, fatigue (tiredness), weakness, decreased blood pressure, heat stroke, and, rarely, death.
If you or your child has CF, you’re also at higher risk for diabetes or two bone-thinning conditions called osteoporosis (OS-te-o-po-RO-sis) and osteopenia (OS-te-o-PEE-nee-uh). CF also causes infertility in men, and the disease can make it harder for women to get pregnant. (The term “infertility” refers to the inability to have children.) Other conditions, such as an airway blockage, also can lead to bronchiectasis. Many things can cause a blockage, such as a growth or a noncancerous tumor. An inhaled object, such as a piece of a toy or a peanut that you inhaled as a child, also can cause an airway blockage. A problem with how the lungs form in a fetus may cause congenital bronchiectasis. This condition affects infants and children.
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