How Is Bronchiectasis Treated?
The goals of treatment are to:
- Treat any underlying conditions and respiratory
infections
- Help remove mucus from your lungs
- Prevent complications
Early diagnosis and treatment of bronchiectasis are
important. The sooner your doctor can start treating any underlying conditions
that may be causing the bronchiectasis, the better the chances of preventing
further damage to your lungs.
The mainstays of treatment for bronchiectasis
are:
- Medications, especially antibiotics
- Chest physical therapy (CPT)
Medications
The main medicines used to treat bronchiectasis
are:
- Antibiotics are the main
treatment for the repeated respiratory infections that bronchiectasis causes.
Doctors usually prescribe oral antibiotics to treat these infections. For
hard-to-treat infections, you may be given antibiotics through a tube into a
vein in your arm. Your doctor may be able to help you arrange for a home care
provider to give you intravenous antibiotics at home.
- Bronchodilators open your
airways by relaxing the muscles around them. Inhaled bronchodilators can be
breathed in as a fine mist from a metered-dose inhaler (puffer) or a nebulizer
(ne'-byu-lye"-zer). These medicines work quickly because the drug goes directly
into your lungs. Doctors usually recommend that you use a bronchodilator right
before you do your chest physical therapy.
- Corticosteroids help reduce
inflammation in your lungs. They work best when you take them with an
inhaler.
- Mucus thinners, such as
acetylcysteine, loosen the mucus.
- Expectorants help loosen the
mucus in your lungs. They often come in combination with decongestants, which
may provide additional relief. You do not need a prescription for them.
- Saline nasal washes help control
sinusitis.
Chest Physical Therapy
CPT is also called chest clapping or percussion. It
involves pounding your chest and back over and over with your hands or a device
to loosen the mucus from your lungs so that you can cough it up. You should do
CPT for bronchiectasis three or four times each day.
CPT is often called postural drainage. This means
that you sit or lie on your stomach with your head down while you do CPT. This
lets gravity and force help drain the mucus from your lungs.
Some people find CPT difficult or uncomfortable to
do. Several devices have been developed that may help with CPT. The devices
include:
- An electric chest clapper, known as a mechanical
percussor.
- A removable inflatable therapy vest that uses
high-frequency air waves to force the mucus that is deep in your lungs toward
the upper airways so you can cough it up.
- A "flutter" device, a small handheld device that
you breathe out through. It causes vibrations that dislodge the mucus.
- A positive expiratory pressure mask that creates
vibrations that help break the mucus loose from the airway walls.
Several breathing techniques may also help loosen
some of the mucus so you can cough it up. These techniques include:
- Forced expiration technique (FET)forcing
out a couple of breaths or huffs and then doing relaxed breathing
- Active cycle breathing (ACB)FET with deep
breathing exercises that can loosen the mucus in your lungs
Depending on how serious your condition is, your
doctor may also recommend:
- Oxygen therapy.
- Surgery to remove a section of your lung. Doctors
usually do this only if other treatments have not helped and only one part of
your lung is affected. If you have major bleeding, your doctor may recommend
either surgery to remove the bleeding part of your lung or a procedure to
control the bleeding.
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