What is Bronchiectasis?

This leaflet will explain the condition Bronchiectasis. Bronchiectasis is a condition where there is increased widening of the lower airways. Mucus gathers in the airway and increased the risk of infection. This infection then causes the production of more mucus and airway damage. Treatment is needed to break this cycle and help the lungs to heal.

What causes Bronchiectasis?

The cause of this condition is one or more of the following

• Accidental inhalation of an object, such a small piece of plastic, into the airway causing an obstruction and then inflammation.
• Following an episode of pneumonia, usually in younger children.
• In about a third of patients it is not possible to identify a precise cause for the problem. It is suspected that many of these patients may have developed Bronchiectasis as a result of a previous pneumonia.
• Immune deficiency disease resulting in repeated episodes of bacterial infections.

What are the symptoms?

Symptoms experienced by each patient vary but may include:

• coughing
• sputum production
• fatigue
• wheezing
• occasional weight loss
• occasional shortness of breath

How is it diagnosed?

Computed Tomography (CT) Scan (see CT Scan information sheet)
This will tell us if your child has bronchiectasis, where it is in their lungs and how severe it is.

Sputum Specimens
Samples of your child’s sputum will tell us which bacteria are growing to ensure your child is given an appropriate antibiotic.

Blood Sample
Regular blood tests will tell us about your child’s immune system, which help the body fight infection and inflammation.

Cilia Tests
Mucus is usually produced constantly in the lungs and transported up to the throat where it is swallowed. The mucus is moved by the action of the billions of tiny hair-like projections, which line the airways. These “waft” mucus up towards the throat. In order to test for the condition it is necessary to take a small swab from inside the nose.

Sweat Test.
This is a test that collects an amount of sweat from your child’s skin and the amount of chloride and sodium is measured. It is a pain free test and takes about 30 minutes.

How does the condition develop?

The classical view of bronchiectasis is that it inevitably gets worse. However, we are now diagnosing many more children as a result of increased use of CT scanning.
Many of our patients have relatively mild disease as a result of early diagnosis. In further tests, we have found that in many patients the condition has not deteriorated and in some the condition has even improved or disappeared.

If an underlying cause has been discovered, that will be treated; for example removal of inhaled foreign body.

Once this has happened, the treatment remains the same for all children with bronchiectasis. The treatment consists of:
 

• physiotherapy designed to meet your child’s needs as taught to you by our physiotherapist.
• antibiotics at times of infection and the possible use of low dose antibiotics throughout the winter months. This is given to try to stop infection occurring and the term you will hear used is prophylactic.
• possibly, the use of inhaled medication (the sort used by patients with asthma) to "open up" the airways and reduce the inflammation.
• We may advise that your child has a flu vaccine at the GP surgery at the beginning of October. We will inform your child’s GP of this.

Your child will be regularly monitored at clinic to check the condition. The aim of treatment is to stop the condition getting worse and to keep the airways clear of secretions and infection. Unfortunately the condition can never be fully cured.

What can we do to help our child?

As already discussed, the aim of treatment is to keep the airways clear of mucus and infection. So you can help, by making sure your child takes the correct medicine that has been prescribed by the doctor.

You will need to be more vigilant in spotting the signs of a cold and infections so that you can contact the doctor for appropriate treatment as soon as possible.

It is very important that you ensure that your child is not subjected to a smoke filled environment, as this will make the condition worse. If you smoke, then we would be happy to liaise with your GP to enable you to access support from your practice for you to stop.

As your child grows up, there may be peer pressure for them to smoke. They will need your support and it will help if you also do not smoke. Encourage your child to take part in all normal activities such as sport at school and out of school activities. This will be good for their physical, emotional and social well-being.

Being honest with your child about their illness at a level they can understand will help them to deal with their illness and allow them to live their lives to the full.

Where can I go for more information or help?

It is important that we see your child regularly. You will receive an appointment to attend clinic where you will have access to the doctor, the specialist nurse, and the physiotherapist. These people will help you with the care of your child and they will try to address any fears or worries you have at the time.

You can contact both the doctor and the specialist nurse at other times if you need to. The contact numbers are at the end of this sheet. In addition, we have a team social worker that will be able to help with such issues as schooling and finance should you need it.

If you would like to see the hospital social worker please ask when you come to clinic or inform the specialist nurse who will be able to arrange an appointment for you.

There is a notice board in the Children’s Outpatient Department at the Freeman Hospital informing all respiratory children’s families of other support networks available to them.

We hope this information sheet has been helpful to you but is by no means a replacement for talking to either the doctor or nurse. If you would like more information or advice please contact either:

• Doctor Spencer’s secretary, 0192 2231277 Monday to Friday 9.00am – 5.00pm or
• The Respiratory Nurse Specialist for Children on direct line 0191 21372430 or 0191 2336161 Ext 37243 or Bleep 3490. Monday to Friday 9.00am – 5.00pm or
• Physiotherapist for the Children’s Respiratory Service,0191 2336161 Monday to Friday 9.00am – 5.00pm