Bronchiectasis

Bronchiectasis

Bronchiectasis is a respiratory disease characterized by abnormal widening of one or more airways.^[1] Illness present as birth is called congenital bronchiectasis while that occurring later in life is acquired bronchiectasis.^[2] The symptoms can be life-threatening particularly when there is severe difficulty of breathing.^[3]

Epidemiology

Bronchiectasis is a relatively uncommon respiratory illness in the United States. It is estimated that 110,000 people in the United States have bronchiectasis. Bronchiectasis seems to affect more women than men. In children however, bronchiectasis is more common in boys than girls.^[3]           

Causes

In over half of the cases, no exact cause can be found. Some conditions that may cause brochiectasis include severe lung infections like tuberculosis (TB) and  pneumonia which can damage the airways at the time of infection, immune system deficiencies making the person susceptible to infections, inherited conditions like primary ciliary dyskinesia and cystic fibrosis, diseases that cause inflammation in other parts of the body that may lead to inflammation and damage to the bronchi such as ulcerative colitis, Crohn's disease, rheumatoid arthritis and systemic lupus erythematosus. Also, inhaled objects that get stuck in the airway may cause local damage to the airway causing the disease as well as regurgitated stomach acid and inhaled poisonous gases.^[4]

Symptoms

Signs and symptoms of bronchiectasis include cough which is worse when lying down, shortness of breath, daily production of large amounts of coughed up mucus, chest pain, abnormal chest sounds and clubbing.^[5] The symptoms develop gradually so they may be noticeable months or years after the event that caused the illness. The person may also have bluish skin color, breath odor, fatigue, wheezing, paleness and weight loss. The patient may also cough up blood.^[2]

Diagnosis

Getting the medical history of the patient and conducting a physical examination especially a lung examination are vital. Choice of laboratory test should be tailored to each patient and the clinical scenario. High-resolution CT (HRCT) scanning is the criterion standard for diagnosing bronchiectasis.^[6]

Treatment

Antibiotics are the mainstay of treatment. Other treatment options are physiotherapy and other exercise therapies, immunizations, inhalers and surgery. If symptoms are severe, the patient may need hospital confinement. Patients are urged to stop smoking. Most patients (with no underlying cause) have a good outlook.^[4]

References:

1. http://www.patient.co.uk/health/Bronchiectasis.htm
2. http://www.nlm.nih.gov/medlineplus/ency/article/000144.htm
3. http://www.localhealth.com/article/bronchiectasis
4. http://www.patient.co.uk/health/Bronchiectasis.htm
5. http://www.lung.org/lung-disease/bonchiectasis/symptoms-diagnosis-treatment.html
6. http://emedicine.medscape.com/article/296961-workup

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Strychnos Nux-Vomica (Maqianzi, Poison Nut) [1, 2, 3, 4]:

WARNING! This substance is HIGHLY POISONOUS. The seeds contain Strychnine, which may cause convulsions, breathing difficulties and death, even if as little as 5 milligrams is ingested.

Recommendation: Strongly against (There is no evidence in the form of clinical trials which reports the effectiveness of Strychnos Nux-Vomica, because it is highly poisonous to humans, and is not recommended.)

Grade of Evidence: Very low quality of evidence

* www.gradeworkinggroup.org

Summary References

Treatments:

1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

2. David Michael Wood et al. Case report: Survival after deliberate strychnine self-poisoning, with toxicokinetic data. Critical Care October 2002 Vol 6 No 5

3. Arnold, M.D., Harry L. (1968). Poisonous Plants of Hawaii. Tokyo, Japan: Charles E. Tuttle Co.. p. 20. ISBN 0804804745.

4. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/strychnos-nux-vomica

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