Dr. Michael BauerDear Dr Bauer,

I was diagnosed with bronchiectasis about 20 years ago. I am now on Spiriva which helps keep my lungs clear. My question is – why is there so much coughing with this condition?

                                                                                                 JH, New Hampshire 


You have asked some interesting and important questions about bronchi- ectasis. This condition is one of the less common forms of Chronic Obstructive Pulmonary Disease (COPD).

Occasionally, the larger bronchial passages in the lung develop scars and become dilated in spots. This is the definition of bronchiectasis and typically occurs after a very bad pneumonia. Two or three generations ago, tuberculosis was a common cause of bronchiectasis. These days, bacterial pneumonia can result in this condition. When the bronchial tubes are scarred and dilated, they are not coated with protective mucus and are prone to inflammation and infection. Bronchiectasis usually affects localized areas within the lung. Sometimes, lying in a particular position can irritate the scar or cause pooling of mucus. This causes cough and discomfort. Postural drainage is a common treatment for bronchiectasis. We often use courses of rotating antibiotics to keep infection and inflammation at low levels. Rarely, bronchiectasis can cause cough associated with bleeding. Like other forms of COPD, inhaled steroids and bronchodilators are very helpful. This is a chronic condition, since the lung scars never heal up completely. With proper medications, symptoms are significantly improved.

You may find help by joining Internet support groups specifically for people with bronchiectasis. Enter bronchiectasis support group in the search box on www.msn.com and www.yahoo.com. You may also visit www.bronchiectasis.info.