Bronchiectasis is a destructive lung disease characterized by chronic dilatation of the bronchi associated with persistent though a variable inflammatory process in lungs. Usually acquired, but may result from the underlying genetic or congenital defects of airway defences.
Pathology
The diagnostic feature of Bronchiectasis is dilated bronchi.
The Ried’s classification differentiates between pathological and radiological appearances of Bronchiectasis.
Cylindrical bronchiectasis
Varicose bronchiectasis
Saccular and cystic bronchiectasis
Atelectatic bronchiectasis
Causes
Congenital-cystic fibrosis, primary hypogammaglobulinemia
Acquired-in children-inhaled foreign body, pneumonia complicating from measles, whooping cough, primary TB
In adult-pulmonary TB, bronchial tumor, suppurative pneumonia
Clinical features.
1. Bronchitis: attacks of recurrent bronchitis more common in winter. Clubbing of finger is diagnostic.
2. Hemorrhagic or bronchiectasis sicca: recurrent hemoptysis with good health in between
3. Suppurative: chronic cough, copious purulent expectoration general toxemia clubbing of fingers varying from slight beak curvature of finger nails to bulbous drumstick enlargement
4. with a relatively rapid onset: symptoms developing with comparative suddenness as a sequale to partial bronchial obstruction by foreign body or after anesthesia
Signs
There may be signs of bronchitis, fibrosis, consolidation, collapse or of cavitations.
Early stages: fine crackles or sticky rhonchi and slight alteration in character of breathe sounds.
Late stages: bronchial breathing, coarse creps and perhaps signs of cavity. Sharp metallic or leathery rales are characteristic. Recurrent pneumonia in the same area of the lung is classically associated with bronchiectasis.
Investigation
Culture and sensitivity of sputum.
Radiology
Sinus radiographs
Chest radiography
HRCT: high resolution CT
Special investigation
Immunoglobulin
Barium studies
Alpha 1 antitrypsin deficiency
Detection of cystic fibrosis
Homeopathic treatment
Since it belongs to syco-syphilitic miasm, if not treated with anti miasmatic remedies the prognosis will not be favorable. And in clinical, it is seen that, bronchiectasis due to acquired causes responds very well to the homeopathic treatment. However, if bronchiectasis due to genetic or congenital factors complete cure is impossible but palliation of the symptoms only.
Moreover, in the young and adult patients, the prognosis is favorable, but in aged people, symptomatic relief is the result.
Anyway overall results are favorable with homeopathic treatment.
Treatment-homeopathic medicines-Antim tart, Phosphorus, Acalypha indica, etc.