Bronchiectasis in asthma, the association between asthma and bronchiectasis, or severe asthma – the liaison between these two respiratory diseases is more than just a coincidence and yet very different!
Background
Asthma is a respiratory disease that is characterised by chronic inflammation of the breathing airways coupled with episodes of coughing, wheezing and chest tightness. According to Australian statistics, asthma affects around 2.7 million Australians, which is 11% of the total population.
On the other hand, bronchiectasis is another respiratory disease but results from an infection or medical condition, such as pneumonia or cystic fibrosis. It remains highly irreversible and although increasingly recognised, there is little information on its incidence.
The link between asthma and bronchiectasis
Many studies have reported the relationship between asthma and bronchiectasis and most often they coexist. Bronchiectasis is increasingly being diagnosed in patients with asthma that can contribute to disease severity. For instance, a study concluded that almost one-third of the patients with uncontrolled asthma also had bronchiectasis.
It is difficult to distinguish between asthma and bronchiectasis as their symptoms overlap -both causes difficulty in breathing, and are chronic inflammatory conditions that involve the airways.
This is why, the recognition of asthma-related comorbidities or bronchiectasis-related comorbidities often results in greater success in treatment, quicker diagnosis and enhanced management of these diseases.
What are the differences between Asthma and Bronchiectasis?
- Asthma is mainly the narrowing of the airways making it difficult to breathe from time to time, but bronchiectasis occurs when the walls of the airways thicken due to inflammation caused by a lung infection.
- When symptoms in asthma get worse, it is called an asthma attack. In the case of bronchiectasis, increased mucus production and recurrent lung infections can lead to flare-ups.
- Both asthma and bronchiectasis affect people from all age groups, but asthma can start as early as childhood.
- The symptoms of asthma are reversible, with or without treatment, however, bronchiectasis remains irreversible.
The risk factors for asthma include air pollution, exposure to industrial gas, tobacco smoke, and outdoor allergens. For bronchiectasis, the risk factors include lung infections, pneumonia, tuberculosis, whooping cough in early life, genetic abnormalities and immunologic conditions.
How are asthma and bronchiectasis diagnosed?
In an Asthma clinic, the clinician usually starts by asking about your medical history followed by a physical test. You may need to undergo a lung function test or other tests, such as a chest X-ray or a CT Scan.
During your diagnose, be ready to answer questions about your family history, the medicines you take and your lifestyle. This may include your current health status, allergies or exposure to chemicals at work or home.
This is followed by a lung function test to test your breathing functions. During the test, you may be asked to inhale a medicine called a bronchodilator which opens ups the airways. In case your breathing improves significantly after inhaling, you might probably have asthma. Spirometry and Peak airflow are some of the widely used lung tests.
For bronchiectasis, the diagnosis is similar to asthma, where your clinician will examine the functioning of the lungs to check for blockages and abnormalities. The lung tests will create detailed images of your lungs and the airways to assist in diagnosing bronchiectasis.