Sinus issues causes Bronchiectasis exacebation?

@ainekrech Hi Elaine. I'm not usually in lung discussions, but I do have allergic asthma, and I do have a physical problem with chest tightness that interferes with clearing phlegm from my chest. This set up a situation where I got lung infections repeatedly always starting on the left side which is the tight side. I even had more phlegm production because of my body reacting to metals in dental work. I know that only because when it was all removed, my asthma improved immediately, and then when I broke my ankle and got more metal in my body, my asthma got worse again with more phlegm. I have since had the ankle hardware removed and returned to being metal free again. One thing I learned when going through surgery was to use antibiotic ointment inside my nose to prevent infections after surgery as requested by the surgeon. He gave me Mupiroicin which is generic for Bactroban and I was to use it with a pea sized glob 2 x daily for 5 days? I can't quite remember, but I tried this when I would get a sinus infection or one that spread to my chest and it worked great. I do it only at night when I go to bed so I won't have it running down my face. That may be something inexpensive to try and your doctor would likely give you a prescription for that.

Besides antibiotics, what helps me breathe a lot better is to address the physical issues of tight muscle and fascia that are restricting the movement of my chest wall. Physical therapists can help, and mine does myofascial release which is specialized training to stretch the tight restrictive fascia. The tight fascia can even extend into the lungs themselves making the airways tight inside them and trapping phlegm. For me stretching the front of the chest and neck against the tightness extending toward the sternum has released tightness inside my left lung and let the mucus clear out right away. It had felt like mud in there and felt different than the rest of the lungs. Now it seems about the same. I also have a condition called thoracic outlet syndrome that causes chest tightness that contributes to this problem.

You may want to look at our discussion on myofascial release to learn how this can help so many physical conditions.

Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
There is a provider search for MFR therapists at https://www.mfrtherapists.com/

Does this MFR therapy sound like something you would want to try?

@ainekrech Elaine, have you had a sputum culture done to see if the culprit is Mycobacteria or Pseudomonas?
Certainly sinus infections can cause exacerbations, but unless the antibiotic targets the correct bacteria, things are probably not going to improve.
Increased coughing and sputum usually indicate a lung infection if you have bronchiectasis. Have you seen a pulmonologist experienced in treating bronchiectasis to see wht their opinion is?
Sue

I had a bronchoscopy done and they found those. Treated for that, but it was months ago. Have had two respiratory problems since. Was on antibiotics for four years, then off with many issues.
Have an excellent team of pulmonologists. My pulmonary PA would like to get a third sinus surgery. They’ve never helped in my opinion.
Thank you

Have they tried nasal antibiotics when you have an exacerbation to rule out the sinuses as the source of your lung issues? Or cultured the sinus bacteria and the lungs at the same time?
I agree, except for fixing a badly deviated septum from a broken nose, sinus surgery did nothing for my frequent infections.

One thing that has helped me is to avoid both sinus infections ans lung exacerbations is to use Mucinex and NAC to thin all the mucus in my body. NAC is also antiinflammatory.
Sue

Sue, do you use both mucinex & NAC? Are you on Cellcept? For anti-inflammatory prescriptions. I too have Bronchiectasis with a lot of phlegm. I went to a ENT specialist yesterday because I was having frequent nosebleeds a month ago (none since) I had a couple even after keeping my nose hydrated with saline spray, as I am on O2 at night. The ENT did her exam and said I may have had a sinus infection then, and prescribed a nose antibiotic to use. I was unaware that a sinus infection can cause flare-ups of Bronchiectasis. I’m curious to try the ointment and see if it decreases my phlegm amounts.

Sue,
Thank you so much for your reply! I will check with them to see if I can do those things first.
I appreciate so much this helpful site!
Thanks!
Elaine

Thank you! Will look into this too!
Great group here!

I totally understand your reluctance to have sinus surgery and my experience may give an idea or two.
Background: I’m new to bronchiectasis. It appeared on a followup CT in Jan. I’d had CT with many nodules/mucus plugs thought to be MAC Aug of 2022. . I was also diagnosed with asthma by the pulmonologist then. After second CT, I was sent to ENT and chose to go to Mayo for consult in March. MAC cultures ended up being negative.
I’ve also had long termsinus problems with a septoplasty years ago.
I requested allergy testing this spring and have severe pollen allergies. I also had opaque frontal sinus on CT.

A few things from my experience that may be relevant for you.
1. One theory is that the post nasal drainage caused the mucus/nodules in lungs and then bronchiectasis. Another is that I might have had MAC and cleared it.
2. Azelastine nasal spray really helped decrease my drainage and dramatically improved my horrid cough when combined with Flonase, which never helped alone. I thought Azelastine was a miracle drug. 🙂 Mayo changed it to a compounded “triple nasal spray” to add Atrovent to the antihistamine and steroid.
3. A short tapering dose of high dose prednisone with Augmentin helped nasal congestion a lot, but didn’t clear frontal sinus.
4. Tobrax eye drops that local ENT had me use in nose while in a head hanging position seemed to clear it. I did it for about 6-8 weeks while waiting to get into a frontal sinus specialist for possible surgery. When I finally got into specialist, frontal sinus had cleared.
5. LocalENT had also mentioned a procedure using ablation to decrease drainage, but University ENT didn’t mention it.
6. I still had a lot of post nasal drainage at frontal sinus specialist ENT appointment in May and he started me on Mometazone added to Neil Med saline rinse and encouraged sinus irrigation 2x/day.
I don’t know if any of these meds would help you, but it might be worth asking. Good luck!

I have a tight muscle structure and mild bronchiectasisMAC. I don't seem to have a lot of mucous to cough up and use the pipe with ball bearings device to keep my lungs strong and my airways clear. I have a tightness at the base of my rib cage that I have often thought was indigestion, gall bladder problem, etc but CT scans don't show any abnormalities (one showed a sluggish gall bladder but no disease). When I was having a problem I thought was a gall bladder attach, my doctor said what relieved the pain and I said heat. That would be in keeping with some kind of fascia problem? In reading about MFR and problems that it helps, I identified strongly with bladder leakage since a teenager when I jumped, coughed too hard, etc. At 85, it is still there and much worse. When I have a respiratory illness, I go through boxes of maximum strength pads! I am going to pursue whether there is a connection to all of this and the relief that MFR could bring.
I have one other question: could MFR therapy be similar to Gua sha. My acupuncturist has used this on my back and it releases lots of little red bumps on the outside of both the left and right sides of my rib cage. I started having this done thinking it would release any toxins related to MAC and bronchiectasis but it is used for releasing unhealthy bodily matter from blood stasis within sore, tired, stiff or injured muscle areas.

I find Azelastine plus flonase also a great help on the post nasal drip. Right now it is ragweed season where I am and my nasal/dripping symptoms and coughing/sputum have increased like they always do at this time of the year. The sodium chloride 3% is helping with the sinus congestion/headache and in fact since I started using it I have had almost zero sinus headaches as it opens up those passages as well as my lungs (some how?) Again since using sodium chloride 3# and azelastine I am not actually having any exacerbation and I can tell because my breathing is not worse and my heart rate has not increased. I get allergy shots but they have not cured the issue and in past years I have ended up in the hospital from this fall allergy exacerbation problem but so far this year...knock on wood....I am handling it all better (I credit 3% sodium chloride plus 3 x a week azithromycin*not for everyone and problematic re resistance issues.) I also have that vasomotor rhinitis problem which certain smells and weather sets off that contributes to the problem. One doctor told me the sinuses nose and lungs are all one system and so one affects the other. It's a war. ps. my ct scans of sinuses don't show anything really wrong there. I find movement of any kind can set off the nose running coughing etc on some occasions because of increased blood flow to the nose etc. but other times exercise has no negative effect...no rhyme or reason to any of it.