Bronchiectasis with a Side of Asthma

Posted by scoop @scoop, Oct 6, 2023

Bronchiectasis: a condition where damage causes the tubes in your lungs (airways) to widen or develop pouches. It makes it hard to clear mucus out of your lungs and can cause frequent infections. Coughing a lot with pus and mucus is the main symptom of bronchiectasis. Bronchiectasis can’t be cured but can be managed with treatment.

Asthma: a lung disease, where your airways get narrow and swollen and are blocked by excess mucus. Medications can treat these symptoms.

Question -- fellow co-morbid sufferers: how do you know how much bronchiectasis vs asthma? Do people with asthma alone have to clear excess mucus? What medications have helped either your asthma and/or bronchiectasis? If you feel gunky in the morning, is it more bronchiectasis than asthma? Will under treating either condition result in the worsening of the other?

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@sweethighland

Thank you very much. Wow, you are free from pseudomanas with Azithromycin? Was your psuedomonas chronically showed up in your culture and what load may I ask? May I know your dose? My doctor is considering giving it as a preventive measure. Many patients in Europe use it 3 days a week as well.

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No my pseudomonas is probably not gone. Have not had sputum checked lately but it is in a quiet phase. It only showed up last November with high amounts, colonized. May have been there for a long time before because I did not have it checked. My dose is 250 mg three times a week. I think the suggestion is that I go off it after one year which will be this December. One pulmonary doctor said he advised 6 months on during the worst times for you and 6 months off (like over the spring summer period). So I expect to stop it in December/January and resume the following fall. I also do 3% sodium chloride.

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It does not get rid of Pseudomonas. My pulmo once told me that Pseudo likes to be with other bacterias or some such thing. And if you keep those lower then Pseudo might retreat more. So maybe it helps due to that? Also found this explanation online:

The macrolide antibiotic azithromycin (AZM) provides a paradigmatic example of an “unconventional” antibacterial drug. Besides its growth-inhibiting activity, AZM displays potent anti-inflammatory properties, as well as antivirulence activity on some intrinsically resistant bacteria, such as Pseudomonas aeruginosa.

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@sweethighland

Thank you Christine. I'm glad that Azithromycin 3 days a week is helping you. My doctor is considering giving me for 3 days a week but he wants to hold that for now. I'm just like you, cold weather inflame my airways and my bronchiectasis gets worse in the winter. I will talk to my doctor about it. Thank you.

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Hi sweethighland! Glad you have an appointment to discuss this possible step. I do hope you will have the same success.
All the best!

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@liz440

No my pseudomonas is probably not gone. Have not had sputum checked lately but it is in a quiet phase. It only showed up last November with high amounts, colonized. May have been there for a long time before because I did not have it checked. My dose is 250 mg three times a week. I think the suggestion is that I go off it after one year which will be this December. One pulmonary doctor said he advised 6 months on during the worst times for you and 6 months off (like over the spring summer period). So I expect to stop it in December/January and resume the following fall. I also do 3% sodium chloride.

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6 months on during the worst times for you and 6 months off (like over the spring summer period). This sounds like a wise advice. I will ask my doctor.

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@irenea8

It does not get rid of Pseudomonas. My pulmo once told me that Pseudo likes to be with other bacterias or some such thing. And if you keep those lower then Pseudo might retreat more. So maybe it helps due to that? Also found this explanation online:

The macrolide antibiotic azithromycin (AZM) provides a paradigmatic example of an “unconventional” antibacterial drug. Besides its growth-inhibiting activity, AZM displays potent anti-inflammatory properties, as well as antivirulence activity on some intrinsically resistant bacteria, such as Pseudomonas aeruginosa.

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Thank you for this information. Good to learn. Have you got better from taking AZM?

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@sweethighland

Thank you for this information. Good to learn. Have you got better from taking AZM?

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Hello, I never took the Azithromycin. I tried just one 250 ml and had a heart reaction. The reaction was strong enough to make me afraid to try it again. I am sure my reaction was rare. I know many people are able to take AZ and do ok.

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Today at pulmonologist meeting I asked "how do I know it's asthma" vs something else.

Answer:
1) Symptoms: cough, wheeze, SOB, tightness (esp, tightness)
2) Triggers: GERD, pets, allergies
3) Asthma gets better with asthma medication (albuterol, symbicort, etc)

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