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Do you drink tap water?
How does the water we drink that goes into our stomach cause a MAC infection in our lungs and possibly more bronchiectasis?
The answer is two-fold: by inefficient swallowing and gastric reflux.
All of us micro-aspirate liquid into our lungs throughout the day. This might be from liquid “going down the wrong pipe” as can happen with swallowing issues, coughing, or “just because.”
Although a certain number of aspirations is considered normal and not a concern for those with healthy immune systems and lungs, this may not be the case for people with impaired airways.
Gastroesophageal reflux is another way bacteria can enter the lungs. Both acid and non-acid gastric refluxate can come up from the stomach and enter the lungs. This liquid can contain bacteria that have not been killed off by our stomach acid and possibly cause infection.
One way to help prevent reflux is to take precautions. These precautions might include:
🦠Raising the head of your bed
🦠After eating, waiting a couple of hours before lying down, doing airway clearance or exercising
🦠Squatting down instead of bending at the waist whenever possible
🦠Losing weight if overweight
🦠Not eating trigger foods
In addition to reducing swallowing issues and GERD, we can also reduce the MAC in our drinking water. Boiling water for 10 minutes, using a LifeStraw pitcher or drinking spring water will greatly reduce this exposure.
If you choose to drink spring water, do not drink from a water cooler as a MAC biofilm might be lining the inside of the machine. The same is true for refrigerator-filtered water and ice and Brita-like charcoal pitchers.
Not everyone with bronchiectasis will get a MAC infection. However, there is about a 10-20% chance one will and the precautions I have laid out can reduce that probability.
Some BE and MAC specialists tell their patients to just live their lives and not try to control bacteria that are everywhere in our environment. Others suggest taking preventive measures. So it is best for those with BE to have this conversation with your medical team and see what they recommend.
Bronchiectasis is a life-long condition and changes can be made over time.
Best,
Linda Esposito
#bronchiectasis #maclungdisease #ntmlungdisease #GERD #lifestraw
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Could you please identify what the “trigger foods” are?
Thank you.
Thank you, Linda! Just to add a tidbit about swallowing: NTMs, food, drink, etc. can also enter lungs due to a lax epiglottis. This is the flap that covers the airway in the lungs. When I was at NJH it was determined that there was seepage to the upper part of my epiglottis when I drank multiple swallows (gulped) at a time. There was no penetration when I took a single swallow at a time. My throat was scanned when I ate and drank. Fortunately, the seepage did not penetrate the entire width of the epiglottis (when gulping) but who's to say when that will change. They told me to do hard swallows to exercise the epiglottis. There are quite a few different exercises depending on the extent of the seepage. I would never have known this had I not gone to NJH after my M. Abscessus diagnosis.
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4 ReactionsThank you, Kathy, for this wonderful additional information. Yes, at NYU I was also tested for swallowing and worked with a speech therapist on swallowing exercises. They were surprisingly difficult! Even now, instead of clearing my throat, I try to do a hard swallow. It instantly brings me back to those weeks of practicing with a speech pathologist; a reminder of how much intention and effort went into retraining something we usually take for granted.
Warm regards and a happy new year,
Linda
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2 Reactions@susannesemann If you are able to search on the internet you will find much information about what to eat and not eat with GERD/ACID REFLUX. The GERD/ACID REFLUX diet.
Hope this will help.
Barbara
@blm1007blm1007
I will do that, Barbara. Thank you!
As always - great information you have provided
@becleartoday I am seeing a ST now as a follow up to what I learned at NJH. I forget a lot about intentional swallow. I do the exercises, but you're so right about retraining something we take for granted.
Hope the new year brings everyone joy and health. Roz
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2 Reactions@becleartoday Hi Linda, You're welcome. It's good to hear NYU tests for swallowing. I really cut down on my hard swallow exercises, but this discussion has gotten me back on course. I live in AZ and there have been a few summer days where intentional swallowing was very difficult. I now take my life straw water bottle everywhere. Happy New Year!
@kathyjjb Me too Kathy! I don't have Gerd, but I do have a poorly shaped epiglottis & was choking a lot.
My first pulmonologist's nurse also stressed swallowing instead of throat clearing or coughing - she better than anyone except the speech therapist at describing then demonstrating!
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1 ReactionOh, that sounds terrible, i.e. the choking. It sounds like you are doing better now-I hope. There are quite a few exercises for the epiglottis, but I only do the hard swallows.