Why is boiling drinking water essential in MAC?

In short, GERD or reflux. If you drink water containing NTM (like MAC), it’s possible that when you lie down—especially during sleep—stomach contents can reflux and be aspirated into the lungs. The stomach contents are very damaging to the lungs. Stomach fluids are supposed to stay in the stomach for digestion. If they end up in the lungs, the stomach fluids will think they are still in the stomach and work hard to continue digestion, thus damaging the lungs, and possibility cause bronchiectasis and expose lung tissue to NTM.

What a great question! I was at NJH and one day I had a barium test where I ate graham crackers dipped in barium goo and quite a few drinks of barium liquid. While I was swallowing, they took their x-rays. What they are looking for is if the epiglottis was open or close while swallowing. The epiglottis is a flap of cartilage that prevents food or water from entering the trachea during swallowing. The flap is to open during breathing and closed during swallowing. In my case, there was very minimal seepage at the muscles that connect flap. They gave me swallowing exercises that I was to do for 6-8 weeks to strengthen the muscles, which I did. My case was minor, so I didn't need much as for exercises. Also, I don't boil my drinking water. I installed an ultrafiltration system that filters anything above .01 microns. I have to change out the 4 cannisters every 9-12 months. I also drink bottled Icelandic Glacier mineral water, which supposedly doesn't contain mycobacterium-not sure if that's true. There's also the chance of aspirating food or drink by breathing and drinking at the same time, hence it "goes down the wrong way".

Sorry, forgot to mention-my explanation was in addition to what Scoop said. Fortunately, I don't have GERD, but NJH tests for that as well. Best decision I have made in this journey of BE and MABs was to go to NJH.

@paxmundi This is another one of those issues surrounding MAC & Bronchiectasis where the answer is "It depends."
If you have GERD, where stomach contents can be forced upwards from the throat and inhaled, and water happens to be in the mix, and the water has significant numbers of NTM bacteria, you could get NTM from water into your lungs.
Or, if like @kathyjjb or me, you have a swallowing disorder, you could aspirate water while drinking if you begin to choke/cough. We have both done therapy to alleviate this (I still need to do the exercises every few days.)

Different people take different approaches to the situation. Some only drink boiled water, others use a LifeStraw or similar filter (.2 microns or smaller) to remove any NTM. Some people drink bottled spring water (from natural ground springs, which has low or no NTM in it.) This is different from purified drinking water, which is municipal water further purified or filtered, but with no particular standards. Others drink whatever is available, and let the chips fall where they may.

What do I do? I drink water from a dual filter system with a larger pore 1 micron filter and a .2 micron final filter. If I am out, and plan ahead, I carry my own or bottled spring water. If not, I drink whatever is available. Have been doing this for years without getting reinfected - maybe I am just lucky.

Thank you for this thorough reply, Sue! It makes sense and I will pass this on to the new doc (that I am trying out).

Curious what the exercises are.

You need to be diagnosed by a speech or respiratory therapist and get the correct exercises for your condition. Then they coach you until you do them correctly.

Most of the exercises for swallowing issues focus on strengthening the tongue and the swallowing muscles. My speech therapist recommended that I get an EMST 150 device, which strengthens the expiratory muscles. Using the device only requires about 5 minutes of time, five days per week.

Can you recommend any online exercises for swallowing?

@paxmundi, @sueinmn, @scoop
While at NJH my lead doctor, the pulmonologist, and from another department involved with NJH, indicated to me that they, NJH, always test for Acid Reflux because they feel there is a strong relationship of it to BE. Bronchiectasis. To my understanding GERD, GORD, LPR, all are related to concerns with possible acid reflux.
It appears that if you have BE you should consider testing, tests, for GERD,GORD,LPR.
I was told I do not have GERD, acid reflux, (hope I did the test correctly) but to be on the safe side I boil any type of water to drink.
I have to get into the habit of taking my water out with me to eating establishments. I have crossed my fingers a few times and requested bottled water.
Barbara