Do you always have phlegm in your throat and can't spit it out? There may be something wrong here, don't take it lightly!

Do you always have phlegm in your throat and can't spit it out? There may be something wrong here, don't take it lightly!

Every time the seasons change, there are always a few people around me who keep coughing.

I cough during the day, I cough at night, I cough when I talk too much, I cough when I don’t talk for a long time…

Some friends not only have a cough, but they also always feel like there is a phlegm stuck in their throats that they can't cough out no matter how hard they try. In severe cases, they may even cough up blood.

If this is the case for you, be careful, you may have bronchiectasis!

Lesser-known bronchiectasis

When it comes to bronchial diseases, the one that people hear about the most is bronchitis.

But in fact, there is another disease that occurs in the bronchi, which has a high incidence and great harm, and that is bronchiectasis.

According to statistics, the prevalence of bronchiectasis in people over 40 years old in my country is 1.2%, and the proportion of bronchiectasis in patients with chronic obstructive pulmonary disease is as high as 30%.

What exactly is bronchiectasis? How does it come about?

To understand these questions, we first need to know what the bronchi are and where they are located in the human body.

The bronchi are located in the human lungs and usually refer to the branches of the trachea.

It connects to the trachea at the top and the lungs at the bottom, with the end connected to a string of alveoli. Its overall shape resembles a large tree growing upside down, so it is also called the "bronchial tree" in medicine.

When the trachea is cut open, its wall is divided into three layers from the inside to the outside: the mucosal layer, the submucosa and the adventitia.

The mucosal layer contains many epithelial cells with cilia, which can clean up the garbage in the respiratory tract, such as inhaled dust and pathogens, by regularly swinging their cilia.

The submucosal layer is rich in glands, which are mainly responsible for secreting mucus to moisten and protect the tube walls.

The outer membrane is considered the skeleton of the bronchus, mainly composed of cartilage, smooth muscle, and elastic fibers, and plays a supporting and protective role.

**When the normal structures such as smooth muscle and elastic fiber in the outer membrane of the bronchi are destroyed, the bronchi are prone to deformation and expansion. **And this expansion may be irregular, thick in some places and thin in others, and cystic or beaded.

This is called bronchiectasis.

After bronchi dilation, the walls of the bronchi become thicker and less elastic, and sputum accumulates in the bronchi. People are prone to repeated coughing, coughing up large amounts of thick sputum, and even coughing up blood.

Why did the bronchus become dilated when it was fine?

Bronchiectasis is a common destructive disease of the lung structure, mainly caused by the following reasons:

1. Infection

About one-third of bronchiectasis is caused by respiratory tract infections .

Infectious diseases, such as influenza, measles, whooping cough, tuberculosis, pneumonia, etc., can cause a lack of immunoglobulins in the human body, making it impossible for mucociliary cells to clear obstacles, making it difficult for secretions in the cavity to be discharged normally.

Over time, the bronchi will develop chronic suppurative inflammation and fibrosis, causing the walls of the bronchi to thicken, ulcerate, scar, and twist, and the supporting structure to be destroyed, eventually leading to irreversible expansion.

2. Foreign bodies in the airway

When tumors, swollen lymph nodes or some other tiny foreign objects (such as melon seeds, peanuts, pencil heads, etc.) exist in the bronchi for a long time, the ducts will be blocked, resulting in poor air discharge. At this time, the pressure in the lumen gradually increases, causing expansion, which will eventually lead to bronchial dilatation.

3. Congenital disease or immune deficiency

Some people have congenital abnormalities in lung development, such as bronchial chondrodysplasia, cystic fibrosis, cilia deficiency, pulmonary sequestration, α1-antitrypsin deficiency, etc., and are prone to bronchiectasis.

In addition, people who take immunosuppressants for a long time (including after transplantation), are infected with HIV, have immunodeficiency diseases such as hypoimmunoglobulinemia and chronic lymphocytic leukemia , are prone to repeated lung infections and are more likely to develop bronchiectasis than ordinary people.

4. Idiopathic bronchiectasis

Currently, the cause of bronchiectasis is unknown in approximately 50% to 70% of patients.

These bronchiectasis with no known cause are collectively referred to as "idiopathic bronchiectasis."

Is it bronchial dilatation if there is always phlegm in the throat?

Coughing up phlegm is the most typical symptom of bronchiectasis. If you always feel that there is phlegm in your throat, does it mean that you have bronchiectasis?

1. How to determine bronchiectasis?

Bronchiectasis should be suspected if you have the following symptoms:

**Long-term coughing up thick yellow-green sputum: **People with bronchiectasis will often cough up yellow-green purulent sputum, and the sputum is very large, reaching hundreds of milliliters per day.

**Recurrent hemoptysis: **Most patients with bronchiectasis will have blood in their sputum, a small amount or a large amount of hemoptysis, etc. Generally speaking, coughing up blood means that the infection has worsened.

**Frequent colds or bronchitis: **The respiratory tract of patients with bronchiectasis is relatively fragile and prone to repeated infections. Inflammation damages the bronchial mucosa and the blood vessels underneath it. Once an attack occurs, they will cough up pus, sputum, or even hemoptysis.

Bronchiectasis is often caused by infection and is often aggravated acutely. If the patient has chest tightness, shortness of breath, worsening dyspnea, increased coughing, worsening fatigue, fever, etc., he must go to the hospital for treatment in time.

2. Can bronchiectasis be cured?

Bronchiectasis is caused by permanent damage to the structure of the bronchial walls, and medication alone cannot reverse this process.

However, for some children with bronchiectasis caused by the presence of foreign objects, as long as the foreign objects are removed as soon as possible, the dilated bronchi may gradually return to normal.

In addition, for some cases of bronchiectasis with smaller and more concentrated lesions, it can be treated by surgically removing the bronchi at the lesion site.

Although bronchiectasis cannot be cured, as long as patients pay attention to maintenance in daily life, the discomfort and pain caused by this disease can be greatly alleviated.

Patients can drink more water to prevent dehydration and cause sputum to be too thick.

If the sputum is thick and cannot be coughed out despite repeated coughing, it is recommended to take some expectorants, such as ambroxol hydrochloride, acetylcysteine , etc.

You can also **exercise appropriately to improve your own immunoglobulin function and try not to catch a cold.

**Avoid spicy food and eat more foods rich in vitamin A,** such as carrots, tomatoes, animal liver, etc., to protect the respiratory mucosa.

Treating bronchiectasis is a long-term battle. I hope every patient can keep a calm mind and never blindly believe in some drugs and treatments from informal channels in pursuit of a "cures", which will result in losing both life and money in the end.