Healthbeat Report: Constant Coughing

June 23, 2011 (CHICAGO)

That troublesome cough could be caused by something even doctors may not be looking for.

Everybody coughs once in a while. But when the cough keeps up for weeks and longer a serious illness could be the cause. Physicians will check for the usual suspects, but the problem may be a little understood disease that's easily misdiagnosed and possibly more common that realized. But, once found, there is help.

For dogs Tarver and Bella, a quick walk is just part of the daily routine. But before Rebecca Haskin takes the dogs out, there's another exercise that has to happen. In order to breathe easier, the 28-year-old needs to treat her clogged airways. A nebulizer gets medication to her lungs and a special vibrating vest helps shake up mucus trapped in her airways.

"I've always had lung issues. It's just kinda of progressively gotten worse," said Haskin.

As an infant, Haskin was diagnosed with asthma. But that didn't slow her down. Then, in her late teens, an extra nasty respiratory infection led to a surprising diagnosis: bronchiectasis, a lung condition she never heard.

"It's tough," she said.

Haskin and her doctors suspect she may have had this condition all her life. And there may be a surprising number of others in the same situation. Advanced imaging is beginning to reveal cases that may have gone undetected.

"The CT scans are so good that they are picking up bronchiectasis that 10 or 20 years ago was not diagnosed," said Dr. Pamela McShane, pulmonologist, University of Chicago Medical Center.

So, what is bronchiectasis? It's a condition where the lungs's airways are abnormally stretched and widened, preventing mucus from being cleared. The airways then become inflamed and infected. Symptoms include a constant cough that produces large amounts of mucus, shortness of breath, abnormal chest sounds and pain.

For a long time no one was really sure what was causing Myriam Aponte's embarassing cough and respiratory infections. When a CT scan revealed she had bronchiectasis, her treatments changed.

"I feel, I want to say 90 percent better," said Aponte.

So, what causes it? Researchers, including Dr. McShane, are trying to figure that out. It may be inherited and immune system irregularities seem to play a role. It can also be associated with other illnesses such as cystic fibrosis, COPD, even rheumatoid arthritis. Many people seem to develop it from a past lung infection. Cases can range from mild to severe. Treatments include keeping the airways clear and preventing infection with longterm antibiotics.

"It's exciting to know at least we are beginning to find these patients and bring them in and give them the treatment they need and deserve," said Dr. McShane.

Right now Rebecca Haskin only has a lung capacity of about 35 percent. She's not sure if an earlier diagnosis would have made a difference, but she's determined to keep looking forward.

"The best thing I can do is continue to do everything ," said Haskin.

Even though patients with bronchiectasis may have an infection doctors say they are not contagious. And while bronchiectasis is not curable per se, doctors say once the right diagnosis is made and treatments kick in, patients can see a dramatic improvement, including a lot less coughing.

For a for more information on bronchiectasis and research opportunities at the University of Chicago Medical Center, visit www.uchospitals.edu/news/highlight28.html

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