People with bronchiectasis have an abnormal widening of one or more of the airways in the lungs. There are many different reasons why this can occur. Mucus builds up within these abnormal airways causing patients to have a productive cough and being prone to recurrent lung infections.
The bronchiectasis service focuses on the investigation, diagnosis and treatment of bronchiectasis by working with patients to achieve the best control of this condition. By taking a whole team approach of a variety of disciplines, the burden of symptoms associated with this condition can be significantly reduced.
More on what we do
Patients will usually meet the bronchiectasis service if they have been referred to the team with suspected or confirmed bronchiectasis.
The initial clinic will focus on the symptoms the patient is experiencing, arranging investigation to diagnose bronchiectasis, seeking a possible cause for bronchiectasis, meeting the multi-disciplinary team and commencing a strategy for reducing the patient’s symptoms.
Subsequent follow-up will focus on the patient’s specific needs, this will include: working with our Physiotherapist on techniques, learning therapy administration with our specialist nurse or a review with a consultant.
The key investigation to confirm a diagnosis of bronchiectasis is a CT scan. This provides the team with a 3-dimensional picture of the structure of your lungs to better understand your condition.
Other tests that the team performs include:
- Sputum analysis (to identify bugs causing your persistent infections)
- Blood tests (to identify possible causes of bronchiectasis)
- Nitric oxide (to aid diagnosis of a rare cause of bronchiectasis)
- Sweat tests (to rule out Cystic Fibrosis in certain patients)
- Spirometry (a breathing test to assess lung function)
- Pulse oximetry (to measure oxygen levels)
The bronchiectasis service is research active. This has included giving patients the opportunity to be involved in trials of new therapies, contributing to international registries to better understand bronchiectasis, and research led by the local department. Future and ongoing work within the service includes research into the immunological problems leading to bronchiectasis and better understanding of antibiotic resistance.
If you would be interested in being involved in research within the department, then please let the team know when you meet them.
Treatments focus on targeting the symptoms patients experience and managing the disease. Key areas of focus include keeping the widened airways clear of mucus and controlling infection in the lungs.
Examples of treatments include:
- Specialist physiotherapy techniques and devices
- Exercise courses
- Solutions and tablets to loosen mucus
- Assistance with nasal symptoms via irrigation and steroids
- Anti-inflammatory medications
- Inhaled maintenance antibiotics
- Rescue antibiotics (including intravenous antibiotics which can be given at home in some cases)
The core team is made up of healthcare professionals with a specialist interest in bronchiectasis. They are:
- Dr Lee Dobson, Consultant Respiratory Physician
- Dr Phil Mitchelmore, Consultant Respiratory Physician
- Mrs Hilary Mortimer, Bronchiectasis Nurse Specialist
- Ms Maria Del Pilar Rodal Bravo, Respiratory Nurse Specialist
- Mrs Kat Thomson, Clinical Lead Physiotherapist in Respiratory Medicine
- Dr Nick Withers, Consultant Respiratory Physician
The service also works closely with other specialist teams including: the regional immunology centre; radiology; microbiology; rheumatology; vascular access; stop smoking services; ear, nose & throat (ENT); pharmacy; and the regional Primary Ciliary Dyskinesia service.
Where to find us
RD&E Wonford, Barrack Rd, Exeter EX2 5DW
Department of Respiratory Medicine