Bx is a chest disease in which the breathing tubes in the lungs become damaged and scarred.

 

Normally, the inside of the breathing tubes is smooth and covered with tiny hairs (cilia). These hairs help to clear phlegm or mucus from the lungs.

 

If a child has Bx, their lungs make more mucus (phlegm or sputum) than normal. The tiny hairs that should clear the mucus stop working properly and the mucus gets stuck in the scarred areas in the breathing tubes.

 

This extra mucus is a great place for bacteria or viruses to grow and cause infection.

 

These infections cause damage and more scarring to the breathing tubes and lungs. The breathing tubes become baggy and holes form in the lungs. Once this has happened, the scarring and damage cannot be fixed. However, with good treatment, further damage can be prevented.

 

What causes Bx?

• a severe bronchiolitis or pneumonia requiring hospitalisation (see Pneumonia and Bronchiolitis on this website)
• less severe chest infections which carry on for a long time
• a long-standing wet sounding cough

There are also other less common causes:

• some people get Bx because they cannot fight infection very well. In some children it can be because they are born with a problem in their immune (infection-fighting) system. Some medications cause diifculty in fighting off infection
• Bx can also start if an object, such as a nut or a piece of a toy goes down the “wrong way”, gets stuck in the breathing tubes and stays there
• children can have very bad reflux of acid from their stomachs or have food that goes down their airway as well as their food pipe when they eat (aspiration). These children sometimes cough or choke when feeding
• some children’s Bx is caused by the tiny mucus-clearing hairs (cilia) in the lungs not working properly. This condition is called PCD (primary ciliary dyskinesia¹)

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