BE, MAC Lung Disease and Water

How does the water we drink that goes into our stomach cause a MAC infection in our lungs?

The answer is two-fold: by inefficient swallowing and gastric reflux.

All of us micro-aspirate liquid into our lungs throughout the day. This might be from liquid “going down the wrong pipe” as can happen with swallowing issues, coughing, or “just because.” Although a certain number of aspirations is considered normal and not a concern for those with healthy immune systems and lungs, this may not be the case for people with impaired airways.

Gastroesophogeal Reflux is another way bacteria can enter the lungs. Both acid and non-acid gastric refluxate can come up from the stomach and enter the lungs. This liquid can contain bacteria that have not been killed off by our stomach acid and possibly cause infection.

One way to help prevent reflux is to take GERD precautions. These precautions might include:
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• Raising the head of your bed
• Not eating several hours before lying down
• Losing weight if overweight
• Not eating trigger foods

In addition to reducing swallowing issues and GERD, we can also reduce the MAC in our drinking water. Boiling water for 10 minutes or drinking spring water will greatly reduce this exposure and is something I do.

If you choose to drink spring water, do not drink from a water cooler as a MAC biofilm might be lining the inside of the machine. The same is true for refrigerator filtered water and ice and Brita-like charcoal pitchers.

Not everyone with bronchiectasis will get a MAC infection. However, there is about a 10-20% chance you will and the precautions I have laid out can reduce that probability.

Some BE and MAC specialists tell their patients to just live their lives and to not try to control bacteria that is everywhere in our environment. Others suggest taking preventive measures. So it is best to have this conversation with your doctors and see what they recommend.

Remember, we have a life-long condition so you can always make changes gradually over time.

#bronchiectasis #maclungdisease #ntmlungdisease #GERD