Steroids and Inhaled Corticosteroids (ICSs) can cause osteoporosis and increase the risk of infections. Some of us with bronchiectasis take steroids and ICSs because of other medical conditions. In addition to BE we might have comorbidities such as rheumatoid arthritis, asthma, COPD and inflammatory bowel disease (IBS).
Others take inhaled corticosteroids because they have had their sputum or blood tested, they know their bronchiectasis is an eosinophilic disorder and using an inhaler makes a difference.
In a wonderful 2021 patient bronchiectasis conference sponsored by the European Lung Foundation and the European Respiratory Society, Dr. James Chalmers discusses the difference between neutrophilic and eosinophilic inflammation. Dr. Chalmers says that research shows that in 80% of bronchiectasis patients, their condition is neutrophilic and ICS use will not improve their health status. However, in 20% of cases, their inflammation is also eosinophilic and steroids might make a difference.
Dr. Colin Swenson and Dr. Wendi Drummond also discuss steroid inhalers in their podcast series NTMTALK.com. Dr. Swenson says that many of us are needlessly on inhalers. Sometimes they are prescribed because of a flare-up. Or, if the person is already on steroids, the dosage is increased. Unfortunately, many remain on high doses even after the flare-up is resolved.
My suggestion is that you discuss this issue with your physician and have tests done to determine if ICS use is warranted.Do not take it upon yourself to stop your medication as this could have serious consequences.
I have always said, both in my book, “The BE CLEAR Method to Living with Bronchiectasis” and in my social media posts, it is all about EDUCATION. The better we understand our medical condition(s), the better we can ADVOCATE for our care.
#bronchiectasis #IBD #RA #osteoporosis #COPD #asthma #celiac #inflammation #lupus
Linda Cooper Esposito, MPH is a health educator with bronchiectasis. She developed the BE CLEAR Method to Living with Bronchiectasis and writes with compassion and humor about this chronic lung disease.