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Bronchiectasis

What is bronchiectasis?

Bronchiectasis involves damage to your airways (bronchial tubes), specifically to the tiny hairs (cilia) that line the inside of your airways. Damaged cilia can't do their job of sweeping dirt and mucus out of your lungs. With bronchiectasis, your airways widen and stretch out. In some places the airways are so stretched out they form little pockets. Germs, dust and mucus collect in these pockets and get stuck.

These germs, dust and mucus can cause infection. The cilia can't sweep them away, so the infections keep coming back. Bronchiectasis creates a vicious cycle: infections in airway pockets damage your airways, and when your airways are damaged, you get more infections.

Bronchiectasis can’t be cured, but with the right treatment most people with bronchiectasis can live relatively healthy lives.

What causes bronchiectasis?

Bronchiectasis can be caused by:

  • an infection that damages the airways, like pneumonia or tuberculosis
  • something blocking part the airways, like a piece of food stuck in the airway
  • cystic fibrosis
  • diseases that affect the cilia inside the airways, like ciliary dyskinesia or Kartagener’s syndrome

Who's at risk for bronchiectasis?

Bronchiectasis affects adults, children and infants. Adults usually get bronchiectasis after an infection in the lungs, for example after severe pneumonia, tuberculosis or whooping cough.

In babies and children, bronchiectasis is often the result of a congenital problem (something they're born with or that they develop during birth). The main congenital cause of bronchiectasis is cystic fibrosis. Other conditions such as immunodeficiency disorders are also linked to bronchiectasis. 

What are the symptoms of bronchiectasis?

The most common symptom of bronchiectasis is a chronic cough, or a cough that doesn't go away, and is productive, meaning coughing brings up mucous of phlegm. Bronchiectasis causes people to cough up large amounts of mucus. The mucus is sometimes yellow or green and it sometimes smells bad.

Other symptoms of bronchiectasis include:

  • feeling short of breath
  • chest pain
  • wheezing
  • coughing up blood
  • fever
  • weakness
  • weight loss without trying

What treatments are available for bronchiectasis?

Having bronchiectasis makes it hard for your lung’s natural cleaning system to clear out germs, dust and mucus. People with bronchiectasis have to clear their lungs every day to get rid of germs, dust and mucus. This is usually done by a physiotherapist or a trained member of your family. Clearing your lungs helps prevent infections. 

The main treatments for bronchiectasis are medications and chest physical therapy. If your bronchiectasis is caused by an underlying disease or infection, your doctor will treat that, too. Sometimes people with advanced bronchiectasis will need surgery or a lung transplant.

What medications treat bronchiectasis?

If your bronchiectasis is caused by a bacterial infection, antibiotics are used to clear up the infection.

Bronchodilators relax your airway muscles

Corticosteroids may be given if you have bronchiectasis that is caused by swelling in your airway. Corticosteroids work slowly to reduce that swelling.

Mucus thinners thin your mucus to make it easier to cough it up.

Expectorants help bring up the mucus.

Chest physical therapy (CPT, percussion, postural drainage) is a way of loosening the mucus in your chest. People usually do chest physical therapy while sitting or lying with their heads down (postural drainage). The therapy helps loosen the mucus, and lying with your head down helps the mucus drain away from your lungs.

After you’ve loosened the mucus, it’s easier to cough it up. People with bronchiectasis often do CPT and cough up mucus three or four times a day. There are different ways of doing chest physical therapy. Some people use their fist to pound on their chest. Others use a device like an electric chest clapper, an inflated vest, a “flutter” machine or a positive expiratory pressure mask

There are also breathing exercises that help loosen mucus. For more information on bronchiectasis treatment and breathing exercises, please see this page from the U.S. National Heart Lung and Blood Institute

What can be done to stay healthy when you have bronchiectasis?

People with bronchiectasis can experience worsening symptoms during flare-ups. If you have bronchiectasis, you can try to stay healthy to prevent flare-ups by:

Can bronchiectasis be prevented?

Some cases of bronchiectasis can’t be prevented. Other cases can be prevented by treating lung infections right away. Early treatment means there is less chance for long-term lung damage.

Call our lung health information helpline ( 1-888-344-LUNG) and make sure you are managing your disease properly.