Bronchiectasis

Overview

Bronchiectasis is a long-term lung condition where the airways (tubes that carry air in and out of the lungs) become widened and scarred. This damage makes it hard for the lungs to clear mucus, leading to repeated infections and breathing problems.

Bronchiectasis is not very common, but it is a recognized condition worldwide. The number of people diagnosed has been increasing in recent years.

Bronchiectasis can affect people of any age, but it is more often diagnosed in adults over 60 and in women. It can also affect children, especially if they have an underlying condition like cystic fibrosis.

Symptoms

Common symptoms

• A daily cough that brings up a lot of mucus (phlegm)
• Shortness of breath, especially during activity
• Frequent chest infections that need antibiotics
• Wheezing or a rattling feeling in the chest
• Fatigue and feeling generally unwell

Symptoms in children

• Cough that lasts for weeks or months
• Poor weight gain or slow growth
• Frequent respiratory infections
• Chest pain or discomfort

Symptoms in older adults

• Sometimes symptoms are less obvious, like confusion or increased falls due to low oxygen
• Worsening of other health conditions like heart failure
• Less typical cough without much mucus

Causes

Main causes

• Damage from a severe lung infection in the past (such as pneumonia, tuberculosis, or whooping cough)
• Genetic conditions that affect mucus clearance (like cystic fibrosis or primary ciliary dyskinesia)
• Immune system problems that make the body prone to infections
• Inhaling a foreign object or harmful fumes

Risk factors

• Having had severe lung infections during childhood
• Having a family history of lung or immune system diseases
• Living or working in areas with poor air quality or exposure to toxic chemicals

When to see a doctor

See a doctor urgently if:

• If you cough up even a small amount of blood
• If you have severe shortness of breath that is not normal for you
• If you have a high fever with chills and a worsening cough

Book a routine appointment if:

• If you have a daily cough with mucus that lasts for more than a few weeks
• If you have repeated chest infections that keep coming back
• If you feel unusually tired or short of breath doing everyday tasks

Diagnosis

Your doctor will take a detailed medical history, listen to your lungs, and recommend tests to see if you have bronchiectasis.

Tests that may be done

• Chest X-ray to get a first look at the lungs
• High-resolution CT scan (a detailed scan) to see the airways clearly
• Sputum (mucus) culture to check for bacteria or fungi
• Lung function tests (spirometry) to measure how well your lungs work
• Blood tests to check for underlying conditions

What to expect at your appointment

You will likely be referred to a lung specialist (pulmonologist). The process may take a few appointments. The tests are generally not painful and help your doctor create a treatment plan just for you.

Treatment

Treatment for bronchiectasis focuses on clearing mucus from the lungs, preventing infections, and managing symptoms so you can feel better and stay active.

Self-care at home

• Learn airway clearance techniques (physiotherapy exercises to help cough up mucus)
• Drink plenty of water to keep mucus thin
• Avoid smoking and exposure to secondhand smoke or lung irritants
• Get enough rest and stay up to date with recommended vaccinations

Medical treatments

Doctors may prescribe medicines to help thin and clear mucus, antibiotics to treat or prevent lung infections, and inhaled treatments to open the airways. Physical therapy and breathing exercises are also often recommended. Your healthcare team will work with you to find the best plan.

When is surgery considered?

In very rare cases, if the bronchiectasis is limited to one small area of the lung and symptoms are severe, surgery to remove that part may be considered. This is not common and is decided on an individual basis.

Living with this condition

Living with bronchiectasis means making airway clearance a daily habit. You may need to set aside time each day to do breathing exercises or use devices to help clear mucus. Most people learn to recognise early signs of infection so they can get treatment quickly.

Lifestyle tips

• Stay physically active as much as you can – walking, gentle yoga, or swimming can help
• Avoid smoking and limit alcohol
• Keep a healthy weight – being underweight can make you more prone to infections
• Join a pulmonary rehabilitation program if available – these help with exercise and breathing techniques

Diet and exercise

A balanced diet rich in fruits, vegetables, lean protein, and whole grains supports your immune system. Drinking enough water is important to keep mucus thin. Moderate exercise, like walking or cycling, can improve your lung function and overall energy.

Mental health and emotional wellbeing

Living with a chronic lung condition can sometimes cause stress, anxiety, or low mood. It is completely normal to feel this way. Talk to your doctor or a mental health professional – help is available.

Prevention

Not all cases of bronchiectasis can be prevented. However, treating lung infections promptly and avoiding smoking can lower the risk. Good management of underlying conditions like asthma or immune problems also helps.

Vaccines

Getting the flu vaccine every year and the pneumonia vaccine (as recommended by your doctor) can help prevent serious lung infections that could worsen bronchiectasis.

Screening programmes

There is no routine screening for bronchiectasis in the general population. If you have symptoms or a strong family history, talk to your doctor.

Complications

If left untreated

• Repeated and worsening lung infections
• Progressive shortness of breath and reduced lung function
• Coughing up larger amounts of blood (haemoptysis)
• Heart problems (such as right heart failure) from chronic low oxygen

Long-term outlook

With good medical care and daily self-management, many people with bronchiectasis maintain a good quality of life for many years. The condition is chronic, but most people can manage their symptoms and stay active. Early and consistent treatment makes a big difference.

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