Bronchiectasis

What is bronchiectasis?

This is a lung condition that causes a cough (often with mucus), shortness of breath, and other symptoms. In people with this condition, the airways (the branching tubes that carry air within the lungs) are damaged. This causes the airways to become wider than normal. It also leads to increased mucus, which can be hard to cough up. When mucus stays in the lungs, it makes people more likely to get lung infections or bronchitis.

Bronchiectasis has many different causes. These include certain infections or problems with the body’s infection-fighting system (called the “immune system”). Other diseases that can cause bronchiectasis include cystic fibrosis, and pneumonia that is severe or comes back multiple times.

What are the symptoms of bronchiectasis in adults?

Symptoms of bronchiectasis can include:

• Long-lasting cough – The cough usually brings up thick, sticky mucus. It can last weeks or even months.
• Shortness of breath, or breathing that sounds like whistling (wheezing)
• Frequent bronchitis or other lung infections
• Coughing up blood
• Sharp chest pain – The pain tends to get worse when taking a breath.

Some people with bronchiectasis also have chronic sinusitis. This condition can cause a stuffy nose, pain in the cheeks or forehead, and yellow or green mucus from the nose.

Will I need tests?

Maybe. First, your doctor or nurse will ask about your symptoms and do an exam. You might have some or all of these tests:

• Blood tests – These can help find the cause of the bronchiectasis, if not already known.
• “Sputum culture” – This means testing a sample of mucus you cough up.
• Chest X-ray
• CT scan of your chest – This is an imaging test that creates pictures of the inside of the body. It can show a detailed picture of your lungs and airways. A CT scan is usually needed to know if you have bronchiectasis, and to see which parts of your lungs are involved.
• “Pulmonary function tests” – These show how well your lungs are working.
• “Bronchoscopy” – You might have this if you are coughing up blood. During this procedure, a doctor uses a thin tube called a “bronchoscope” to look at your airways inside your lungs.

How is bronchiectasis in adults treated?

Doctors can give several different treatments to help with symptoms and prevent further problems. These can include:

• Medicines to treat and prevent lung infections, reduce airway inflammation, and help thin mucus in the lungs
• Airway clearance therapy (also sometimes called “chest physiotherapy”) – This involves loosening the mucus in the lungs so you can cough it up more easily. There is more than 1 way to do this. A doctor, nurse, or therapist can show you the different ways.
• Pulmonary rehabilitation (“rehab”) – This involves learning about other ways to improve your symptoms. It includes getting information about your lung disease, learning ways to save your energy, and exercising with a therapist.

Less often, people with more severe disease might need other treatments. These might include:

• “Bronchial artery embolization” – Coughing up a lot of blood can be life-threatening. This is a procedure to help stop the bleeding in the airways. The doctor puts a thin tube into an artery in the leg and moves it up to the lungs. Then, they use tiny tools to block the artery in the bleeding area.
• Surgery – If part of a lung is damaged or keeps getting infected, doctors might do surgery to remove the most involved areas. But this is rare.
• Lung transplant – This is done at a transplantation center. A surgeon replaces the diseased lungs with healthy lungs. This is done only in people who have severe disease and meet certain conditions.

If the bronchiectasis is caused by another medical condition, your doctor will treat that condition. This might help the bronchiectasis.

What can I do on my own?

You should:

• Quit smoking, if you smoke. It does not matter how long you have smoked or how much you smoke. Quitting can slow your disease and help you feel better. If you are having trouble quitting, your doctor or nurse can help.
• Get the vaccines your doctor recommends to help prevent infections. These include the flu shot every year (usually in the fall), the pneumonia vaccine at least once, and the COVID-19 vaccine. Depending on your age and health, your doctor might also recommend the respiratory syncytial virus (“RSV”) vaccine.
• Try to avoid being exposed to respiratory viruses during “cold and flu season.” These infections can be very hard on your lungs and can make symptoms worse. Wash your hands often, and stay away from people who are sick.

When should I call the doctor?

Call your doctor or nurse for advice if:

• You are coughing more than usual, or your cough bothers you during sleep or other activities.
• You have shortness of breath or noisy breathing (wheezing).
• You have new chest pain.
• You cough up dark yellow or green mucus, or thick, sticky mucus every day.
• You cough up blood.
• You have a fever.

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