Bronchiectasis is a condition where the bronchial tubes of your lungs are permanently damaged, widened, and thickened. These damaged air passages allow bacteria and mucus to build up and pool in your lungs. This results in frequent infections and blockages of the airways.
Bronchiectasis is manageable, but it cannot be cured. With treatment, you can typically live a normal life. However, flare-ups must be treated quickly so that oxygen flow is maintained to the rest of your body and further lung damage is prevented.
Any lung injury can cause bronchiectasis. There are two main categories of this condition. One is related to having cystic fibrosis (CF) and is known as CF bronchiectasis. Cystic fibrosis is a genetic condition that causes an abnormal production of mucus.
The other category isn’t related to cystic fibrosis and is called non-CF bronchiectasis. The most common known causes of non-CF bronchiectasis include:
- an abnormally functioning immune system
- inflammatory bowel disease
- autoimmune diseases
- Alpha-1 antitrypsin deficiency (an inheritable cause of COPD)
- allergic aspergillosis (an allergic lung reaction to fungus)
About one-third of all cases of bronchiectasis are caused by cystic fibrosis. Cystic fibrosis affects the lungs and other organs like the pancreas and liver. In the lungs, this results in repeated infections. In other organs, it causes poor functioning.
Symptoms of bronchiectasis can take months or even years to develop. Some typical symptoms include:
- chronic daily cough
- coughing up blood
- abnormal sounds or wheezing in the chest with breathing
- shortness of breath
- chest pain
- coughing up large amounts of thick mucus every day
- weight loss
- thickening of the skin under your nails and toes, known as clubbing
- frequent respiratory infections
If you’re experiencing any of these symptoms, you should see your doctor immediately for diagnosis and treatment.
Your doctor will listen to your lungs to check for any abnormal sounds or evidence of airway blockage. You’ll likely need a complete blood test to look for infection and anemia. Other tests may include:
- sputum test to check your mucus for viruses or bacteria
- chest X-ray or CT scan to provide images of your lungs
- pulmonary function tests to find out how well air is flowing into your lungs
- QuantiFERON test or purified protein derivative (PPD) skin test to check for tuberculosis
- sweat test to screen for cystic fibrosis
There’s no cure for bronchiectasis, but treatment is important to help you manage the condition. The main goal of treatment is to keep infections and bronchial secretions under control. It’s also critical to prevent further obstructions of the airways and minimize lung damage. Common methods of treating bronchiectasis may include:
- methods for clearing the airways (like breathing exercises and chest physiotherapy)
- pulmonary rehabilitation
- antibiotics to prevent and treat infection
- bronchodilators like albuterol (Proventil) and tiotropium (Spiriva) to open up airways
- medications to thin mucus
- expectorants to aid in coughing up mucus
- oxygen therapy
- vaccinations to prevent respiratory infections
You may need the help of chest physiotherapy. One form is a high-frequency chest wall oscillation vest to rid your lungs of mucus. The vest gently compresses and releases your chest, creating the same effect as a cough. This dislodges mucus from the walls of the bronchial tubes.
If there’s bleeding in the lung, or if the bronchiectasis is located in only one part of your lung, surgery may be needed to remove the affected area.
Draining of the bronchial secretions, aided by gravity, may also be performed on a daily basis as a part of treatment. A respiratory therapist can teach you techniques to aid in coughing up the excess mucus.
If your bronchiectasis is caused by conditions like immune disorders or COPD, your doctor will treat those conditions as well.
For about 50 percent of the cases, the exact cause of bronchiectasis is unknown. In up to 35 percent of people, it may occur after a lung infection. For others, it’s related to cystic fibrosis or other medical conditions. Avoiding smoking, polluted air, cooking fumes, and chemicals can help protect your lungs and maintain lung health. You and your children should be vaccinated against the flu, pertussis, and measles, as these conditions have been linked to the condition in adulthood. But oftentimes, when the cause is unknown, prevention is difficult. Early recognition of bronchiectasis is important so that intervention can begin before significant lung damage occurs.