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.
There’s no cure for bronchiectasis, but it’s manageable. With treatment, you can typically live a normal life.
However, flare-ups must be treated quickly to maintain oxygen flow to the rest of your body and prevent further lung damage.
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. CF is a genetic condition that causes an abnormal production of mucus.
The other category is non-CF bronchiectasis, which isn’t related to CF. The most common known conditions that can lead to non-CF bronchiectasis include:
- an abnormally functioning immune system
- inflammatory bowel disease
- autoimmune diseases
- chronic obstructive pulmonary disease (COPD)
- alpha 1-antitrypsin deficiency (an inheritable cause of COPD)
- allergic aspergillosis (an allergic lung reaction to fungus)
- lung infections, such as whooping cough and tuberculosis
CF 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
- change in the structure of fingernails and toenails, known as clubbing
- frequent respiratory infections
If you’re experiencing any of these symptoms, you should see your doctor immediately for diagnosis and treatment.
A chest computed tomography scan, or chest CT scan, is the most common test for diagnosing bronchiectasis, since a chest X-ray doesn’t provide enough detail.
This painless test creates precise pictures of your airways and other structures in your chest. A chest CT scan can show the extent and location of lung damage.
After bronchiectasis is confirmed with the chest CT scan, your doctor will try to establish the cause of the bronchiectasis based on your history and physical exam findings.
It’s important to find out the exact cause so the clinician can treat the underlying disorder to prevent the bronchiectasis from getting worse. There are numerous causes that can induce or contribute to the bronchiectasis.
The evaluation for the underlying cause mainly consists of laboratory and microbiologic testing and pulmonary function testing.
Your initial evaluation will likely include:
- complete blood count with differential
- immunoglobulin levels (IgG, IgM, and IgA)
- sputum culture to check for bacteria, mycobacteria, and fungi
If your doctor suspects CF, they’ll order a sweat chloride test or genetic test.
Specific therapies may slow down the progression of bronchiectasis related to the following conditions:
- mycobacterial infections
- certain immunodeficiencies
- cystic fibrosis
- recurrent aspiration
- allergic aspergillosis
- possibly autoimmune diseases
There’s no cure for bronchiectasis in general, 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 include:
- clearing the airways with breathing exercises and chest physiotherapy
- undergoing pulmonary rehabilitation
- taking antibiotics to prevent and treat infection (studies are currently being done on new formulations of inhaled antibiotics)
- taking bronchodilators like albuterol (Proventil) and tiotropium (Spiriva) to open up airways
- taking medications to thin mucus
- taking expectorants to aid in coughing up mucus
- undergoing oxygen therapy
- getting vaccinations to prevent respiratory infections
You may need the help of chest physiotherapy. One form is a high-frequency chest wall oscillation vest to help clear 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 only in one part of your lung, you may need surgery to remove the affected area.
Another part of daily treatment involves draining of the bronchial secretions, aided by gravity. A respiratory therapist can teach you techniques to aid in coughing up the excess mucus.
If conditions like immune disorders or COPD are causing your bronchiectasis, your doctor will also treat those conditions.
The exact cause of bronchiectasis is unknown in about
For others, it’s related to genetic abnormalities and other medical conditions that affect the lungs. Avoiding smoking, polluted air, cooking fumes, and chemicals can help protect your lungs and maintain lung health.
But often when the cause is unknown, prevention is challenging. Early recognition of bronchiectasis is important so that you can get treatment before significant lung damage occurs.