Bronchiectasis in adults

Bronchiectasis is a long-term lung condition in which your airway walls have become damaged, widened and thickened.

Bronchiectasis can develop at any age. This page focuses on bronchiectasis in adults. For information on children with bronchiectasis, see bronchiectasis in children.

Key points

  1. The damaged airways can cause mucus build-up. When mucus stays in the lungs it can lead to infections and an ongoing chesty cough and shortness of breath.
  2. There is no cure for bronchiectasis. However, good treatment stops it getting worse and most people who have bronchiectasis enjoy a good quality of life.
  3. The main aims of treatment are to keep your airways open, reduce mucus build-up and prevent further damage to your lungs.
  4. If you have been diagnosed with bronchiectasis, see a doctor if you are coughing or bringing up more phlegm than normal, are more short of breath or coughing up blood, or have a fever or new chest pain.

What is bronchiectasis?

In people with bronchiectasis, your airways (the branching tubes of your lungs) are damaged and wider than normal. This leads to mucus build up. Over time it becomes harder to cough the mucus up. Bacteria grow in the mucus, and can cause further lung infection.

Each new infection causes more damage to your airways, making them wider, thicker and floppier. Your lungs struggle to move air in and out, leading to continuous coughing and shortness of breath.

Over time, bronchiectasis can get worse, making day-to-day activities harder to do. It can also lead to long stays in hospital and reduce life expectancy. 

With early diagnosis and treatment, ongoing airway damage can often be reduced.


Image credit: American Thoracic Society

What causes bronchiectasis?

Bronchiectasis is caused by damage to your airway walls. It begins most often in early childhood but can develop at any age. Common causes include the following:

Cause Description
Unknown In up to half of cases the cause is unknown.
Infection Certain lung infections can cause bronchiectasis in some people. Some bugs that can cause it are pertussis, measles and influenza.
Weakened immune system This is where your immune system is not able to fight infections properly. You can be born with this (called primary immunodeficiency), or get it later from another condition like HIV.
Poor mucus clearance Having a condition like cystic fibrosis or primary ciliary dyskinesia where you can’t clear mucus properly. 
Other causes These include inhaling noxious chemicals and autoimmune conditions. You can even be born with it. 

Smoking is not a major cause of bronchiectasis – many people with the condition have never smoked. However, because smoking irritates your lungs it makes the condition worse.

What are the symptoms of bronchiectasis?

The main symptoms of bronchiectasis are coughing up lots of mucus (phlegm) and a long-term wet-sounding cough. The phlegm can be clear or different colours. Other symptoms include:

  • shortness of breath
  • wheezing
  • chest pain.

You may also feel tired and generally unwell.

If you have a wet-sounding cough that is ongoing and lasts for weeks, see your doctor.

How is bronchiectasis diagnosed?

Your doctor will talk to you about your symptoms and examine you. They may do some or all of these tests:

  • blood tests
  • breathing test (called pulmonary function test)
  • certain scans (chest x-ray and CT scan)
  • sputum/phlegm test
  • looking into your airways with a camera if you are coughing up blood.

How is bronchiectasis treated?

The main aims of treatment are to keep your airways open, reduce mucus build-up and prevent further damage to your lungs.

Chest physiotherapy

A physiotherapist can show you how to clear your lungs of extra mucus and teach you exercises to do at home. You will need to do this once or twice a day.

Pulmonary rehabilitation

In pulmonary rehabilitation you are taught ways to improve your symptoms. You may be taught about your condition and ways to pace yourself and helped to start an exercise programme. Read more about pulmonary rehabilitation.

Antibiotics

Your doctor may prescribe a course of antibiotics if you have signs of an infection. It's important to finish the course even if you feel better, as stopping the antibiotics too soon could cause the infection to come back quickly. Often a 2-week course of antibiotics is required. If you have frequent chest infections, your doctor may prescribe antibiotics on a long-term basis.

Self-care for bronchiectasis

There are a number of things you can do to help relieve the symptoms of bronchiectasis and stop the condition getting worse.

  • Quit smoking (if you smoke) – smoking is a major irritant to your lungs and will make the condition worse.
  • Keep yourself well hydrated – drinking plenty of fluid, especially water, helps prevent mucus from becoming thick and sticky. Keeping mucus moist and slippery makes it easier to cough up.
  • Vaccinations - to help protect you from some infections you can get the flu vaccination every year. Pneumococcal vaccination is also recommended, but this is not funded for most adults. This vaccine protects you from some of the kinds of bacteria that cause pneumonia. Contact your GP for this.
  • Chest physiotherapy should be done once or twice a day at home when you are well, and more often if you are sick.
  • Exercising regularly – being physically active helps keep your chest free of infection by helping to clear the mucus. Aim to exercise at least 3–4 times per week. Any type of exercise that makes you take long, deep breaths is good. It’s okay if you cough during exercise.
  • Eating a balanced diet.
  • Having a warm, dry home.

Bronchiectasis action plan

If you have bronchiectasis, talk to your healthcare provider about drawing up a bronchiectasis action plan. This is a written document about what you need to do to manage your bronchiectasis well. It means you don't need to rely on remembering what your healthcare provider tells you to do.

A bronchiectasis action plan has information on how to recognise and handle worsening symptoms, and when, how and who to contact in an emergency. Some people need antibiotics on hand at home for prompt treatment of flare-ups. Bronchiectasis action plans include the following:

Support

Asthma New Zealand provides education, training and support to anyone with bronchiectasis and their families/whānau. Read more

Learn more

Bronchiectasis (Bx) KidsHealth, NZ
Living with bronchiectasis Asthma + Respiratory Foundation, NZ
Bronchiectasis Bronchiectasis Foundation, NZ

References

  1. Bronchiectasis: rates still increasing among Pacific peoples BPAC, NZ, 2012
  2. Bronchiectasis Starship Clinical Guidelines, NZ
Credits: Health Navigator Editorial Team. Reviewed By: Dr Jeremy Steinberg, FRNZCGP Last reviewed: 29 May 2020