Bronchiectasis

Bronchiectasis is a long-term lung condition where the airways have become damaged, widened and thickened – mainly due to infections. The damaged airways are prone to mucous build-up which leads to increased infections and an ongoing chesty cough.

Key points

  • Bronchiectasis can develop at any age but begins most often in early childhood. In New Zealand, Maori and Pasifika children are at greater risk of getting bronchiectasis.
  • The sooner you or your child gets treatment for bronchiectasis, the better the chances of preventing further lung damage.
  • There is no cure for bronchiectasis; however, with proper care, most people who have it can enjoy a good quality of life.
  • Treatment includes bronchodilators to open the airways, physiotherapy to help clear the mucous and antibiotics if an infection is present.
  • See your doctor if you or your child have an ongoing, persistent wet cough that lasts for 4 weeks or more.

What is bronchiectasis?

In healthy lungs, tiny hairs called cilia work to move mucus along so that it is easily coughed out. In people with bronchiectasis, damage to the airways causes the cilia to flatten and extra mucus to collect in the airways. Bacteria grows in the mucus, causing further lung infection.

Each new infection causes more damage to the airways, making them wider, thicker and floppier. The lungs struggle to move air in and out, resulting in 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 can reduce life expectancy. 

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

What causes bronchiectasis?

Bronchiectasis is caused by damage to the airway walls. It begins most often in early childhood but can develop at any age. It affects young people more frequently than adults. Common causes include:

Smoking is not a major cause of bronchiectasis – in fact, many people with the condition have never smoked. However, because smoking is a major irritant to the lungs it will make the condition worse.

What are the symptoms of bronchiectasis?

The main symptoms of bronchiectasis are coughing up lots of mucous (phlegm) and a wet-sounding cough. The phlegm can be clear, pale yellow or yellow-greenish in colour. 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, get it checked out.

How is bronchiectasis diagnosed?

Your doctor will ask you about your symptoms, such as how often you cough, whether you bring up any phlegm and whether you smoke. They may also listen to your lungs with a stethoscope as you breathe in and out. You may need to have a chest X-ray or CT scan to assess the damage of your airways. If your doctor thinks you may have a lung infection, they may take a sample of your phlegm, so it can be checked for bacteria.

How is bronchiectasis treated?

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

Chest physiotherapy

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

Bronchodilators

Bronchodilators are medicines that help make breathing easier by relaxing your airway muscles, allowing air to flow more freely. They can be given as inhalers or by nebuliser (a machine that converts liquid medication into a fine mist). Examples of bronchodilators include ipratropium, terbutaline and salbutamol.

Antibiotics

Your doctor may prescribe a course of antibiotics if you or your child have signs of an infection. It's important to finish the course even if you feel better, as stopping the antibiotics too quickly could cause the infection to recur quickly. 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, including:

  • Quitting smoking (if you smoke) – smoking is a major irritant to your lungs it will make the condition worse.
  • Keeping yourself well hydrated – drinking plenty of fluid, especially water, helps prevent airway mucous from becoming thick and sticky. Good hydration helps keep airway mucous moist and slippery, which makes it easier to cough up.
  • Eating a balanced diet.

People with bronchiectasis are at greater risk of chest infections. You can reduce the chance of getting an infection by:

  • Having the flu vaccine every year.
  • Exercising regularly _ being physically active helps keep your chest free of infection by helping to clear the mucous. Aim to exercise at least 3 to 4 times per week. Any type of exercise that makes you take long, deep breathes is good. It’s okay if you cough during exercise.
  • Having a warm, dry home.

Bronchiectasis action plan

If you have bronchiectasis, talk to your healthcare provider about drawing up a bronchiectasis action plan for you. This is a written document designed to help you remember what you need to do to manage your bronchiectasis well.

Many of us have difficulty remembering directions or instructions that are given by our healthcare provider. A bronchiectasis action plan will provide you with instructions and information on how to recognise and handle worsening symptoms, and when, how, and who to contact in an emergency. Examples of bronchiectasis action plans include:

School and bronchiectasis

If your child has bronchiectasis, they can still enjoy active involvement in school. Teachers can make a significant difference.

  • Don't discourage coughing – it is vital to get rid of the mucous. Allow the child to leave the room for this if they want.
  • Be aware of the child's need to take medication.
  • Encourage involvement in sports. Exercise will help a child with bronchiectasis – it doesn't matter if they cough.
  • A child with bronchiectasis can attend school camps and trips.

Learn more

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

References

  1. Bronchiectasis: rates still increasing among Pacific peoples BPAC Sept, 2012
  2. Bronchiectasis Starship Clinical Guidelines 
Credits: Health Navigator Editorial Team. Last reviewed: 06 Sep 2017