Pulmonary Conditions & Diseases: Bronchiectasis

Bronchiectasis is a chronic lung condition in which the airways in the lungs (bronchi) are enlarged, thickened and inflamed, causing increased mucus production. Because the airways are enlarged and inflamed, it is harder for the lungs to clear the mucus, leading to mucus collecting within the airways, which increases the risk of lung infections. Recurrent infections in bronchiectasis can also, in turn, make the condition worse. There are multiple causes of bronchiectasis, including infections, conditions present at birth (congenital), obstruction in the airways and aspiration.

What are the signs and symptoms?

Common symptoms of this condition are:

• A daily or persistent productive cough ( a cough that brings up mucus) for more than 3 weeks
• Shortness of breath or wheezing
• Frequent lung infections
• Fatigue or weakness
• Chronic sinusitis (a condition with pain in the cheeks, forehead, stuffy nose, nasal congestion, yellow/green mucus)
• Coughing up blood (hemoptysis)
• Chest pain (pleurisy)

What are the risk factors and triggers?

There are several different causes of bronchiectasis. Some are conditions you are born with (congenital), and others are acquired (developed later in life).

• Cystic Fibrosis (CF)
• Lung infections such as tuberculosis or recurrent pneumonia
• Objects or blockages in the lungs (obstruction)
• Breathing in food, liquids or other materials into the lungs (aspiration)
• Immune system and lung structure problems present at birth

How is it diagnosed?

Diagnosis of the condition requires testing, such as:

• Imaging: Chest X-rays or CT scans that look for dilated, damaged airways in the lungs
• Labs: Blood tests can look for causes or related diseases to bronchiectasis if not already known
• Breathing Tests (pulmonary function tests): Check how well your lungs are working
• Sputum Culture (a sample of the mucus you cough up) to look for infections.

What is the treatment?

Treatment for bronchiectasis depends on the severity of the illness as well as its cause. Some treatments may include:

• Medications to loosen up mucus (expectorants) so you can cough it up more easily
• Airway clearance therapy (chest physiotherapy): Loosens mucus so it may be coughed up more easily, with examples being percussion therapy – tapping the chest or back with a cupped hand, and chest vibration- a hand or special equipment such as a vest vibrates the chest and back
• Antibiotics to prevent or treat lung infections
• Surgery to remove an affected part of the lung is usually done in severe cases or with recurrent infections. Lung transplants (removing damaged lungs and replacing them with healthy lungs) may also be performed in patients with severe cases who meet certain conditions
• Smoking cessation is very important if you are found to have bronchiectasis, as cigarettes can further damage the lungs and lead to frequent lung infections

Our Piedmont Pulmonary Critical Care and Sleep Medicine board-certified pulmonologist will work directly with you to help you understand the condition and provide evidence-based, high-quality care that is both individualized and comprehensive.