Bronchiectasis

You’ve picked up a nagging cough, and you’re a little short of breath. Maybe you’re more tired than normal. You may have a little wheezing sound when you breathe, too. And pretty much every day, you’re coughing up some stuff.

You could have bronchiectasis, a disease that affects more than 110,000 people in the U.S.

What Is Bronchiectasis?

Bronchiectasis is when the walls of your bronchi, the tubes that carry air into and out of your lungs, become thickened and damaged.

This makes it harder to breathe. You could have flare-ups of extreme breathing trouble (your doctor will call them exacerbations) from time to time.

Bronchiectasis is a chronic disease that gets worse over time. It’s not curable, but you can live with it for a long time. There’ll be times when breathing is pretty easy and times with exacerbations, when catching your breath can be a chore.

Bronchiectasis Symptoms

Coughing and shortness of breath are common symptoms of bronchiectasis. Others include:

  • Coughing up phlegm
  • Chills or night sweats
  • Coughing up blood
  • Fatigue
  • Wheezing or a whistling sound when you breathe

Because it can be so hard to breathe, people who have it might also lose weight.

Bronchiectasis Causes

Your bronchial walls gradually get thicker because of inflammation and infections that keep coming back. Both of these things prevent mucus from draining like it should. That extra mucus can trap bacteria, causing more infections, scarring, and thickening. This makes your lungs struggle to work over time.

Acid reflux into your lungs, like with gastroesophageal reflux disease (GERD), may also damage them.

Bronchiectasis Risk Factors

Typically, younger people don’t get bronchiectasis. Fewer than 1 in 20,000 people ages 18 to 34 have it. But that goes up to about 1 in every 350 people for those 75 or older.

Two-thirds of bronchiectasis cases are in women. But it’s more common in young boys than in girls.

You’re also at higher risk if you have one of these conditions:

  •  Allergic bronchopulmonary aspergillosis, a type of lung inflammation
  • Alpha-1-antitrypsin deficiency, a condition that raises your risk of lung and liver disease
  • Cystic fibrosis, a genetic disease that damages your lungs, digestive system, and other organs
  • Conditions that affect the cilia, small hair-like growths that “sweep” mucus from your bronchi
  • Immunodeficiency diseases (such as HIV or AIDS)
  • Inflammatory bowel diseases, like Crohn’s disease and ulcerative colitis
  • Low levels of proteins that fight infections in your blood (humoral immunodeficiency)
  • Rheumatic diseases, like rheumatoid arthritis and Sjogren’s syndrome

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Bronchiectasis Diagnosis

If you have symptoms, especially if you’ve had them for a while, you should see your doctor. You’ll probably get a chest X-ray, a CT scan, and blood tests (which can flag infections). Your doctor might also give you a breathing test or other tests to confirm a diagnosis.

Bronchiectasis Treatment

Because this chronic condition gets worse over time, it’s important to catch bronchiectasis early and treat it. That will prevent infections, slow damage, and make the condition easier to manage.

Antibiotics to fight infections are often the first line of attack. One type of antibiotic, called macrolides (azithromycin and clarithromycin), also eases inflammation. You doctor may also prescribe medicine to thin mucus.

Your doctor may use a machine called a nebulizer to give you drugs that open your airways and curb inflammation. It turns the medicine into a mist that you breathe directly into your lungs. The doctor will probably suggest that you get flu and pneumonia vaccinations to keep certain infections at bay.

They may also suggest oxygen therapy or methods and devices to shake mucus free. This can include physically pounding on your chest (known as chest physical therapy -- CPT -- or chest clapping or percussion) to clear your bronchi and lungs.

In some cases, you might need surgery, even a lung transplant.

Living With Bronchiectasis

You can live better with bronchiectasis if you take steps to make your lungs healthier and ease flare-ups:

  • Take medicines as your doctor prescribes them.
  • Avoid lung infections and harmful fumes and gases.
  • If you smoke, stop smoking.
  • Drink plenty of fluids to help prevent mucus from getting too thick.
  • Exercise.
  • Improve your diet.

With bronchiectasis, at some point, you’ll have to deal with an exacerbation or worsening of your condition. You may have:

  • More phlegm
  • Different color of phlegm
  • Blood in your phlegm
  • Nagging cough
  • Stronger cough
  • Tougher breathing
  • Heavy fatigue
  • Chest pain

It’s important to talk with your doctor, who may prescribe medicines or other therapies that can open up your airways.

Bronchiectasis is serious. But it’s manageable if you listen to your body -- and your doctor.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on September 25, 2019

Sources

SOURCES:

American College of Chest Physicians; CHEST Foundation: “Bronchiectasis.”

National Heart, Lung, and Blood Institute. “How the Lungs Work.”

American Lung Association. “Bronchiectasis.”

National Heart, Lung, and Blood Institute. “Bronchiectasis.”

The University of Chicago Medical Center. “Bronchiectasis.”

American Thoracic Society. “What is Bronchiectasis?” “Treating Bronchiectasis.”

The BMJ: “Treatment of bronchiectasis in adults.”

American Journal of Respiratory and Critical Care Medicine: “Non-Cystic Fibrosis Bronchiectasis.”

International Journal of Chronic Obstructive Pulmonary Disease: “Effects of long-term bronchodilators in bronchiectasis patients with airflow limitation based on bronchodilator response at baseline.”

Alpha-1 Foundation: “What is Alpha-1?”

Mayo Clinic: “Cystic fibrosis.”

UpToDate: “Treatment of Bronchiectasis in Adults,” “Acid Reflux (Gastroesophageal Reflux Disease) in Adults.”

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