Bronchiectasis

You’ve picked up a nagging cough, and you’re a little short of breath. Maybe you’re a tad 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.

That’s got you wondering.

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

What Is It?

When you breathe, air travels into your trachea -- your “windpipe” -- where it flows through a bunch of tubes that branch off into your lungs. These branches between the trachea and your lungs are the bronchi. When you have bronchiectasis, the walls of your bronchi become thickened and damaged, which makes it harder to breathe and brings flare-ups of extreme breathing difficulty (known as exacerbations) from time to time.

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

Causes

The gradual thickening of your bronchial walls is caused by inflammation and repeated infections. Both of these things help keep your mucus from draining properly. That extra mucus can catch bacteria, causing more infection, scarring, and thickening. This makes your lungs struggle more and more to work over time.

Generally, people with conditions that may damage their lungs or cause lung infections have a better chance of getting bronchiectasis. These conditions include:

  • Cystic fibrosis
  • Immunodeficiency diseases (such as HIV or AIDS)
  • Conditions that affect the cilia, the small hair-like elements that “sweep” mucus from your bronchi.

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

When to See a Doctor

Coughing and shortness of breath are common symptoms, but they aren’t the only ones. Bringing up phlegm, chills or night sweats, fatigue, even coughing up blood can be signs you have bronchiectasis. And with so much difficulty breathing, people with it can lose weight, too.

Any of these symptoms, especially if you’ve had them for a while, should nudge you toward your doctor. You’ll probably have a chest X-ray, a CT scan, or blood tests (which can flag infections). You could have a breathing test or other tests to confirm a diagnosis.

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Treatment

Because it’s a chronic condition that can get worse over time, it’s important to catch bronchiectasis early and treat it. If it’s discovered early, and if the infections are kept to a minimum, damage can be slowed down, and the condition can be easier to manage.

Antibiotics fight infections and are often the first line of attack. Another type of antibiotic, called macrolides (azithromycin and clarithromycin, for example), also can ease inflammation. You might get more medicine to thin mucus.

Some meds to help open airways or curb inflammation can be used with a machine called a nebulizer, which gives a mist with the medicine that you breathe directly into the lungs. Flu vaccinations are often recommended to keep viruses at bay.

Your doctor 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, surgery may be needed, up to a lung transplant.

Living With Bronchiectasis

You can live better with bronchiectasis if you:

  • Take medicines as prescribed.
  • Avoid lung infections and harmful fumes/gases.
  • If you smoke, stop smoking.
  • Stay hydrated to help prevent mucus from getting too thick.
  • Exercise more.
  • Improve your diet.

All of that can make your lungs healthier and ease flare-ups.

If you struggle with bronchiectasis, you’ll undoubtedly have a time when you have to deal with an exacerbation. These can include:

  • 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 stuff. But it’s manageable if you listen to your body -- and your doctor.

WebMD Medical Reference Reviewed by Louise Chang, MD on October 14, 2018

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.”

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