Bronchiectasis

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Introduction

What is bronchiectasis?

Bronchiectasis is a respiratory disease that affects the elastic properties of the bronchial tubes, the main airways of the lungs. Bronchiectasis results in severe congestion, chronic cough, a decreased ability to effectively expel sputum (mucus from the lower airways), and shortness of breath.

Bronchiectasis is a relatively uncommon respiratory disorder in the United States. Approximately 110,000 people in the United States have bronchiectasis. Bronchiectasis is more common in women than men. However, in children, bronchiectasis is more common in boys than girls (Source: NHLBI).

Cystic fibrosis is the most common cause of bronchiectasis, and it accounts for half of all cases. Immune disorders, such as human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), can also play a role in the development of bronchiectasis. Less common genetic causes of bronchiectasis are ciliary dyskinesia (rare condition affecting the tiny structures that move mucus out of the airways) and allergic bronchopulmonary aspergillosis (exaggerated immune response to the fungus Aspergillus).

Symptoms of bronchiectasis often take months or years to develop and worsen over time. Treatments for bronchiectasis include antibiotics, bronchodilators, expectorants, and chest physical therapy. Healthy lifestyle practices can reduce the risk of bronchiectasis or improve symptoms, including good hand washing, drinking plenty of fluids, eating a well-balanced diet, getting plenty of rest, and refraining from smoking.

Bronchiectasis symptoms can be associated with a serious or life-threatening condition. Seek immediate medical care (call 911) for severe difficulty breathing, which may be accompanied by pale or blue lips, rapid heart rate (tachycardia), sweating, and anxiety.

Seek prompt medical care if you are being treated for bronchiectasis but mild symptoms recur or are persistent.

Symptoms

What are the symptoms of bronchiectasis?

Bronchiectasis causes bronchial airway damage and chronic congestion, as well as a number of other symptoms. The symptoms can vary in intensity among individuals.

Common symptoms of bronchiectasis

You may experience bronchiectasis symptoms daily or just once in a while. At times, any of these bronchiectasis symptoms can be severe:

Serious symptoms that might indicate a life-threatening condition

In some cases, bronchiectasis can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Bluish coloration of the lips or fingernails
  • Change in level of consciousness or alertness, such as passing out or unresponsiveness
  • Rapid heart rate (tachycardia)
  • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking
Causes

What causes bronchiectasis?

Bronchiectasis is caused by damage to the lining of the main airways of the lungs (bronchi), usually the result of a pre-existing infection. The walls of the bronchi lose the capability to allow you to effectively cough up sputum, or mucus, leading to further congestion and damage. Cystic fibrosis is a common cause of bronchiectasis, but immune disorders, such as HIV/AIDS, can also play a role in the development of bronchiectasis.

What are the risk factors for bronchiectasis?

A number of factors increase the risk of developing bronchiectasis. Not all people with risk factors will get bronchiectasis. Risk factors for bronchiectasis include:

  • Allergic bronchopulmonary aspergillosis (exaggerated immune response to the fungus Aspergillus)
  • Ciliary dyskinesia (rare condition affecting the tiny structures that move mucus out of the airways)
  • Cystic fibrosis
  • HIV/AIDS
  • Immune system disorders
  • Immunodeficiency

Reducing your risk of bronchiectasis

You may be able to lower your risk of bronchiectasis by:

  • Getting childhood vaccines against measles and whooping cough
  • Getting pneumococcal and annual flu vaccines
  • Practicing good hygiene to prevent the spread of infection
  • Refraining from smoking and avoiding secondhand smoke
  • Taking medicine as prescribed, even if you do not have symptoms
Treatments

How is bronchiectasis treated?

Treatment for bronchiectasis begins with seeking medical care from your health care provider. The goal of treatment is to help clear congestion and decrease infection. In severe cases that do not respond to therapy or that are accompanied by severe bleeding, your health care provider may recommend surgical resection of the affected air passages.

Medications for the treatment of bronchiectasis

Different types of medications may be used to treat bronchiectasis. Examples include:

  • Antibiotics to treat infections

  • Bronchodilators (administered by a nebulizer or metered dose inhaler) to improve airway patency

  • Expectorants to relieve congestion

Respiratory therapy for the treatment of bronchiectasis

Respiratory therapy may be used to treat bronchiectasis. Examples include:

  • Breathing techniques, such as forced expiration technique and active cycle breathing, to help move fluid in the lungs

  • Chest physical therapy (CPT) to loosen mucus in the lungs

  • Coughing techniques to help move fluid in the lungs

  • Hydration to keep mucus thin

  • Oxygen therapy to increase blood oxygen levels, if they are low

  • Postural drainage, or lying in a position with your head down, to help drain fluid from the lungs

  • Using an incentive spirometer (medical device) to improve lung function

What are the potential complications of bronchiectasis?

Complications of untreated or poorly controlled bronchiectasis can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of bronchiectasis include:

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Dec 29
  1. Bronchiectasis. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001199/
  2. What is bronchiectasis? National Heart, Lung, and Blood Institute Diseases and Conditions Index. http://www.nhlbi.nih.gov/health/dci/Diseases/brn/brn_whatis.html
  3. Barker AF. Bronchiectasis. N Engl J Med 2002; 346:1383.
  4. Collins RD. Differential Diagnosis in Primary Care, 5th ed. Philadelphia: Lippincott, Williams & Williams, 2012.
  5. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy. Philadelphia: Saunders, 2013.
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