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Bronchiectasis

When you have bronchiectasis, your airways (bronchial tubes) are damaged.

Bronchiectasis damages the tiny hairs (cilia) that line the inside of your airways. Damaged cilia can’t do their job of sweeping dirt and mucus out of your lungs. With bronchiectasis, your airways widen and stretch out. In some places the airways are so stretched out they form little pockets. Germs, dust and mucus collect in these pockets and get stuck.

After a while the germs, dust and mucus that are stuck in your airways get infected. Your tiny hairs (cilia) can’t sweep them away, so the infections keep coming back. Bronchiectasis creates a vicious cycle; infections in airway pockets damage your airways, and when your airways are damaged, you get more infections.

Bronchiectasis can’t be cured, but with the right treatment, most people with bronchiectasis can live relatively normal lives.

Bronchiectasis can be caused by many things:

  • infections that damage the airways (pneumoniatuberculosis )
  • something blocking off part the airways, for example, a piece of food stuck in the airway
  • cystic fibrosis
  • diseases that affects the tiny hairs (cilia) inside the airways, for example primary ciliary dyskinesia, Kartagener’s syndrome

Prevention:


Some cases of bronchiectasis can’t be prevented; other cases CAN be prevented by getting treatment for lung infections right away. Getting help right away means there is less chance for long-term lung damage.

Get vaccinated: to avoid getting some childhood infections. You should get all of your childhood vaccines and get your flu shot every year.

Make sure you manage your lung disease. Call our lung health information helpline ( 1-888-344-LUNG) and make sure you are managing your disease properly.

Symptoms:


The most common symptom of bronchiectasis is a cough that’s chronic (it doesn’t go away) and productive (it brings up phlegm/mucus). Bronchiectasis causes people to cough up large amounts of mucus. The mucus is sometimes yellow or green and it sometimes smells bad.
Other symptoms of bronchiectasis include:

  • feeling short of breath
  • chest pain
  • wheezing
  • coughing up blood
  • fever
  • weakness
  • weight loss without trying

Treatment:


Having bronchiectasis makes it hard for your lung’s natural cleaning system to clear out germs, dust and mucus. People with bronchiectasis have to clear their lungs every day to get rid of germs, dust and mucus.

Clearing your lungs helps prevent infections.

The main treatments for bronchiectasis are medications and chest physical therapy. This is usually done by a physiotherapist or a trained member of your family.

If your bronchiectasis is caused by an underlying disease or infection, your doctor will treat that too. Sometimes people with advanced bronchiectasis will need surgery or a lung transplant.

Medications:


Antibiotics are used if infection is the main cause of your bronchiectasis. Bronchodilators: relax your airway muscles. Corticosteroids may be given if you have bronchiectasis that is caused by swelling in your airway. Corticosteroids work slowly to reduce the swelling in your airways.

Mucus thinners: thin your mucus to make it easier to cough it up.
Expectorants: help bring up the mucus.
Chest physical therapy (CPT, percussion, postural drainage) for bronchiectasis

Chest physical therapy is a way of loosening the mucus in your chest. People usually do chest physical therapy while sitting or lying with their heads down (postural drainage). The therapy helps loosen the mucus, and lying with your head down helps the mucus drain away from your lungs.

After you’ve loosened the mucus, it’s easier to cough it up. People with bronchiectasis often do CPT and cough up mucus three or four times a day. There are different ways of doing chest physical therapy:

  • some people use their fist to pound on their chest
  • other people use a device, for example: an electric chest clapper, an inflated vest, a “flutter” machine or a positive expiratory pressure mask

There are also breathing exercises that help loosen mucus.
For more information on bronchiectasis treatment and breathing exercises, please see this page from the U.S. National Heart Lung and Blood Institute.

Staying healthy when you have bronchiectasis

People with bronchiectasis can get flare-ups, times when their symptoms are worse. If you have bronchiectasis, stay as healthy as possible by:

  • not smoking and avoiding second-hand smoke
  • eating a balanced diet
  • getting the flu shot every year
  • getting the pneumococcal pneumonia shot every few years (ask your doctor)
  • making sure you’ve gotten shots against measles, rubella and pertussis
  • fighting germs by washing your hands properly
  • getting help right away if you are having a flare-up