What is bronchiectasis?
Bronchiectasis is a condition in which 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, which can cause infection. Bronchiectasis creates a vicious cycle: infections in airway pockets damage your airways, and when your airways are damaged, you get more infections.
Bronchiectasis is considered an obstructive lung disease. It can affect adults, children and infants. Adults usually get bronchiectasis after an infection in the lungs, for example after severe pneumonia, tuberculosis or whooping cough.
In babies and children, bronchiectasis is often the result of a congenital problem (a problem they are born with or develop during birth). The main cause of congenital bronchiectasis is cystic fibrosis. Other conditions such as immunodeficiency disorders are also linked to bronchiectasis.
Causes of bronchiectasis
Bronchiectasis can be caused by:
- an infection that damages the airways, like pneumonia or tuberculosis
- something blocking part the airways, like a piece of food stuck in the airway
- cystic fibrosis
- diseases that affect the cilia inside the airways, like ciliary dyskinesia or Kartagener’s syndrome
If you have a lung infection, it's important to get it treated right away. Early treatment means there is less chance for long-term lung damage, such as developing bronchiectasis.
Symptoms of bronchiectasis
The most common symptom of bronchiectasis is a chronic cough (a cough that doesn't go away) that is productive, meaning coughing brings up mucous or phlegm. 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
Treating bronchiectasis
It can’t be cured, but with the right treatment most people with bronchiectasis can live relatively healthy lives. The main treatments for bronchiectasis are medications and chest physical therapy. Sometimes people with advanced bronchiectasis will need surgery or a lung transplant.
Medications for bronchiectasis
If your bronchiectasis is caused by a bacterial infection, antibiotics are used to clear up the infection.
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 that swelling.
Mucus thinners thin your mucus to make it easier to cough it up, and expectorants help bring up the mucus.
Chest physical therapy
Chest physical therapy (CPT, percussion, postural drainage) is a way of loosening the mucus in your chest. People with bronchiectasis have to clear their lungs every day to get rid of germs, dust and mucus, as their lungs cannot do this on their own. This is usually done by a physiotherapist or a trained member of your family.
The therapy helps loosen the mucus, and lying with your head down helps the mucus drain away from your lungs. People with bronchiectasis often do CPT and cough up mucus three or four times a day.
People usually do chest physical therapy while sitting or lying with their heads down (postural drainage). There are different ways of doing chest physical therapy: some people use their fist to pound on their chest. Others use a device like an electric chest clapper, an inflated vest, a “flutter” machine or a positive expiratory pressure mask.
Preventing flare-ups
People with bronchiectasis can experience worsening symptoms during flare-ups. If you have bronchiectasis, you can try to stay healthy to prevent flare-ups by:
- not smoking and avoiding second-hand smoke,
- eating a balanced diet,
- getting vaccinated as recommended by your healthcare provider (flu shot, pneumococcal pneumonia shot, ensuring you're vaccinated against measles, rubella and pertussis), and
- washing your hands properly to avoid infections.
Bronchiectasis and pulmonary rehab
Your doctor may recommend pulmonary rehabilitation to help you strengthen your lungs and make breathing easier.
The Canadian Lung Association's BREATHE Better, Stay STRONG virtual pulmonary rehabilitation program is an eight-week, free program that can be done from the comfort of home. It includes progressive exercise, education and tools and resources to help you manage your condition.