Bronchiectasis

Bronchiectasis is a condition in which the airways in your lungs are damaged.

In people with bronchiectasis, inflammation damages the airways. The airways become widened and thickened, and they make extra mucus. Mucus can then build-up in your airways, leading to repeated chest infections.

Bronchiectasis can affect one area of a lung, or both of your lungs. It can affect people of all ages.

The most common symptom of bronchiectasis is an ongoing (chronic) cough. The cough is usually productive, or 'wet'. This means you cough up sputum (mucus) from your airways.

Other symptoms may include:

• fatigue (tiredness)
• shortness of breath or wheezing
• chest pain
• sinusitis
• coughing up blood or blood-stained sputum

Recurrent chest infections are common in people with bronchiectasis.

There are many causes of bronchiectasis. An infection in childhood, such as pneumonia, is a common cause.

Examples of other infections that can lead to bronchiectasis include:

• childhood infection with whooping cough, influenza (flu) or measles
• severe pneumonia
• COVID-19 infection

Other causes of bronchiectasis can include:

• cystic fibrosis — a genetic condition that can cause thick, sticky mucus to build up in your lungs
• chronic obstructive pulmonary disease (COPD) or asthma
• autoimmune disorders such as rheumatoid arthritis, Sjögren's syndrome and inflammatory bowel disease
• allergic bronchopulmonary aspergillosis (ABPA) — an allergic reaction to a fungus called aspergillus
• problems with your immune system

Sometimes, an obvious cause can't be found.

Your doctor will ask you about your symptoms and your overall health. They may examine you, including listening to your breathing with a stethoscope.

You may need imaging tests, such as a:

• chest x-ray
• high resolution CT scan— this is the best test for diagnosing bronchiectasis

Other tests may include:

• sputum tests
• blood tests
• breathing tests (lung function tests) to check how well your lungs are working

Your doctor may refer you to a specialist for further tests and treatment.

Bronchiectasis may be reversible in children and teenagers who have early treatment. There is currently no cure for bronchiectasis in adults, but there are treatments available.

Treatment for bronchiectasis generally aims to:

• treat infections and reduce flare-ups
• relieve your symptoms
• improve your quality of life
• prevent further lung damage

People with bronchiectasis should have a self-management plan. This outlines your usual treatment and what to do if your symptoms get worse.

Lifestyle and general measures

If you smoke, try to quit. You can call Quitline on 13 7848 for help to stop smoking.

Your doctor may refer you to a dietitian to make sure you are getting the right amount of nutrients from your diet. Regular exercise is also important — talk to your doctor about what types of exercise are best for you.

You should get vaccinated against influenza and pneumococcal disease. This helps to reduce your risk of serious infections.

Medicines

Medicines for bronchiectasis may include:

• antibiotics to treat flare-ups
• long-term antibiotics to treat ongoing infections and prevent flare-ups in some cases
• medicines to help loosen mucus and make it easier to cough up

Physiotherapy

A physiotherapist may prescribe a daily program to help clear your airways of sputum. This may include:

• physical exercises
• breathing exercises
• coughing exercises
• moving into positions that make it easier to drain sputum

Surgery

Rarely, surgery is needed to remove a badly damaged section of your lung.

A lung transplant may be considered in people who have severe disease that is not improving with other treatments.

Complications can include severe breathing difficulties and heart disease.

People with bronchiectasis are also at increased risk of anxiety and depression. Talk to your doctor about treatment and support for these conditions.

It's important to get vaccinated against conditions that can cause airway and lung infections and inflammation. These include:

• measles
• whooping cough
• pneumococcal disease
• influenza

It's also important to quit smoking and avoid passive smoking and vaping.

For more information on bronchiectasis, or if you need support, visit the Lung Foundation Australia. You can also call them on 1800 654 301.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.