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You are in: Home > Chest Information > Chest Conditions > Bronchiectasis >

Bronchiectasis

• What is bronchiectasis?
• Process of damage to airways
• Causes of bronchiectasis
• Symptoms of bronchiectasis
• What does an exacerbation mean?

What is bronchiectasis?

Bronchiectasis is a long–term condition which affects the lungs. It is defined by inflamed, permanently and irreversibly damaged airways. Common symptoms of bronchiectasis include a chronic cough, coughing up sputum (phlegm), recurrent respiratory tract (chest) infections, fatigue and breathlessness.

In bronchiectasis two things happen:

• Damage to an airway – making it unable to clear mucus
• Infection of the mucus in the blocked airway

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Process of damage to airways

• In bronchiectasis parts of some airways become damaged and widen.
• The areas are permanently / irreversibly damaged by inflammation and produce excessive mucus.
• The airways lose some or all of their ability to clear mucus. Mucus gathers in the damaged airways, creating an environment where bacteria can grow. This can lead to repeated chest infections and as a result the airways become scarred and more inflamed and produce even more mucus.

Sometimes the airway becomes blocked or 'plugged', affecting airflow. Surrounding lung tissues and airways can also become affected. The damage to the airways can be thought of as a 'vicious circle'. In order to manage bronchiectasis the circle has to be broken.

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Causes of bronchiectasis

In bronchiectasis the damage to the airways is usually caused by infection such as:

• Previous pneumonia
• Whooping cough
• Measles
• Tuberculosis (TB)

Other causes can include:

• Obstruction or blockage in the airways: this can be due to a growth / tumour or something that has been inhaled, e.g. a peanut
• Autoimmune diseases (e.g. rheumatoid arthritis (RA), systemic lupus erythematosus (SLE))
• Inflammatory bowel disease (e.g. crohn's disease, ulcerative colitis)
• Cystic fibrosis
• Disorders that affect the function of the cilia
• Immune deficiencies
• Chronic asthma
• Alpha 1 / antitrypsin deficiency
• Allergic bronchopulmonary aspergillosis (ABPA): this is an allergic reaction to a fungus called aspergillus (usually in people with asthma or cystic fibrosis)

In about 50% of people with bronchiectasis no cause is identified.

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Symptoms of bronchiectasis

Common symptoms include:

• Chronic productive cough
• Coughing up sputum: this can vary in colour and quantity
• Recurrent chest infections: this is due to bacteria growing in the damaged airways
• Fatigue: this is often a result of coughing frequently during day and / or night as well as fighting off infections
• Breathlessness / wheezing: this is due to the inflammation / blockage of the airways

Symptoms may vary from day to day and will depend on the severity of your disease. It is likely that you will have 'good' periods (when you feel well) and periods when your condition deteriorates and your symptoms increase. This is known as an 'exacerbation'.

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What does an exacerbation mean?

It is important that you, and your medical team, learn about what symptoms are 'normal' for you and how to recognise if things are getting worse.

An exacerbation is when your condition deteriorates and your symptoms increase. When this happens you need to access medical advice as soon as possible as you may need antibiotics and / or further treatment.

Contact your GP as soon as possible if you notice any of the following changes:

• Increased coughing
• Increased amount / consistency of sputum
• Darker colour sputum
• Fever or chills
• Aches and pains
• Breathlessness
• Blood in sputum (haemoptysis)

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