Bronchiectasis

Bronchiectasis is a long-term chest (lung) condition, in which one or more sections of the airways become damaged and inflamed, causing them to become wider than normal.  Extra mucus is produced, which becomes difficult to clear so it collects in the widened parts of the airways.

This build up of mucus in the airways can become infected by bacteria. Bacterial infection causes further inflammation and damage to the airways and this can cause even more mucus to build up. This creates a 'vicious cycle' of infection, inflammation and damage.

Good control early on is really important to break the cycle and prevent further damage.

Process of damage to airways

Process of damage to airways

Causes of bronchiectasis

In bronchiectasis the damage to the airways is most often caused by a severe lung infection, usually during childhood or as a young adult.

Other causes can include:

  • Obstruction or blockage in the airways: an inhaled object (such as a peanut) or a tumour
  • Acid from the stomach (acid reflux) which comes back up from the stomach and is breathed in
  • Conditions that affect the immune system making you more susceptible to infection and subsequent damage
  • Conditions that cause inflammation in other parts of the body such as rheumatoid arthritis or Crohn's disease can also cause inflammation in the lungs
  • Some inherited conditions such as cystic fibrosis
  • Ciliary defects such as primary ciliary dyskinesia or yellow nail syndrome (rare)
  • An allergic reaction to a fungus such as aspergillus. This is often seen in people who also have asthma

In about half of all people with bronchiectasis the cause of the damage cannot be found.

Symptoms of bronchiectasis

The main symptoms are coughing up sputum (phlegm) and repeated chest infections. Other symptoms include:

  • Tiredness
  • Breathlessness, especially when exercising
  • Wheezing
  • Coughing up blood
  • Joint pain and chest pain

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'.

What does an exacerbation mean?

Sometimes you may notice your symptoms getting worse over a couple of days. This is often referred to as a flare-up or an exacerbation and is usually due to a chest infection. It is important that a chest infection is treated as quickly as possible to prevent further damage to your airways.

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

  • Increased coughing
  • Increased breathlessness
  • Generally feeling unwell
  • Fever, aches and pains
  • Increased tiredness and lethargy
  • Change in sputum colour to dark green
  • Increase in amount or the thickness of sputum you are producing
  • Blood in your sputum
Find out more about bronchiectasis in the CHSS booklet Living with Bronchiectasis (PDF) and the factsheet Common questions about bronchiectasis (PDF).