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Bronchiectasis

What is Bronchiectasis?

Bronchiectasis is a long-term chest condition, in which sections of the airways become damaged and inflamed, causing them to become wider than normal. Extra mucus (the thick fluid that keeps your airways moist) is produced and collects in the widened parts of the airways.

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

Early management and treatment of bronchiectasis is really important to help break the cycle and prevent further damage.

Causes of bronchiectasis

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

Other causes include:

  • An obstruction or blockage in the airways such as a tumour or an inhaled object (e.g. a peanut).
  • Acid which comes back up from the stomach (acid reflux) and is breathed into the lungs.
  • 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 also causing inflammation in the lungs.
  • Some inherited conditions such as cystic fibrosis.
  • Ciliary defects (problems with the fine hairs that line your airways) 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 is unknown.

Symptoms of bronchiectasis

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

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

Your 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

65-year-old Agnes was diagnosed with bronchiectasis when she was just 22

“When I was younger, I used to get chest infections all the time. I tried to manage it with antibiotics but as I’ve got older the infection got more of a problem.

“I have to clear the phlegm from my lungs every day. If it builds up, it gets infected and I have to contact the doctor straight away and get to hospital.

“It can sometimes feel frustrating and it’s like having a rattling feeling in my chest. I can feel out of breath or breathless sometimes when it gets bad and that’s hard.”

Agnes has also been part of our Cheerful Chesters peer support group for six years.

“We do exercises and then always have a good chat afterwards and a cup of tea. The others are like me and have a chest condition, so we understand each other and what we’re all going through.”

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Life following a bronchiectasis diagnosis

The symptoms and diagnosis of bronchiectasis can mean making changes to your life that may be upsetting or frustrating. It can mean that you can’t do some of the things that you once loved doing.

It’s important at this time to look after yourself as much as you can. This means eating well, staying hydrated, exercising within your own limits, and letting yourself rest when you need to.

If you’re struggling to cope with the mental weight, help is available to you. Speak to your loved ones, remember that they want to help. Stay in touch with your care provider or GP too as they can help you manage and control your condition.

Call our Advice Line for free on 0808 801 0899 or text NURSE to 66777 if you’d like information on support groups, bronchiectasis or even just a trained listening ear. We’re here to support you and help you to build a life worth looking forward to.

Visit our Living with a Chest Condition section for more information about how to manage your condition at home, how to stay well and reduce your risk of developing further chest conditions.

This page was last updated on May 6, 2022 and is under regular review. If you feel anything is missing or incorrect, please contact health.information@chss.org.uk to provide feedback.

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