Bronchiectasis is a long-term medical condition where the airways of the lungs gets abnormally widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection.
The most common sign of bronchiectasis include:
- a persistent cough that usually brings up phlegm (sputum)
The severity of symptoms can vary greatly. Some people have only a few signs that don’t appear often, while others have wide-ranging daily symptoms.
The symptoms tend to get worse if you have an infection in your lungs.
When to see your Doctor
You should see your care provider if you have a persistent cough. While this may not be caused by bronchiectasis, it needs further investigation.
If your Doctor feels you may have bronchiectasis, they’ll refer you to a specialist in treating lung conditions (a respiratory consultant) for further tests.
How the lungs are affected
The lungs are full of tiny branching airways, known as bronchi. Oxygen travels through these airways, ends up in tiny sacs known as alveoli, and from there is absorbed into the bloodstream.
The inside walls of the bronchi are coated with sticky mucus, which protects against damage from particles going down into the lungs.
In bronchiectasis, one or more of the bronchi are abnormally widened. This implies more mucus than usual gathers there, which makes the bronchi more vulnerable to infection. If an infection does start, the bronchi may be damaged again, so even more mucus gathers in them, and the risk of infection increases further.
Over time, this cycle can create gradually worsening damage to the lungs.
Why it happens
Bronchiectasis can start if the tissue and muscles that surround the bronchi are damaged or destroyed.
There are many reasons why this may occur. The three most common causes in the UK are:
- a lung infection during childhood, such as pneumonia or whooping cough, that damages the bronchi
- underlying issue with the immune system (the body’s defence against infection) that make the bronchi more vulnerable to damage from an infection
- allergic bronchopulmonary aspergillosis (ABPA) – an allergy to some type of fungi that can cause the bronchi to get inflamed if spores from the fungi are inhaled
However, in many situations of bronchiectasis, no obvious cause for the condition can be discovered (known as idiopathic bronchiectasis).
Who is affected
Bronchiectasis is seen to be uncommon. It’s estimated that around 1 in every 1,000 adults in the UK have the condition.
It can affect anyone at any age, but signs don’t usually develop until middle age.
Over 12,000 people were admitted to hospital in England during 2013-14 with bronchiectasis. The majority of these people were over 60 years old.
How bronchiectasis is treated
The damage created to the lungs by bronchiectasis is permanent, but treatment can assist relieve your symptoms and stop the damage getting worse.
The main treatments include:
- exercises and special devices to assist you clear mucus out of your lungs
- medication to help improve airflow within the lungs
- antibiotics to treat any lung infections that begins
Surgery is usually only considered for bronchiectasis in rare cases where other treatments haven’t been effective, the damage to your bronchi is confined to a small area and you’re in good general health.
Complications of bronchiectasis are rare, but they can get serious. One of the most serious complications is coughing up large amounts of blood, produced by one of the blood vessels in the lungs splitting. This issue can be life-threatening and may require emergency surgery to treat it.
. For people with very severe symptoms, however, bronchiectasis can be fatal if the lungs stop working properly.
Around 1,000 deaths reported in England and Wales each year are thought to be caused by bronchiectasis.
Information about you
If you have bronchiectasis, your clinical team may pass information about you on to the National Congenital Anomaly and Rare Diseases Registration Service (NCARDRS).
This helps scientists look for better ways to prevent and treat this condition. You can opt out of the register at any time.