Bronchiectasis
What is Bronchiectasis?
Bronchiectasis is a long-term, or ‘chronic’, condition where a person’s airways become widened or inflamed. A build-up of thick mucus can occur if the airways are not able to clear themselves properly. Mucus can get stuck in tiny pockets within the airways, leading to increased risk of infection.
Who is at risk of developing Bronchiectasis?
Bronchiectasis is an uncommon condition. Most people are diagnosed in middle age and older- symptoms don’t tend to develop until later in life. For some people there is no obvious cause; this is known as Idiopathic Bronchiectasis. For others, it may be possible to identify a possible cause, sometimes many years before symptoms appeared. You can read about potential causes on the NHS Conditions website.
What are the symptoms?
The main symptom of Bronchiectasis is coughing up green or yellow mucus daily, although it can also be white and frothy. People can also experience wheezing and fatigue. Shortness of breath can occur during a flare-up, known as an ‘exacerbation’. People with Bronchiectasis can be more vulnerable to chest infections. It is important to monitor symptoms regularly, as recurrent chest infections are a symptom of Bronchiectasis. In rare cases and as a result of a complication, people may cough up a large amount of blood. This is medical emergency and help should be sought immediately by dialling 999 or going straight to your nearest accident and emergency department at a local hospital.
What if I have some of these symptoms?
If you have any of the symptoms mentioned above, speak to your GP or practice nurse as they may wish to complete some tests, or refer you to a specialist team. If you don’t have a GP, you can search for local GP services on the Service Finder web page. You may be asked to blow into a special tube (a spirometry test) to check how well your lungs are working, have a blood test, a chest scan or provide a phlegm (mucus) sample. Click here to find out more.
How is Bronchiectasis treated?
Damage to the lungs caused by bronchiectasis cannot be reversed, however, there are various treatments to stop the damage getting worse and help relieve symptoms. These include:
- Active Cycle of Breathing Techniques (ACBT)
- Exercises to help clear the airways- your GP may refer you to a respiratory physiotherapist who can teach you these techniques
- Exercise and Pulmonary Rehabilitation
- Body positions to help clear the airways (postural drainage)
- Medical devices to help widen the airways and clear mucus
- Medication to improve airflow in the lungs, such as inhalers.
- Medication to reduce phlegm thickness and make it easier to cough up, used with a nebuliser
- Antibiotics to treat bacterial infections, perhaps with longer than normal courses of antibiotics- it is important to finish the course, and some people may need long term antibiotics in either tablet or inhaled form. Your healthcare provider may ask for regular phlegm/sputum samples to target treatment better.
- Antifungals to treat fungal infections
- Antivirals to treat viral infections
- Oral steroids to treat inflammation
How does Bronchiectasis affect daily life?
Bronchiectasis affects everyone differently, depending on the underlying cause and how severe the condition is. It is known as a ‘progressive’ condition, meaning that it becomes worse over time, but it can be managed well with the right treatment and healthy lifestyle choices such as diet and exercise. Coughing and breathlessness can affect people’s quality of life, ability to complete daily tasks and remain physically active. Experiencing fatigue is a common symptom- physiotherapy and occupational therapy can help to with energy conservation and adaptations.
Experiencing breathlessness can lead to low mood, anxiety or fear. If you are feeling worried, or have low mood, information about looking after your mental health can be found on the Mental Health Foundation website. Information about how to exercise safely can be found here.
What can I do to help myself?
- If you have been given medication you should take this as prescribed by your GP or nurse. It is also important to stay up to date with vaccinations, particularly for flu, pneumonia and COVID-19.
- Learning about your symptoms will help you to identify any signs of infection if your symptoms worsen. Learning how to clear your airways will help you get rid of excess mucus.
- If you are feeling breathless, you may find breathing techniques/exercises helpful. Keeping as physically active as you can, eating well and learning how to conserve energy and plan ahead can help to manage breathlessness.
- During cold weather try to stay as warm as possible and keep your nose and mouth covered when you go out, for example with a scarf.
- If you smoke, you should try to stop and avoid inhaling other people’s smoke. Details about support to give up smoking can be found here. You can find local Stop Smoking services using the Service Finder tool.
- Regular chest clearance, or airway clearance, can be helpful.
- If you are referred for Pulmonary Rehabilitation, make sure to complete the course.
There is some more guidance on how to manage your Bronchiectasis on the British Lung Foundation website. You can find out more about living well on our Health and Wellbeing web pages.
What should I do if I feel unwell?
If you feel unwell and your breathing is affected, tell someone as soon as you can. If you have a prescription of rescue medication, take this as instructed. If your medication does not help to relieve symptoms, contact your GP or practice nurse.
24-hour NHS advice is available by dialling 111 or visiting www.111.nhs.uk. In an emergency dial 999 or go straight to your nearest accident and emergency department at a local hospital.
Resources
Bronchiectasis- ASTHMA+LUNG UK
Bronchiectasis overview- NHS website
Quit Smoking- Better Health, NHS Keeping active with a lung condition- ASTHMA+LUNG UK