Bronchiectasis

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What is bronchiectasis?

Bronchiectasis is a long-term condition in which the airways of the lungs become damaged, scarred and permanently widened. This damage cannot be reversed.

Mucus collects in the widened airways, which leads to repeated chest infections and ongoing inflammation.

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Who gets it?

Bronchiectasis can affect people of any age, but it is more common in women and in older people.

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What causes it?

Often no single cause is found. Lung infections that damage the airways, especially in childhood, are thought to be an important cause. Recognised risk factors include:

Past infections such as pneumonia, whooping cough, measles, tuberculosis or fungal infections
Problems with the airways' natural clearing system, such as primary ciliary dyskinesia, Kartagener's syndrome or Young's syndrome
An airway blocked by an inhaled object, a narrowing, a tumour or enlarged lymph nodes
Immune and inflammatory conditions, including low antibody levels, HIV, allergic bronchopulmonary aspergillosis (ABPA), inflammatory bowel disease, rheumatoid arthritis and Sjögren's syndrome
Inherited conditions such as cystic fibrosis and alpha-1 antitrypsin deficiency
Repeatedly breathing in stomach contents, or damage from inhaled fumes
Malnutrition, poverty and air pollution

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What are the symptoms?

Symptoms build up over time and vary from person to person.

A long-lasting cough that brings up large amounts of sputum, often worse in the morning
Repeated chest infections or pneumonia, with fever, tiredness and more cough and sputum
Coughing up blood, usually together with infected sputum
Weight loss, poor appetite and a low-grade fever
Poor growth in children

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How is it diagnosed?

The most reliable test is a high-resolution CT (HRCT) scan of the chest. Your doctor may also arrange:

A chest X-ray
Blood tests (full blood count, CRP and ESR)
Breathing tests (spirometry) and a six-minute walk test
Sputum tests for bacteria and tuberculosis
Bronchoscopy
Tests of the immune system

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How is it treated?

Treatment aims to control symptoms, prevent flare-ups and protect the lungs from further damage. It may include:

Prompt treatment of emergencies and flare-ups
Chest physiotherapy to clear mucus from the airways
Antibiotics when needed
Pulmonary rehabilitation: supervised exercise and education

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Living with bronchiectasis: what to do

Small daily habits make a big difference to how well you feel.

Clear your chest every day, as your physiotherapist showed you
Take your medicines exactly as prescribed
Drink plenty of fluids and eat a healthy, balanced diet
Exercise gently and regularly, for example walking, swimming or cycling, as your doctor advises
Notice how much sputum you produce and its colour, and seek advice if it changes
Have the flu vaccine every year and the pneumococcal vaccine as your doctor recommends
Wash your hands often and wear a mask in crowded places

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Living with bronchiectasis: what to avoid

Protect your lungs from anything that could trigger an infection or flare-up.

Letting your medicines run out
Smoking, or being around people who smoke
Close contact with anyone who has a cold, flu or chest infection
Heavily polluted places

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Where to get care

Specialist care for bronchiectasis is available free of charge at government hospitals and at district chest clinics across Sri Lanka.

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