Bronchiectasis is a chronic lung disease in which the airways or bronchi become permanently widened and scarred. It can cause a persistent cough, production of large amounts of mucus (phlegm or phlegm) each day, and shortness of breath. As the damage progresses, the airways lose their ability to clear mucus, allowing bacteria to grow and multiply. This can lead to repeated infections and lung inflammation, worsening bronchiectasis and creating a cycle of illness. There is no cure for bronchiectasis, but it requires ongoing management with medical therapy. e60dc2a1-f33c-4a05-9b50-8e3e8e5976291301f1a4-8208-49fc-984f-c4804863eaad Types of Bronchiectasis Bronchiectasis is usually classified based on the extent and location of the damage to the lungs. The types of bronchiectasis are: e60dc2a1-f33c-4a05-9b50-8e3e8e597629365bacb4-a21a-4e13-8804-91ffc87bcb8a Cylindrical or tubular The airways are widened, but most retain their original shape. This is the mildest and most common type of bronchiectasis. Varicose veins The airways appear to be stretched irregularly. Cystic Large cyst-like sacs filled with mucus develop in the airways. This is the most severe type of bronchiectasis. Bronchiectasis can also be focal, affecting one or two areas of the lungs, or diffuse, affecting multiple areas. In some cases, bronchiectasis is caused by other lung diseases. For example, fibrotic lung diseases, such as interstitial lung disease, cause swelling that pulls on the bronchi, causing bronchiectasis. Bronchiectasis Symptoms Bronchiectasis symptoms usually develop over many years after a respiratory infection and gradually worsen. For the past few months or yearse60dc2a1-f33c-4a05-9b50-8e3e8e59762930a2d404-1437-41e7-b053-4fd2d505995e A lot of phlegm (saliva mixed with mucus) is secreted every day, often coughing Shortness of breath Frequent recurring chest infections or worsening cold symptoms Cough or coughing up blood Fever Chest pain Wheezing Fatigue Nail club where the skin and tissues thicken and the nails curve downward e60dc2a1-f33c-4a05-9b50-8e3e8e5976294c0d441e-1123-4828-9673-8a1be43a8f00 Bad breath Pale Skin60dc2a1-f33c-4a05-9b50-8e3e8e597629111f693d-3f44-4862-8a9e-e84df59cda7d Bronchiectasis Causes and Risk Factors Causes Bronchiectasis is the result of a cycle of airway damage, inflammation, mucus buildup, and lung infection. Irreversible changes in the lungs. Damage to the airways and the buildup of bacteria in the lungs can lead to inflammation and infection, which further widens the airways. e60dc2a1-f33c-4a05-9b50-8e3e8e597629d88e2431-342c-4135-af9c-da5b8dc0a19b This cycle of lung damage can be caused by a variety of factors, including genetic disorders. infectious diseases and environmental pollutants, etc. In approximately 40% of cases, the initial cause of bronchiectasis is unknown. Includes e60dc2a1-f33c-4a05-9b50-8e3e8e597629d88e2431-342c-4135-af9c-da5b8dc0a19b and below. Rare: e60dc2a1-f33c-4a05-9b50-8e3e8e597629bc46088b-b2c8-48aa-9a1e-7c5d4ea8f8b6 Severe or recurrent respiratory infections Cystic fibrosis, primary ciliary dyskinesia, alpha-1 Genetic diseases that can affect the lungs, such as antitrypsin deficiency e60dc2a1-f33c-4a05-9b50-8e3e8e5976295706968b-a238-431c-bac9-e33 Cancer leukemiae60dc2a1-f33c-4a05-9b50-8e3e8e5976295706968b-a238-431c-bac9-e3377d1cb973 such as 77d1cb973 Conditions or drugs that weaken the immune system, such as HIV or drugs used after organ transplants Autoimmune or inflammatory diseases such as rheumatoid arthritis, Sjögren’s syndrome, inflammatory bowel disease, and lupus Chronic pulmonary aspiration, inhalation of inflammatory substances such as food particles and digestive fluids airway se60dc2a1-f33c-4a05-9b50-8e3e8e597629d88e2431-342c-4135-af9c-da5b8dc0a19b Airway obstruction due to tumor or foreign body e60dc2a1-f33c-4a05-9b50-8e3e8e597629cb962969-c0f3-40ba-8526-58628995d8a3 Allergic bronchopulmonary aspergillosis, allergic fungal reaction Environmental exposures including inhalation of smoke and toxins Infection caused by tuberculosis Severe or recurrent lung infections, or other mycobacteria Lung diseases such as chronic obstructive pulmonary disease (COPD) or asthma How is bronchiectasis diagnosed? Diagnosis Diagnosis of bronchiectasis begins with a thorough examination of symptoms, medical history, and family history. Your health care provider may perform many other tests to help with diagnosis and check for infections, underlying conditions, and immune system function. These include: e60dc2a1-f33c-4a05-9b50-8e3e8e5976291ff99580-73ec-4b44-9f72-6f43f19a3eed A chest X-ray or computed tomography (CT) scan images the lungs to identify dilation or structural changes in the airways. Sputum cultures are used to identify bacteria and fungi in the body. Airways Pulmonary function tests to assess airflow and vital capacity Blood tests to check for infections (including HIV) and assess immune function Bronchoscopy, a procedure that uses a bronchoscope (a long, flexible tube with a light and camera at the end) to closely view the airways and remove blockages Specific test conditions for various immune system and autoimmune diseases e60dc2a1-f33c-4a05-9b50-8e3e8e5976293047b502-af2f-4ac8-87a7-8bdb0fee6657 Bronchiectasis Treatment and Medication Options Treatment Bronchiectasis can be treated, but not cured. The main goal of bronchiectasis treatment is to keep the airways clean, thereby reducing the risk of infections that can lead to lung deterioration. Damage.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292f2f494e-7d8a-4555-a7af-048a10b5 63efe60dc2a1-f33c-4a05-9b50-8e3e8e597629fa887242-cda2-425e-8199-3cf0bffdab85 Airway Clearance Clearing mucus from the airways is the most commonly recommended preventive treatment, and many people with this condition will use it once or twice a day. We perform airway purification rituals. Keeping your airways clear of mucus can help prevent the development of bacterial infections. Some people are able to open their own airway using various breathing techniques, while others may need the help of a professional or special equipment. Airway and mucus clearance may include: e60dc2a1-f33c-4a05-9b50-8e3e8e597629fa887242-cda2-425e-8199-3cf0bffdab85 Active Cycles of Breathing (ACBT). homee60dc2a1-f33c-4a05-9b50-8e3e8e597629a86d9425-97e0-4714-b60d-46d33392749c Forced exhalation technique (FET), or huffing. Inhale and exhale quickly, as if you were misting your breath through your O-shaped mouth. Mirrore60dc2a1-f33c-4a05-9b50-8e3e8e59762954dcb1bd-516b-4475-a37d-4dbe0d74ff80 Chest physical therapy, also known as chest physical therapy and percussion, involves a therapist or trained caregiver patting or tapping your chest and back to loosen and drain mucus. lungse60dc2a1-f33c-4a05-9b50-8e3e8e597629c1117e6d-117a-4995-80c0-ce0e86c936d8 Postural drainage. It involves lying with your chest lower than your chest and gasping for air. abdomen e60dc2a1-f33c-4a05-9b50-8e3e8e59762954dcb1bd-516b-4475-a37d-4dbe0d74ff80 Hand-held devices, masks, and therapeutic best percussive ventilation that help loosen mucus through vibration or oscillating positive pressure (PEP) and high-frequency broadcasting techniques such as intrapulmonary (IPV)e60dc2a1-f33c-4a05-9b50-8e3e8e59762954dcb1bd-516b-4475-a37d-4dbe0d74ff80 Medications: Treating Symptoms and Infections A variety of medications can help manage symptoms, infections, and underlying conditions. Contains: e60dc2a1-f33c-4a05-9b50-8e3e8e597629c1117e6d-117a-4995-80c0-ce0e86c936d8 Antibiotics (pills, inhalers, or IVs) to fight infections Bronchodilators, inhalers to relieve airway narrowing and make breathing easier Corticosteroids to reduce inflammation in the inhaled airways Drugs that thin mucus (mucolytics) and expectorants (often given via nebulizer) Macrolide drugs to treat infections and reduce inflammation e60dc2a1-f33c-4a05-9b50-8e3e8e597629b2815548-8908-4732-88c8-8f7cf9934005 Medication: Disease Modifying Treatment There is one drug approved by the U.S. Food and Drug Administration (FDA) to specifically treat bronchiectasis: brensocatib. (Brin supplement). It targets enzymes associated with inflammation in people with non-cystic fibrosis bronchiectasis, helping to reduce flare-ups and slow the progression of the disease. For fibrosis-associated bronchiectasis, long-term macrolide therapy may also help reduce recurrence and slow the decline in lung function. If you have bronchiectasis, you may need more advanced treatments, such as: e60dc2a1-f33c-4a05-9b50-8e3e8e597629f06497c4-8584-4881-a246-0e5f2b4d9b42 Oxygen therapy, treatment to supplement oxygen when blood oxygen levels are low (using an oxygen tank and mask) levele60dc2a1-f33c-4a05-9b50-8e3e8e59762954dcb1bd-516b-4475-a37d-4dbe0d74ff80 Bronchial artery embolization, a technique in which a catheter is used to inject a substance to block bleeding vessels when there is heavy bleeding accompanied by coughing. Lobectomy, a surgical procedure that removes a section of the lung that has significant bleeding. Lung transplantation is reserved for patients with terminal disease, primarily advanced cystic fibrosis. Lifestyle Changes for Bronchiectasis Lifestyle Changes Bronchiectasis is a lifelong condition, but certain lifestyle changes can help reduce symptoms and infections, prevent disease progression, and improve quality of life. Infection Prevention and Hygiene If you have bronchiectasis, preventing respiratory infections can slow or stop the disease cycle. It is also important to avoid exposing the lungs to substances that can cause inflammation that can damage the airways and perpetuate bronchiectasis. Some helpful habits include: Don’t smoke and avoid second-hand smoke. e60dc2a1-f33c-4a05-9b50-8e3e8e597629d385826b-dc9b-46f2-9039-7f4b93d366d4 Minimize smoke and smoke exposure. Pollution.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d385826b-dc9b-46f2-9039-7f4b93d366d4 Stay up to date on routine vaccinations against infectious respiratory diseases such as influenza, COVID-19, pneumonia, and pertussis (pertussis). cough).e60dc2a1-f33c-4a05-9b50-8e3e8e5976291ed1767e-cd90-4617-9217-30b2b3a05f7b To reduce the risk of infection, practice good hygiene, including washing your hands frequently, especially before eating, and avoiding crowded places during cold and flu season. Stay away from people who have respiratory infections such as colds or the flu. e60dc2a1-f33c-4a05-9b50-8e3e8e59762951ffbe0a-b6c6-4d78-be7f-88e9c3adf2d7 To avoid accidentally inhaling mineral oil or petrolatum into your nose, do not use it near your nose. Lungs.e60dc2a1-f33c-4a05-9b50-8e3e8e59762963bddc41-e70d-4233-9686-bb084917fedc Hydration and Diet Hydration and diet can affect the quality of mucus, the level of inflammation throughout the body, and the immune system’s ability to fight infections. Bronchiectasis. Here’s how to stay healthy. e60dc2a1-f33c-4a05-9b50-8e3e8e597629313e292c-3a6f-4d5a-9493-63ec22861339 Drink plenty of water to thin mucus and make it easier to remove. Consider a diet high in vegetables, fruits, whole grains, or lean protein and low in sodium, added sugars, saturated fat, and refined grains. Maintain adequate levels of vitamin D through supplements, fish such as salmon and mackerel, mushrooms, and milk. Talk to your doctor about the right way to get the vitamin D you need. Exercise Regular physical activity may help clear mucus from the airways, improve shortness of breath, and reduce flare-ups. Start slowly and gradually increase your activity over time. The exercise program includes: e60dc2a1-f33c-4a05-9b50-8e3e8e5976295356517c-a696-453d-b185-4dc3a5a98535 Aerobic exercise such as walking, swimming, dancing, and bicycling Strength training using hand weights or resistance bands, strength training such as calisthenics, such as isometric exercises such as push-ups and planks, warm-up and cool-down stretching Prognosis and outlook for bronchiectasis The damage in bronchiectasis is irreversible, and the prognosis depends on the cause, severity of the disease, access to medical care, and other medical conditions. If treated early and aggressively, people with bronchiectasis can expect to live full lives with a normal life expectancy. Longer term, larger studies in different populations are needed to better understand the risk of death, the risk of death from this condition. The prognosis may be more serious due to the following factors: as:e60dc2a1-f33c-4a05-9b50-8e3e8e59762956023b96-2a12-44cc-8680-9ec595602b 3ee60dc2a1-f33c-4a05-9b50-8e3e8e59762995377385-097f-4262-b65f-72150d6378a5Smoking history and decreased lung function Cystic fibrosis Complications such as chronic bronchitis and emphysema Complications such as high blood pressure in the pulmonary arteries and enlargement and failure of the right ventricle of the heart Poor Access to Treatment Complications of Bronchiectasis Complications The main complication of bronchiectasis is frequently recurring respiratory infections that can worsen symptoms. As bronchiectasis progresses, further complications may occur. The lungs respond to ongoing inflammation and low oxygen levels by growing new, fragile blood vessels along the airway walls. This is a process called neovascularization. However, these blood vessels can easily rupture, sometimes causing life-threatening amounts of hemoptysis (hemoptysis). The same process can also increase blood pressure in the lungs, causing pulmonary hypertension. Pulmonary hypertension over time puts strain on the right side of the heart (cor pulmonale) and in severe cases can lead to heart failure and respiratory failure. e60dc2a1-f33c-4a05-9b50-8e3e8e597629d606ed81-321a-47f1-bda3-69ef23af7937 Frequent infections and antibiotic treatment can cause pulmonary hypertension. When antibiotic-resistant bacteria build up in the airways, the resulting inflammation can flare up symptoms and cause lung deterioration. function.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299c8b5165-5cad-4ef6-8a36-be8e48581315 Chronic inflammation from bronchiectasis can also cause muscle loss and unintentional weight loss. time.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292b23324d-1a73-4e4b-b057-0311295b2b9d Complications can also occur due to too much mucus in the airways. If the mucus is too thick or blocks the airways, part of the lung may collapse. This condition, called atelectasis, can make shortness of breath worse. e60dc2a1-f33c-4a05-9b50-8e3e8e5976292c492516-04ed-4340-8880-6a21bf5ec810 Other potential complications from bronchiectasis include: e60dc2a1-f33c-4a05-9b50-8e3e8e59762908a97e33-fb02-4705-92f9-259ff4dec6be pneumonia lung abscess empyema, or pus located in the space between the lungs and the chest wall bloodstream infections Recurrent pleurisy, inflammation of the membranes around the lungs Secondary amyloidosis, or abnormal accumulation of proteins in tissues and organs Support for people with bronchiectasis Support the Bronchiectasis and NTM Association This group provides a variety of educational materials and resources for people living with bronchiectasis and non-tuberculous mycomycosis (NTM). This includes a list of local support groups, online community groups, and meet-up opportunities. NTM Info & Research (NTMir) NTMir, a nonprofit organization serving patients and caregivers dealing with NTM, offers a variety of ways people with NTM and bronchiectasis can connect and support each other. This group includes online resources and information, virtual and in-person support groups, a physician referral list, and more. Key points: Bronchiectasis, a chronic lung disease, causes airways to become permanently widened and scarred, allowing mucus to build up and increasing the risk of infection. Symptoms usually take some time to appear and often occur after a respiratory infection. Symptoms may include coughing up blood or phlegm, shortness of breath, and fatigue. Bronchiectasis has many causes, including genetic disorders, pollutants, and infections. About 40 percent of people with bronchiectasis have no idea why they developed it. There is no cure for bronchiectasis, but by keeping your airways open, taking medications, and making lifestyle changes, you can manage your symptoms and prevent them from getting worse. Resources We Trust Cleveland Clinic: Bronchiectasis American Lung Association: Bronchiectasis and Newly Diagnosed Bronchiectasis & NTM Association: Diagnostic Testing and Evaluation National Heart, Lung, and Blood Institute: Bronchiectasis: Causes and Risk Factors Columbia University: Bronchiectasis Guide
