What Is Bronchiectasis?

• Cylindrical or Tubular Your airways have widened but mostly retain their original shape. This is the mildest and most common type of bronchiectasis.
• Varicose Your airways have an irregular, stretched appearance.
• Cystic Your airways develop large, cyst-like sacs filled with mucus. This is the most severe type of bronchiectasis.

Bronchiectasis may also be focal, affecting one or two lung areas, or diffuse, affecting multiple areas.

Common symptoms include:

• Chronic, daily cough, which may last months or years

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• Large, daily production of sputum (saliva mixed with mucus), which is often coughed up
• Shortness of breath
• Frequent, recurrent chest infections or colds, which often worsen symptoms
• Coughing up blood, or hemoptysis
• Fever
• Chest pain
• Wheezing
• Fatigue
• Nail clubbing, in which your nails curve downward because of thickening skin and tissue

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• Bad breath
• Pale skin

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• Severe or recurrent respiratory infections
• Genetic conditions that can affect the lungs, such as cystic fibrosis, primary ciliary dyskinesia, and alpha-1 antitrypsin deficiency

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• Cancers such as leukemia

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• Conditions or medications that weaken the immune system, including HIV and medications used after organ transplants
• Autoimmune or inflammatory diseases such as rheumatoid arthritis, Sjögren's syndrome, inflammatory bowel disease, and lupus

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• Chronic pulmonary aspiration, the inhalation of substances such as food particles and digestive fluids that inflame the airways

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• Airway obstruction from tumors or foreign objects

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• Allergic bronchopulmonary aspergillosis, an allergic fungal reaction
• Environmental exposure, including smoke or toxin inhalation
• Infections with tuberculosis, which can cause severe or repeated lung infections, or other mycobacteria
• Lung diseases such as chronic obstructive pulmonary disease (COPD) and asthma

• Chest X-ray or computed tomography (CT) scans to image your lungs and spot any airway dilation and structural changes
• Sputum culture to identify bacteria or fungi in your airways
• Lung function tests to assess your airflow and lung capacity
• Blood tests to look for infections (including HIV) and evaluate immune function
• Bronchoscopy, a procedure to look closely at your airways and remove any obstructions using a bronchoscope, a long, flexible tube with a light and camera at the end
• Specific tests for various immune system and autoimmune disorders and other conditions

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Airway Clearance

• Active cycle of breathing technique (ACBT), a type of deep breathing exercise that can be performed at home

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• Forced expiration technique (FET), or huffing, which involves taking a breath and quickly breathing out with an O-shaped mouth as if to fog up a mirror

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• Chest physical therapy, also known as chest physiotherapy and percussion, in which a therapist or trained caregiver taps or gently pounds your chest and back to loosen and drain the mucus from your lungs

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• Postural drainage, which involves huffing while lying with your chest lower than your abdomen

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• Handheld devices, masks, and therapy vests that help loosen mucus with vibration or high-frequency airwaves technologies such as oscillating positive expiratory pressure (PEP) and intrapulmonary percussive ventilation (IPV)

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Medication: Treatments for Symptoms and Infections

• Antibiotics (pills, inhaler, or intravenous), to fight infections
• Bronchodilators, inhalers to relieve airway narrowing and ease breathing
• Inhaled corticosteroids that reduce airway inflammation
• Mucus thinning drugs (mucolytics) and expectorants, often delivered through a nebulizer
• Macrolides, which treat infections and reduce inflammation

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Medication: Disease-Modifying Treatment

Other Treatments

• Oxygen therapy, a treatment providing supplemental oxygen (with an oxygen tank and mask) if you experience low blood oxygen levels

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• Bronchial artery embolization, a technique that uses a catheter to inject a substance that blocks a bleeding blood vessel, if you have significant bleeding with cough
• Lobectomy, a surgical procedure to remove a section of the lung that is experiencing significant bleeding

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• Lung transplant, which is reserved for end-stage disease, mostly people with advanced cystic fibrosis

Bronchiectasis is a lifelong condition, but certain lifestyle changes can help reduce symptoms and infections, prevent disease progression, and improve your quality of life.

Infection Prevention and Hygiene

When you have bronchiectasis, preventing respiratory infections can help slow or stop the cycle of disease. It’s also important to avoid exposing your lungs to substances that can potentially cause inflammation, which can damage the airways and perpetuate bronchiectasis. Helpful habits may include:

• Do not smoke and avoid secondhand smoke.

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• Minimize exposure to fumes and pollution.

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• Stay current on routine vaccinations for infectious respiratory diseases, including influenza, COVID-19, pneumonia, and pertussis (whooping cough).

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• Maintain good hygiene to reduce your risk of infections, such as by frequently washing your hands, especially before eating, and avoiding crowded spaces during cold and flu season.
• Stay away from people with respiratory infections, including the cold and flu.

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• Don’t use mineral oil or petroleum jelly near your nose to avoid accidentally inhaling the substances into the lungs.

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Hydration and Diet

• Drink plenty of water to help keep mucus thinner and easier to clear.
• Consider a diet high in vegetables, fruits, whole grains, or lean proteins and low in sodium, added sugar, saturated fats, and refined grains.
• Maintain adequate levels of dietary vitamin D through supplements, fish such as salmon and mackerel, mushrooms, and milk; ask your doctor about the right way to get the vitamin D you may need.

Exercise

• Aerobic activities such as walking, swimming, dancing, and bike riding
• Strength-training exercises, including those using hand weights and resistance bands, as well as calisthenics such as push-ups and isometric exercises such as planks
• Warm-up and cooldown stretches

• A history of smoking and low lung function
• Cystic fibrosis
• Coexisting conditions such as chronic bronchitis or emphysema
• Complications such as high blood pressure in the arteries of your lungs or enlargement and failure of the right ventricle of your heart
• Poor access to treatment

The primary complication of bronchiectasis are the frequent reoccurring respiratory infections that threaten to make the condition worse. If bronchiectasis advances, additional complications may develop.

Your lungs respond to ongoing inflammation and low oxygen levels by growing new, fragile blood vessels along the airway walls, a process called neovascularization. But these vessels rupture easily, causing hemoptysis (coughing up of blood), sometimes in life-threatening amounts.

• Pneumonia
• Lung abscesses
• Empyema, or pus in the space between the lungs and chest wall
• Bloodstream infections
• Recurrent pleurisy, inflammation of the membranes around the lungs
• Secondary amyloidosis, or abnormal buildup of proteins in tissues and organs

Bronchiectasis & NTM Association

This group offers various education materials and resources for people living with bronchiectasis and nontuberculous mycobacteria (NTM). It includes a listing of local support groups, an online community group, and meetup opportunities.

NTM Info & Research (NTMir)

A nonprofit organization serving patients and caregivers dealing with NTM, NTMir offers various ways for people with NTM and bronchiectasis to connect and support one another. The group has online resources and information, virtual and in-person support groups, physician referral lists, and more.

• When you have the chronic lung condition bronchiectasis, your airways are permanently widened and scarred, trapping mucus and increasing your risk of infection.
• Symptoms typically take a while to develop but often occur after a respiratory infection. They may include coughing up blood and sputum, shortness of breath, and fatigue.
• Bronchiectasis has many different causes, including hereditary conditions, pollutants, and infections. About 40 percent of people with bronchiectasis do not know why they developed it.
• Although there is no cure for bronchiectasis, clearing airways, taking medications, and lifestyle changes can help you manage its symptoms and stop it from getting worse.