Bronchiectasis is a chronic (long term) lung condition, caused by damage to the airways that affects their ability to clear out mucus. As a result, mucus builds up and bacteria begin to grow leading to repeated, serious lung infections. The main symptom of bronchiectasis is a mucus-producing cough. Treatment is likely to include antibiotics and other medications, while physiotherapy is used to remove mucus from the lungs.
Bronchiectasis is a consequence of damage to the bronchi - usually caused by a lung infection. Prior to the introduction of widespread immunisations programmes, bronchiectasis often occurred as the result of infection with measles or whooping cough. Today bronchiectasis more commonly occurs as the result of an illness such as pneumonia. Other causes include:
- Cystic fibrosis
- Immune deficiency
- Recurrent aspiration of fluid into the lungs (as occurs with gastroesophageal reflux)
- Inhalation of a foreign object into the lungs (if left untreated)
- Inhalation of harmful chemicals eg: ammonia
- In rare cases it may be congenital (present at birth).
Signs and symptoms
The main symptom of bronchiectasis is a mucus-producing cough. The cough is usually worse in the mornings and is often brought on by changes in posture. The mucus may be yellow-green in colour and foul smelling, indicating the presence of infection. Other symptoms may include:
- Coughing up blood (more common in adults)
- Bad breath
- Wheezing chest - a characteristic crackling sound may be heard when listening with a stethoscope.
- Recurring lung infections
- A decline in general health
- In advanced bronchiectasis, breathlessness can occur.
An initial diagnosis of bronchiectasis is based on the patient's symptoms, their medical history and a physical examination. Further diagnostic tests may include:
- Chest x-ray
- CT (computerised tomography) scan
- Blood tests
- Testing of the mucus to identify any bacteria present (sputum test)
- Checking oxygen levels in the blood
- Lung function tests (spirometry).
- Antibiotics are used to treat acute lung infections. Where the infection is severe, hospitalisation and treatment with intravenous antibiotics may be required.
- Bronchodilators (as used in people with asthma) to improve the flow of air to the lungs.
- Corticosteroids to reduce inflammation in the lungs.
- Occasionally, medications to thin the mucus may be used.
- Vaccination against influenza (flu) and pneumococcal pneumonia.
The Ministry of Health recommends the following measures to help prevent bronchiectasis in children:
- Not smoking during pregnancy and having a smoke-free home
- Breastfeeding your children
- Eating a healthy balanced diet
- Early detection and treatment of chest infections
- Making sure homes are warm and dry (making chest infections less likely)
- Immunisation for diseases like measles and whooping cough which can lead to bronchiectasis.
- Protecting infants and children from inhaling foreign objects such as food particles
- Seeking medical assistance right away if a foreign object is inhaled into the lungs is also important.
Asthma and Respiratory Foundation (2017). Key statistics: Respiratory disease in New Zealand (Web Page). Wellington: Asthma and Respiratory Foundation New Zealand. https://www.asthmafoundation.org.nz/research/key-statistics [Accessed: 03/05/2017]
KidsHealth (2014). Bronchiectasis (Web Page). Paediatric Society of New Zealand (Christchurch) and Starship Foundation (Auckland). https://www.kidshealth.org.nz/bronchiectasis-bx [Accessed: 03/05/17]
O’Toole, M.T. (Ed.) (2013). Bronchiectasis. Mosby’s Dictionary of Medicine, Nursing & Health Professions (9th ed.). St Louis, MI: Elsevier Mosby.
Edwards, E., Asher I. (2013). Bronchiectasis (Web Page). Starship Clinical Guidelines. Auckland: Starship Children’s Health. https://www.starship.org.nz/for-health-professionals/starship-clinical-guidelines/b/bronchiectasis/ [Accessed: 03/05/17]
Ministry of Health (2015). Bronchiectasis (Web Page). Wellington: Ministry of Health. www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/bronchiectasis [Accessed: 03/05/17]