What Is Bronchiectasis?

A Chronic Condition Caused by the Permanent Widening of Airways

In This Article
Table of Contents

Bronchiectasis is the permanent widening of the airways of the lungs, including the bronchi and bronchioles. It can be caused by diseases like tuberculosis or congenital disorders like cystic fibrosis, leading to coughing, wheezing, and frequent lung infection. Bronchiectasis is classified as an obstructive lung disease along with asthma and chronic obstructive pulmonary disease (COPD).

There are several risk factors that can predispose you to bronchiectasis, including smoking and recurrent lung infections. You may need several tests to diagnose bronchiectasis, including imaging studies and pulmonary function tests. If you have bronchiectasis, you can benefit from a variety of medical treatments, including antibiotics, bronchodilators, and chest physiotherapy.

Bronchiectasis affects between 1 in 1,000 and 1 in 250,000 adults, depending on which part of the world you live in. The condition is more common in women, with the risk increasing with advancing age.

Bronchiectasis Symptoms

Symptoms of bronchiectasis may not be apparent until months or even years after the changes in your lungs have begun. You may initially experience intermittent effects of the condition. The symptoms tend to occur when the lungs are under more strain than usual, such as when you have a lung infection or during physical exertion.

Eventually, as bronchiectasis worsens, you may feel the effects more frequently—often on a daily basis—without any obvious triggers.

Common symptoms of bronchiectasis can include:

If you experience these symptoms, you should seek medical attention. Lung infections might not improve without treatment, such as an antibiotic.

Over time, the effects of bronchiectasis can impact your quality of life and limit your overall ability to walk or get around without becoming severely short of breath. Weight loss, fatigue, weakness, and pain when breathing can occur.

Causes

Inflammation and infection can cause the dilation (widening) of the airways that characterizes bronchiectasis. When this occurs, excessive mucus begins to pool in the enlarged areas.

Damage to the cilia, the finger-like lining of the airways that clear mucus and debris, can lead to obstruction. Since mucus cannot be easily cleared because of this, it sits in the lungs, becoming a breeding ground for bacteria and leading to further lung infections.

The lung damage that leads to bronchiectasis can occur as a result of a congenital lung condition or a respiratory illness.

Common causes include:

  • Cystic fibrosis (CF): A genetic disorder characterized by the progressive stiffening of the lungs and other organs with abnormal mucus production in the lungs and digestive tract
  • Respiratory infections: Severe or recurrent pneumonia or influenza, especially during childhood, can permanently harm the lungs. Measles or tuberculosis are closely associated with bronchiectasis.
  • Inflammatory conditions: Allergies, asthma, and autoimmune conditions may lead to bronchiectasis by causing thickening of your airways.
  • Ciliary disease: Cilia can be damaged by airborne toxins, including cigarette smoke and environmental pollutants. Primary ciliary dyskinesia is a genetic condition that results in a build-up of mucus and inflammation, eventually causing bronchiectasis.
  • Airway obstruction: Your airways can become blocked by an object (such as a food particle) or a tumor. You may be more prone to airway obstruction after surgery because of a post-operative weakened cough reflex.

Although cystic fibrosis remains the leading cause of bronchiectasis, the cause of bronchiectasis in up to 50% of people without cystic fibrosis is unknown, according to a 2013 study in the American Journal of Respiratory and Critical Care Medicine.

​Diagnosis

Diagnosis of bronchiectasis involves a medical history, physical examination, and diagnostic testing. If you have symptoms, your doctor will assess factors such as whether your condition has been gradually worsening and whether you have episodic flare-ups.

Your physical examination will include an assessment of your breath sounds, as well as your breathing rate, heart rate (pulse), blood pressure. Your doctor will also observe your breathing to determine whether you are struggling to breathe.

An investigation of bronchiectasis is appropriate in otherwise healthy individuals who have a cough for more than eight weeks, especially if there is an excess production of mucus and/or the cough worsens with exposure to dust, smoke, or other triggers.

In addition to your physical examination, your doctor may order some specific tests in your evaluation of bronchiectasis, such as:

  • Imaging tests: Chest imaging may include a chest X-ray or chest computerized tomography (CT) scan.
  • Lab tests: You may need an arterial blood gas that measures your blood oxygen, carbon dioxide, and bicarbonate levels. Sputum culture is used to grow and identify microbial organisms that could be causing a respiratory tract infection.
  • Specialized tests: Pulmonary function tests measure how much air volume you can inspire (breath in) and expire (breath out). A lung diffusion test compares the amount of carbon monoxide in the air you inhale versus the amount in the air you exhale; the ability to process carbon monoxide is a measure of lung strength and health.. Lung plethysmography assesses your lung volume.

Treatment

Although the condition can't be cured, most people who have bronchiectasis are able to live a normal and active life. There are several goals when it comes to the treatment of your bronchiectasis.

Treatment and prevention of infections is an important part of management. Maintaining comfort and drainage of excessive secretions from your lungs is another therapeutic target. The prevention of further complications is a key feature of bronchiectasis treatment as well.

The course of treatment can vary from person to person, with some people responding better than others. A 2015 review published in the Cochrane Database of Systemic Reviews found no clear evidence that any single treatment was universally beneficial.

As such, expert insights from a qualified pulmonologist may be needed to tailor the treatment options best suited for you as an individual.

Treatment options include a combination of the following:

A Word From Verywell

If you or your child has risk factors for bronchiectasis, it is important to get medical attention and treatment for respiratory infections because they can worsen the condition. With consistent medical attention and lifestyle strategies, you can minimize the effects and progression of bronchiectasis.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cottin V, Cordier JF, Richeldi L. Orphan Lung Diseases: A Clinical Guide to Rare Lung Disease. New York, NY: Springer; 2015.

  2. Redondo M, Keyt H, Dhar R, Chalmers JD. Global impact of bronchiectasis and cystic fibrosis. Breathe (Sheff). 2016;12(3):222-35. doi:10.1183/20734735.007516

  3. Hill AT, Sullivan AL, Chalmers JD, et al. British Thoracic Society guideline for bronchiectasis in adults. Thorax. 2019;74(Suppl 1):1-69. doi:10.1136/thoraxjnl-2018-212463

Additional Reading