Symptoms of Bronchiectasis

Recognizing this lung disease

Bronchiectasis is a type of chronic obstructive pulmonary disease (COPD) characterized by a persistent cough and recurrent lung infections. With bronchiectasis, you can experience a daily cough that doesn't improve or resolve on its own. You can also experience issues such as low energy and weight loss.

You may develop bronchiectasis as a complication of cystic fibrosis or recurrent lung infections. Because you may already have a history of respiratory illnesses before you experience the effects of bronchiectasis, it can be challenging to recognize bronchiectasis as a separate condition.

Persistent symptoms—even at times when you do not have an infection—can be a warning sign that you have developed this serious and lasting respiratory complication.

Frequent Symptoms

A daily cough is the most common effect of bronchiectasis. With this condition, your cough is likely to be productive—which means that you will cough up sputum (or in rare instances, you may cough up blood).

When the bronchi and bronchioles (airways in your lungs) become wider than they normally should be (the main problem in bronchiectasis), mucus can build-up inside them. The cilia, tiny hairs that normally catch small particles in your lungs, also do not function well in bronchiectasis. Furthermore, bronchiectasis causes your airways to become obstructed (blocked).

A cough is your body's way of getting rid of this mucus build-up when your lungs cannot get rid of sputum on their own.

Chronic Cough

woman coughing up sputum
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A persistent, daily cough is common in bronchiectasis. In general, a cough that develops due to a viral infection should resolve within a few weeks. With bronchiectasis, the cough does not resolve on its own. That persistence is a clue that you could be dealing with an airway disease rather than a short-term infection.

With bronchiectasis, you are unlikely to experience a spontaneous improvement in your cough.

Some characteristics of your cough—the smell and sputum production—might not be exactly the same all the time.

Thick Sputum

When you have bronchiectasis, you are likely to cough up large amounts of thick, discolored sputum. Sputum, also described as phlegm, is composed of mucus, saliva, and/or dead cells or microorganisms (such as viruses and bacteria). Your sputum may even appear brownish or it can be blood-tinged at times.

The consistency and color of your sputum can change depending on factors—such as whether you have an infection.

Foul Smelling Sputum

Your sputum can be foul-smelling when you have bronchiectasis. This can also manifest with bad breath. The smell of your sputum can vary, and it will likely be more intense when you have an infection.

Rare Symptoms

In addition to a nagging, productive cough, you may also experience additional effects of bronchiectasis. The condition can have a severe effect on your ability to breathe, and you might notice changes in your fingers described as "clubbing of the nails."

Hemoptysis

With bronchiectasis, you may occasionally experience hemoptysis (coughing up blood). This occurs when tiny blood vessels near the surface of bronchial tubes are torn—usually as a result of an infection or a violent cough.

Normally, the bleeding appears as brown or pink streaks in your sputum. If you cough up large amounts of blood, you need to get emergency medical care.

Dyspnea

You can experience dyspnea (shortness of breath) when your airways become blocked with mucus. Typically, dyspnea worsens with exertion or exercise, especially when bronchiectasis is relatively mild in severity. As the disease progresses, you may have shortness of breath even when you are at rest.

Clubbing of the Fingers

Clubbing of the fingers and nails makes your nail bed curve down in a way that looks like an upside-down spoon. You can develop clubbing with lung diseases, digestive diseases, Grave's disease (a type of hyperthyroidism), and cancers such as Hodgkin's disease.

When clubbing occurs due to a medical illness, it is believed to develop as a result of chronically low oxygen levels in the body.

Keep in mind that some people's fingers normally have an appearance similar to that of clubbing—a change in the appearance of your fingers could mean that you have clubbing due to bronchiectasis.

Wheezing

Wheezing is often described as a whistling sound heard during inhalation (breathing in) or exhalation (breathing out). When you have bronchiectasis, your wheezing may be so loud that it can be heard without a stethoscope.

Because wheezing occurs when your airways become narrow or blocked, it may be more noticeable when you have more mucus build-up than usual.

Pain With Breathing

Pleurisy (pain with breathing) can develop with severe bronchiectasis. Generally, the pain is worse with deep breathing. You might get in the habit of taking shallow breaths to avoid pain. This can worsen the mucus build up in your lungs, resulting in a self-perpetuating cycle.

Pleuritic chest pain can occur due to the effects of bronchiectasis on your lungs, and it can become worse with complications such as pneumonia or blood clots.

Complications/ Sub-Group Indications

Over time, you may experience more widespread effects of bronchiectasis. The condition can have an effect on your overall health and well being, and it is associated with a shortened life span.

Weight Loss

You may be surprised to experience unintentional weight loss. This can happen due to a loss of appetite that develops when you have a bad taste in your mouth. Additionally, bronchiectasis causes your body to consume more calories due to the physical demands of coughing and effortful breathing.

Fatigue and Weakness

Fatigue is an overall feeling of tiredness or lack of energy. It is the type of exhaustion that can't be overcome easily with a good night of sleep or a cup of coffee. You can feel weak when you have bronchiectasis associated fatigue.

The weakness caused by bronchiectasis affects the entire body (as opposed to localized weakness, which affects only a specific limb, muscle group, or one side of the body).

Lack of sleep caused by excessive coughing at night can make you feel very tired and weak during the day. Some of the medications that you may need to take to control your symptoms—such as antihistamines, blood pressure medicines, sleeping pills, steroids, or diuretics—can also cause fatigue as a side effect.

Recurrent Lung Infections

Respiratory infections in bronchiectasis may precipitate a cycle of repeated inflammation, infection and airway obstruction. Recurrent infections can lead to bronchiectasis, and bronchiectasis also predisposes you to recurrent lung infections.

Infections can also lead to fever and exacerbate hemoptysis, pleurisy, weight loss, fatigue, and generalized weakness.

When to See a Doctor/ Go to the Hospital

When you have bronchiectasis, you need to maintain regularly scheduled medical care. And you also need to talk to your doctor if your condition seems to be progressing. You may also experience a respiratory emergency as a result of your bronchiectasis, so it is important to familiarize yourself with signs of an emergency.

Signs of Worsening Illness

Be sure to see your doctor if you have a fever, experience shortness of breath or pain with breathing, or see dark streaks in your sputum when you cough.

Weight loss and low energy can be caused by worsening bronchiectasis or by another medical condition, so you will need to discuss these issues with your doctor so that you can get the right diagnosis.

Medication Side Effects

If you are having trouble sleeping or if you feel dizzy or have palpitations (a sense that your heart is racing), you could be having a medication side effect. Be sure to talk to your doctor, because you may need a change in your prescription.

Emergency Issues

Serious respiratory emergencies can manifest with a number of sudden problems. You should seek emergency care if you have:

  • Difficulty breathing, struggling to breathe
  • Severe wheezing, or increased wheezing
  • A feeling that you may lose consciousness or faint
  • Cyanosis (pale or blue fingertips or lips)
  • Coughing up blood (thin blood or more than 1/4 of a teaspoon of blood)
  • Grunting noises when you breathe
  • Tachypnea (rapid, shallow breathing)
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