How Bronchiectasis Is Treated

Antibiotics, Bronchodilators, Expectorants, and More

The goal of bronchiectasis treatment is to control lung infections, promote the drainage of excessive secretions, and prevent complications. This may involve antibiotics, expectorants, bronchodilators, and several different techniques and procedures.

A elderly woman having heart pain

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The multi-strategy/multi-goal approach to treating this form of obstructive lung disease is due to its repetitive cycle, in which the airways abnormally widen, causing inflammation and the pooling of mucus. That mucus then blocks the airways, prompting an accumulation of bacteria that causes infection (and, therefore, more inflammation)—and on and on. Each of these elements of the condition may need to be addressed.

Proper and immediate treatment of lung infections is important, as it decreases the chance of bronchiectasis.

Lifestyle Changes

Certain lifestyle changes can be adopted that may be useful when paired with medications and therapies. Some may also help prevent bronchiectasis in the first place.

Exercise

Depending on your physical abilities, gentle exercise has been shown to be very helpful in improving lung function with bronchiectasis.

Pulmonary rehabilitation programs can help you get back on your feet and moving again in the safety of a doctor's office, with medical help nearby should you need it. Ask your doctor about starting pulmonary rehabilitation and incorporating light exercise, such as walking or yoga, into your daily or weekly routine.

Eating Adequate Calories

Bronchiectasis and COPD (and the medications used to treat these conditions) can reduce your appetite and cause fatigue, making you less interested in food. In addition, labored breathing takes energy that you might not be eating enough calories to sustain.

Talk to your doctor or a nutritionist about ways to combat this, and try eating six to eight smaller, more frequent meals throughout the day that are rich in whole grains, fruit, and vegetables.

Maximizing your intake of foods with a high antioxidant level, such as dark leafy greens, berries, and citrus fruit, may boost your immune system to help you fight off further infections.

In addition, incorporating more plant-based fats such as avocado, olives, coconut, and nuts and seeds can help improve your energy levels.

Avoiding Respiratory Irritants

Respiratory irritants can exacerbate symptoms of bronchiectasis. Quitting smoking and avoiding secondhand smoke and air pollution are three steps that you can take to help prevent bronchiectasis or hinder its progression.

There are many quitting aids that you can try if you're not ready to go cold turkey. If you need help, be sure to discuss this with your doctor, since they can help guide you as well as prescribe quitting aids.

In addition, you can make changes to avoid other lung irritants. For example, to ingest less air pollution, try exercising in parks as opposed to, say, running on a sidewalk next to a busy road. If you must regularly walk near a busy street, try to do so before or after rush hour.

Annual Flu Shot

Flu shots not only help prevent the flu, but they can also help prevent the exacerbation of bronchiectasis. Ask your healthcare provider what you can do about getting your annual flu shot. Often, local drugstores offer a flu vaccine in the fall and winter months. 

Pneumonia Vaccine

COPD and bronchiectasis patients are at higher risk of pneumonia, so getting the pneumonia vaccine can help reduce your chances of contracting the infection. If you're younger than 65 and have a lung condition, the Centers for Disease Control and Prevention (CDC) recommends getting the vaccine once, then again in two doses when you're over age 65.

Physical Therapy

Two forms of chest physiotherapy may be helpful in treating bronchiectasis, especially when combined with other treatment methods.

Postural Drainage

Postural drainage is an airway clearance technique that uses gravity to help drain mucus from certain parts of the lungs. Postural drainage may be used with other forms of chest physiotherapy to further loosen secretions so that they can be expelled from the airways easier.

Chest Percussion and Vibration

Along with postural drainage, percussion and vibration help further mobilize and loosen secretions, making it easier for them to be expelled from the airways. Percussion and vibration can be performed either by using your hands or by using a manual percussive device.

Over-the-Counter (OTC) Therapies

Expectorants are OTC medications that can help loosen mucus, making it easier for it to be expelled from the airways through coughing. In other words, it makes coughs more efficient.

Common brand-name expectorants are Robitussin and Mucinex (both have guaifenesin as the active ingredient). Look for syrup or tablet forms at your local drugstore.

Prescriptions

The primary medications used in the treatment of bronchiectasis are antibiotics, which treat the infection, and bronchodilators, which open the airways to make breathing easier. Mucolytics may also be used to break up mucus secretions.

Antibiotics

Used to treat many different types of bacterial infections, antibiotics are commonly used to treat lung infections that are associated with bronchiectasis, since bacteria often infect the bronchi.

Antibiotics must be prescribed by your doctor. However, whether antibiotics will be beneficial depends on the cause of bronchiectasis, as well as its severity and acuity and your history of infections, including what kinds of bacteria have been or are present. As a result, before antibiotics are started, a thorough evaluation by your doctor is required. They can be given orally (by mouth) or intravenously (through a vein), or can be inhaled via a nebulizer machine.

To avoid antibiotic resistance, be sure to take the entire course of antibiotics—even if you start to feel better before you use them all up.

Antibiotics can sometimes cause side effects, such as gastrointestinal issues, but you can minimize some of these reactions (such as by eating more probiotic-rich foods like kimchi and yogurt, taking a probiotic during and after your course of treatment, or drinking ginger tea).

Bronchodilators

A bronchodilator is a common medication used in the treatment of bronchiectasis. Bronchodilators work by relaxing and expanding the airways, making it easier to breathe.

Common bronchodilator medications include albuterol and Atrovent (ipratropium bromide)—medications that are also sometimes used to treat asthma.

Mucolytics

Mucus-thinning medications (known as mucolytics) are also used in bronchiectasis treatment. N-acetyl cysteine, or NAC, is one example. They are usually administered through a nebulizer and inhaled with a mixture of hypertonic saline solution, which helps the medication get deeper into the lungs.

Mucolytics help thin and dissolve mucus secretions so that they can be coughed up more easily.

Surgery

For those who do not respond well to other types of conservative treatment, and if bronchiectasis is confined to a specific portion of the lungs, surgical removal of that part of the lung (surgical resection) may be an option.

It is important to note, however, that surgical resection of the lung is not recommended for everyone, as complications for those with this condition can be rather high. In fact, it is mostly considered a last resort for those with bronchiectasis who fit the proper criteria.

Talk to your doctor for more information to see if this type of treatment is right for you.

Frequently Asked Questions

How serious is bronchiectasis?

It can be very serious, depending on how effectively it's treated, how frequently symptoms such as coughing and dyspnea (shortness of breath) occur, and to what degree it affects quality of life. Bronchiectasis isn't a terminal disease, however, and most people are able to manage it for their entire lives.

Can my bronchiectasis be cured?

No. Bronchiectasis is a chronic condition that cannot be cured. If it's not treated, it is likely to get worse. The sooner it's diagnosed, however, the less likely it is to progress and the fewer exacerbations, or flare-ups of symptoms, you'll have.

How does bronchiectasis affect life expectancy?

Most people who have bronchiectasis that is not a complication of cystic fibrosis have a normal lifespan, especially if they get proper treatment and live a healthy lifestyle. Among the factors that can affect how long someone with bronchiectasis lives are their age, overall health, and the number and severity of exacerbations they experience.

How long will I need to take antibiotics for a bronchiectasis flare-up?

One to two weeks. Don't stop taking them sooner than your doctor prescribes, even if you start feeling better. Your symptoms could easily return if you don't finish the entire course of medication.

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Article Sources
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  2. American Lung Association. Bronchiectasis.

  3. Cleveland Clinic. Bronchiectasis. Updated May 31, 2019.

  4. American Lung Association. Treating and managing bronchiectasis. Updated March 26, 2020.

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