Definition:

Bronchiectasis is a long-term, chronic, irreversible condition affecting the lungs which leads to airways becoming widened and inflamed. Pockets develop which trap mucus which is also known as phlegm, sputum or sometimes catarrh.

This mucus can become very hard to get rid of and can act as a breeding ground in which bacteria can grow. When this happens, people with bronchiectasis often have chest infections.

For almost 50% of those diagnosed with bronchiectasis there is no clear cause for the disease. This is called idiopathic bronchiectasis. For others it may be a consequence of a completely different illness, such as inflammatory bowel disease, pneumonia, rheumatoid arthritis or asthma. It can also be caused by exposure to certain types of fungus or moulds, or by inhaling something small that blocks the airways. Therefore, it can affect people of any age, including children.

Symptoms:

Symptoms vary but the most common symptom is a long-term cough, usually coughing up mucus. People with more severe bronchiectasis can cough up a lot of mucus every day, whereas others might have a dry cough with minimal mucus produced.

It is common to suffer from frequent chest infections. Frequent chest infections result in lung damage that decreases your lung function leading to breathlessness - in turn this could affect your ability to do normal ‘day-to-day’ activities. For example, shopping, climbing the stairs, cleaning/housework & taking the dog for a walk might all become more tiring. If you are experiencing such symptoms, please consult a healthcare professional.

Other common symptoms include problems with the sinuses, and problems resulting from frequent coughing such as fatigue, incontinence, chest pain and depression.

Diagnosis:

Bronchiectasis is hard to diagnose and often people have the condition without knowing. To be diagnosed you would need to be referred to a specialist (most likely at a hospital). Formal diagnosis then comes from a variety of tests – a combination of HRCT scanning/chest x-rays, lung function testing (spirometry, peak flow results) & blood tests. In some cases, a bronchoscopy might be needed.

Bronchiectasis is sometimes called ‘non-cystic fibrosis bronchiectasis’, as it causes similar lung symptoms to the genetic condition cystic fibrosis. However, in addition to having a different cause, the treatment options and outlook are different.

Treatment:

Bronchiectasis cannot be cured but it can be treated.

If you smoke, current guidance states that it is important to stop. Support for this can be found by consulting with local healthcare professionals who will explain what help is available.

There are very few pharmaceutical treatments approved for use with people who have bronchiectasis, but it is a hot topic in research. This means that, at the moment, treating the symptoms of the disease is the most common way to manage the condition.

If you have bronchiectasis, it is important to clear the mucus from the lungs and therefore help prevent chest infections. Chest physiotherapy or airway clearance techniques such as breathing exercises can be useful, as can using physiotherapy devices such as a PARI PEP S or PARI O-PEP. Saline solutions delivered by a nebuliser can also be used to help loosen the mucus and make it easier to cough up.

Your doctor should use a scoring system for to help them identify the severity of your bronchiectasis and therefore adjust your treatment accordingly. They should give you a personalised self-management plan to help you manage.

You may be prescribed antibiotics to treat chest infections, and an annual flu jab should be given to prevent flu.

Disclaimer: none of the above constitutes medical advice & you should always seek help from a qualified healthcare professional such as your GP, hospital consultant, nurse or pharmacist