Bronchiectasis is a long-term chest (lung) condition, in which one or more sections of the airways become damaged and inflamed, causing them to become wider than normal. Extra mucus (the thick fluid that keeps your airways moist) is produced and collects in the widened parts of the airways.
This build up of mucus in the airways can become infected by bacteria. Bacterial infection causes further inflammation and damage to the airways and this can cause even more mucus to build up. This creates a 'vicious cycle' of infection, inflammation and damage.
Early management and treatment of bronchiectasis is really important to help break the cycle and prevent further damage.
Causes of bronchiectasis
In bronchiectasis the damage to the airways is most often caused by a severe lung infection, usually during childhood or as a young adult.
Other causes include:
- An obstruction or blockage in the airways such as a tumour or an inhaled object (e.g. a peanut)
- Acid which comes back up from the stomach (acid reflux) and is breathed in to the lungs
- Conditions that affect the immune system making you more susceptible to infection and subsequent damage
- Conditions that cause inflammation in other parts of the body such as rheumatoid arthritis or Crohn's disease also causing inflammation in the lungs
- Some inherited conditions such as cystic fibrosis
- Ciliary defects (problems with the fine hairs that line your airways) such as primary ciliary dyskinesia or yellow nail syndrome (rare)
- An allergic reaction to a fungus such as aspergillus. This is often seen in people who also have asthma.
In about half of all people with bronchiectasis the cause of the damage is unknown.
Symptoms of bronchiectasis
The main symptoms are coughing up mucus (sputum or phlegm) and repeated chest infections. Other symptoms include:
- Breathlessness, especially when exercising
- Coughing up blood
- Joint pain and chest pain
Symptoms may vary from day to day and will depend on the severity of your disease. It is likely that you will have 'good' periods (when you feel well) and periods when your condition deteriorates and your symptoms increase. This is known as an 'exacerbation'.
What does an exacerbation mean?
Sometimes you may notice your symptoms getting worse over a couple of days. This is often referred to as a flare-up or an exacerbation and is usually due to a chest infection. It is important that a chest infection is treated as quickly as possible to prevent further damage to your airways.
Contact your GP as soon as possible if you notice any of the following changes:
- Increased coughing
- Increased breathlessness
- Generally feeling unwell
- Fever, aches and pains
- Increased tiredness and lethargy
- Change in sputum colour to dark green
- Increase in amount or the thickness of sputum you are producing
- Blood in your sputum