Bronchiectasis – what is it?

Bronchiectasis is a chronic lung condition where the airways – the bronchi – become abnormally widened. This widening results in the airways being less effective at moving natural secretions within the airway, leading to a build-up of secretions which can make the lungs more susceptible to infections. Repeated infections can also lead to worsening of the airway damage. It’s vital to understand what bronchiectasis is, why it happens and what the symptoms are to effectively manage and improve your quality of life.

Why does it happen?

In healthy lungs, air moves in and out of the bronchi efficiently. However, in bronchiectasis, these airways lose their elasticity due to damage and become dilated. This structural change affects the natural clearance process of mucus within the airway, which then creates an environment conducive to bacterial growth and recurrent infections. Over time, this cycle of infection and inflammation can cause further lung damage, which is irreversible.

Symptoms of bronchiectasis

Your exact symptoms of bronchiectasis can vary, but the most common symptoms include:

• Persistent cough – a daily cough that produces large amounts of phlegm, often green or yellow in colour
• Shortness of breath – difficulty breathing, especially during physical activities
• Chest pain – discomfort or pain as a result of the constant coughing and infections
• Wheezing – a whistling sound when breathing, due to the airway obstruction
• Fatigue – a general sense of tiredness and lack of energy
• Frequent chest infections – regular episodes of respiratory infections that may require medical attention

You may find that your symptoms develop gradually, and their severity may fluctuate. We find that some patients experience mild symptoms, while others face more severe challenges.

Causes of bronchiectasis

A number of factors that can lead to the development of bronchiectasis:

• Infections – severe respiratory infections like pneumonia, whooping cough or tuberculosis can damage the bronchial walls
• Immune system disorders – conditions that weaken the immune system make the lungs more vulnerable to infections
• Allergic reactions – allergic bronchopulmonary aspergillosis, a reaction to certain fungi, can cause inflammation and damage to the airways. It’s most common in people with asthma or cystic fibrosis.
• Genetic conditions – diseases like cystic fibrosis lead to thick, sticky mucus production, contributing to bronchiectasis.
• Obstructions – blockages in the airways due to foreign objects or tumors can cause localised bronchiectasis.

Diagnosis of bronchiectasis

To effectively manage your symptoms you need an accurate diagnosis. You may be asked for a combination of tests to properly diagnose your condition. This is usually done via a respiratory doctor.

• Your medical history and a physical examination –this will involve discussing symptoms and listening to your breathing
• Imaging tests – a CT scan offers detailed images of the lungs, which will reveal the characteristic airway widening of bronchiectasis
• Sputum culture – analysing mucus samples helps identify specific bacteria or fungi, which will help determine the right targeted treatment
• Lung function tests – these assess the extent of lung impairment and help monitor disease progression
• Blood tests – these can detect underlying conditions like immune deficiencies or infections

Complications associated with bronchiectasis

Potential complications of bronchiectasis include recurrent lung infections, breathlessness, and, in severe cases, reduced oxygen levels. This can impact people’s quality of life. However, with the right management these risks are significantly reduced, helping you maintain a good quality of life.

Management and support

While bronchiectasis is a chronic condition, various strategies can help minimise the risk of infection, manage symptoms and improve quality of life:

• Airway clearance techniques – respiratory physiotherapy methods and devices assist in clearing mucus from the lungs
• Medications – antibiotics treat infections, bronchodilators ease breathing and expectorants can help loosen mucus
• Vaccinations – regular immunisations can prevent respiratory infections that may exacerbate the condition
• Pulmonary rehabilitation – structured exercise and education programs enhance lung function, maintain physical function and overall wellbeing

The difference respiratory physiotherapy with Air Physiotherapy can make

Respiratory physiotherapy forms a key part of the long term management of bronchiectasis, and is recommended by the British Thoracic Society Guidelines. At Air Physiotherapy, we specialise in providing personalised care for individuals with bronchiectasis at the time of diagnosis, and at regular points to ensure you are staying infection free and active. We are also on hand to help during times of infection.

Our comprehensive approach includes tailored airway clearance techniques, breathing exercises and ongoing support to help you manage your condition effectively. Our personalised pulmonary rehabilitation programmes in particular will help give you the confidence and skills to be able to work towards achieving all that you want to in life; we’ll support you every step of the way.