Bronchiectasis

Symptoms of bronchiectasis 

Symptoms of bronchiectasis are generally more common in older people.

The most common symptoms of bronchiectasis include:

• a persistent cough that usually brings up phlegm (sputum)
• breathlessness

The severity of symptoms can vary widely.

Some people have only a few symptoms that don't appear often, while others have wide-ranging daily symptoms.

The symptoms tend to get worse if you develop an infection in your lungs.

Other symptoms may include:

• wheezing
• coughing up blood or blood-stained phlegm
• chest pain 
• joint pain
• clubbing of the fingertips – the tissue beneath the nail thickens and the fingertips become rounded and bulbous

When to see your GP 

You should see your GP if you develop a persistent cough.

Your GP may need to rule out other lung infections, such as pneumonia and bronchitis, which have symptoms similar to those of bronchiectasis.

If your GP suspects you may have bronchiectasis, they'll refer you to a specialist in treating lung conditions (a respiratory consultant) for further tests.

When to seek immediate medical advice 

Some people with bronchiectasis develop a severe lung infection that may need to be treated in hospital.

Signs and symptoms of serious lung infection include:

• a  blue tinge to the skin and lips (cyanosis)
• confusion
• a high temperature of 38C (100.4F) or above
• rapid breathing (more than 25 breaths a minute)
• severe chest pain that makes it too painful to cough and clear your lungs

If you experience any of the symptoms above, contact your GP or if this isn't possible, contact GP out of hours service.

Why it happens 

The lungs are full of tiny branching airways, known as bronchi.

Bronchiectasis can develop if the tissue and muscles that surround the bronchi are damaged or destroyed. 

There are many reasons why this may happen.

Common causes include:

• a previous severe lung infection
• inhaling a foreign body into your lungs
• a tumour
• underlying problems with the immune system (the body’s defence against infection) that make the bronchi more vulnerable to damage from an infection
• allergic bronchopulmonary aspergillosis (ABPA) – an allergy to a certain type of fungi that can cause the bronchi to become inflamed if spores from the fungi are inhaled

However, in roughly 40 per cent of cases of bronchiectasis, no obvious cause for the condition can be found (known as idiopathic bronchiectasis).

How bronchiectasis is treated

The damage caused to the lungs by bronchiectasis is permanent. However, treatment can help relieve your symptoms and stop the damage getting worse.

The main treatments include:

• exercises and special devices to help you clear mucus out of your lungs
• medication to help improve airflow within the lungs
• antibiotics to treat any lung infections that develop

Possible complications 

Complications of bronchiectasis are rare, but they can be serious.

One of the most serious complications is coughing up large amounts of blood. This is caused by one of the blood vessels in the lungs splitting.

This problem can be life-threatening and may require emergency surgery to treat it.

Outlook 

The outlook for people with bronchiectasis is highly variable and often depends on the underlying cause.

Living with bronchiectasis can be stressful and frustrating. However, most people with the condition have few symptoms and a normal life expectancy. For people with very severe symptoms, however, bronchiectasis can be fatal if the lungs stop working properly.

More useful links

• Bronchiectasis
• How to use your health service
• Air pollution and health
• Air quality in Northern Ireland
• Bronchiectasis - Asthma and Lung UK
• Support for chest conditions