What is bronchiectasis?

Bronchiectasis (pronounced as brong-ke-EK-tah-sis and derived from the Greek bronkhia meaning branches of the lung's main bronchi plus the Greek word ektasis meaning dilation) is the abnormal widening of the bronchi or their branches that usually causes an increased risk for infection.
Bronchiectasis is a condition in which the bronchial tubes in the lung become damaged from inflammation or other causes and the smooth muscles of the bronchial tubes are destroyed. In addition, the elasticity of the bronchi is often lost.
Bronchiectasis may be acquired or have a genetic origin.
Many clinicians consider bronchiectasis to be a form of chronic obstructive pulmonary disease (COPD); it includes chronic bronchitis and emphysema.
What are the types of bronchiectasis?
Some researchers have described three primary types of bronchiectasis. These types are defined by their anatomical/microscopic appearance.
- Cylindrical bronchiectasis, the mildest form of bronchiectasis shows the loss of normal airway tapering.
- Saccular or varicose bronchiectasis shows further distortion of the airway wall along with more mucous and sputum production by the individual; some of the bronchi may appear to be in a beaded form.
- The most severe form of bronchiectasis and the least common form is cystic bronchiectasis. This form has large air spaces and a honeycombed appearance in CT scan studies and usually has thicker walls than the blebs seen with emphysema. Some people have more than one type in their lungs.
What causes bronchiectasis?
Bronchiectasis is caused by damage to the walls of the bronchi; this damage consists of destroying the smooth muscles and the elastic tissue that allow the bronchial tubes to contract. Consequently, if the bronchi are damaged, secretions that are normally produced in the lung are not well removed and cause an increased likelihood that infections (pneumonia, bronchitis) can develop.
Unfortunately, these infections can cause further damage to the bronchial walls producing a cycle of increased damaged and then increased infection. As the cycle continues, lung functionality decreases.
The causes of bronchiectasis can be acquired (infection, environmental exposure, drug and/or alcohol abuse, for example) and/or congenital (alpha-1 antitrypsin deficiency, immotile cilia syndrome, for example).
- One common inherited cause of bronchiectasis is cystic fibrosis.
- The other causes of bronchiectasis are sometimes referred to collectively as non-cystic fibrosis bronchiectasis.

SLIDESHOW
COPD Lung Symptoms, Diagnosis, Treatment See SlideshowWho is at risk for bronchiectasis?
People at risk for bronchiectasis include:
- Individuals with alpha-1 antiproteinase (alpha-1 antitrypsin) deficiency or an embryological defect termed immotile cilia syndrome.
- People with cystic fibrosis
- Children that develop lung infections with lung tissue destruction are at risk for bronchiectasis to develop later in life.
- People that have recurrent lung infections, aspirate foreign bodies or have had a history of tuberculosis or inflammatory bowel disease.
- People that abuse drugs and alcohol.
- Individuals are exposed to toxic gases or any substances that damage lung tissue.

What are the symptoms of bronchiectasis?
The signs and symptoms of bronchiectasis develop and change over time.
The first common symptoms include a recurrent cough and sputum production; usually the sputum/mucous is clear but eventually may become bloody if injuries to the bronchial wall occur. In addition, mucous may change to a green or yellow color when the infection is present.
As the disease progresses, chronic coughing with mucous production increases and the person usually becomes more fatigued and short of breath as lung function decreases.
Some people may develop wheezing; some may lose weight due to the increased effort needed to breathe.
Occasionally, symptoms of a primary disease like pneumonia may mask some of the symptoms of bronchiectasis so it may be more difficult to diagnose bronchiectasis if an underlying disease is present.
When should I contact my doctor for bronchiectasis?
You should contact your doctor for medical care if you have a chronic cough (lasting about three weeks or more), a new onset of shortness of breath and/or any coughing up blood (hemoptysis).
Individuals who have repeated bouts of pneumonia and increased sputum production should also seek medical care.
How is the diagnosis of bronchiectasis made?
The diagnosis of bronchiectasis usually involves a history and physical exam, with the history being a chronic daily cough and sputum production.
Sputum analysis, chest X-ray, and high-resolution CT of the chest (lungs) are tests usually ordered. In most cases, the definitive diagnosis is made with a CT of the chest although occasionally a chest X-ray is sufficient. These exams usually show the changes in the bronchioles that are consistent with bronchiectasis.
For some patients, other tests may be ordered to determine if underlined diseases are contributing to bronchiectasis. Such tests include alpha-1 antitrypsin levels, autoimmune screening tests, and measures of vitamin D deficiency as this is commonly found in bronchiectasis and correlates with disease severity.
Patients may need to be tested for cystic fibrosis. Chronic infections like fungal infections (Aspergillus) may need to be ruled out.
Pulmonary function tests also may be ordered to determine the patient's baseline lung function to help determine the extent of lung tissue compromise.
Subscribe to MedicineNet's Allergy and Asthma Newsletter
By clicking "Submit," I agree to the MedicineNet Terms and Conditions and Privacy Policy. I also agree to receive emails from MedicineNet and I understand that I may opt out of MedicineNet subscriptions at any time.
What is the treatment for bronchiectasis?
Unfortunately, bronchiectasis is not a curable disease, but a slowly progressive disease. Treatment for bronchiectasis is based on the control of symptoms and preventing additional infections.
Treatment protocols frequently include keeping immunizations up-to-date, eliminating aggravating factors such as cigarette smoke, alcohol, and drugs, and encouraging good nutrition. Increasing fluid intake to keep mucous less sticky is another treatment. Sometimes an expectorant (to loosen the mucous) and mucous thinning medication can help decrease symptoms.
Chest physical therapy, which usually involves rhythmic clapping on the back of your chest, can help with loosening sputum so it can be coughed up.
If patients acquire an infection, antibiotics are effective against the pathogen (virus, bacteria, or fungus), and chest physiotherapyise is utilized as primary treatment. In addition, bronchodilators, corticosteroid therapy and, if needed, oxygen therapy are utilized in many patients. Patients with severe exacerbations of bronchiectasis usually need hospitalization and IV medications.
Patients with bronchiectasis that are poorly controlled with antibiotics may require surgical therapy. Surgical therapy (or in some individuals, bronchoscopy) can remove mucus plugging, foreign bodies, or tumors that exacerbate bronchiectasis.
Excessive hemoptysis may need to be treated surgically or by bronchial artery embolization.
Some patients may benefit from surgical removal of nonfunctional lung tissue.
From 
Lung Disease/COPD Resources
Featured Centers
Health Solutions From Our Sponsors
What is the prognosis of bronchiectasis?
In general, congenital causes of bronchiectasis (cystic fibrosis, for example) usually have a worse prognosis than bronchiectasis developed from acquired diseases. Those with acquired bronchiectasis can have a fair to good prognosis if bronchiectasis is recognized early and appropriate treatment is done. However, bronchiectasis is often slowly progressive.
Those patients that pay attention to getting early and appropriate treatment along with avoiding situations that may exacerbate the disease will likely have a fair to good prognosis.
Can bronchiectasis be prevented?
Bronchiectasis due to genetic defects is currently not preventable. However, the incidence in the rate of progression of bronchiectasis can be reduced by avoiding those environmental factors that increase bronchiectasis risk such as alcohol, drugs, environmental toxins, and smoking cigarettes.
In addition, avoiding those situations that can lead to pulmonary infections can reduce the risk of developing bronchiectasis.
Pertussis (whooping cough) in children can lead to bronchiectasis later in life. Immunization can prevent this cause.
<https://emedicine.medscape.com/article/296961-overview>
Top Bronchiectasis (Acquired, Congenital) Related Articles
CT Scan (Computerized Tomography)
A CT scan is an X-ray procedure that combines many X-ray images with the aid of a computer to generate cross-sectional and three-dimensional images of internal organs and structures of the body. A CT scan is a low-risk procedure. Contrast material may be injected into a vein or the spinal fluid to enhance the scan.Chest Pain
Chest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy, pneumothorax, shingles, pneumonia, pulmonary embolism, angina, heart attack, costochondritis, pericarditis, aorta or aortic dissection, and reflux esophagitis.
Diagnosis and treatment of chest pain depends upon the cause and clinical presentation of the patient's chest pain.
Chest X-Ray
Chest X-Ray is a type of X-Ray commonly used to detect abnormalities in the lungs. A chest X-ray can also detect some abnormalities in the heart, aorta, and the bones of the thoracic area. A chest X-ray can be used to define abnormalities of the lungs such as excessive fluid (fluid overload or pulmonary edema), fluid around the lung (pleural effusion), pneumonia, bronchitis, asthma, cysts, and cancers.Childhood Vaccination Schedule
Childhood immunizations can protect children from potentially deadly diseases. Vaccinations included on the childhood immunization schedule include Hib, polio, DTaP, MMR, HPV, flu, chickenpox, meningitis, rotavirus, pneumonia, hepatitis A, and hepatitis B.Congestive Heart Failure (CHF): Symptoms, Causes, Stages, Treatment
Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.COPD Quiz
COPD is a combination of three conditions? Take this quiz to learn the three conditions that make up the pulmonary disease called chronic obstructive pulmonary disease (COPD).Energy Foods for COPD
What are COPD foods to avoid that may trigger symptoms? Learn more about the COPD diet. Boost your energy and combat COPD with these diet tips.COPD Lung Symptoms
COPD is a pulmonary disorder caused by obstructions in the airways of the lungs leading to breathing problems. Learn about COPD symptoms, diagnosis, and treatment options.Drug Abuse and Addiction
Drug abuse and addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Drug abuse and addiction are preventable.Exercises for COPD
The more you exercise, the better you'll feel with COPD. Breathe easier with these 10 exercises from WebMD.Cough: 19 Tips on How to Stop a Cough
Coughing is a reflex that helps a person clear their airways of irritants. There are many causes of an excessive or severe cough including irritants like cigarette and secondhand smoke, pollution, air fresheners, medications like beta blockers and ACE inhibitors, the common cold, GERD, lung cancer, and heart disease.Natural and home remedies to help cure and soothe a cough include staying hydrated, gargle salt water, use cough drops or lozenges, use herbs and supplements like ginger, mint, licorice, and slippery elm, and don't smoke. Over-the-counter products (OTC)to cure and soothe a cough include cough suppressants and expectorants, and anti-reflux drugs. Prescription drugs that help cure a cough include narcotic medications, antibiotics, inhaled steroids, and anti-reflux drugs like proton pump inhibitors or PPIs, for example, omeprazole (Prilosec), rabeprazole (Aciphex), and pantoprazole (Protonix).Vaccination Schedule for Adults and Adolescents
Immunizations can prevent many diseases nowadays. It's important to follow the vaccination guidelines recommended on the CDC's vaccination schedule for adults and adolescents in order to stay informed about new vaccines and to learn how often and when the vaccines should be administered.Lungs Picture
The lungs are a pair of spongy, air-filled organs located on either side of the chest (thorax). See a picture of the Lungs and learn more about the health topic.What Causes a Buildup of Mucus in the Lungs?
What causes mucus in the lungs? Learn the signs and symptoms of accumulation of mucus in your lungs and what to do if you have too much mucus in the lungs. Since not all cough medicines are the same, choosing the best treatment for you depends on your type of cough and symptoms.What Is the Life Expectancy of Someone With COPD?
Chronic obstructive pulmonary disease (COPD) is a group of diseases with the chief symptom of breathlessness and cough. COPD is a slowly progressive disease. Depending on the disease severity, the five-year life expectancy for people with chronic obstructive pulmonary disease (COPD) ranges from 40%-70%. That means 40-70 out of 100 people will be alive after five years of diagnosis of COPD.