Bronchiectasis

What is Bronchiectasis?

Bronchiectasis is a chronic lung condition when the airways/bronchi (tubes that carry air in and out of the lung) are widened, inflamed, and often scarred. This damage can happen in one or many parts of the lung or in both lungs [1, 2]. 

In bronchiectasis, the mucus that normally helps us clear dust, germs, and other small particles we inhale gets thick and difficult to clear by coughing. This leads to inflammation and frequent infections that result in flare-ups (exacerbations) and more damage to the airways.

Is There a Cure for Bronchiectasis?

Although there is no cure for bronchiectasis at this time, there are treatments that will help you breathe better, clear your lungs of mucus, and prevent flare ups. You and your caregivers can work with your healthcare provider to put together a treatment plan and find tools to help you manage your condition.

GAAPP is a Proud Member of the World Bronchiectasis Day Collaborative Effort that Brought the Bronchiectasis “World” Together on
July 1st 2022

You will find evidence-based resources provided by international bronchiectasis experts and patient advocacy organizations available in several languages on the World Bronchiectasis Day webpage.

It includes lots of information about diagnosis, airway clearance, patient support groups, and treatments.

We highly recommend the educational “basic information sheet” on bronchiectasis which is available in multiple languages here.

In 2023, GAAPP recorded an educational webinar on bronchiectasis you can find here. Our speakers from around the globe included Lauren Dunlap, a patient advocate (US), Ashok Gupta, MD (India), Ghulam Mustafa, MD (Pakistan), and Tonya Winders, MBA (CEO of GAAPP).

This multidisciplinary group of two healthcare practitioners and two patient advocates discussed the following topics:

• World-view perspectives from allergy/immunology and pulmonology specialists in the diagnosis, epidemiology, therapeutic endpoints, and advancements in treatment for non-CF bronchiectasis (NCFB).
  
• Overlapping conditions often associated with NCFB (e.g., immune deficiencies, infections).
  
• Disease management and lifestyle factors that are involved from a patient’s perspective when choosing treatment options and stigmas associated with the diagnosis.

What are Common Symptoms of Bronchiectasis and How is it Diagnosed?

People experience different symptoms depending on their type of disease [1, 2].

• Cough that lasts a long time (chronic cough) with or without phlegm
• Sputum/phlegm production
• Loss of sleep due to coughing
• Shortness of breath (breathlessness)
• Frequent lung infections that require treatment (flare ups/exacerbations)
• Unexplained weight loss and/or chest pain
• Fever and/or chills

The most definitive way to diagnose bronchiectasis is using a lung imaging (radiology) test called computerized tomography (CT). Scans can be used to show the presence of enlarged airways and inflammation or scarring typical of bronchiectasis. If you experience symptoms, your healthcare provider will send you for this test.

Additional tests may include cultures of your airway mucus to test for germs (bacteria, fungi, or mycobacteria) to see if you need treatment with antibiotics. 

What are the Causes of (or Risk Factors for) Bronchiectasis? 

There are many possible causes of bronchiectasis, including pre-existing medical conditions that are often called co-morbidities, as well as genetic, auto-immune, and infection-related causes. [3] Treatment depends on the type of bronchiectasis you have.

Bronchiectasis was originally called a “rare disease,” but with more research and increased awareness that led to better diagnosis, it is now accepted as the third most common lung disease in the world after asthma and COPD, [1] affecting many adults and children. 

Severe infections

• Tuberculosis (TB) and pneumonia are the most common causes in the world [4] especially in Asian countries such as India. [5]
• NTM lung disease is a rare condition caused by an infection with non-tuberculous mycobacteria. [14]

Genetic disorders

• Primary ciliary dyskinesia (PCD) patients often get the condition early in life and require special diagnosis and treatment. [6]
• Alpha-1 antitrypsin deficiency (genetic COPD) requires genetic testing to diagnose. Specialized treatment (augmentation therapy) is available in some countries. [3]
• Cystic fibrosis is often diagnosed in children using genetic testing and requires specialized treatments. [15]
• Primary immunodeficiency and other autoimmune conditions that require specialized diagnosis and treatment. [3]

Asthma

Asthma is often found as a comorbidity in bronchiectasis [7] and studies have shown that people with asthma and bronchiectasis respond well to inhaled corticosteroid treatment. [8]

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) often co-exists [9, 10] with bronchiectasis and they share many symptoms resulting from obstruction of the airways, but these are two separate conditions.

Chronic rhinosinusitis

Chronic rhinosinusitis (inflammation of the sinuses, hollow cavities in the head) is thought to be related to a type of inflammation called eosinophilic bronchiectasis. [11, 12]

Gastrointestinal reflux disease

Gastrointestinal reflux disease (GERD/GORD) is aspiration of gastric material into the lung; this is thought to be a risk for several lung conditions. [13]