Bronchiectasis is a long-term lung condition in which the airways (bronchi) become abnormally widened and scarred. This lets mucus build up instead of clearing, which leads to a cycle of repeated infection and inflammation that gradually damages the lungs. The two main symptoms are a persistent daily cough and bringing up a lot of phlegm. There is no cure, but bronchiectasis can be managed well, and early diagnosis is key to preventing lasting lung damage. If you have an ongoing cough with phlegm or frequent chest infections, see a doctor.
Respiratory illnesses are common, and conditions like asthma, emphysema and bronchitis are widely known. Bronchiectasis is discussed far less often, yet it can quietly erode lung health and quality of life if it is not caught and managed. Bloom, together with our partner Momentum Health4Me, takes a closer look at what bronchiectasis is, how to recognise it, and how it is treated. If you want cover that includes chronic care, you can explore health insurance options tailored to your needs.
Key takeaways
| • Bronchiectasis is a chronic condition where the airways widen and scar, so mucus pools and infections keep recurring. |
| • The hallmark symptoms are a persistent daily cough and producing a lot of phlegm, often with repeated chest infections. |
| • A high-resolution CT scan is the main test used to confirm a diagnosis. |
| • There is no cure, but airway clearance, treating infections early and vaccinations can keep it well controlled. |
What is bronchiectasis?
Bronchiectasis is a chronic lung condition in which the walls of the airways become damaged, widened and thickened. Healthy airways clear mucus efficiently, but in bronchiectasis the damaged, dilated airways let mucus collect and stagnate. That trapped mucus is a breeding ground for bacteria, leading to a vicious cycle of infection, inflammation and further airway damage. Over time this can form irregular pockets in the airways and reduce lung function. The damage is permanent, which is why early diagnosis and good day-to-day management matter so much.
What causes bronchiectasis?
Causes fall broadly into two groups: cystic fibrosis related and non-cystic fibrosis related. In many people, though, no single cause is ever found, which is known as idiopathic bronchiectasis.
Cystic fibrosis (CF) is a genetic condition affecting the lungs and digestive system, causing thick, sticky mucus that clogs the lungs. It is a well-recognised cause of bronchiectasis. You can learn more from the South African Cystic Fibrosis Association.
Non-CF causes can include:
| • Past or repeated lung infections, such as pneumonia, tuberculosis, whooping cough or measles |
| • Allergic lung inflammation, known as allergic bronchopulmonary aspergillosis |
| • Autoimmune and inflammatory conditions, such as rheumatoid arthritis and inflammatory bowel disease (Crohn’s disease and ulcerative colitis) |
| • A weakened immune system, including from HIV |
| • Chronic obstructive pulmonary disease (COPD) |
| • Inhaling harmful substances or inadvertently breathing food or liquid into the lungs (aspiration) |
Symptoms of bronchiectasis
Symptoms often develop gradually. The two main ones are a persistent daily cough and producing a lot of phlegm (sputum). Other common symptoms include:
| • Shortness of breath and wheezing |
| • Recurring chest infections |
| • Feeling constantly tired or run down |
| • Coughing up blood or blood-stained mucus (haemoptysis) |
| • Unexplained weight loss |
| • Rounded, thickened skin around the nails, known as clubbing |
Many people also have flare-ups, called exacerbations, when symptoms suddenly get worse, often due to a chest infection. Preventing and treating these promptly is a key part of managing the condition. See a doctor if you have an ongoing combination of these symptoms.
Who is at risk?
Bronchiectasis becomes more common with age and is somewhat more common in women. You may be at higher risk if you have:
| • A history of frequent or severe chest infections, including whooping cough |
| • A rheumatic or autoimmune condition, such as rheumatoid arthritis |
| • A condition affecting the cilia, the tiny hairs that clear mucus from the airways |
| • A genetic condition such as alpha-1 antitrypsin deficiency |
| • Lung damage from inhaling harmful substances, or a tendency to aspirate food or liquid |
How is bronchiectasis diagnosed?
A doctor will start with your symptoms and history, and may arrange several tests. A high-resolution CT scan of the chest is the main test used to confirm bronchiectasis, as it shows which airways are widened and how much of the lung is affected. A chest X-ray, blood tests and a sputum sample help check for infection, lung function tests (spirometry) measure how well your lungs are working, and a sweat test can check for cystic fibrosis. In some cases a pulmonologist, a lung specialist, may perform a bronchoscopy to look inside the airways. Identifying any underlying cause helps guide the right treatment.
Treatment and management
There is no cure, but bronchiectasis can be managed effectively. The goals are to clear mucus, treat and prevent infections, and keep flare-ups to a minimum. Common approaches include:
| • Airway clearance. Chest physiotherapy and breathing exercises help move mucus out of the lungs, sometimes with the help of a device. |
| • Medicines. Antibiotics to treat and sometimes prevent infections, mucus-thinning medicines, and bronchodilators to open the airways. |
| • Vaccinations. Staying up to date with flu and pneumococcal vaccines helps prevent the infections that trigger flare-ups. |
| • Pulmonary rehabilitation. A supervised programme of exercise and education to improve breathing and fitness. |
| • Advanced care. Oxygen therapy in more advanced cases, and rarely, surgery, for severe, localised disease. |
Can bronchiectasis be prevented?
It cannot always be prevented, but you can lower your risk and protect your lungs:
| • Keep vaccinations up to date. Childhood vaccines against whooping cough and measles, and flu and pneumococcal vaccines, help prevent the infections linked to bronchiectasis. |
| • Protect your lungs. Avoid smoking and limit exposure to polluted air and harmful chemicals. |
| • Treat chest infections early. Getting prompt treatment for lung infections helps limit lasting airway damage. |
When to see a doctor
See a doctor if you have a cough that has lasted for weeks, especially with daily phlegm, repeated chest infections, breathlessness or coughing up blood. Early diagnosis and an effective treatment plan are the best way to protect your lungs from further damage.
Cover for chronic respiratory conditionsBronchiectasis is one of the chronic conditions covered by Bloom’s Health4Me, with access to a doctor and chronic medication benefits to help you manage it. Fill in your details and we will call you back. |
Frequently asked questions
Don’t ignore the signs
Bronchiectasis is easier to control the earlier it is caught. If you have a lingering cough with phlegm or keep getting chest infections, see a doctor. With the right treatment and support, most people with bronchiectasis manage their symptoms well and stay active.
Bronchiectasis is one of the chronic conditions covered by Bloom’s Health4Me. Make sure you and your family are covered with affordable health insurance. Compare Health4Me options, read more about common chronic diseases, explore the full range of benefits, or understand the difference between health insurance and medical aid. You can also speak to a medical professional through our Hello Doctor service. To get started, get in touch and we will call you back.
