Bronchiectasis is a condition that affects the lungs. It causes a persistent cough and an excess amount of sputum (phlegm).

The airways

Air passes in and out of the lungs through a series of branching airways called bronchial tubes. Usually, the bronchial tubes narrow smoothly towards the edges of each lung. However, in bronchiectasis, the airways of the lungs are irreversibly damaged and, instead of narrowing, they are abnormally widened.

The lung’s airways are covered in mucus and tiny, hair-like structures called cilia. The mucus acts as a protective ‘blanket’ against any unwanted particles that try to enter the lungs. The cilia waft the particles and any excess mucus up and out of the lungs. This is usually a tiny amount that is swallowed without noticing but, if there is a lot of mucus, it can cause coughing.

How bronchiectasis occurs

In bronchiectasis, the cilia that line the bronchial tubes are destroyed, causing a build-up of dust, mucus, and bacteria. Excessive amounts of mucus form on the back of the throat producing sputum. The sputum can be very thick, sticky, and difficult to dislodge through coughing.

The build up of sputum in the airways attracts bacteria that can live in the sputum and infect the lungs. Infections cause further irreversible damage to the bronchial tubes, and the increased damage makes another infection more likely, leading to a cycle of deterioration.

The bronchial tubes may be damaged as a result of a childhood illness, such as pneumonia, or whooping cough, or it may have no known cause.

Outlook

In the past, bronchiectasis was a condition that almost always started during childhood. However, with improved hygiene, childhood immunisation, and more frequent use of antibiotics, nowadays the condition does not often develop until middle age or later.

There is currently no cure for bronchiectasis, and the damage to the airways is usually permanent. However, early detection and treatment can help prevent the damage to the lungs from getting worse. Medication is effective at treating the recurrent infections, and there are a number of exercises that can help relieve the symptoms.

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