Bronchiectasis is a lung condition where the breathing tubes in the lungs (bronchi) have been damaged, enlarged and scarred – primarily due to infection. This causes mucus to build up in the extra space. Over time, the airways’ ability to clear out mucus and to transport oxygen is reduced. This can lead to worsened lung scarring and other health problems.
Bronchiectasis is usually caused by a severe chest infection needing hospital admission often at a young age, or by repeated more mild chest infections.
Typically, in healthy lungs, the mucus gets cleared up by tiny hairs called cilia that line the breathing tubes so that it’s easily coughed out. However, when these hairs are not working properly, mucus gets stuck in the breathing tubes. This allows bacteria to grow in the excess mucus, causing further lung infections which damage the airway walls.
As a result, the breathing tubes become baggy, and holes form in the lungs. However, bronchiectasis is often preventable, or even reversible, if diagnosed early enough.
Most people with bronchiectasis have a chronic, mucus-producing cough. Other symptoms may include coughing up blood, bad breath, wheezing chest, recurring lung infections and a decline in general health.
The main symptom of bronchiectasis is a wet or rattling cough which produces a lot of sputum or phlegm. While older children and adults can cough this up, it is more difficult for younger children, and the cough may sound more rattling.
If you or your child has coughed every day for more than six weeks, or if your child has had three or more stays in hospital with chest problems, consult a health professional and ask about bronchiectasis.
To diagnose bronchiectasis, your doctor will need to take a complete medical history, ask about childhood diseases, and investigate recent chest infections. Following this, a physical examination is carried out; which includes listening to the chest. If there are symptoms of bronchiectasis, a chest x-ray will be recommended, and a CT scan of the lungs if essential (this is a painless examination and is similar to an x-ray). Blood and sputum tests are also required to detect and identify any bacteria or fungi that are infecting the lungs or breathing passages.
Bronchiectasis often is treated with medicines, hydration, and chest physical therapy (CPT).
Antibiotics, bronchodilators, expectorants, or mucus-thinning medicines can be used to treat bronchiectasis. As bronchiectasis can cause repeated lung infections, oral antibiotics can treat these issues. For more difficult infections, antibiotics may be given through an IV, to ensure that the medicine gets to where it needs to go. Other medicines can be used to thin and loosen mucus (expectorants) in the lungs; making it easier to cough up.
Drinking plenty of water is an easy way to help bronchiectasis, and can help to thin mucus and prevent it from becoming an ordeal to cough up.
Chest Physical Therapy, or CPT, is a more physical way of aiding those with bronchiectasis. This involves tapping or pounding the chest or back to physically loosen mucus. This should only be done by a medical professional or a trained carer, as amateur attempts can cause serious damage if done incorrectly.
Living a healthy lifestyle is possible with bronchiectasis, and helps to minimise the impact it has on your life. Simple things like avoiding smoking, keeping physically active, drinking plenty of water, and even avoiding dairy can help to keep your mucus under control.
People with chronic lung diseases also often experience mental health problems such as anxiety or depression. Addressing these issues is just as important as addressing the physical aspects of bronchiectasis. Support groups, therapy, or medication can help improve your quality of life and keep you happy and healthy.
Alongside the Asthma and Respiratory Foundation NZ, the Bronchiectasis Foundation has a range of resources and information to help those with bronchiectasis as well as those who care for them. These include action plans and advice for schools and pre-schools. Check out their website at bronchiectasisfoundation.org.nz for more information.
Esther-Jordan Muriwai was our Cody Forbes Award for Courage winner in 2014. She battled bronchiectasis for most of her young life, yet accomplished so much and inspired so many.
“Once she hits puberty, she will either get better or worse,” Miranda’s doctor said to her mother Robyn about her childhood bronchiectasis. While it is now over 20 years since Miranda was diagnosed, Robyn still often reflects on the 10-year period of their lives that were spent in and out of hospital.