Normal cell wall of the bronchus vs the damaged cell wall and increase in mucus that causes bronchiectasis.
Normal versus damaged bronchus with bronchiectasis.

What is bronchiectasis?

Bronchiectasis is a lung condition that causes coughing up of mucus. It is (pronounced brong-kee-ek-tuh-sis). In the lungs, the bronchi are the passages that allow air to enter the lungs. In bronchiectasis, the inside surfaces of the bronchi get thicker over time from inflammation that leave scars. Thicker walls cause mucus to collect in these passages because the walls are not strong enough to make the mucus move out of the lungs. In addition, the cilia (thin strands that look like hair and that help move mucus) are destroyed. When that happens, infections can happen more easily and breathing becomes difficult. Times that breathing or coughing gets worse are called exacerbations.

How common is bronchiectasis?

It is estimated that there are 500,000 individuals in the United States with bronchiectasis and one person out of 150 people aged 75 years old and older has bronchiectasis. The risk of getting this condition increases with age. However, younger people can and do get bronchiectasis. In adults, it is much more common in women than in men. In children, it is more common in boys than girls. It is possible, but rare, for children to be born with bronchiectasis.

What are risk factors for bronchiectasis?

People with the following conditions are considered to have risk factors for bronchiectasis:

  • Cystic fibrosis
  • Chronic and inflammatory lung disease
  • Chronic or severe lung infections, like tuberculosis, non-tuberculous mycobacteria (NTM) or pneumonia
  • Deficits in the immune system
  • Repeated aspiration (breathing in) of things other than air, such as food particles, that cause damage to the lungs

What causes bronchiectasis?

Bronchiectasis may be caused by cystic fibrosis (CF), a genetic condition that results in long-lasting lung infections and reduced ability to breathe. CF gets worse over time.

For non-CF bronchiectasis, the cause is not always known. This is called idiopathic bronchiectasis. However, in other cases, causes include:

  • Past severe infection that has damaged the lung
  • Genetic diseases like primary ciliary dyskinesia or alpha-1 antitrypsin deficiency
  • Immune system conditions that make it difficult to fight off infections
  • Aspirating (breathing in) things like fluids, stomach acid, or foods into the lungs
  • Allergic bronchopulmonary aspergillosis, an allergy to a particular type of fungus
  • Other conditions like rheumatoid arthritis, Crohn’s disease, and Sjogren’s syndrome
  • Obstructed airways (airways blocked by something like a tumor or an inhaled object)

What are the symptoms of bronchiectasis?

Some of the most common symptoms are:

  • Coughing that results in a lot of mucus
  • Coughing up mucus that has blood in it (known as hemoptysis)
  • Chest pain or tightness because it is harder to breathe
  • Wheezing or making whistling noises when breathing
  • Clubbing of nails
  • Loss of weight
  • Flare-ups that usually include:

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