Bronchiectasis

Bronchiectasis is a long-term lung disease. When the airways become widened and scarred, mucus can build up more easily. This creates an environment where bacteria can grow, leading to repeated lung infections and further lung damage

Although bronchiectasis was once considered uncommon, experts now believe it is one of the most common obstructive lung diseases, after asthma and COPD. Increased use of CT imaging and national disease registries has helped healthcare providers better understand how often it occurs and how it overlaps with other airway conditions. 

UC Health provides specialized care for people living with bronchiectasis through an integrated program focused on complex airway diseases, including cystic fibrosis (CF), non-CF bronchiectasis and primary ciliary dyskinesia. Patients have access to advanced testing, airway clearance therapies, pulmonary rehabilitation and coordinated care from a multidisciplinary team. UC Health also participates in clinical research, national registries and collaborative care networks that help advance treatment options and improve patient outcomes.

Bronchiectasis develops when the walls of the airways become damaged from repeated inflammation or infection. Over time, the airways lose their ability to clear mucus from the lungs.

As mucus builds up, bacteria can grow more easily. This can lead to repeated infections, more inflammation and additional lung damage. Without proper treatment, this cycle can gradually reduce lung function over time. 

Bronchiectasis can affect one part of the lung or several areas. Some people have mild symptoms, while others may have more severe disease that affects daily life and breathing.

Bronchiectasis is a lifelong condition, but early diagnosis and expert care can help control symptoms, reduce infections, slow disease progression and improve quality of life. 

Symptoms of bronchiectasis often develop slowly and may get worse over time. Some people experience flare-ups, also called exacerbations, when symptoms suddenly become more severe.

Common symptoms include:

• Chronic cough with mucus 

• Shortness of breath  

• Wheezing 

• Frequent lung or respiratory infections 

• Chest pain or chest tightness 

• Fatigue or low energy  

• Coughing up blood (hemoptysis) 

• Unintentional weight loss 

• Clubbing of the fingers or toes in advanced disease 

Because these symptoms can look similar to asthma, COPD and other lung conditions, it is important to see a healthcare provider for an accurate diagnosis. 

Bronchiectasis happens when damage to the airways prevents the lungs from clearing mucus normally. Many different conditions can lead to this damage.

Previous Lung Infections 

Severe or repeated infections can damage the airways, including:

• Pneumonia  

• Tuberculosis 

• Whooping cough  

• Severe viral infections 

Chronic Lung or Airway Conditions 

Some chronic lung diseases increase the risk of bronchiectasis, including:

• COPD  

• Severe asthma 

• Allergic bronchopulmonary aspergillosis (ABPA)  

Immune System Disorders

Some people develop bronchiectasis because their immune system cannot fight infections effectively. Causes may include: 

• Primary immunodeficiency disorders 

• Autoimmune diseases such as rheumatoid arthritis or inflammatory bowel disease  

Genetic and Congenital Conditions

Inherited conditions can affect how the lungs clear mucus, including: 

• Cystic fibrosis 

• Primary ciliary dyskinesia  

• Alpha-1 antitrypsin deficiency 

Airway Blockage or Aspiration 

Bronchiectasis may also develop when the airways become blocked or irritated because of:

• Inhaled foreign objects  

• Tumors 

• Chronic aspiration from swallowing problems or acid reflux  

In some cases, the exact cause of bronchiectasis is never identified.

Bronchiectasis can affect people of all ages, but certain factors may increase risk, including:

• Recurrent lung infections 

• Smoking or exposure to lung irritants 

• Severe asthma or COPD  

• Autoimmune disease 

• Immune deficiencies 

• Gastroesophageal reflux disease (GERD) 

• Difficulty swallowing or aspiration  

• Family history of inherited lung diseases 

• Exposure to environmental pollutants

   

The Nontuberculous Mycobacterial (NTM) Lung Disease and Bronchiectasis Link

Bronchiectasis is closely linked to nontuberculous mycobacterial (NTM) lung disease, a chronic infection caused by bacteria commonly found in soil and water.

People with bronchiectasis are more likely to develop NTM infections because damaged airways cannot clear bacteria as effectively. These infections can increase inflammation, worsen mucus buildup and cause more lung damage over time. 

UC Health provides specialized care for people with bronchiectasis and NTM lung disease through a multidisciplinary team that includes pulmonary, infectious disease, respiratory therapy and airway clearance specialists.

Without treatment, bronchiectasis can lead to serious health problems, including:

• Recurrent lung infections  

• Progressive lung damage 

• Respiratory failure  

• Significant coughing up of blood (hemoptysis) 

• Low oxygen levels  

• Pulmonary hypertension 

• Reduced quality of life and exercise tolerance  

Early diagnosis, airway clearance therapy, infection management and coordinated pulmonary care can help reduce complications, protect lung function and support long-term health.