Bronchiectasis is a chronic lung condition in which the walls of the bronchi become damaged due to infection, inflammation or other causes, leading to abnormal and permanent widening of the airways.
Under normal conditions, tiny hair-like structures in the airways help clear mucus, bacteria and inhaled particles from the lungs. When the bronchial walls are damaged, this clearance function becomes less effective. Mucus may then build up inside the airways, creating an environment where bacteria can grow more easily.
Repeated infections can further damage the bronchial walls, causing a cycle of mucus retention, inflammation and recurrent infection. Bronchiectasis usually cannot be completely cured, but with proper management, symptoms can be controlled, infections can be reduced, and quality of life can be maintained.
Common causes include previous severe infections such as pneumonia, tuberculosis, whooping cough or measles, which may damage the airway structure. It may also be related to long-term airway obstruction, such as inhaled foreign bodies or tumours. Some patients may have underlying conditions such as abnormal ciliary function, cystic fibrosis or immune system deficiency.
Patients with bronchiectasis often experience a long-term chronic cough, commonly associated with a large amount of phlegm. Some patients may cough up thick yellow-green sputum, especially in the morning.
Because mucus can remain trapped in the airways, patients may have repeated respiratory or lung infections, such as pneumonia. During infections, cough, sputum volume, sputum colour and shortness of breath may become worse.
Some patients may have blood-stained sputum or even more significant coughing up of blood. Other symptoms may include shortness of breath, chest tightness, chest pain, wheezing and fatigue.
If a cough does not go away, phlegm increases noticeably, or thick sputum, blood-stained sputum and lung infections occur repeatedly, bronchiectasis or other lung conditions should be considered.
The key goals in bronchiectasis management are symptom control, airway clearance and prevention of recurrent infections. Patients should follow medical advice and should not stop treatment or delay follow-up on their own.
Drinking enough fluids may help make sputum easier to clear. Some patients may also learn postural drainage, chest physiotherapy or other airway clearance techniques under the guidance of healthcare professionals.
If antibiotics, bronchodilators, expectorants or other medications are prescribed, they should be used as directed. Patients should also avoid smoking and second-hand smoke, reduce exposure to air pollutants, and receive influenza, COVID-19 or other relevant vaccinations as advised by their doctor to lower the risk of respiratory infections.
If there is a persistent cough, repeated coughing up of large amounts of yellow-green sputum, blood-stained sputum, coughing up blood, worsening shortness of breath, chest pain, fever or recurrent pneumonia, patients should consult a respiratory specialist to understand the underlying cause and receive appropriate follow-up.
