What Is Bronchiectasis?

Bronchiectasis - A Type of COPD

female doctor listening with a stethoscope to a woman's chest
What is bronchiectasis and what are the causes and symptoms?. Istockphoto.com/Stock Photo©AlexRaths

Definition: Bronchiectasis

Bronchiectasis is a form of chronic obstructive pulmonary disease (COPD) in which the large airways of the lungs (bronchi) become damaged and widened. Mucous can collect in these dilated airways, allowing bacteria to grow and cause recurrent lung infections. The disease may be localized to one area of a lung, or generalized throughout both lungs.

Natural History of Bronchiectasis

Bronchiectasis often begins with repeated respiratory infections in childhood.

These infections result in a thickening, widening, and scarring of the bronchi - the tubes which pass from the trachea and down into the alveoli, the area in the lungs where the exchange of oxygen and carbon dioxide takes place. Meanwhile, the accumulation of mucus in the widened areas makes conditions right for infections to begin.  Infections lead to exacerbations of the disease and further widening and scarring of the bronchi.


This condition is often caused by repeated lung infections during childhood. Common infections that could lead to bronchiectasis such as whooping cough are less common due to immunizations, but yet the incidence of bronchiectasis continues to rise.

Roughly 50 percent of cases are due to the hereditary condition cystic fibrosis. It can also occur due to obstruction of the airways by a tumor such as lung cancer, or a foreign body, due to immune suppression from either congenital disorders or HIV, due to an allergic reaction to a fungus known as allergic bronchopulmonary aspergillosis, or due to primary ciliary dysplasia.

Symptoms of Bronchiectasis

Some common symptoms include:

  • A chronic daily cough - The cough associated with bronchiectais is often worst in the early morning and then again late at night.
  • Mucus production - The daily cough of bronchiectasis is accompanied by mucus which can be clear, yellow, green, or even blood tinged.
  • Symptoms due to repeated infections such as a fever and respiratory symptoms.
  • Wheezing.
  • Coughing up blood.
  • Clubbing - Clubbing is a condition in which the fingertips take on the appearance of an inverted spoon.
  • When it is severe, shortness of breath and profound fatigue.

Diagnosis of Bronchiectasis

A diagnosis of bronchiectasis begins with a careful history and physical exam followed by imaging and lung function studies. Some tests that aid in the diagnosis include:

  • Chest x-ray - A chest x-ray may show some signs of the disease.
  • Chest CT scan - The diagnosis is usually made based on the appearance of a CT scan.
  • Pulmonary function tests can help with the diagnosis as well as the severity.
  • A bronchoscopy may be done to rule out a foreign body or lung cancer.


The most important step in treatment is to treat the underlying cause of the disease. Infections are common and need to be treated and monitored. It was thought that treatments used for cystic fibrosis could help for people without cystic fibrosis with bronchiectasis, but more recently it appears that some of these treatments may even be harmful. Airway clearance techniques may help with decreasing sputum and with lung function. Oxygen therapy may be needed if the disease is severe, and occasionally surgery is needed to remove a very damaged area of a bronchus.


In addition to repeated infections, some people develop atelectasis - a collapse of part of or all of a lung and respiratory failure may occur. The disease can also lead to right heart failure, something known as cor pulmonale.


The prognosis of bronchiectasis depends on the underlying cause.  For some people, this can be very serious or fatal (as in the case of cystic fibrosis) whereas for others, living a full and mostly normal life is possible.

Factors associated with longer life expectancy include a high body mass index (in other words, not being underweight), regular vaccinations, especially against influenza and pneumonoccus, and regular clinic visits.

Factors associated with a poorer prognosis include hypoxia (a low blood oxygen level), hypercapnia (an elevated blood carbon dioxide concentration), increased shortness of breath, and more severe disease as seen on radiology studies.

Examples: Joshua developed bronchiectasis when his lung tumor obstructed one of the large airways in his lungs.


American Lung Association. Learn About Bronchiectasis. Updated 06/05/16. http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/bronchiectasis/learn-about-bronchiectasis.html

Elaraachli, W., Conrad, D., and A. Wang. Using Cystic Fibrosis Therapies for Non-Cystic Fibrosis Bronchiectasis. Clinical Chest Medicine. 2016. 37(1):139-46.

Lee, A., Burge, A., and A. Holland. Airway clearance techniques for bronchiectasis. 2015. 11:CD008351.

Pizzutto, S., Upham, J., Yerkovich, S., and A. Chang. Inhaled non-steroid anti-inflammatories for children and adults with bronchiectasis. Cochrane Database of Systematic Reviews. 2016. 27:CD007525.