Bronchiectasis is a chronic lung condition in which the airways become permanently widened and damaged.
Normal airways are narrow and lined with thin mucus and tiny hairs that sweep particles and bacteria up and out. In bronchiectasis, the airways are stretched, the cilia are damaged, and mucus pools — creating a habitat for chronic infection. Infection damages the airway, the damaged airway holds more mucus, more mucus invites more infection.
A validated risk-stratification score based on age, BMI, FEV1, prior hospitalizations, exacerbation frequency, sputum colonization, radiologic severity, and breathlessness. Score 0–4 = mild, 5–8 = moderate, 9+ = severe. At 4 years, mild patients have <3% mortality; severe patients have 25–30%.
Bronchiectasis is a chronic lung condition in which the airways become permanently widened and damaged. Normal airways are narrow and lined with thin mucus and tiny hairs (cilia) that sweep particles and bacteria up and out. In bronchiectasis, the airways are stretched, the cilia are damaged, and mucus pools — creating a habitat for chronic infection. The result is a cycle: infection damages the airway, the damaged airway holds more mucus, more mucus invites more infection. It used to be considered a rare disease. It isn't.
The hallmark is a chronic productive cough that produces large amounts of mucus most days. Patients describe coughing up colored or thick sputum every morning, sometimes more than a cup per day. Frequent lung infections, sometimes 4–6 per year, are common. Other symptoms include breathlessness, fatigue, weight loss, and chest discomfort.
Diagnosis requires a high-resolution CT scan of the chest (HRCT). On CT, dilated airways are visible — they look bigger than the blood vessels next to them, and they extend further toward the lung edge than normal. We then look for the cause: post-infection scarring, immune deficiency, cystic fibrosis, primary ciliary dyskinesia, allergic bronchopulmonary aspergillosis (ABPA), inflammatory bowel disease, rheumatologic causes, or NTM infection. Most patients also need sputum cultures, spirometry, and bloodwork to look for underlying causes.
Treatment has three goals: clear the mucus, control infection, and prevent decline. Airway clearance — daily techniques (huff coughing, positive expiratory pressure devices like the Aerobika, vests for severe disease) — physically moves mucus out of the airways. Inhaled or oral antibiotics treat chronic infection or suppress flares; azithromycin three times weekly reduces exacerbations. Treating the underlying cause includes immune globulin replacement for immune deficiency and surgery for localized severe disease.
This page is general medical information, not personalized medical advice. If you have questions about your specific health, talk with your Nimbus clinician.
