Bronchiectasis

Bronchiectasis is a long-term lung condition in which the airways (bronchi) are permanently widened and scarred. This makes it harder to clear mucus, leading to repeated infections and a chronic productive cough.

Causes

Bronchiectasis usually develops after something has damaged the airways:

• Past lung infections — especially tuberculosis, pneumonia, whooping cough, measles. TB is a major cause of bronchiectasis in India, because of its continuing high burden.
• Immune system problems
• Cystic fibrosis (present from birth)
• Ciliary dyskinesia (a genetic condition affecting airway cleaning)
• Aspiration — where food or stomach contents repeatedly enter the lungs
• Sometimes the cause is never identified

Symptoms

• A persistent cough, usually producing large amounts of phlegm
• Breathlessness
• Recurrent chest infections
• Tiredness
• Wheezing
• Coughing up blood (sometimes)
• Chest pain

Diagnosis

High-resolution CT scan of the chest is the main test. Additional tests look for causes — sputum analysis (including TB testing in India), blood tests, immune assessment.

Treatment

Bronchiectasis is a long-term condition but can be well-managed:

• Daily airway-clearance techniques — taught by a respiratory physiotherapist
• Treatment of any underlying cause
• Antibiotics for flare-ups and sometimes long-term preventive courses
• Inhalers for breathing symptoms
• Flu and pneumococcal vaccines
• Pulmonary rehabilitation
• Stop smoking
• Surgery — rarely, for localised severe disease

A persistent cough with phlegm for more than a few weeks in India should always prompt TB testing — free at government health facilities.