Bronchiectasis

What is bronchiectasis?

  • Bronchiectasis is a common disease which typically causes cough, often with a tendency to get recurrent chest infections.
  • The air tubes within the lungs, which are normally rather like thin straws with thin walls, become like wide straws with much thick walls, and this means infections are much more likely.
  • There is a very long list of possible causes for bronchiectasis. Sometimes a cause may never be found.
  • Here we list resources that may be of use to you.
  • We are grateful particularly to colleagues elsewhere in Scotland, particularly NHS Greater Glasgow and Clyde, NHS Forth Valley and NHS Lothian for the videos shown.
  • The British Lung Foundation also have several useful pages on bronchiectasis.
  • Here you will find another booklet on bronchiectasis, written by a patient.
  • Here is a cross sectional view of the chest (imagine looking from the soles of the feet at a "slice" of the chest. The black bit are those parts of the body containing air - you can see the lungs are black on each side of the heart (the white bit in the middle). You can see the air tubes are grossly dilated, particularly for those air tubes you can see on the left side of the picture (actually the right lung).

How to self manage bronchiectasis?

General advice for you and your GP team

  • Generally bronchiectasis is not regarded as a life threatening illness (occasionally it is, but this is uncommon) and generally it is more of a nuisance for you.
  • These tips below should give you the best chance of remaining well.

Sputum

  • Bronchiectasis is typically associated with a daily cough productive of sputum (spit).
  • This is therefore not unexpected but you should be concerned if the volume or muckiness (we call this purulence) increases.
  • So, if your sputum is usually just a teaspoonful a day of yellow sputum, but then turns a nasty colour of green and there is more of it, it is quite likely you have a respiratory tract (chest) infection.
  • Ideally you should already have a NHS "spit kit" (sterile container) at home (your practice nurse should be able to provide you with one or two to have at home ready ). Spit into the kit and then promptly deliver it to your GP practice and they can send it off to see what bacteria (bugs) are growing.
  • This can be be very helpful to do 3-4 times a year, so that when you get another infection your GP knows which antibiotics to choose.

Antibiotics

  • Importantly you should get a minimum of 14 days of high dose oral antibiotics if you get a chest infection (most people get 5-7 days but with bronchiectasis longer is needed).
  • Your GP may have to treat you before the result of the spit sample is known.
  • Occasionally some people with bronchiectasis need to take long term antibiotics at home e. g. oral antibiotics such as azithromycin, or nebulised (mist like inhalation) of antibiotics such as colomycin.
  • If treatment in the community does not work then sometimes admission to hospital for intravenous (IV) antibiotics is needed.

Keeping active

  • Click here for some advice about this in and around Aberdeen

Diet

  • Eating plenty of fruit and vegetables in your diet protect the body against infection (anti-oxidant effects)
  • It is also important to keep your weight just right, not too light and not too heavy. Click here for more advice.

Vacccinations

  • Get your flu jab each year.
  • Also check your practice nurse has given you a one off "pneumonia" (pneumococcal) vaccination - this lasts for several years.

Physiotherapy videos - why and how to do it?

  • Physiotherapy helps symptoms such as cough, difficulty clearing secretions from your chest and breathlessness.
  • Coughing can also result in incontinence and joint pains, and physios can help with this too.
  • The overall aim is to improve your quality of life.

Physiotherapy - what is "active cycle of breathing"?

Physiotherapy - How to do autogenic drainage?

Physiotherapy - Positive Expiratory Pressure (PEP)?

Physiotherapy - Oscillatory positive expiratory pressure (OPEP)?

Physiotherapy - How to use nebulisers?