Bronchiectasis - information for patients

About your bronchiectasis

Bronchiectasis means some of the airways in your lungs have become widened and
scarred. Widened airways do not clear mucus properly, mucus that sits still
becomes infected, and infection causes more damage. Treatment is aimed at
breaking that cycle, and it works.

Most of the treatment is something you do rather than something you take.

1. Clearing your chest, every day

This is the most important part of your treatment. A respiratory
physiotherapist will teach you a technique that suits you, usually a cycle of
relaxed breathing, deeper breaths and huffing, sometimes with a small handheld
device, and sometimes with positions that let gravity help.

Do it every day, usually twice, and for longer when you have an infection. Ten
to twenty minutes twice a day is typical. It is not glamorous and it is easy to
let slip when you feel well, but it is the single thing that most reduces
infections and keeps your lungs in better condition over years.

If you were shown a technique once and are no longer sure you are doing it
right, ask to be referred back. This is normal and worth doing.

2. Exercise

Regular aerobic exercise - walking, cycling, swimming, anything that makes you
breathe harder - helps clear the chest as well as improving your fitness. If
breathlessness limits what you can do, ask about pulmonary rehabilitation.

3. Vaccination

Have the influenza vaccine every autumn, and the pneumococcal and COVID-19
vaccines when you are offered them.

4. Treating infections promptly

You will get chest infections. What matters is recognising and treating them
quickly.

Signs of an infection are: more phlegm than usual, phlegm that changes colour,
more breathlessness, more coughing, feeling generally unwell, or a fever, for
more than about 24 to 48 hours.

If this happens, start the plan we have agreed with you, or contact your GP
practice. Courses of antibiotics for bronchiectasis are usually 14 days -
longer than for an ordinary chest infection - because shorter courses tend to
be followed by a rapid relapse.

Before you start antibiotics, send a sputum sample if you possibly can. Knowing
which bacteria are there is what allows us to choose an antibiotic that
works, and the sample is much less useful once treatment has begun.

5. Keeping an eye on things

We will usually check a sputum sample and your breathing tests at your routine
reviews, and arrange a chest x-ray if your symptoms change. Tell us if you
cough up blood, lose weight without meaning to, or notice that your usual
infections are becoming more frequent.

When to get help urgently

Contact us or your GP the same day if you cough up more than streaks of blood,
become much more breathless than usual, have chest pain, or are unwell with a
high fever. Call 999 if you cough up a large amount of blood or are severely
breathless.

Further information: Asthma + Lung UK, www.asthmaandlung.org.uk, helpline
0300 222 5800.