Centers of Excellence

The Lung Center

Bronchiectasis

Bronchiectasis is a chronic condition in which the walls of the bronchi (lung airways) are thickened from long-term inflammation and scarring. As a result, mucus produced by the cells lining the bronchi does not drain properly. This leads to a mucus build-up that can cause recurrent infections, which can ultimately cause a decline in lung function over time.

Bronchiectasis is often part of another disease affecting the entire body, divided into two categories: cystic fibrosis (CF)-bronchiectasis and non-CF bronchiectasis. Roughly 50 percent of cases of non-CF bronchiectasis have no identifiable cause, which presents a challenge for both diagnosis and treatment.

As bronchiectasis is both a disease of the bronchial tubes and results in recurrent infection, our multidisciplinary team at the Brigham and Women’s Hospital Lung Center consists of infectious disease experts, pulmonologists and thoracic surgeons who specialize in bronchiectasis and provide comprehensive, specialized care for patients. Their expertise and collaboration with other specialists throughout Brigham and Women's Hospital provides patients with a highly-informed diagnosis and a cohesive treatment plan.

Bronchiectasis Topics

Risk Factors for Bronchiectasis

Risk factors for bronchiectasis include:

Causes of Bronchiectasis

Bronchiectasis is often part of another disease that affects the entire body. It can be caused by the following conditions:

Symptoms of Bronchiectasis

The most common symptoms of bronchiectasis are:

  • Coughing up discolored or bloody mucus daily
  • Feeling tired or run-down
  • Chest pain
  • Fevers and/or chills
  • Shortness of breath that is worse during flare-ups
  • Wheezing while breathing
Diagnosis of Bronchiectasis

To diagnose bronchiectasis, our specialists will carefully review your medical history and conduct a full physical examination. Your physician may also order additional tests, including:

Treatment for Bronchiectasis

While there is no cure for bronchiectasis, our physicians will create a personalized treatment plan that will allow you to manage your symptoms. Typically, your doctor will prescribe a combination of medication and lifestyle changes. Surgery is only recommended in extreme cases or to treat the condition causing your bronchiectasis.

Lifestyle changes

  • Stop smoking
  • Exercise regularly
  • Stay well-hydrated
  • Eat a balanced diet
  • Get the flu vaccine annually
  • Get the pneumococcal vaccine to protect against pneumonia

Medications

Your doctor will likely prescribe medications to help manage your symptoms. These can be administered either in pill form or through a nebulizer, a device consisting of a facemask or mouthpiece, a chamber that converts the medication into a mist, and a compressor that allows you to pump the medication into your lungs. Medications include:

  • Antibiotics to combat bacteria infecting the bronchi. These can include macrolides such as azithromycin, erythromycin and clarithromycin that kill bacteria and reduce inflammation in the bronchi.
  • Bronchodilators to relax the lung muscles during a particularly severe flare-up of symptoms.
  • Mucus-thinning medications that make mucus easier to cough up.
  • CF-related medications that improve the function of the gene that causes the disease.

Devices

There are several handheld devices that can help to remove mucus from your lungs using a combination of air pressure and vibrations to facilitate coughing. Vests are also available that generate more vigorous vibrations to help clear the mucus. Your physician will help you determine if a device is right for you.

Surgery

Surgery is only recommended in extreme cases or to treat the underlying cause of your bronchiectasis. Possible surgical interventions include:

  • Lobectomy, removing the part of your lung affected by the bronchiectasis. A lobectomy is only recommended when your symptoms are not responding to treatment, you do not have an underlying condition, and bronchiectasis is only affecting a single section of your lung.
  • Lung transplantation to remove scarred and non-functioning lungs. The Brigham and Women’s Hospital Lung Transplant Program is the largest in New England and provides innovative and compassionate care to patients with severe bronchiectasis.
What You Should Expect

A multidisciplinary team will work with you every step of the way, from diagnostics through evaluation, to create a cohesive and comprehensive treatment plan. Our unique approach features same-day consultations with multiple specialists and fosters seamless, expert care. Your medical condition will be closely monitored and managed to promote optimal lung functioning and an improved quality of life.

Most patients do not require surgery. However, if you do, you will meet with your health care team first for pre-operative information and tests. On the day of your surgery, you will receive care from surgeons, anesthesiologists and nurses who specialize in thoracic surgery and interventional pulmonary procedures. After surgery, you will recover in our designated thoracic post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

Multidisciplinary Care

Bronchiectasis patients benefit from the wide range of specialists at The Lung Center, including thoracic surgeons, pulmonologists and imaging experts. This collaboration ensures comprehensive diagnosis and targeted treatment for patients.

Any recommended surgery or procedure will be performed by an experienced, board-certified surgeon, in collaboration with the treatment team including nurses and physician assistants, all of whom specialize in taking care of patients with bronchiectasis.

Resources

Learn more about bronchiectasis topics in our health library.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Access a complete directory of patient and family services.

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