Some coughs don’t go away. You finish a round of antibiotics, feel better for a few weeks, and then the mucus comes back. Maybe you’ve been told you have bronchitis two or three winters in a row, or you’ve noticed that you bring up phlegm most mornings without ever feeling truly sick.
That pattern is worth discussing with a healthcare provider. A long-lasting wet cough and repeated chest infections can point to several different lung conditions, and bronchiectasis is one that’s often mistaken for something else.
Only a qualified healthcare provider can determine what’s causing your symptoms. Understanding bronchiectasis, however, can help you know what questions to ask and why an accurate diagnosis matters.
In This Article
- What is bronchiectasis?
- What happens to the airways?
- What are the symptoms of bronchiectasis?
- What causes bronchiectasis?
- Bronchiectasis vs. Bronchitis
- Bronchiectasis vs. COPD
- Why mucus clearance matters
- Airway-clearance techniques and equipment
- How Rotech supports airway clearance at home
- How can you lower your risk of a flare-up?
- What are the signs of a bronchiectasis flare-up?
- Frequently asked questions
What Is Bronchiectasis?
Bronchiectasis is a chronic lung condition in which the airways become permanently widened and damaged. The damaged airways don’t clear mucus normally, so mucus can build up in the lungs. This can lead to repeated lung infections, swelling and irritation in the airways, coughing, and more airway damage over time, according to the American Lung Association.
What Happens to the Airways?
Your airways, called bronchi, are the tubes that carry air into and out of your lungs. They’re lined with tiny hair-like structures called cilia that help move mucus, dust, and germs out of the lungs.
With bronchiectasis, the airway walls become permanently widened and damaged. The cilia may no longer move mucus well, allowing it to collect in the lungs.
Trapped mucus creates an environment where germs can grow. This may lead to infection and inflammation, which can cause more airway damage. Healthcare professionals sometimes describe this as a cycle because infection, inflammation, and poor mucus clearance can continue to make one another worse.
That’s why healthcare providers often focus treatment on helping people move mucus out of their lungs.
What Are the Symptoms of Bronchiectasis?
Bronchiectasis symptoms often develop gradually and may worsen over time. They can also vary from one person to another, as not everyone experiences every symptom.
Possible symptoms include:
- A long-lasting cough that brings up mucus or phlegm
- Frequent or recurring respiratory infections
- More mucus than usual or mucus that changes in color and amount
- Shortness of breath
- Wheezing
- Fatigue
- Fever, chills, or night sweats during a flare-up
- Chest pain or tightness
- Coughing up blood
A cough that brings up mucus or phlegm is the most common symptom. Healthcare providers may refer to this as a productive cough, which simply means you cough up mucus. The American Thoracic Society’s patient guide also notes that symptoms may worsen during a flare-up, with changes such as more mucus, a different mucus color, fever, fatigue, or worsening shortness of breath.
Coughing up blood should be reported promptly to a healthcare provider. Severe breathing difficulty, significant bleeding, chest pain, blue or gray lips, fainting, or new confusion may require emergency care. Call 911 if symptoms are severe or quickly worsening.
What Causes Bronchiectasis?
Bronchiectasis develops after damage occurs in the airways. Repeated lung infections, severe respiratory illnesses, and certain medical conditions can all contribute to that damage.
Possible causes and contributing conditions include:
- Previous serious lung infections, such as pneumonia, tuberculosis, or whooping cough
- Immune-system problems that make infections harder to fight off
- Cystic fibrosis
- Primary ciliary dyskinesia, a genetic condition that affects how the cilia work
- Aspiration, which happens when food or liquid enters the lungs
- A blockage in an airway
- Autoimmune or inflammatory conditions
- Other underlying lung diseases
The American Thoracic Society reports that the cause remains unknown in about 40% of cases. Healthcare providers call this idiopathic bronchiectasis, which means the cause is unknown.
Because several conditions can cause similar symptoms, a long-lasting cough or repeated infection isn’t enough to diagnose bronchiectasis. Bronchiectasis is usually diagnosed with chest imaging, most often a CT scan.
Your provider may also order breathing tests, test a mucus sample for germs, or check for another condition that may have damaged your airways. These tests may help identify a cause that can be treated or managed.
Bronchiectasis vs. Bronchitis
Bronchiectasis and bronchitis sound similar, but they aren’t the same condition.
Acute Bronchitis
Acute bronchitis is short-term inflammation of the airways, often related to an infection. It usually improves as the infection and inflammation go away.
Chronic Bronchitis
Chronic bronchitis involves a long-lasting cough that produces mucus. It’s commonly discussed as a form of chronic obstructive pulmonary disease, or COPD.
Bronchiectasis
Bronchiectasis involves permanent widening and damage to the airway walls. That damage remains after an infection clears, making mucus harder to move and contributing to repeated infections.
The symptoms can overlap, so repeated bronchitis doesn’t necessarily mean someone has bronchiectasis. Some people diagnosed with bronchiectasis have a history of repeated bronchitis or pneumonia, which is one reason the conditions may be confused.
Bronchiectasis vs. COPD
Bronchiectasis and COPD are different lung conditions, although both can cause coughing, mucus, shortness of breath, and symptom flare-ups.
Though, bronchiectasis isn’t automatically a form of COPD. Some people have bronchiectasis, some have only COPD, and some have both.
When someone has both conditions, healthcare providers need to address the complete picture. A pulmonologist, which is a healthcare provider who specializes in lung conditions, or a primary care provider may review your health history, imaging, breathing tests, and symptoms before recommending treatment.
Related Reading: What to Do When You Feel Short of Breath With COPD
Why Does Mucus Clearance Matter?
When mucus sits in damaged airways, it traps germs and feeds the cycle of infection, inflammation, and further airway damage. Airway clearance helps loosen the mucus and move it upward so it can be coughed out.
Bronchiectasis treatment may focus on:
- Treating health conditions that contribute to bronchiectasis
- Removing excess mucus
- Treating and preventing infections
- Managing symptoms
- Reducing flare-ups
- Limiting additional airway damage
Existing airway damage usually can’t be reversed, but treatment can help manage symptoms, clear mucus, and reduce flare-ups. Because bronchiectasis affects everyone differently, your healthcare provider or respiratory therapist can help choose an approach that fits your symptoms, daily routine, and other treatments.
What Airway-Clearance Techniques and Equipment May Be Used?
Your healthcare provider or respiratory therapist can help choose the airway-clearance methods that make sense for you. Your plan may include:
Breathing and Coughing Techniques
A respiratory therapist may teach breathing or coughing methods that help move mucus upward so it can be coughed out. These may include a series of controlled breaths called active-cycle breathing, or a method called huff coughing, which uses a strong exhale to help move mucus.
Chest Physiotherapy
Chest physiotherapy uses certain body positions and gentle tapping on the chest to help loosen mucus.
Positive Expiratory Pressure Devices
Positive expiratory pressure, or PEP, devices are handheld tools that create resistance or vibration as you breathe out. This can help loosen mucus and move it through your airways.
Nebulized Treatments
Your healthcare provider may prescribe inhaled medication or a concentrated saltwater solution called hypertonic saline. A nebulizer turns the liquid into a mist that you breathe into your lungs.
These treatments may help open the airways or loosen thick mucus. Use only the medication, solution, equipment, and schedule your healthcare provider prescribed for you.
If you have been prescribed this type of equipment, you can learn more about Rotech’s nebulizer services.
Airway-Clearance Vests
Some people are prescribed an airway-clearance vest. This treatment is called high-frequency chest wall oscillation, or HFCWO.
The fitted vest creates repeated, gentle vibrations around your chest. These vibrations help loosen mucus and move it upward so you can cough it out. Your healthcare provider will determine whether an airway-clearance vest belongs in your treatment plan.
Don’t change your airway-clearance method, equipment, or treatment schedule without guidance from your healthcare provider or respiratory therapist.
How Rotech Supports Airway Clearance at Home
Rotech offers airway-clearance therapy, including AffloVest®, for people whose healthcare providers prescribe this type of equipment.
AffloVest is a wearable airway-clearance vest that creates gentle vibrations around your chest to help loosen mucus so you can cough it out more easily. Because the vest is battery-powered, it’s designed to allow movement during therapy.
Rotech’s support includes:
- Local, in-person equipment setup
- Education about using the prescribed equipment
- Help with the ordering process
- Insurance support
- Ongoing equipment assistance
An airway-clearance vest isn’t right for everyone with bronchiectasis. It doesn’t cure the condition, guarantee that infections won’t happen, or replace medication and other prescribed treatments. Your healthcare provider will decide whether a vest belongs in your treatment plan.
You can also explore Rotech’s respiratory and home medical services.
How Can You Lower Your Risk of a Flare-Up?
Respiratory infections can trigger bronchiectasis flare-ups, so cold and flu season is a good time to review the routines that support your lung health.
These may include:
- Stick with the airway-clearance plan your provider gave you
- Wash your hands regularly
- Keep your distance from people who are sick when you can
- Clean and care for respiratory equipment according to the manufacturer’s and your provider’s instructions
- Stay current on vaccines your healthcare provider recommends
- Take prescribed medications as directed
- Pay attention to your usual cough, mucus, breathing, and energy so you can recognize a change.
These habits can lower certain risks, but they can’t prevent every infection or flare-up.
What Are the Signs of a Bronchiectasis Flare-Up?
Knowing what your symptoms usually look and feel like can make a flare-up easier to recognize.
Contact your healthcare provider if you notice:
- More coughing than usual
- More mucus
- A noticeable change in the color, thickness, smell, or amount of mucus
- Increasing shortness of breath or wheezing
- Fever or chills
- Greater fatigue
- Coughing up blood
- Loss of appetite or unintentional weight loss
- Symptoms that are worsening or not improving
- Respiratory infections that are happening more often
These changes can have more than one cause, so a healthcare provider should evaluate them.
Frequently Asked Questions About Bronchiectasis
Is bronchiectasis the same as bronchitis?
No. Acute bronchitis is usually short-term inflammation of the airways related to an infection. Chronic bronchitis involves a long-lasting cough that produces mucus and is commonly associated with COPD. Bronchiectasis involves permanent widening and damage to the airways. Because the symptoms overlap, testing is needed to tell the conditions apart.
Is bronchiectasis a type of COPD?
No, bronchiectasis and COPD are separate conditions. Both may cause coughing, mucus, breathlessness, and flare-ups, and some people have both diagnoses. If you have both conditions, your healthcare provider will consider both when recommending treatment.
What is the most common symptom of bronchiectasis?
The most common symptom is a long-lasting cough that produces mucus or phlegm. The amount or color of the mucus may change during an infection or flare-up, according to the American Thoracic Society.
Why does bronchiectasis cause so much mucus?
Damaged, widened airways don’t move mucus as effectively as healthy airways. Mucus can collect in the lungs, where germs may grow and contribute to repeated infection and inflammation.
What does bronchiectasis mucus look like?
Bronchiectasis mucus can vary in amount, thickness, and color. During a flare-up, some people notice more mucus or a change in its color, so discuss changes from your usual pattern with your healthcare provider.
Can bronchiectasis be cured?
Bronchiectasis causes permanent airway damage, so the condition usually can’t be reversed. Treatment can still help manage symptoms, clear mucus, treat infections, address contributing conditions, and reduce flare-ups. In rare cases where damage is limited to one area of the lung, surgery may be considered.
How is bronchiectasis diagnosed?
Bronchiectasis is usually diagnosed with chest imaging, most often a CT scan. A provider may also order breathing tests, mucus cultures, or tests for conditions that may have caused the airway damage.
What is airway-clearance therapy?
Airway-clearance therapy includes techniques and equipment prescribed to loosen and move mucus out of the lungs. It may include special breathing and coughing methods, gentle chest tapping, handheld breathing devices, nebulized treatments, or a vibrating airway-clearance vest.
Can an airway-clearance vest help with bronchiectasis?
An airway-clearance vest may help some people loosen and move mucus, but it isn’t appropriate for everyone. Your healthcare provider will determine whether a vest fits your diagnosis, symptoms, and treatment plan.
How often should airway clearance be performed?
There’s no single schedule that applies to everyone. How often you need airway clearance depends on your symptoms, how much mucus you have, and whether you’re feeling as usual or starting to feel worse. Follow the schedule provided by your healthcare provider or respiratory therapist.
When should someone with bronchiectasis call a healthcare provider?
Contact your provider when symptoms change from your usual pattern. This may include more coughing or mucus, changes in mucus color or amount, fever, worsening shortness of breath, increased fatigue, or coughing up blood. Severe breathing difficulty or significant bleeding requires immediate medical attention.
Understand Your Symptoms and Treatment Options
Bronchiectasis is easy to miss because it looks like so many other things, including bronchitis, COPD, and ordinary seasonal infections. If a wet cough has stuck around or chest infections keep returning, talk with a healthcare provider. They can evaluate your symptoms and order appropriate testing.
If you’ve already been prescribed airway-clearance equipment, Rotech can help with setup, education, insurance questions, and ongoing equipment support at home.
Want to learn more about clearing mucus at home? Explore Rotech’s airway-clearance therapy services.