Bronchiectasis in Adults

Bronchiectasis in Adults

What is Bronchiectasis?

• Bronchiectasis is a long term condition and simply means scarred bronchial tubes (airways)
• Normal airways are smooth and allow air to move freely into the lungs
• The airways in bronchiectasis become damaged in places, with enlargement (scarring)

• Excess mucus (or sputum) can get lodged in these areas, and if not cleared can get infected

• These repeated infections cause damage and more scarring to the lungs

The scarring is usually permanent, however with good management there can be some improvement and it is possible to prevent further damage.

What causes Bronchiectasis?

Bronchiectasis is most commonly due to severe chest infections such as pneumonia, whooping cough or tuberculosis in the past.

Other illnesses linked are:

• Inflammatory bowel disease
• Immune system deficiencies
• Arthritis disorders
• Primary Cilia Dyskinesia
• Sometimes people with COPD or asthma develop bronchiectasis

However in many cases of bronchiectasis a clear cause cannot be found.

Diagnosing Bronchiectasis

Your consultant will ask you about your medical history and symptoms, and may order a CT scan, chest x ray, blood tests and sputum tests if they suspect you have bronchiectasis. You then may need regular monitoring of the condition to see how your lungs are working (lung function tests).

Symptoms of Bronchiectasis

For most people the most common symptoms are:

• A wet sounding cough (mucus in the airways)

• Repeated chest infections
• Breathlessness, or having difficulty breathing
• Feeling tired, trouble concentrating
• Problems with you sinuses

These symptoms may worsen with an infection.

Other symptoms include:

• Cough incontinence
• Anxiety or depression

What is the management for Bronchiectasis?

There are two main elements to the treatment of bronchiectasis:

1. Clearance of sputum from the lungs

2. Recognition and management of infections

Chest Physiotherapy

Regular chest clearance is very important and will help you clear your airways which can reduce your cough and the number of infections you have. This includes breathing exercises called “The Active Cycle of Breathing Technique” (ACBT). You should complete these daily as advised, and will need to increase the amount of times you do it if you get a chest infection. Your respiratory physiotherapist will advise you on the best method, frequency etc.

Regular exercise helps to keep your chest free of infection by helping to clear the mucus and to maintain good lung function. The British Lung Foundation website has useful information on exercising with a lung condition.

Recognition and management of infections

Knowing how much sputum you usually clear, including its colour and consistency, is an important part of learning how to manage your condition. Recognising changes and seeking treatment sooner can help prevent a severe flare up. You may need to increase your regular chest clearance exercises during this time.

Some signs of being more unwell are:

• Feeling unwell
• Coughing up more sputum
• The colour of your sputum changes
• You are more breathless.

You should agree a plan with your health care professional about what to do when you have a flare up.  Some GP’s prescribe stand by antibiotics. You should see your GP and take a sputum sample as early as possible. 

Antibiotics If you get a chest infection or have a flare-up, you may need antibiotics.  The treatment is often for 2 weeks.  The antibiotics will vary depending on which bugs are in your sputum, so it is important to try and get a sputum sample if you notice things changing.

Other medications that may be prescribed to help ease symptoms are:

Inhalers If there is asthma or wheeze also present, inhalers may beprescribed.

Mucolytics If your phlegm is thick, sticky and hard to clear your health care professional may suggest a drug to break up the sputum to make it easier to clear (a mucolytic) such as Carbocysteine, ora nebuliser to breathe in a salt solution called saline.

Feedback for Inpatient Therapies

Please scan the QR code or follow the link below: 

If you have been seen by a Physiotherapist or Occupational Therapist during your admission, please leave us some feedback by scanning the QR code or following the link and filling in the short survey.

https://apps.worcsacute.nhs.uk/PublicSurvey/AHPFeedback

Ward admitted to:__________________________________

Therapy team who treated you: _______________________

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience

We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback

Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)

If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:

Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net

Opening times:

The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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