Symptoms of Bronchiectasis

A chronic cough, which is moist and produces mucus is the most common symptom. It is caused by inflammation, excessive build up of mucus in the airways and difficulty clearing this mucus. The amount, thickness and colour of the mucus can be indicative of infection. A colour chart guides (Below:Figure x) when to be concerned about changes in colour of mucus. If your mucus changes colour or becomes darker, thicker and increased in amount, you should see your medical practitioner.

These flare-ups are indicating a new infection or increased inflammation is present in your lungs. It may be accompanied by increased coughing with mucus production. A flare up needs management from a medical practitioner.

This may be due to an infection within the lungs, prolonged coughing, constriction of muscles around the breathing tubes or a blood clot in your lungs. If you experience this symptom, see your medical practitioner to determine its likely cause

Breathlessness may be due to coughing or constriction of the airways due to mucus. It may also be due to low levels of oxygen in the blood, which can be present during an infection.

This can be due to the build up of mucus in the lungs which makes breathing more challenging when exercising, particularly if you haven’t done your airway clearance. Your heart and lungs have to work harder to deliver oxygen to your exercising muscles. This can contribute to weakness in your peripheral muscles, due to loss of muscle mass and change in muscle fibre types (from slow twitch endurance fibres to fast twitch fibres which fatigue more readily). If you experience frequent infections or flare-ups or have chronic colonization of a specific bug in your mucus, your body is constantly working against that infection and this can contribute to fatigue and lethargy.

This can occur due to infection in your lungs, strain from coughing or due to a PE. If you notice any blood in your sputum (small or large amounts), consult with your medical practitioner.

This can affect up to 55% of females with bronchiectasis and is more common than in the general population. It is made worse by coughing, which increases the pressure on the pelvic floor muscles. Incontinence episodes can range from unintentional small leaks to complete loss of control or urine or faeces. To manage continence issues and engage in pelvic floor muscle training, advice from a continence physiotherapist would be helpful (Link: https://www.continence.org.au/).

This is the retrograde flow of gastric contents into the oesophagus (Figure x). In people with bronchiectasis, this can occur more frequently and lead to symptoms of heartburn and acid regurgitation, wheezing or chronic cough. For people with bronchiectasis and suspected reflux, they should see their medical practitioner to determine if a formal diagnostic test is needed to confirm its presence and gain advice on medication or lifestyle changes which may necessary to reduce the symptoms.

Figure x. Normal sphincter function (left) and abnormal function (with reflux) (right)

This can range from underlying condition associated with a diagnosis of bronchiectasis (such as rheumatoid arthritis) or osteopenia or osteoporosis. Other conditions may be osteoarthritis or areas of musculoskeletal pain. In the event of these conditions or the presence of pain, modifications to therapy (including physiotherapy) may be necessary to accommodate these symptoms. It is important to mention the presence of any of these conditions or report pain to your medical practitioner or physiotherapist.

Upper airway symptoms can affect people with bronchiectasis, particularly those whose underlying cause is primary ciliary dyskinesia. Common symptoms are nasal congestion or obstruction, facial pain or pressure, itching and sneezing, altered sense of smell, headaches, mucopurulent discharge, post-nasal drip and cough. Patients should note the colour of their nasal secretions (Figure x). A mix of medical therapies are available to manage sinusitis, patients should consult their medical practitioner in the presence of these symptoms.

Figure x. Snot Colour Analysis Chart

These psychological syndromes are common in people with bronchiectasis and can negatively impact on disease progression and clinical state. Effective treatments are available.

Ischaemic heart disease can be present in some people with bronchiectasis. In the event of symptoms, patients should contact their medical practitioner for management.