Bronchiectasis: The Phantom Menace

Posted on January 13, 2020   |   

This article was written by Bret Denning, JD


You may know that COPD is an “umbrella term” describing progressive lung diseases including emphysema, chronic bronchitis, and refractory (non-reversible) asthma and chronic bronchitis.* But there is another lung condition that is often overlooked because of its similarity to COPD: Bronchiectasis (brong-ke-EK-ta-sis). To help raise more awareness of this condition and who it may be impacting, we’ll be sharing six posts over the upcoming year.

What is bronchiectasis?

Bronchiectasis: The Phantom Menace Bronchiectasis is a disease of the small airways that leads to damage of the airway walls. This makes it difficult for people to clear out mucus from the lungs by coughing. One of the key differences from chronic bronchitis is that in bronchiectasis, the inner diameter of the airway can actually get wider. That may seem like a good thing but it isn’t. With scarring and thickening of the airway walls, widening of the airways is what makes it harder to clear out mucus. When mucus is not cleared out bacteria can start growing, which can lead to severe and repeated infections.

How severe?

Some people live with both COPD and bronchiectasis and don’t know it. One study found that in one year alone, 93% of these people had at least two health events (or exacerbations) like needing antibiotics, or a hospitalization relating to respiratory infections. Frequent events often result in major flare-ups in symptoms, and can lead to permanent loss of lung function, increase in additional symptoms, higher rates of disability or even loss of life. Even in those who did not experience frequent flare-ups, 90% of those who had pneumonia were found to have some bronchiectasis.

Who can get bronchiectasis?

Recent research estimates that 340,000-522,000 adults received treatment for bronchiectasis in the United States in 2013**. Bronchiectasis can be caused by infections like tuberculosis or pneumonia, immunodeficiency (low antibody levels), autoimmune diseases such as rheumatologic disease, or genetic conditions such as cystic fibrosis or alpha-1 antitrypsin deficiency. Recent research shown that individuals with bronchiectasis may be more susceptible to developing nontuberculous mycobacterial (NMT) lung infections. Recent data has also found potentially 49%-59% of patients with moderate to severe COPD also had bronchiectasis.***

In the next post, we’ll talk more about the symptoms and how one is diagnosed. If you’d like to read more about bronchiectasis in the meantime, here’s some recommended places to find more information. The Healthy Body, Healthy Mind video series includes an educational program titled Solutions for COPD and Bronchiectasis Patients, which can be viewed by clicking the link (https://www.youtube.com/watch?v=PNFu5Lj_QSk). You can also read more at the Bronchiectasis and NTM Initiative website: https://www.bronchiectasisandntminitiative.org.

If you have any questions about this blog post or suggestions for future posts, please put them in the comments section below.

* To read more about emphysema and chronic bronchitis, please visit https://www.copdfoundation.org/What-is-COPD/Understanding-COPD/What-is-COPD.aspx

** Seifer et al. Health-care utilization and expenditures among patients with comorbid bronchiectasis and chronic obstructive pulmonary disease in US clinical practice. (2019). Chronic Respiratory Disease, Volume 16: 1–8. DOI: 10.1177/1479973119839961.

*** Kosmas E, Dumitru S, Gkatzias S, et al. Bronchiectasis in patients with COPD: an irrelevant imaging finding or a clinically important phenotype? American College of Chest Physicians. Elsevier Inc., 2016. DOI: http://dx.doi.org/10.1016/jchest.2016.08.994.

1 Comments



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  • Thank you for this introductory and concise article and helpful links. A phantom indeed! Awareness among the medical community is very important when it comes to treatment outcomes. I am going to share or at least refer to this article when I discuss my treatment plan with my doctors as they are treating my frequent exacerbations as chronic bronchitis, even though my Ct scan confirmed features of COPD it also revealed Bronchiectesis along with early pulmonary infiltrates. These later developed into pneumonia.

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