Bronchiectasis flare-ups (exacerbations)

A bronchiectasis flare-up is when your symptoms get worse. The medical name for this is an exacerbation. On this page, we cover the symptoms of a bronchiectasis flare-up and what to do if you’re having a flare-up. 

Symptoms of a bronchiectasis flare-up

If you’ve been diagnosed with bronchiectasis and your usual symptoms get worse, this could be a sign that you’re having a flare-up. The medical name for a flare-up is exacerbation.

Flare-ups are usually caused by bacterial infections, like a chest or lung infection, so your healthcare professional might also call a flare-up an infective exacerbation.

If you’re having a flare-up, one or more of your usual bronchiectasis symptoms may get worse. For example, you may:

  • cough more, or cough up more phlegm (sputum)
  • notice a change in the colour or texture of your phlegm
  • feel more breathless than usual
  • feel more tired (fatigued).

You could also get new symptoms:  

  • fever (a high temperature of 38 degrees Celsius or more)
  • coughing up blood or bloodstained phlegm (haemoptysis). If this happens, follow NHS advice and get checked by a healthcare professional as soon as possible
  • a sharp pain in your chest that hurts more when you breathe (pleurisy).

What causes flare-ups?

The main cause of bronchiectasis flare-ups are bacterial infections, like chest or lung infections.    

Bronchiectasis flare-ups can also be caused by:

People with bronchiectasis tell us that other things make their bronchiectasis symptoms worse, but more research is needed to see how they’re linked to bronchiectasis flare-ups. This includes: 

What to do if you're having a flare-up

It’s important to manage flare-ups quickly to prevent further damage to your lungs.

If you think you’re having a flare-up, you should follow the advice on your bronchiectasis self-management plan. This should include personalised information about managing flare-ups.

This might involve:  

  • Providing a phlegm (sputum) sample to your healthcare professional. This is important as they can use the results to work out what is causing your flare-up and the best way to treat it.
  • Taking antibiotics. You’ll only need to take antibiotics if your flare-up is caused by a bacterial infection.
  • Doing the airway clearance techniques that your respiratory physiotherapist taught you.
  • Using other medication and treatments for your bronchiectasis as prescribed.
  • Seeing your healthcare professional when you feel better to make sure you’re treating and managing your condition well.  

If you’ve had three or more flare-ups in the last year, ask your healthcare professional about being referred to a respiratory specialist. They can help you prevent future flare-ups. 

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