Managing your condition at home is an important part of living well with bronchiectasis. We have more information about self-managing your bronchiectasis.
If you get a chest infection or have a flare-up, you’ll take a course of antibiotics, usually for 14 days.
You should give a phlegm sample to your doctor at least once a year, or when you’re unwell and notice your symptoms changing. Your doctor might start you on antibiotics without having to wait for phlegm sample results.
People who have bronchiectasis sometimes have bacteria in their phlegm that can be more difficult to clear, such as Pseudomonas and non-tuberculous mycobacterium (NTM). Your doctor will tell you the treatment options, such as inhaled antibiotics.
It’s important to finish your antibiotics, even if you feel better. This is because stopping early may mean the bacteria aren’t treated fully, so the infection could come back.
You will be prescribed antibiotics based on:
- the type of bacteria found in your phlegm (sputum)
- antibiotics that worked for you in the past.
You may need to take antibiotics for much longer if you have several flare-ups a year.
Your doctor will discuss if this is the right option for you.
How are antibiotics taken?
Antibiotics can be taken as tablets or inhaled as a mist through a nebuliser.
If you’re really unwell, you might be given antibiotics directly into a vein. This is called intravenous antibiotics and they are normally given in hospital but can sometimes be given at home.
Clearing your chest
A respiratory physiotherapist will teach you airway clearance techniques (ACTs). ACTs will help to:
- remove phlegm (sputum) from your lungs
- control your cough
- reduce chest infections.
Your physiotherapist will tell you when to do your ACTs. They’ll usually suggest a routine for when you are well, and changes to make when you’re unwell. Some ACTs work better when timed with taking your medications. Remember to keep hydrated by drinking plenty of water.
What is a respiratory physiotherapist?
A respiratory physiotherapist is a specialist healthcare professional who can help you to keep active. They will know about how your lungs work, how your muscles work, and the best exercises to help with your breathing.
Active cycle of breathing techniques (ACBT)
The most common airway clearance technique used in the UK is the active cycle of breathing techniques (ACBT).
The Association of Chartered Physiotherapists in Respiratory Care (ACPRC) have more information on the active cycle of breathing techniques.
If your phlegm is sticky and hard to cough up, or if you have more than three flare-ups in a year, your healthcare professional may suggest:
- a check-up with a respiratory physiotherapist
- a device to help clear your chest. For example, Acapella or Aerobika positive expiratory pressure therapy (PEP) devices. Speak to your healthcare professional about whether you need one of these.
- a mucolytic drug to break up the phlegm and make it easier to clear from your lungs
- a nebuliser to breathe in a salt solution called saline. This may help if you have a lot of infections and find it difficult to clear phlegm from your lungs with physiotherapy. The saline helps break up the phlegm and makes it easier to cough up.
Speak to your physiotherapist first
Do not attempt to do these exercises without being shown by a trained physiotherapist.
Some people with bronchiectasis don’t get short of breath, and for others, it’s the main symptom. Becoming more breathless can be a sign of a chest infection and you will need to take antibiotics to treat the infection.
Keeping active can help with breathlessness too. It makes your muscles stronger, meaning they work better, which can help you manage your breathlessness. Read more about keeping active.
Over time you’ll learn what level of breathlessness is normal for you. If you get breathless, pacing your activities can really help. We have more information on living well with breathlessness, including information on sex and breathlessness.
If you're more breathless than usual
If you’re feeling more breathless than usual, speak to your healthcare professional as soon as possible.
Help to quit smoking
If you smoke, quitting is the best thing you can do for your health. Your healthcare professional should offer you support to quit every time they see you.
We also have a lot of information on quitting smoking, including the support you can get from the NHS.
If you get breathless, ask your healthcare professional about pulmonary rehabilitation (PR).
PR is a six to eight week course led by a respiratory physiotherapist. The course includes:
- a physical exercise programme made for you
- information on looking after your body and lungs
- advice on managing your condition
- information on managing breathlessness.
Managing bladder leaks (incontinence)
Living with a lung condition like bronchiectasis can sometimes put extra pressure on your bladder, bottom, and pelvic floor muscles.
Some people with bronchiectasis may pee or sometimes poo when coughing or laughing. Strengthening the muscles used to control your bladder and bottom is a good way of treating incontinence. There are a lot of ways to do this. You can:
Surgery for bronchiectasis is rare. It can be an option for people who have bronchiectasis in a specific area of the lungs and whose symptoms are not controlled by other treatment.
If you cough up blood, you may have a scan called bronchial angiography to look at the blood vessels in your lungs. If this shows blood vessels that cause bleeding, a surgery called embolisation can be done to block off the blood vessels that cause the bleeding.
A lung transplant is rarely needed in bronchiectasis. It’s for people who have very severe lung disease and no other treatment options.
Most people with bronchiectasis do not require oxygen therapy. However, if your oxygen levels are low you may need to breathe in oxygen through a tube or mask. This might be short-term because of a chest infection, or long-term if your lungs are damaged.
Make sure you review your treatment with your healthcare professional at least once a year.
At your yearly reviews, you can expect to:
- give phlegm (sputum) samples for testing
- review your symptoms
- review how often you have flare-ups
- change any treatment if needed.