What is bronchiolitis obliterans?
Bronchiolitis = inflammation in the small airways (bronchioles)
Obliterans = permanent narrowing
Bronchiolitis obliterans happens when your small airways (called bronchioles) become inflamed and scarred. The scarring causes your airways to become permanently narrowed. In severe cases, the scarring may block some of your small airways.
It’s sometimes known as obliterative bronchiolitis or constrictive bronchiolitis. Some people also call it ‘popcorn lung’.
Conditions with similar names
Bronchiolitis obliterans is not the same as bronchiolitis. Bronchiolitis is an infection in the airways that can affect children under two. Bronchiolitis usually gets better by itself, but bronchiolitis obliterans does not.
Bronchiolitis obliterans is also different to bronchitis and chronic bronchitis. Bronchitis is an infection affecting the larger airways (called the bronchi). Chronic bronchitis is a form of chronic obstructive pulmonary disease (COPD).
What causes bronchiolitis obliterans?
Bronchiolitis obliterans is a rare condition which can affect adults and children. The risk of getting bronchiolitis obliterans may be higher if you or your child:
- have had a lung transplant. This is known as bronchiolitis obliterans syndrome. Around 1 in 2 people who receive a lung transplant will develop bronchiolitis obliterans syndrome within five years.
- have had an infection such as respiratory syncytial virus (RSV). This is known as post-infectious bronchiolitis obliterans (PIBO). PIBO is the most common type of bronchiolitis obliterans in children.
- have breathed in toxic chemicals such as diacetyl (a chemical used to flavour popcorn), sulphur mustard gas, nitrogen oxides, fly ash and fiberglass.
- have an autoimmune disease like arthritis, lupus, or inflammatory bowel disease.
What are the symptoms of bronchiolitis obliterans?
Symptoms of bronchiolitis obliterans may include:
- a dry cough
- breathlessness
- difficulty breathing
- noisy breathing (wheezing).
How is bronchiolitis obliterans diagnosed?
Your doctor will ask you or your child about your symptoms and medical history.
You or your child will also need medical tests to help your healthcare professional confirm your diagnosis:
| Tests you might need | Why might I need this? |
| Lung function tests | This will tell your doctor if your airways are narrowed or blocked. If you have bronchiolitis obliterans, the tests will show a large blockage which does not get better after using a reliever inhaler. |
| Chest X-ray or CT scan | These scans take detailed pictures of your lungs. This will show your healthcare professional if your lungs are damaged. |
| Lung biopsy | If your CT scan pictures are not clear, you may need to have a small piece of tissue or some cells from your lungs taken for testing. This is called a biopsy. |
How is bronchiolitis obliterans treated?
There is no cure for bronchiolitis obliterans because the damage to your lungs cannot be reversed. Instead, treatments will try to slow down how the condition develops and help make your symptoms better.
Treatments may include:
- medicines to help reduce the inflammation in your lungs. This is usually a steroid or an antibiotic.
- oxygen therapy. You may be given oxygen through an incubator, a face mask, or a tube up your nose (called a nasal cannula). If you need oxygen regularly, you may be offered oxygen at home. Read more about oxygen therapy.
In rare and severe cases of bronchiolitis obliterans your healthcare professional may recommend you have a lung transplant.
Keeping well with a lung condition
- Stop smoking. If you smoke, stopping is the one of the best things you can do for your health. If your child has bronchiolitis obliterans, do not smoke, or let others smoke, around your child. Try to avoid exposing your child to a lot of air pollution if you can.
- Get vaccinated. Getting your flu and pneumonia vaccines can help prevent you from becoming unwell. Speak to your healthcare professional to find out how to get vaccinated.
- Keep active. Regular exercise can help you to manage symptoms and improve your quality of life.
- Eat a healthy diet. A well-balanced diet with the right vitamins and minerals can help you to stay well and keep your lungs healthy.
- Stay hydrated. Drinking plenty of fluid will keep you hydrated and keeps phlegm and mucus moving. If phlegm sits in your airways and lungs, you’re more likely to get an infection.
- Practice good hygiene. To avoid getting infections, use a tissue and wash your hands with warm water and soap after coughing and sneezing.
What is the outlook for bronchiolitis obliterans?
Bronchiolitis obliterans is a serious condition that affects everyone differently. The outlook for you or your child may depend on what caused the condition. Talk to your healthcare professional because they will give you the best advice about your condition.
Your healthcare professional will continue to monitor you or your child using lung function tests throughout your life. You may find that your condition improves over time with treatment. But for some people, your condition may not change or may get worse.
Ask your doctor who to contact if you have any questions, or if you’re unsure about something. It’s important to be able to recognise when your condition is getting worse, or if you’re becoming ill, and when you should seek emergency care. Agree a plan with your specialist about what you should do.
More support
Living with a long-term condition or looking after a child with a long-term condition, like bronchiolitis obliterans, can be difficult.
Find help and support by:
- Talking to your healthcare professional
- Calling our helpline. Our friendly team can help answer your questions or worries.
- Joining one of our free online support groups. Our Breathe Easy Programme is a friendly community, which provides practical advice to help you manage your lung condition.
Get support
Call our helpline for support with your condition. Get advice on your medicines, symptoms or travelling with a lung condition, or just call us to say hello.
