Bronchiectasis: Evaluation and Long-Term Care

Bronchiectasis is a long-term lung condition that often causes a daily cough with phlegm and repeated chest infections. Dr. David Kupferberg, a pulmonary and critical care physician with more than 25 years of experience, sees patients with bronchiectasis in Jerusalem and Efrat, looks for the cause and plans care with them that aims to reduce flare-ups.

Dr. Kupferberg sees patients aged 16 and over.

Dr. David KupferbergPulmonary & Critical Care Physician

Book Efrat ClinicBook Jerusalem Clinic (Wolfson)

What is bronchiectasis?

The airways, or bronchi, carry air in and out of the lungs and normally keep themselves clear of mucus. In bronchiectasis, some airways have become permanently widened and scarred, so mucus collects in them instead of clearing.

Germs can grow in the trapped mucus and cause chest infections, and each infection can inflame the airways further. Treatment aims to break this cycle.

Bronchiectasis is a different condition from COPD, although some people have both. A chest X-ray may look normal, so the diagnosis is made on a CT scan of the chest.

Drawing of two airways cut across, surrounded by lung tissue: on the left, a narrow airway with a thin wall; on the right, a much wider airway with a thick wall and mucus pooled in its lower part.
Left: a normal airway. Right: a widened, scarred airway with mucus trapped inside.

What are the symptoms of bronchiectasis?

Symptoms vary from person to person. Many people have spells, called flare-ups or exacerbations, when their symptoms get worse, often with a chest infection. Common symptoms include:

  • A daily cough, often bringing up phlegm (mucus)
  • Chest infections that keep coming back, sometimes needing antibiotics several times a year
  • Breathlessness
  • Tiredness, especially during a flare-up

When should I see a lung specialist?

Specialist care for bronchiectasis aims to find the cause, clear the airways and reduce flare-ups. See a lung specialist if:

  • A CT scan has shown bronchiectasis
  • You have a daily cough with phlegm
  • You keep getting chest infections
  • You need antibiotics several times a year

How does Dr. Kupferberg evaluate bronchiectasis?

Dr. Kupferberg looks for a cause and works out a practical plan with you. The evaluation usually includes:

  1. A review of your CT scan, your history of chest infections and any sputum (phlegm) test results.
  2. A search for an underlying cause, with blood tests or other investigations coordinated as needed.
  3. Spirometry to measure your lung function. Spirometry is charged in addition to the consultation.
  4. A plan that covers daily airway clearance, when to send a sputum sample, what to do in a flare-up, and vaccines.
  5. Regular follow-up, in person or by video.

How to give a sputum sample

A sputum sample is phlegm coughed up from deep in your chest. The lab checks it for germs, which helps guide antibiotic treatment.

If the lab gives you its own instructions, follow them. In general:

  1. Use the sterile container you’re given.
  2. Collect the sample first thing in the morning, before eating or drinking.
  3. Rinse your mouth with plain water.
  4. Breathe in deeply a few times, then cough deeply to bring up phlegm from your chest, not saliva.
  5. Spit it into the container, close it tightly and label it.
  6. Take it to the lab as soon as you can. If there’s a delay, ask the lab how to store it.
  7. During a flare-up, give the sample before starting antibiotics if you can, but don’t delay the antibiotics to do so.

Frequently asked questions

What is bronchiectasis, and what causes it?

Bronchiectasis means some airways in the lungs have become permanently widened and scarred. Mucus collects in them, so people often have a daily cough with phlegm and repeated chest infections. It’s diagnosed on a CT scan. Causes include past severe infections, immune problems, reflux and aspiration, and some inflammatory conditions, but often no cause is found.

Is bronchiectasis serious?

It’s a long-term condition, but many people live full lives with it. What matters most is preventing flare-ups, since frequent infections can gradually affect lung function. Daily airway clearance, treating infections early, vaccines and regular follow-up help keep it stable. Your specialist will tailor a plan to how often you get flare-ups.

How is bronchiectasis treated?

The mainstays are daily airway clearance (breathing techniques or devices that help you cough up mucus), exercise, prompt antibiotics for flare-ups, guided by sputum cultures, and vaccines. Some people with frequent flare-ups benefit from longer-term treatment to reduce infections. Treating an underlying cause, if one is found, is also important.

Is bronchiectasis contagious?

No. Bronchiectasis itself isn’t contagious. The chest infections people with bronchiectasis get are caused by germs, and some of those can spread like any respiratory infection, so the usual hygiene measures, such as hand washing and staying home when you have a fever, and vaccines still make sense.

Sources

Book a bronchiectasis consultation

See Dr. Kupferberg in Jerusalem or Efrat to review your CT scan, look for a cause and plan care that aims to reduce flare-ups.

Book Efrat ClinicBook Jerusalem Clinic (Wolfson)

In an emergency, such as severe shortness of breath or chest pain, call Magen David Adom at 101 or go to the nearest emergency room.

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