Why have I got bronchiectasis?

It is difficult to say exactly how many people have bronchiectasis. Estimates used to be between 26 and 50 thousand patients in the UK. A more recent study suggested that there are over 300,000 living with bronchiectasis in the UK. This is much less common than conditions such as COPD, yet much more common than conditions such as cystic fibrosis. In the North East of England, for example, there are approximately 1200 patients with a diagnosis of bronchiectasis.

 

Causes

• Up to half of people who are diagnosed with bronchiectasis have ‘idiopathic bronchiectasis’. This means that they have bronchiectasis, but do not have any other underlying cause. There are also certain illnesses that are linked with bronchiectasis:
• Some other medical conditions are associated with bronchiectasis such as inflammatory bowel disease (ulcerative colitis and Crohn’s disease), rheumatoid arthritis and sjogren’s syndrome.
• Having an immune system deficiency can also be linked with developing bronchiectasis. 
• Certain lung infections often seen in childhood such as whooping cough, pneumonia or TB can be linked with developing bronchiectasis later in life.
• A problem with the normal structure or function of the lungs can also lead to bronchiectasis. This includes conditions such as primary ciliary dyskinesia, where the tiny hairs that work to protect the lungs do not work properly.
• Sometimes, people who have had chronic obstructive pulmonary disease or asthma for many years can go on to develop bronchiectasis also.
• If your doctor suspects a diagnosis of bronchiectasis, they will also test for any of these related causes to ensure that you have the right treatment.  

Common misunderstandings

“I thought a cough and a spit sort of thing was like when old people had been smoking and things like that, and they’ve brought it on themselves, not something that just happened to you, I mean I don’t smoke.” Celia, 67

“Have I still got emphysema? Is bronchiectasis worse than emphysema, or different?” Jean, 76

People often ask if bronchiectasis is the same as the smoking related lung disease COPD, and people who have bronchiectasis are often upset and frustrated that others assume smoking has caused the problems with their lungs.

Bronchiectasis is not the same as COPD or asthma.

Bronchiectasis is caused by many different conditions.

Many patients with bronchiectasis have never smoked, whilst COPD is caused by smoking fairly heavily.

It is important to note that some patients develop bronchiectasis as a complication of COPD. As both conditions can cause, cough, breathlessness, repeated chest infections and abnormal breathing tests, it is not surprising that they can also sometimes be mixed up.

In the UK, most GPs will look after 150-200 patients with COPD, whereas most practices will have less than 10 patients with bronchiectasis.

One thing that clearly links the two conditions is the need to stop smoking if you are a smoker to reduce your chances of further lung damage and also reduce the risks of developing lung cancer and other smoking-related diseases.

“Is it catching?”

Bronchiectasis is not catching or contagious. If you have bronchiectasis, you may find that if you are around people who have chest infections or colds that you are more prone to becoming unwell yourself. The day to day coughing of a person who has bronchiectasis however is not ‘catching’.

There are strict cross infection guidelines for cystic fibrosis (a rarer cause of bronchiectasis). This is because in that setting there is clear evidence of bacteria being spread between patients. There are very limited studies in bronchiectasis and current practice is therefore based on opinion. As new research becomes available the advice may change. It is practical to suggest avoiding mixing with other patients who have bronchiectasis when they have an active infection. You should ask your Doctor or Nurse if you have concerns.