How Is Bronchiectasis Treated?

Bronchiectasis often is treated with medicines, hydration, and chest physical therapy (CPT).

If the bronchiectasis is isolated to a section of the lung, or if there's a lot of bleeding, surgery may be recommended. If the bronchiectasis is widespread and causing respiratory failure, your doctor may recommend oxygen.

The goals of treatment are to:

• Treat any underlying conditions and lung infections.
• Help remove mucus (a slimy substance) from your lungs. Maintaining good hydration helps with the removal of mucus.
• Prevent complications.

Early diagnosis and treatment of bronchiectasis are important. The sooner your doctor can start treating your bronchiectasis and the underlying condition, the better the chances of preventing further damage to your lungs.

Medicines

To treat bronchiectasis, your doctor may prescribe antibiotics, bronchodilators, expectorants, or mucus-thinning medicines.

Antibiotics are the main treatment for the repeated lung infections that bronchiectasis causes. Oral antibiotics often are used to treat these infections.

For hard-to-treat infections, you may be given antibiotics through an intravenous (IV) line inserted into your arm. Your doctor may be able to help you arrange for a home care provider to give you IV antibiotics at home.

Bronchodilators open your airways by relaxing the muscles around them. Inhaled bronchodilators can be breathed in as a fine mist using an inhaler or a nebulizer.

Inhaled bronchodilators work quickly because the medicine goes directly to your lungs. Your doctor may recommend that you use a bronchodilator right before you do CPT.

Your doctor also may recommend medicines such as expectorants and mucus thinners to help you cough up mucus.

Expectorants help loosen the mucus in your lungs. They often are combined with decongestants, which may provide extra relief. Mucus thinners, such as acetylcysteine, loosen the mucus to make it easier to cough up.

For some of these treatments, little information is available to determine how well they work.

Hydration

Drinking plenty of fluid, especially water, helps prevent airway mucus from becoming thick and sticky. Good hydration helps keep airway mucus moist and slippery, which makes it easier to cough up.

Chest Physical Therapy

CPT also is called physiotherapy (FIZ-e-o-THER-a-pe) or chest clapping or percussion. It involves pounding your chest and back over and over with your hands or a device to loosen the mucus from your lungs so that you can cough it up.

You may sit with your head tilted down or lie on your stomach with your head down while you do CPT. Gravity and force help drain the mucus from your lungs.

Some people find CPT hard or uncomfortable to do. Several devices have been developed that may help with CPT, such as:

• An electric chest clapper, known as a mechanical percussor.
• An inflatable therapy vest that uses high-frequency air waves to force the mucus that's deep in your lungs toward your upper airways so you can cough it up.
• A small handheld device that you breathe out through. It causes vibrations that dislodge the mucus.
• A mask that creates vibrations that help break the mucus loose from your airway walls.

Some of the methods and devices are popular with patients and doctors, but little information is available on how well they actually work. Choice usually is based on convenience and cost.

Several breathing techniques also are used that may help move mucus to the upper airways so you can cough it up. These techniques include forced expiration technique (FET) and active cycle breathing (ACB).

FET involves forcing out a couple of breaths and then doing relaxed breathing. ACB is FET that involves deep breathing exercises.

Other Treatments

Depending on your condition, your doctor also may recommend oxygen therapy or surgery to remove a section of your lung.

Oxygen therapy can help raise low blood oxygen levels. For this treatment, you're given oxygen through nasal prongs or a mask. Oxygen therapy may be done at home or in a hospital or other health facility.

Surgery may be used if no other treatments have helped and only one part of your airway is affected. If you have major bleeding, your doctor may recommend either surgery to remove the bleeding part of your airway or a procedure to control the bleeding.