bronchiectasis

Imagine drainage pipes that have been stretched permanently wide and baggy: instead of carrying fluid briskly away, they let it pool and stagnate. Bronchiectasis is that in the lungs — bronchi that have become abnormally and permanently widened, so mucus collects, bacteria settle in, and infection and inflammation feed on each other.

Bronchiectasis is irreversible dilation of the bronchi caused by a destructive cycle of infection and inflammation that damages the airway walls. The result is a chronic daily cough producing large amounts of sputum, recurrent chest infections, and sometimes coughing up blood. Causes include severe or repeated infections, cystic fibrosis, immune deficiencies, primary ciliary dyskinesia, or airway obstruction; many cases remain idiopathic.

It is diagnosed on high-resolution CT, which shows widened airways (often wider than their neighbouring artery) and thickened walls. Management aims to break the cycle: daily airway clearance to move mucus, prompt treatment of infections, and addressing any underlying cause. Although it can coexist with COPD and cause airflow obstruction, it is a distinct disease, not simply a stage of COPD.