Bronchiectasis: The Widened Airways Condition That Makes Mucus Hard to Clear — Explained
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD. Last reviewed October 13, 2026. This content is for educational purposes and is not medical advice.
Quick Answer
Bronchiectasis is a lung condition in which airways become damaged and widened so they can't clear mucus, letting bacteria grow and cause more damage [1]. The main symptom is a cough with lots of mucus and pus. Common causes include infections and cystic fibrosis. There is no cure, but mucus-clearing therapies and medications control symptoms [1].
What the research says
Brensocatib reduced flare-ups in a large phase 3 trial. In 1,721 patients with bronchiectasis, the yearly rate of pulmonary exacerbations was 1.02 with the 10-mg dose and 1.04 with the 25-mg dose, compared with 1.29 with placebo (rate ratio 0.79, 95% CI 0.68 to 0.92, and 0.81, 95% CI 0.69 to 0.94). About 48.5% of treated patients stayed exacerbation-free at 52 weeks versus 40.3% with placebo. Hyperkeratosis (thickened skin) was more common with the drug (Chalmers et al., N Engl J Med, 2025) [5].
Airway clearance, inhaled antibiotics, and long-term macrolides have each shown benefit in randomized trials. A review of the evidence concluded that the goals of treatment are to reduce symptoms, improve quality of life, reduce exacerbations, and prevent disease progression, and that the disease's variety is one of the hardest parts of management (Choi et al., Eur Respir J, 2024) [6].
Bronchiectasis is linked to a higher risk of death, which is why follow-up matters. In a study of 18,134 people with bronchiectasis and 90,313 controls without lung disease, the bronchiectasis group had higher all-cause mortality (adjusted hazard ratio 1.26, 95% CI 1.09 to 1.47) and higher respiratory mortality (adjusted hazard ratio 3.49, 95% CI 2.21 to 5.51). The risk was more pronounced in people who had ever smoked (Sin et al., Respir Res, 2019) [7].
What Is Bronchiectasis?
Bronchiectasis is a lung condition where your airways get damaged and enlarged [1]. Your airways are the tubes that carry air into your lungs.
Mucus in your airways is one way your body protects you from germs. When airways are damaged, they can't clear mucus like they're supposed to. Bacteria then grow in the mucus, causing more inflammation and damage to your lungs [1]. This makes you cough a lot as your body tries to remove the infected mucus.
Bronchiectasis ("bronk-ee-EK-tuh-sis") can be mild or severe depending on how damaged your lungs are. Some people have it and don't even know it. Others have long-lasting symptoms, repeated infections, and severe airway damage.
What types are there?
Healthcare providers describe bronchiectasis based on what the damage looks like and how widespread it is.
Type | What it looks like | Severity note |
Cylindrical | Airways are enlarged evenly and uniformly, like a smooth cylinder; no pouches | Most common and least serious form |
Varicose | Airways are wider in some places and narrower in others, like varicose veins on imaging | Intermediate |
Cystic | Honeycomb-like pockets of fluid (cysts) form in the airways | Most severe form |
Traction | Scarring widens the airways and pulls them out of shape | Intermediate |
Focal | Damage is limited to one area of your lungs | Based on spread |
Diffuse | Damage affects many areas throughout your lungs | Based on spread |
What Are the Symptoms of Bronchiectasis?
The three main signs of bronchiectasis are recurrent pneumonia, shortness of breath and coughing up mucus, and other symptoms include wheezing and coughing up blood [1].
What symptoms should I watch for?
The three big signs are recurrent pneumonia, shortness of breath, and coughing up mucus. Bronchiectasis symptoms include:
Cough with lots of mucus and pus
Repeated colds
Bad-smelling mucus
Shortness of breath
Wheezing
Coughing up blood
What is a flare-up (exacerbation)?
You might have stretches of time where your symptoms aren't as bad, then have a flare-up (exacerbation) where your symptoms get worse. Exacerbation symptoms include extreme tiredness (fatigue), fever and chills, increased shortness of breath, and night sweats [1].
What complications can it cause?
Damage caused by severe bronchiectasis can lead to life-threatening complications [1]:
Complication | What happens |
Respiratory failure | If your lungs aren't working properly, you might not be able to get enough oxygen to your blood and tissues |
Severe bleeding | Blood vessels in your airways may get so damaged that they bleed heavily; you may cough up blood |
Antibiotic-resistant infections | You may get infections that are hard to treat |
What Causes Bronchiectasis?
Airway damage causes bronchiectasis. Mucus in your airways is one way your body protects you from germs. Certain conditions make it so you can't cough out mucus — and the bacteria trapped in it. This can cause lasting damage to your airways.
How does the damage happen?
The damage happens in two phases:
First phase ("insult"): This is the initial damage. It's caused by a bacterial infection, inflammatory disorder, or another condition that affects your lungs [1]. Healthcare providers don't always know the initial cause of the damage.
Second phase ("vicious vortex"): The initial damage makes you more likely to get inflammation and repeated infections. This cycle causes further damage to your lungs [1].
What diseases can start the cycle?
Some of the specific causes of initial damage that start the cycle of bronchiectasis include:
Cause | How it starts the damage cycle |
Cystic fibrosis | Thick mucus is hard to clear from the airways |
Mycobacterial infections | Infections like MAC (mycobacterium avium complex) or tuberculosis damage airway tissue |
Autoimmune or inflammatory disorders | Inflammation damages the airways |
Airway blockages | Foreign bodies, tumors, or lymph nodes block airways and prevent mucus clearance |
Weakened immune system | Conditions like HIV, receiving an organ transplant, and primary immunodeficiencies raise infection risk |
Primary ciliary dyskinesia | The tiny hair-like structures (cilia) that sweep mucus out don't work properly |
Allergic bronchopulmonary aspergillosis (ABPA) | An allergy to a type of fungus |
Radiation fibrosis | Scarring from radiation widens and stiffens airways |
Alpha-1 antitrypsin deficiency | A genetic condition that allows enzymes to damage lung tissue |
It's also associated with other pulmonary disorders, like asthma and COPD (chronic obstructive pulmonary disease) [1].
Who is at risk?
In general, the risk of bronchiectasis increases as you get older. You're also at a higher risk if you have an underlying condition that affects your lungs or immune system [1].
How Is Bronchiectasis Diagnosed?
Healthcare providers diagnose bronchiectasis by listening to your lungs, testing how well they work and using imaging tests to take a closer look.
What will my doctor do?
Healthcare providers diagnose bronchiectasis by listening to your lungs and testing how well they're working. If they think you have bronchiectasis or another lung condition, they'll recommend imaging tests to take a closer look at your lungs.
What tests confirm it?
A healthcare provider may do tests to diagnose bronchiectasis or rule out other conditions:
Test | What it does |
Chest X-ray or CT scan | A machine takes pictures of your lungs to look for damage |
Blood tests and sputum cultures | Samples of your blood or mucus (sputum) are checked for infections |
Lung function tests | Help your provider determine how well your lungs are working |
Genetic testing | Blood or other body fluid samples are tested for genetic conditions |
Sweat chloride test | If cystic fibrosis is suspected, your arm or leg is made to sweat, the sample is collected, and it's tested for signs of cystic fibrosis |
Bronchoscopy | A bronchoscope (a long, flexible tube with a light and camera at the end) finds and removes anything blocking your airways, and mucus or pus samples are taken for testing |
How Is Bronchiectasis Treated?
Healthcare providers treat bronchiectasis by clearing mucus and managing infections, and treating any underlying condition that causes it may also help symptoms.
What is the goal of treatment?
Healthcare providers treat bronchiectasis by clearing mucus and managing infections. If an underlying medical condition is causing bronchiectasis, treating that condition may help your symptoms [1].
What treatment options are available?
Treatment | How it helps |
Antibiotics | Treat bacterial infections; taken as a pill, given by IV (through a vein), or inhaled through an inhaler |
Macrolides | Drugs that treat infections and inflammation at the same time |
Expectorants and mucolytics | Medications that thin mucus and help you cough it out |
Chest physical therapy | Postural draining and chest percussion loosen and remove mucus; breathing exercises open up your airways |
Medical devices | Oscillating positive expiratory pressure (PEP) devices and percussive vests break up and pull mucus out of your lungs |
Brensocatib (Brinsupri™) | For non-cystic fibrosis bronchiectasis with frequent flares; blocks enzymes that cause inflammation in your airways, reducing flare risk |
Surgery | An option for a small area of bronchiectasis; rare |
When should I contact my healthcare provider?
If you have bronchiectasis, contact your healthcare provider if you have signs of infection (like a fever or chills), more trouble breathing than usual, are much more tired than usual, are losing weight unintentionally, are coughing up more mucus (including bloody mucus or yellow or green mucus) [1], or don't have an appetite.
Emergency warning: Go to the ER if you are coughing up a lot of blood, having chest pains, or struggling to breathe [1].
Can bronchiectasis be cured, and what is the long-term outlook?
Bronchiectasis can't be cured — the damage it causes is irreversible [1]. But most people can manage the symptoms by working together with their healthcare providers.
Your outlook will depend on how severe your condition is, how well you respond to treatment, and what other health conditions you have. You may need to practice physical therapies or take medications daily. More severe cases may impact your quality of life [1].
Can it be prevented?
You can reduce your risk of developing bronchiectasis by protecting your lung health:
Check with your healthcare provider about recommended vaccinations for you and your family. Pertussis, the flu, pneumococcal disease, and measles can all cause or worsen bronchiectasis [1].
Work with your provider to treat ongoing health conditions, especially those that affect your lungs. Talk to your provider if medications or therapies aren't working.
Avoid inhaling lung irritants like cigarette smoke, vaping, fumes, and gases. Wear a respirator mask and work in a well-ventilated area [1] if you're around dust or fumes.
How can people live well with bronchiectasis?
Managing damage to your airways might seem overwhelming at first. But in most cases, bronchiectasis shouldn't keep you from living a full life.
Talk to your provider about bothersome symptoms and how to deal with exacerbations. They may not be able to take care of every symptom, but sometimes small changes can greatly improve your quality of life.
How is it different from bronchitis?
Bronchiectasis and bronchitis have similar symptoms, including mucus in your lungs and coughing. But bronchiectasis causes permanent widening of your airways. Bronchitis is a temporary infection [1] that doesn't cause lasting damage.
Conclusion
Bronchiectasis is a condition where lung airways become damaged and widened, so they can't clear mucus properly — and the trapped mucus becomes a breeding ground for bacteria that cause more inflammation and more damage. The hallmark is a daily cough with lots of mucus and pus, often alongside wheezing, shortness of breath, and repeated colds. There are six ways providers describe the damage (cylindrical, varicose, cystic, traction, focal, and diffuse) [1], and the condition starts through a two-phase cycle: an initial "insult" followed by a "vicious vortex" of inflammation and repeated infections. There is no cure, but most people manage well with daily mucus-clearing therapies, devices, medications, and treatment of the underlying cause — and in most cases, bronchiectasis shouldn't keep you from living a full life. Know the flare-up signs, and go to the ER if you're coughing up a lot of blood, having chest pains, or struggling to breathe [1].
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Frequently Asked Questions
What is bronchiectasis?
Bronchiectasis is a lung condition where your airways — the tubes that carry air into your lungs — get damaged and enlarged, or develop pouches. Damaged airways can't clear mucus properly, so bacteria grow in the trapped mucus and cause more inflammation and damage.
How do you pronounce bronchiectasis?
It's pronounced "bronk-ee-EK-tuh-sis."
What is the main symptom of bronchiectasis?
The main symptom is a cough with lots of mucus and pus. Other symptoms include repeated colds, bad-smelling mucus, shortness of breath, wheezing, and coughing up blood. Recurrent pneumonia, shortness of breath, and coughing up mucus are three big signs.
Is bronchiectasis the same as bronchitis?
No. They have similar symptoms (mucus in your lungs and coughing), but bronchiectasis causes permanent widening of your airways, while bronchitis is a temporary infection that doesn't cause lasting damage.
What are the types of bronchiectasis?
There are six descriptions: cylindrical (evenly enlarged airways; most common and least serious), varicose (wider and narrower in places, like varicose veins), cystic (honeycomb-like fluid pockets; most severe), traction (scarring pulls airways out of shape), focal (damage in one area), and diffuse (damage in many areas).
What causes bronchiectasis?
Airway damage — usually from a bacterial infection, inflammatory disorder, or another lung condition. Specific causes include cystic fibrosis, MAC infections, tuberculosis, autoimmune or inflammatory disorders, airway blockages (foreign bodies, tumors, lymph nodes), weakened immune system conditions (HIV, organ transplant, primary immunodeficiencies), primary ciliary dyskinesia, ABPA (a fungus allergy), radiation scarring, and alpha-1 antitrypsin deficiency. It's also associated with asthma and COPD.
What is the "vicious vortex"?
It's the second phase of bronchiectasis damage. The initial damage (the "insult") makes you more likely to get inflammation and repeated infections, and that cycle causes further damage to your lungs.
Is bronchiectasis dangerous?
Severe bronchiectasis can lead to life-threatening complications: respiratory failure (not getting enough oxygen to blood and tissues), severe bleeding from damaged airway blood vessels, and antibiotic-resistant infections that are hard to treat.
How is bronchiectasis diagnosed?
Providers listen to your lungs and test how well they're working. Tests may include a chest X-ray or CT scan, blood tests, sputum cultures, lung function tests, genetic testing, a sweat chloride test (to check for cystic fibrosis), and bronchoscopy (a flexible camera tube that can find blockages and take mucus samples).
What is a sweat chloride test?
A test for cystic fibrosis where your arm or leg is made to sweat, the sweat is collected, and the sample is tested for signs of cystic fibrosis.
How is bronchiectasis treated?
Providers treat it by clearing mucus and managing infections: antibiotics (pills, IV, or inhaled), macrolides (treat infection and inflammation at the same time), expectorants and mucolytics (thin mucus so you can cough it out), chest physical therapy, PEP devices and percussive vests, brensocatib (Brinsupri™) for non-CF bronchiectasis with frequent flares, and — rarely — surgery for a small damaged area. Treating any underlying condition may also help.
What is brensocatib (Brinsupri™)?
A medicine for people with non-cystic fibrosis bronchiectasis who have frequent flares. It blocks enzymes that cause inflammation in your airways, reducing your risk for flares.
Can bronchiectasis be cured?
No — bronchiectasis can't be cured because the airway damage is irreversible. But most people can manage symptoms by working with their healthcare providers, and outlook depends on severity, treatment response, and other health conditions.
Can I live a full life with bronchiectasis?
In most cases, yes. Bronchiectasis shouldn't keep you from living a full life. Talk to your provider about bothersome symptoms and flare-ups — sometimes small changes greatly improve your quality of life, though more severe cases may affect quality of life.
Can bronchiectasis be prevented?
You can lower your risk by protecting lung health: getting recommended vaccinations (pertussis, flu, pneumococcal disease, and measles can all cause or worsen bronchiectasis), treating ongoing health conditions (especially lung conditions), and avoiding inhaling cigarette smoke, vaping, fumes, and gases. Wear a respirator mask and work in well-ventilated areas around dust or fumes.
When should I go to the ER for bronchiectasis?
Go to the ER if you are coughing up a lot of blood, having chest pains, or struggling to breathe.
When should I contact my healthcare provider?
Contact your provider if you have signs of infection (fever or chills), more trouble breathing than usual, much more tiredness than usual, unintentional weight loss, coughing up more mucus (or bloody, yellow, or green mucus), or loss of appetite.
Related Reading
Chest Physiotherapy (Chest PT): Techniques, Uses and Benefits explains chest physiotherapy for clearing mucus.
Pneumonia: Complete Guide to Symptoms, Causes, and Treatment: recurrent pneumonia is one of the big signs of bronchiectasis.
Learn more in our guide to Pulmonary Function Tests (PFTs): Types, Preparation and What Your Results Mean.
Learn more in our guide to Spirometry: What the Lung Function Test Measures, How It's Done and What Results Mean.
Learn more in our guide to Bronchoscopy: Why It's Done, What to Expect, Recovery and Risks.
Sputum Culture: How to Give a Sample, What It Detects and What Results Mean explains the lab test that finds germs in lung mucus.
References
Cleveland Clinic. Bronchiectasis. Cleveland Clinic. Updated March 9, 2026. https://my.clevelandclinic.org/health/diseases/21144-bronchiectasis
American Lung Association. Bronchiectasis. American Lung Association. Accessed October 14, 2026. https://www.lung.org/lung-health-diseases/lung-disease-lookup/bronchiectasis
National Heart, Lung, and Blood Institute. What Is Bronchiectasis? NHLBI, NIH. Updated October 27, 2023. https://www.nhlbi.nih.gov/health/bronchiectasis
Steinbach T. Bronchiectasis. Merck Manual Professional Edition. Reviewed April 2025. Modified August 2025. https://www.merckmanuals.com/professional/pulmonary-disorders/bronchiectasis-and-atelectasis/bronchiectasis
Chalmers JD, et al. Phase 3 Trial of the DPP-1 Inhibitor Brensocatib in Bronchiectasis. New England Journal of Medicine. 2025;392(16):1569-1581. PMID 40267423. https://doi.org/10.1056/NEJMoa2411664
Choi H, et al. Bronchiectasis management in adults: state of the art and future directions. European Respiratory Journal. 2024;63(6):2400518. PMID 38782469. https://doi.org/10.1183/13993003.00518-2024
Sin S, et al. Mortality risk and causes of death in patients with non-cystic fibrosis bronchiectasis. Respiratory Research. 2019;20(1):271. PMID 31796019. https://doi.org/10.1186/s12931-019-1243-3
Medical disclaimer
This article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a healthcare provider for symptoms such as a persistent cough with mucus, shortness of breath, or coughing up blood, and seek emergency care for chest pain, severe bleeding, or difficulty breathing.
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