Bronchiectasis is a chronic lung condition characterized by permanent widening and damage of the airways (bronchi), which leads to impaired clearance of mucus and recurrent infections. This ongoing cycle of infection and inflammation causes progressive lung damage and a range of complications that can significantly affect a person’s health and quality of life.
One of the most common and serious complications of bronchiectasis is **recurrent respiratory infections**. Because the airways are dilated and damaged, mucus tends to accumulate and is not cleared effectively. This stagnant mucus becomes a breeding ground for bacteria and other pathogens, leading to frequent lung infections. These infections can cause symptoms like persistent cough, increased sputum production, fever, and worsening breathlessness. Over time, repeated infections can further damage lung tissue, creating a vicious cycle of infection and injury.
Another major complication is **hemoptysis**, which means coughing up blood. This occurs because the inflamed and damaged bronchial walls develop fragile blood vessels that can rupture. Hemoptysis can range from mild streaks of blood in the sputum to massive, life-threatening bleeding. The risk of severe bleeding increases with the severity of bronchiectasis and the presence of infections or inflammation.
As the disease progresses, some patients may develop **respiratory failure**. This happens when the lungs become so damaged that they cannot adequately exchange oxygen and carbon dioxide. Respiratory failure leads to low oxygen levels in the blood and can cause symptoms such as severe shortness of breath, fatigue, confusion, and cyanosis (bluish discoloration of the skin). In advanced cases, patients may require supplemental oxygen or mechanical ventilation.
**Chronic inflammation** in bronchiectasis can also lead to structural changes in the lungs beyond the airways. For example, the lung tissue around the damaged bronchi may become scarred and stiff, a condition known as fibrosis. This scarring reduces lung elasticity and impairs breathing. Additionally, the persistent inflammation can cause thickening of the bronchial walls, further narrowing the airways and worsening airflow obstruction.
Another important complication is the development of **cor pulmonale**, which is right-sided heart failure caused by lung disease. When bronchiectasis leads to chronic low oxygen levels and lung scarring, the blood vessels in the lungs constrict, increasing pressure in the pulmonary arteries (pulmonary hypertension). The right side of the heart has to work harder to pump blood through these narrowed vessels, eventually leading to heart enlargement and failure. Symptoms of cor pulmonale include swelling in the legs, abdominal discomfort, and worsening breathlessness.
In some cases, bronchiectasis can cause **pneumothorax**, which is the collapse of a lung or part of a lung. This occurs when damaged lung tissue ruptures, allowing air to escape into the space between the lung and chest wall. Pneumothorax can cause sudden chest pain and severe shortness of breath and may require emergency treatment.
Patients with bronchiectasis are also at risk of developing **lung abscesses**, which are localized collections of pus within the lung tissue. These abscesses form when infections become severe and cause tissue destruction. Lung abscesses can cause persistent fever, chest pain, and a foul-smelling cough.
In rare but serious cases, bronchiectasis can be complicated by the formation of **fungal infections**, such as aspergillosis. The damaged airways and mucus accumulation create an environment where fungi can grow. This can lead to allergic reactions or invasive infections that further damage lung tissue.
Because bronchiectasis often involves chronic sputum production and cough, patients may experience **fatigue and reduced exercise tolerance**. The constant effort to clear mucus and the impact of recurrent infections can lead to muscle weakness and overall decreased physical capacity.
In severe bronchiectasis, the extensive lung damage may necessitate **surgical intervention**. Surgery migh
