Bronchiectasis is a long-term condition where the airways (bronchi) become permanently widened and scarred. This damage makes it harder for your lungs to clear out mucus. When mucus builds up, it becomes a trap for bacteria, leading to frequent lung infections known as exacerbations.
Treatment Options
Management generally falls into two categories: daily clearing (removing the mucus) and inflammation control (preventing the damage).
1. Airway Clearance Techniques (ACT)
The “Gold Standard” for daily care. These techniques move mucus from small airways to larger ones so you can cough it up.
- PEP Devices: Handheld tools (like Acapella) that create vibrations to loosen mucus.
- Active Cycle of Breathing (ACBT): A specific sequence of deep breaths and “huffs.”
- Hydration: Drinking plenty of water keeps mucus thin and easier to move.
2. Disease-Modifying Therapy: Brinsupri
Approved in 2025, Brinsupri (brensocatib) is the first medication designed to stop the cycle of inflammation in non-cystic fibrosis bronchiectasis.
- How it Works: It blocks an enzyme (DPP1) that activates aggressive white blood cells in the lungs. By “turning down the volume” on this inflammation, it helps prevent the scarring that leads to widened airways.
- The Goal: Clinical trials showed a 20% reduction in yearly flare-ups and a slower decline in lung function.
- Usage: A single tablet taken once daily. Note that while taking this, you should maintain excellent dental hygiene and avoid “live” vaccines.
Recognizing a “Flare-Up” (Exacerbation)
Even with modern treatments like Brinsupri, infections can still occur. Contact your medical team if you notice:
- Mucus Changes: If it becomes thicker, darker (yellow/green), or much more plentiful.
- Increased Breathlessness: Feeling winded during tasks that are usually easy.
- Fever or Chills: Signs of an active infection.
- Hemoptysis: Seeing blood in your mucus (requires prompt medical attention).
Daily Health & Prevention
- Vaccinations: Keep up with flu, COVID-19, and pneumonia shots.
- Exercise: Pulmonary rehab or regular walking helps keep lungs expanded.
- Avoid Irritants: Stay clear of smoke, strong fumes, and high-pollution areas.