Bronchiectasis in adults | Pūkahukahu hauā

Key points about bronchiectasis

  • Bronchiectasis (pūkahukahu hauā) is a long-term lung condition in which your airway walls have become damaged, widened and thickened.
  • The damaged airways can cause mucus build-up.
  • When mucus stays in the lungs it can lead to infections and an ongoing chesty cough and shortness of breath.
  • There's no cure but good treatment stops it getting worse.
  • If you have bronchiectasis and you are coughing or bringing up more phlegm than normal, are more short of breath or coughing up blood, or have a fever or new chest pain seek medical help.
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Video: Bronchiectasis Animation - What is Bronchiectasis?

Bronchiectasis is a lung condition where mucus collects in the airways, making them prone to infection and resulting in a long-term chesty cough. Discover more about it in this animated video. It may take a few moments to load.

(Salam Hossein, 2012)

In people with bronchiectasis, your airways (the branching tubes of your lungs) are damaged and wider than normal. This leads to mucus build up. Over time it becomes harder to cough the mucus up. Bacteria grow in the mucus, and can cause further lung infection.

Each new infection causes more damage to your airways, making them wider, thicker and floppier. Your lungs struggle to move air in and out, leading to continuous coughing and shortness of breath.

Over time, bronchiectasis can get worse, making day-to-day activities harder to do. It can also lead to long stays in hospital and reduce life expectancy. 

With early diagnosis and treatment, ongoing airway damage can often be reduced.

Image credit: 123rf

Bronchiectasis is caused by damage to your airway walls. It begins most often in early childhood but can develop at any age. Common causes include the following:

Cause Description
Unknown In up to half of cases the cause is unknown.
Infection Certain lung infections can cause bronchiectasis in some people. Some bugs that can cause it are pertussis, measles and influenza.
Weakened immune system This is where your immune system is not able to fight infections properly. You can be born with this (called primary immunodeficiency), or get it later from another condition like HIV.
Poor mucus clearance Having a condition like cystic fibrosis or primary ciliary dyskinesia where you can’t clear mucus properly. 
Other causes These include inhaling noxious chemicals and autoimmune conditions. You can even be born with it. 


Smoking is not a major cause of bronchiectasis – many people with the condition have never smoked. However, because smoking irritates your lungs it makes the condition worse.

The main symptoms of bronchiectasis are coughing up lots of mucus (phlegm) and a long-term wet-sounding cough. The phlegm can be clear or different colours. Other symptoms include:

  • shortness of breath
  • wheezing
  • chest pain.

You may also feel tired and generally unwell.

If you have a wet-sounding cough that is ongoing and lasts for weeks, see your doctor.

How is bronchiectasis diagnosed?

Your doctor will talk to you about your symptoms and examine you. They may do some or all of these tests:

  • blood tests
  • breathing test (called pulmonary function test)
  • certain scans (chest x-ray and CT scan)
  • sputum/phlegm test
  • looking into your airways with a camera if you are coughing up blood.

How is bronchiectasis treated?

The main aims of treatment are to keep your airways open, reduce mucus build-up and prevent further damage to your lungs.

Chest physiotherapy

A physiotherapist can show you how to clear your lungs of extra mucus and teach you exercises to do at home. You will need to do this once or twice a day.

Pulmonary rehabilitation

In pulmonary rehabilitation you are taught ways to improve your symptoms. You may be taught about your condition and ways to pace yourself and helped to start an exercise programme. Read more about pulmonary rehabilitation.


Your doctor may prescribe a course of antibiotics if you have signs of an infection. It's important to finish the course even if you feel better, as stopping the antibiotics too soon could cause the infection to come back quickly. Often a 2-week course of antibiotics is required. If you have frequent chest infections, your doctor may prescribe antibiotics on a long-term basis.

There are a number of things you can do to help relieve the symptoms of bronchiectasis and stop the condition getting worse.

  • Quit smoking (if you smoke) – smoking is a major irritant to your lungs and will make the condition worse.
  • Keep yourself well hydrated – drinking plenty of fluid, especially water, helps prevent mucus from becoming thick and sticky. Keeping mucus moist and slippery makes it easier to cough up.
  • Vaccinations - to help protect you from some infections you can get the flu vaccination every year. Pneumococcal vaccination is also recommended, but this is not funded for most adults. This vaccine protects you from some of the kinds of bacteria that cause pneumonia. Contact your GP for this.
  • Chest physiotherapy should be done once or twice a day at home when you are well, and more often if you are sick.
  • Exercising regularly – being physically active helps keep your chest free of infection by helping to clear the mucus. Aim to exercise at least 3–4 times per week. Any type of exercise that makes you take long, deep breaths is good. It’s okay if you cough during exercise.
  • Eating a balanced diet.
  • Having a warm, dry home.

Bronchiectasis action plan

If you have bronchiectasis, talk to your healthcare provider about drawing up a bronchiectasis action plan. This is a written document about what you need to do to manage your bronchiectasis well. It means you don't need to rely on remembering what your healthcare provider tells you to do.

A bronchiectasis action plan has information on how to recognise and handle worsening symptoms, and when, how and who to contact in an emergency. Some people need antibiotics on hand at home for prompt treatment of flare-ups. Bronchiectasis action plans include the following:


Asthma NZ provides education, training and support to anyone with bronchiectasis and their families/whānau. Read more(external link)(external link)

Stories about people living with bronchiectasis.

Edward and Piri's stories

In this 3-part video series, Edward learns that he has bronchiectasis, a condition that his grandfather died from at a young age. Meanwhile, 17-year-old Piri's whānau have gathered at Starship hospital to try to convince him to be proactive about getting to hospital as soon as his bronchiectasis symptoms re-appear.

Esther-Jordan Muriwai's story

Listen to Esther's story and hear her passion for creating a place for people with bronchiectasis and their families. Esther was the founder and has been the inspiration for her whānau, community and health professionals to set up the Bronchiectasis Foundation of NZ. Visit the Bronchiectasis Foundation(external link) for more of Esther's story and information about bronchiectasis.

Video: Camron Muriwai and Ana Sadlier: Bronchiectasis Foundation I NZ Respiratory Conference 2015

This video may take a few moments to load.

(Asthma Foundation NZ, 2015)

Chloe's story

Chloe is a fun-loving 4-year-old who was diagnosed with bronchiectasis at 3 years old in August 2016. As an infant, she experienced repeated chest and breathing issues and had multiple admissions to hospital with bronchiolitis. At the age of 2, she was diagnosed with asthma. Then a severe case of influenza in July 2015 further damaged her lungs and it took 2 months for her to recover. A visit to Starship hospital in August 2016 confirmed Chloe now had bronchiectasis. 

Read Chloe's story on the Bronchiectasis Foundation(external link) website. 

Katie's story

Katie was diagnosed with bronchiectasis at the age of 8 years old. This followed seven bouts of pneumonia during the 15 months before this. 

"In February 2013 we met Esther-Jordan Muriwai. She had bronchiectasis too. Sometimes we were both sick and in hospital at the same time so we visited each other. Esther told me that if I don’t do my physio I would end up very sick like she was. She encouraged me to do my daily physio and medications. Esther showed me that I can do anything I want to do in my life … I don’t need to let my lung disease stop me from doing things, especially when I am well. Having bronchiectasis doesn’t mean you have to be left out of things.

"To help me stay well I take medication and inhalers, and do twice-daily physio and nebuliser. Sometimes I don’t want to do my physio but I know I have to otherwise I get sicker and go into hospital more often. And this means I miss out on fun things in life like horse riding, swimming lessons, hanging out with my friends, going to school and going to Girl Guides."

Katie and her family worked with Esther talking to newspapers and television and continue to work hard to raise awareness of bronchiectasis.

Read more of Katie's story on the Bronchiectasis Foundation(external link) website.

Video: A 'pretty normal life' – Julie Blamires' research into young people living with bronchiectasis

This short video reports the findings from a qualitative study where she interviewed 15 young people with bronchiectasis. They described what their life was like and what was most important to them. This video may take a few moments to load.

(Julie Blamires, NZ, 2021)

Video: Living with bronchiectasis: Jude's story

This video may take a few moments to load.

(Asthma & Lung UK, 2017)

Video: Freddy's family and their battle with bronchiectasis

This video may take a few moments to load.

(Lung Foundation Australia, 2018)

Video: Bronchiectasis – 3 part video series 

In this 3 part video series Edward learns that he has bronchiectasis, a disease which his grandfather died from at a young age. Meanwhile 17 year old Piri's whanau have gathered at Starship hospital to try to convince him to be proactive about getting to hospital as soon as his bronchiectasis symptoms re-appear. These videos may take a few moments to load.

(Faultline Films NZ, 2010)

(Faultline Films NZ, 2010)

(Faultline Films NZ, 2010)

Find more personal stories at:

Bronchiectasis (external link) KidsHealth, NZ
Living with bronchiectasis(external link) Asthma + Respiratory Foundation, NZ
Bronchiectasis(external link) Bronchiectasis Foundation, NZ


Regional Blue card COPD Action plan [PDF, 355 KB] District Health Boards, NZ, 2019
Bronchiectasis action plan(external link) Northland DHB, NZ
My bronchiectasis action plan(external link) Lung Foundation Australia, 2020 (Call 111 not 000 in NZ)


  1. Bronchiectasis: rates still increasing among Pacific peoples(external link)(external link) BPAC, NZ, 2012
  2. Bronchiectasis management(external link) Starship Clinical Guidelines, NZ

Key facts and figures

Source: The impact of respiratory disease in NZ – 2018 update(external link)

Although bronchiectasis is the rarest of the indicator conditions, the bronchiectasis hospitalisation rate increased by a significant 45% over the study period. Mortality rates increased by 88%.

Being of Māori or Pacific ethnicity was a significant risk factor for bronchiectasis hospitalisation and death, and Asian mortality rates were also higher than non-MPA. The greatest disparity in hospitalisations by age and ethnicity was for Pacific peoples aged over 65 years, whose bronchiectasis hospitalisation rates of 490.5 per 100,000 were 5.94 times higher than for non-MPA. Overall, Pacific peoples were 6.2 times more likely to be hospitalised for bronchiectasis than non-MPA, and Māori were 3.8 times more likely to be hospitalised, while Asian peoples rates were not significantly different. Mortality differences were similar for Māori and Pacific, but 1.7 times the non-MPA rate for Asian peoples.

Bronchiectasis also showed strong socio-economic disparity, with hospitalisation rates 2.5 times higher in the most deprived compared to the least deprived neighbourhoods, and mortality rates 1.8 times higher. The hospitalisation rate increase for the most deprived quintile was steepest for Māori.

Clinical resources

Preventing and managing bronchiectasis in high-risk paediatric populations(external link) BPAC, NZ, 2020
Navigating uncertainty – managing respiratory tract infections(external link) BPAC, NZ, 2019
Te ha ora – the breath of life – national respiratory strategy(external link) Asthma & Respiratory Foundation of NZ, 2015
Bronchiectasis – acute respiratory exacerbation(external link)
Starship Children's Hospital, NZ, 2021
Bronchiectasis – rates still increasing among Pacific peoples(external link) BPAC, NZ, 2012
Using nebulisers safely(external link) BPAC, NZ, 2008
Hill AT, Sullivan LA, Chalmers DJ, et al. British thoracic Society guideline for bronchiectasis in adults(external link) 

Continuing professional development

Bronchiectasis update by Dr Conroy Wong (external link)(The Goodfellow Unit, NZ, 2018)

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Jeremy Steinberg, FRNZCGP

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