Asthma and bronchiectasis: understanding both

Asthma causes variable airway inflammation and tightening, often producing episodes of wheeze, cough, chest tightness and breathlessness. Bronchiectasis involves widened, damaged airways where mucus is harder to clear. It commonly presents with a long-lasting productive cough, repeated chest infections, breathlessness and sometimes blood-streaked phlegm.

The conditions may occur in the same person, and either can contribute to coughing or wheezing. A daily wet cough, increased sputum volume, changes in sputum colour or repeated infections are useful clues that symptoms may not be explained by asthma alone. The pattern guides testing; it does not establish the diagnosis by itself.

Continue prescribed asthma medicines and have inhaler technique checked. Bronchiectasis care may include an airway-clearance routine taught by a respiratory physiotherapist, physical activity suited to your health, hydration, sputum testing during flare-ups and antibiotics when a clinician identifies a bacterial infection that needs treatment. Do not start leftover antibiotics or stop regular inhaled medicine without clinical advice.

Record changes in cough, phlegm, breathlessness, wheeze and temperature. A clinician may use spirometry to assess airflow and response to treatment. Chest imaging helps examine lung structure; a chest X-ray can provide initial information, while a CT scan is commonly used to confirm bronchiectasis.

Contact your clinician promptly when phlegm becomes thicker, darker or more plentiful, fever develops, breathlessness increases, chest pain appears, or your usual airway-clearance routine is less effective. Seek emergency help for severe breathing difficulty, inability to speak comfortably, blue or grey lips, confusion, fainting, or coughing up more than a few streaks of blood. Follow the urgent steps in your asthma or bronchiectasis plan while help is arranged.

Bring a medicine list and describe your usual sputum amount and colour, infection pattern, triggers and response to inhalers. Ask whether you need sputum culture, spirometry or chest imaging; which airway-clearance method fits you; how to recognise an exacerbation; and which changes should trigger an urgent call.