What causes Bronchiectasis to worsen?

I have been wondering about this same question, so hopefully our mentor friends will reply with their experienced insight. I was diagnosed 3 years ago after an episode of hemoptysis. I had experienced vague symptoms since 2016.
Also Eileen--from Iowa

Bronchiectasis advances through both recurring flare-ups (exacerbations) and as a slowly progressive disease on its own. While acute exacerbations (often triggered by infection) cause rapid, sharp increases in lung damage, the underlying condition involves chronic, ongoing inflammation that causes gradual decline even during stable periods.

Have you researched with google to read what is stated on credible websites like Cleveland Clinic etc. etc.
I googled: ' does bronchiectasis continue to worsen even without infection symptoms'
I googled: ' how does Bronchiectasis worsen'
Glad you brought up the subject...I just went to some of the sites to again revisit them.
Barbara

@eileen86 - @cwal gives a good explanation. BUT...you can slow down the progression of damage by careful management. This includes frequent airway clearance, promptly recognizing and treating any infection/exacerbation, avoiding your personal "triggers", and taking REASONABLE precautions.

How do we do this?
Follow the most current treatment/management guidelines from the recognized experts like:
NTMinfo.org
National Jewish Health (NearionalJewish.org)
recognized experts in the field like Doctors Pamela McShane, Jennifer Honda and Joe Falkinhma
Read, read, read some more.

@snoei the best people are Eileen’s. 😂

Thanks everyone for your responses. This is such a good place to get support and solid information.

I am very fortunate that I have an excellent ID doctor who has had about 200 patients with MAC. He collaborates with a pulmonologist at the University of Pennsylvania who also has solid knowledge and a good manner. I’m on my second round of the big three, and religiously take my antibiotics and inhale Arikayce daily. I feel like, after some years of messing around with doctors who didn’t have clue, I am now in good hands. I know this is not the case for so many of us in this group and I would not mention it here except to encourage everyone to keep searching for the right doctor(s). They are out there!

I asked the question because my brother has just been diagnosed with Idiopathic Pulmonary Fibrosis, which gradually gets worse, even when you are not having flares. The advice Sue gave about managing bronchiectasis is spot on, and it seems that it would apply for IPF as well.

Thanks again.

Let me add, I am hyper vigilant about not being around people in the winter, and when I need to be around people I mask and use hand sanitizer. I hate it but last year I came down with (despite my being vaccinated) RSV, Covid, pneumonia and the flu, all within a month and a half. I had to be hospitalized twice. So far this winter I’ve been healthy. 🤞

@eileen86 that is the magic bullet in all this management criteria. Having the most knowledgeable and experienced doctors. I thought I had that with my ID doctor, but recently found out I didn’t. I’ve been recently diagnosed with pseudomonas and other various bacteria on my lungs. I was so disappointed because since I was diagnosed with Bronchiectisis and MAC I was able to stay clear of pseudomonas infections. She put me on one round of Levofloxacin and after 10 days, the culture, which I insisted on having done, she wasn’t going to do another, came back worse she just laughed it off. “Oh well sometimes it works and sometimes it doesn’t and then went on to tell me that that’s all they do, there is no more. I was floored! Then, I went to my Pulmonologist and he and a Superior Pulmanologist wanted to put me on 30 days of Levafloxacin and Tobramycin. My insurance company requested a prior authorization for the tobramycin my pharmacist and I have reached out to my Pulmonologists but have not received a response and therefore I have not been able to get the tobramycin. So, all I can think of a is well, I guess they weren’t concerned about getting this medication in me. I am just totally at a loss for the lack of concern for us who are dealing with this disease and doing everything we can with our knowledge to try to avoid exacerbations. It’s just really tough when you don’t have good medical teams backing you and guiding you !!

@sueinmn
I have bronchiectasis and abpa and went out of town for 6 weeks. Usually i have trouble coughing up sputum after nebulizing and airway clearance but during the 6 weeks I coughed up alot of jade green sputum every evening. Should I of called in antibiotics even though i did not have a fever?

@pattyrobertson I would never assume that you, or anyone else, requires antibiotics. That is a decision for you and your care team, taking your total situation into consideration.

In my case. I need at least 4 ot these symptoms - increased sputum or change in consistency, increased cough, lung congestion/crackles, fever, fatigue, night sweats, weight loss, decreased appetite...before my docs give me antibiotis.