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Whether you’re living with a mild or more advanced case of bronchiectasis, whether you’re currently on antibiotics or not, whether you’re feeling energized or worn out--self-care matters. While it may not always be the easiest way to manage a chronic lung condition, it can be the most personalized, empowering, and ultimately rewarding path forward.  What is Bronchiectasis? The word bronchiectasis comes from the Greek words bronckos (airway) and ektasis (widening or dilation). It’s the “ektasis”—this permanent stretching of the airways—that makes bronchiectasis irreversible. Inflammation and infection damage the airway walls, causing them to lose elasticity. Imagine the stretched-out waistband of an old pair of pajama bottoms—no amount of laundering is going to tighten it again. The same goes for our lungs. But here’s the good news: self-care can make a major difference. It helps keep those overstretched passages from becoming clogged with thick mucus and harmful organisms—like bacteria, viruses, and fungi—that further damage lung tissue. Why Self-Care is a Daily Lifeline A healthy lifestyle is also key to lowering inflammation throughout the body. That means eating nutrient-rich foods, moving your body regularly, and making rest a priority. Your body is smart—it knows the difference between a few toe-touches and a dedicated hour-long stretch class. It knows the difference between a 5-minute power nap and a focused meditation session. It knows the difference between a quick puff on your Aerobika and a full, intentional airway clearance routine. Let me be absolutely clear: self-care does not replace traditional medicine. I’m a firm believer in partnering with a qualified healthcare team that includes both conventional and complementary providers. I encourage you to take full advantage of every service offered by your multidisciplinary team. For me, building a care team took time—and some travel. I eventually sought a second opinion out of state and switched to a new pulmonologist. That decision opened the door to new insights and referrals to specialists who investigated potential underlying causes of my bronchiectasis. Over time, I also incorporated complementary care providers into my healing journey. Together, this team helped me take a holistic and individualized approach to managing my condition. That’s what I hope for you, too. If you’re living with BE and feeling stuck, I urge you to advocate for yourself. Seek the best medical care available in your community. And if that’s not enough, and you have the means, find a top national expert who can support your local team with expert guidance. #bronchiectasis #pulmonology #airwayclearance #lunghealth
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Nutrition is not just about eating—it's about healing. Michelle MacDonald, a clinical nutritionist at National Jewish Health, shared practical, evidence-informed guidance on how food can impact bronchiectasis and nontuberculous mycobacterial (NTM) lung disease in a recent NTM Info & Research webinar. In this post, we break down her advice into actionable tips to help you use nutrition as a tool to support your immune system, build strength, and manage symptoms.  Eat with Intention: Food is Therapy When managing chronic lung conditions like bronchiectasis or NTM, food becomes part of your treatment plan. You need calories to:
Prioritize High-Calorie, High-Protein, Nutrient-Dense Foods Malnutrition can weaken your body’s ability to recover. If you’re feeling drained from MAC or another infection, eating well can help you bounce back. Tips to bulk up your nutrition:
Low body mass index (BMI <18.5) is associated with poorer outcomes in people with bronchiectasis and NTM disease. While there’s no single predictor of disease progression, underweight individuals may struggle more with recovery. MacDonald emphasizes: now is not the time to diet. Being a little above your “ideal weight” can actually be protective. Reevaluate Dairy and Digestive Symptoms There’s a myth that dairy increases mucus production, but research doesn’t support it across the board. Instead:
If you're low in vitamin D, you may be more vulnerable to infection. A level of 30–50 ng/mL is considered optimal at National Jewish Health. Also:
Address Appetite Loss and Calorie Needs During Infection Infection and fever increase your metabolic needs while decreasing your appetite. If food feels unappealing:
Protein supports muscle repair and immune function—both critical during active infection. MacDonald recommends:
Sweet treats are okay—but they shouldn’t replace more nutritious foods. Use desserts as an addition, not a substitution. Manage Reflux to Protect Your Lungs Reflux is linked to worsening symptoms in NTM and bronchiectasis. To manage it:
You are in charge of your nutrition—and that gives you power in your healing journey. Michelle MacDonald’s core message is clear: food can help you fight, restore, and strengthen. Frequently Asked Questions (FAQ) Q: Do I need to avoid all sugar with NTM or bronchiectasis? A: No. Desserts are okay in moderation, but focus on nutrient-dense meals as your foundation. Q: Should I stop eating dairy? A: Not necessarily. Only avoid dairy if it worsens symptoms individually. Q: How do I know if I’m getting enough protein? A: A good rule of thumb is to include a protein source at every meal and aim for around 30 grams per meal. A dietitian can help you fine-tune this. Q: What if I’m losing weight unintentionally? A: Talk to a registered dietitian or your medical team. You may need to increase your calorie intake with healthy fats, snacks, and supplements.  The bacteriophage, also known as phage, is a virus that kills bacteria. There are more phages than any other organism on earth and they are easily found and retrieved from ponds, lakes and the ocean. It is hard to believe but 40% of the bacteria in the ocean is killed by phages every day!
The phage looks like a microscopic land rover sent to explore another planet. Its twenty-sided head sits on a tail that has leg-like fibers attached to it. Each phage has the genetic makeup to destroy a specific bacteria. It uses its tail to puncture the host and inject its own genetic material into it, thereby turning the bacteria into a phage factory. When the bacteria is full, the phage manufactures a substance called endomycin to punch a hole in its host and release the newly made phages. Phages were identified by English bacteriologist Fredrick Twort in 1915 and French Canadian scientist Felix D’Herelle in 1917. D’Herelle realized that they could be used as antibacterial agents and over the years advanced his research by opening phage therapy centers throughout Eastern Europe. However, with the discovery of the miracle drug—penicillin-- by English scientist Alexander Fleming in 1928, interest in phage therapy decreased, especially in the West. Now, one hundred years later, the tide is turning and there is renewed interest in bacteriophage therapy. This interest is mainly due to the mutation of bacteria and fungi and the creation of Antibiotic Drug Resistant (ADR) superbugs caused by the overuse of antibiotics. According to the Center for Disease Control, close to three million people a year in the United States get ADR infections and 35,000 die from them. Unfortunately, the need for new antibiotics is not being met by the pharmaceutical industry. I first learned about phage research and therapy when I attended an NTM and bronchiectasis patient symposium a couple of years ago at Yale University in New Haven, Connecticut. Subsequently, I heard phage therapy brought up at a New York University Bronchiectasis and Non-Tuberculous Mycobacteria Symposium and more recently, last month at the 4th World Bronchiectasis Conference. More and more academic institutions and businesses are creating phage libraries and synthetic phages in the United States as well as around the world. Looking at phage therapy in contrast to antibiotics, we can more clearly see the pros and cons of this therapy that is now gaining attention: Advantages of Phage Therapy Over Antibiotics
Disadvantages of Phage Therapy Over Antibiotics
The good news is that finally there are several high-quality, controlled studies set to begin. They will test the efficacy of phage therapy, mainly addressing bacterial infections in the Cystic Fibrosis population. We are wading into a new era of quality data and I look forward to seeing the results and whether phage therapy is efficacious for the broader lung disease population. #bronchiectasis #phage #phagetherapy #pseudomonas  What do I think is the best method of clearing airways? The simple answer is… whichever one you are willing and able to do on a regular basis. This activity is often prescribed to be done once or twice a day and even more frequently during respiratory infections and flare-ups. Hopefully, you will be able to meet with a therapist to review airway clearance practices. I say hopefully, because even in New York City, I had difficulty finding a therapist with this type of expertise. When I asked my first pulmonologist to refer me to a therapist specializing in airway clearance, he said that he did not know of anyone! So instead, I had a ten-minute airway clearance session with his nurse who asked me to choose between an Acapella® and an Aerobika®.
I knew nothing about the devices and blindly chose the Aerobika. Four months later when I attended a New York City support group, I found out that although most use the Aerobika some preferred the Acapella so I ordered one to test which one works the best for me. I experimented and, most times, I prefer the Aerobika but occasionally I do like to switch things up and use the Acapella. There are some contraindications for using these devices, so it is important that you get your health professional’s approval and not just order one online. I was not comfortable with the limited patient education I received in my doctor’s office, so I searched online for other resources. I found the Pulmonary Wellness & Rehabilitation Center in New York City, and met with a therapist there to review my airway clearance. The center was not on my health plan, but I felt it was important enough to pay for an experienced therapist to teach me the best ways to clear my airways, something I came to see as not only a science but also an art. A year later I switched to a new pulmonologist who referred me to an in-house hospital therapist to review my AC technique and make some minor recommendations. It was reassuring to know that, even with the therapist percussing me like a bongo drum, I did not expectorate more than my usual amount. My pulmonologist later said that, based on what she knew about me, I probably did not have a lot of mucus and that the techniques I was using were sufficient and effective. As you clock in airway clearance hours, try new approaches and get input from your therapist, you will learn what clearance tools in your bronchiectasis toolbox work best for you and when to use them. There is an expression, “A new broom sweeps the floor, but an old broom knows the corners.” It is my hope that once you get adequate professional input and try different practices, you will have the experience to know how to “sweep your corners” and have clearer lungs. #bronchiectasis #airwayclearance #nebulizing #Aerobika |
AuthorLinda Cooper Esposito, MPH is a health educator with bronchiectasis. She developed the BE CLEAR Method to Living with Bronchiectasis and writes with compassion and humor about this chronic lung disease. Archives
May 2025
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