TY - JOUR T1 - Managing bronchiectasis in adults in primary care: a clinical update JF - British Journal of General Practice JO - Br J Gen Pract SP - 183 LP - 184 DO - 10.3399/bjgp21X715565 VL - 71 IS - 705 AU - Kevin Gruffydd-Jones AU - Duncan Keeley AU - James Wildgoose AU - Adam Hill Y1 - 2021/04/01 UR - http://bjgp.org/content/71/705/183.abstract N2 - Bronchiectasis is a condition where patients have symptoms of persistent or recurrent bronchial sepsis related to irreversibly damaged and dilated bronchi.1 The prevalence of bronchiectasis has risen by about 60% between 1994 and 2013 so that a GP practice population of 10 000 will have around 50 patients with the condition.2 Many patients with stable bronchiectasis and acute flare-ups can be managed in primary care.A diagnosis of bronchiectasis should be suspected when a patient presents with a recurrent or persistent (>8 weeks) cough with production of purulent or mucopurulent sputum.1There should be a higher index of suspicion if there are coexistent factors, as outlined in Box 1. A full history and examination should be carried out to exclude other causes of chronic cough, such as chronic obstructive pulmonary disease (COPD), asthma, or lung cancer. Box 2 shows red-flag symptoms suggesting alternative serious pathology. Chronic obstructive pulmonary disease (especially with a history of frequent exacerbations, lower FEV1, and persistent sputum pathogens).Difficult-to-treat asthma.Rheumatoid arthritis.Inflammatory bowel disease.Chronic rhinosinusitis.Presence of persistent pathogenic organisms (especially P. Aeruginosa) in sputum.Box 1. Coexistent conditions raising the probability of bronchiectasis … ER -