Lung Disease

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Increasing level of pollution has made breathing in urban areas very difficult, raising the incidence of respiratory problems. Out of the world’s top 20 cities with polluted air, 13 belong to India and according to the World health Organisation (WHO) report published in 2011, lung diseases rank 2ndin the list of top 20 causes of death. Naturally, lung disease is a big health issue that needs to be addressed. Here are some facts about lung disease you should know about.

To understand the condition of your lungs, you need to first understand how the lungs function. Lungs are soft organs present on both right and left side of the chest. They are protected by a had covering called the ribcage. Each lung is made of sections called lobes. The main function of the lungs is to make oxygen available for purifying blood and to and eliminate carbondioxide from impure blood or deoxygenated blood. So when you breathe, air travels down your windpipe (trachea). The windpipe bifurcates with each branch entering each of the lungs. Into the lungs, the windpipe is further branched to tubes called bronchioles that end in small sacs called alveoli, where the inhaled air reaches for delivering oxygen.

A lung disease or disorder occurs in the various structures of lungs and disrupts its functioning. It can vary from a mild common cold to life-threatening conditions like pneumonia and cancer. Lung disease can be caused by infections, inflammation, obstruction of airways, decreased lung function, problems related to pulmonary circulation, etc. Smoking, infections, air pollution, genetics, exposure to asbestos, etc. can cause various lung diseases.

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Types

The common as well as rare types of lung disease include -

Causes

‘In any form of lung disease mainly the breathing gets affected,’ says Dr Animesh Arya, Senior Consultant, Respiratory Medicine, Delhi based Sri Balaji Action Medical Institute. Here are some common forms of lung diseases he explains.

1. Asthma:It is the most common lung disease triggered by allergies, infections and pollutants that harm the airways and cause inflammation.

2. Acute bronchitis: Bronchitis is the inflammation of the air passage. Acute bronchitis is caused by viral or bacterial respiratory infections.

3. Chronic Obstructive Pulmonary Disease (COPD): It a group of diseases that causes breathing difficulties and interfere with the exhalation process of breathing.

4. Chronic bronchitis: It is a type of COPD caused mainly due to smoking.

5. Emphysema: It is a COPD caused by environmental factors and may also be triggered by allergens or organisms that cause diseases like pneumonia and tuberculosis.

Apart from these common forms of lung diseases, other rare lung diseases include:

6. Cystic fibrosis: It is rare lung disease caused by genetic mutation that results in excess mucus production causing blockage of airways.

7. Acute respiratory distress syndrome (ARDS): It is a medical emergency caused as a result of lung injury due to a severe illness.

8. Lung cancer: It can affect any part of the lung. It is mainly caused due to smoking. Here are  10 common symptoms of lung cancer you need to know.

9. Interstitial lung disease: This is a group of diseases affecting the interstitium, a thin lining separating the air sacs.

Symptoms

‘Bronchitis, asthma, COPD, lung infections and pulmonary fibrosis have similar symptoms even though they are very different in nature,’ says Dr Arya.  He lists a few common symptoms of lung diseases:


  • Difficulty in breathing

  • Chronic cough

  • Being short of breath easily after any strenuous activity

  • Excess mucus production

  • Coughing up blood due to inflammation in the lining of the respiratory tract

  • Chest pain

  • Air hunger which indicates lack of oxygen and also can cause fatigue

Diagnosis

In most cases, chronic cough, chest pain and breathing difficulties necessitate a lung function test. But your doctor might first take a look at the results of your blood test that may indicate whether you have any kind of lung infection. Otherwise, based on your symptoms your doctor might recommend the following lung function tests for you, as explained by Dr Arya.


  • Imaging tests: A chest X ray, CT scan or nuclear lung scanning can be done to reveal any kind of structural abnormality of the lungs and the chest. With the help of an Xray, the doctor will be able to detect lung tumors, infections like pneumonia, emphysema, interstitial lung disease. It also helps identification of fluid accumulation around the lungs (pulmonary edema).

  • Lung Volume measurement or spirometry:  This test will determine how much air your lungs can hold. A device called spirometer is used in the test to record and analyse the volume of air inhaled and exhaled. The test is repeated after administering a bronchodilator which opens up the airways.

  • Diffusing capacity measurement: This test determines how well oxygen is transferred from the air sacs (alveoli) to the bloodstream.

  • Maximal Voluntary Ventilation: The maximum capacity a person can breathe is checked in this test.

  • Lung biopsy: In case interstitial lung disease is suspected, the doctor may suggest a lung biopsy where a tissue from the lung is obtained using procedures like bronchoscopy for investigation.

Treatment

‘If any of the above mentioned symptoms persist for a long time, it is better to consult a doctor immediately for diagnosis,’ says Dr Arya. The management of lung disease depends on the type of lung disease you’re diagnosed with but largely medication is the main treatment option for lung disease patients.


  • Asthma and COPD patients may require bronchodialtors and inhalers for relieving asthma symptoms and opening up the airways. Read more about medicines for asthma

  • Expectorants may be prescribed in case of chronic productive cough to loosen the mucus and facilitate easy expulsion

  • Corticosteroids are given for reducing inflammation and swelling of the lung tissue

  • Patients with extreme shortness of breath are managed with oxygen therapy, where the prescribed level of oxygen is delivered through a mask

  • Antibiotics like azithromycin may be prescribed for patients diagnosed with interstitial lung disease. Lung Infections are also treated with antibiotics

  • There are some thoracic surgical interventions in which the lung volume or contraction and expansion of the diaphragm can be improved for better lung function

  • Lung transplantation is the last option for patients with end stage lung disease


‘However additional measures like lifestyle management are also needed,’ says Dr Arya. These measures not only help you protect lung function but also prevent lung disease. Here are some tips he offers for better management and prevention of lung disease.

  • If you are a smoker, quit smoking and if not, avoid smokers as far as possible.

  • Identify things that you are allergic to and avoid them. Some common allergens include animal dander, dust, and aerosols.

  • Contrary to popular belief, exercise helps with lung diseases. Exercising for even half an hour daily can increase your lung capacity.

  • Manage your weight as being obese puts more stress on your heart and lungs.

  •  It is important is to take your medication on time every day.

  • Lastly, get as much rest as possible.

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