Obstructive lung disease

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at October 31, 2016
StartDiseasesObstructive lung disease

Obstructive lung disease is a form of lung disease characterized by difficulty exhaling. It is a blanket term used to describe lung diseases that cause the bronchioles and bronchi to narrow. Common diseases in this category include asthma, bronchitis, emphysema, chronic obstructive pulmonary disease (COPD), and cystic fibrosis. Common symptoms of this group of disorders include wheezing, shortness of breath, and chronic coughing.

Contents

Definition & Facts

It is common to find COPD and obstructive lung disease used interchangeably, but they are different. Obstructive lung disease is actually the category of lung disease that COPD falls under.

Asthma, one of the common types of obstructive lung disease, involves overly sensitive bronchial tubes. Under normal conditions, there is not much interference with breathing but when the airways become exposed to aggravating factors such as dust or pollen, the bronchial tubes can become inflamed and constrict breathing.

COPD encompasses several conditions such as chronic bronchitis and emphysema. The Centers for Disease Control and Prevention estimates that COPD was the third leading cause of death among Americans in 2014; over 15 million Americans were diagnosed with the condition. Although COPD is predominant in people who are between the ages of 65 and 74, it can affect people of any age.

Symptoms & Complaints

A primary symptom of nearly all the conditions labeled as an obstructive lung disease is shortness of breath during times of physical activity. This occurs because the airways are narrowed and complete exhaling does not occur. The air that is inhaled becomes trapped, which in turn causes the lungs to over-inflate. As the disease worsens, shortness of breath can occur during times of inactivity as well. Additional symptoms can include excessive coughing, wheezing, and chest tightness.

Causes

Obstructive lung diseases can be caused by long-term exposure to cigarette smoke. It can also be the result of prolonged exposure to pollutants and repeated infections of the respiratory system. In some cases, though rare, a person can inherit genetic disorders that are known causes.

Diagnosis & Tests

Pulmonary function tests, such as spirometry, are the most common ways to confirm an obstructive lung disease. In this testing, a person blows into a specific tube attached to a machine. The machine tracks airflow and air volume as it is expelled from the lungs.

A doctor may also order X-rays and computed tomography (CT) scans for images of the chest area. If it is necessary to determine if an additional condition is the cause, a biopsy may be performed using a special scope. This scope, called an endoscope, is equipped with a light and tool on the end that will help the doctor take a look at the inside of the airways and remove tissue samples.

Blood tests are often conducted as well. An arterial blood gas test is used to measure the amount of acid, carbon dioxide, and oxygen the blood contains. This test is commonly used to determine if oxygen therapy is necessary.

Treatment & Therapy

When it has been determined that airway narrowing is due to bronchospasms, inhaled bronchodilators are recommended to help control the spasms and increase the flow of air. When obstruction is due to inflammation of the airways, the common treatment is an oral or inhaled corticosteroid.

Oxygen therapy and breathing exercises may be recommended to help reduce the shortness of breath experienced. If an existing respiratory infection is evident, antibiotics may be prescribed to treat the infection.

After testing has been completed, doctors will go over all the treatments and therapies that might be beneficial to the specific type of obstructive lung disease. Not all treatments will be beneficial for each type of obstructive lung disease. It is important to identify exactly what is causing the narrow airways and if this narrowing is reversible.

There are severe cases of obstructive lung disease that may require more drastic and immediate treatment. There are incidences when the commonly used treatments are not effective and the disease continues to worsen.

In these cases, surgical intervention may be necessary. Surgeries may include lung volume reduction surgery and lung transplantation. A volume reduction involves removal of damaged lung tissue from the upper section of the lungs, which creates more space for the rest of the lungs to expand. Lung transplants are often the last option and involve a complete removal of the original lungs and replacement with donor lungs.

Prevention & Prophylaxis

Many obstructive lung diseases are preventable. Smokers should stop smoking and avoid secondhand smoke. People should also avoid too much exposure to air pollutants; they can take extra steps to protect themselves by changing air filters regularly and using air purifiers.

Treating respiratory infections promptly is another important preventative approach; prompt treatment helps reduce the risk of damaging lung tissue and airways. Although genetic factors cannot be changed, people with hereditary predispositions should be especially diligent in avoiding pollutants and carcinogens. If a diagnosis has already been reached, these same efforts can be used to help reduce the severity of symptoms and gradually increase breathing abilities.

Infections, the flu, and even a minor common cold can result in the appearance of acute symptoms, and it is important to seek medical attention if symptoms seem to be getting worse.