Pulmonology: Understanding lung conditions and treatment options

Pulmonology has become very significant due to the increasing prevalence of respiratory illnesses in modern society. This category includes asthma, chronic obstructive pulmonary disease (COPD), pneumonia, lung cancer, and other respiratory disorders. This article will give you an overview of Pulmonology. It will cover how it functions, the available treatment options for pulmonary conditions, and ways to improve your lung health.

What is Pulmonology?

Pulmonology is a medical specialisation and a branch of internal medicine that focuses on identifying, treating, and preventing respiratory system disorders. 

The respiratory system features the following organs. 

• Mouth and nose

• Pharynx (throat)

• Larynx (voice box)

• Trachea (windpipe)

• Bronchi (lung pathways)

• Bronchioles (smaller pathways in the lungs)

• Alveoli (air sacs in the lungs)

We use several muscles working during respiration, which are mainly the following.

• Diaphragm

• Intercostal muscles

• Accessory muscles

Common Respiratory Conditions

Some of the most common respiratory conditions are discussed below.

1. Asthma

Asthma is a severe inflammatory illness that causes difficulty breathing when the airways narrow down due to inflammation or become obstructed due to mucus. Symptoms include excessive wheezing, coughing, chest congestion, and shortness of breath. Individuals experience varying degrees of disease, but many regularly use preventive medication to minimise symptoms and prevent future occurrences.

2. Chronic Obstructive Pulmonary Disease (COPD)

This is a progressive lung illness that results in blocked airflow from the lungs. The symptoms include difficulty breathing, wheezing, coughing, and mucus (sputum) production. The two most common conditions that contribute to COPD are emphysema and chronic bronchitis.

3. Bronchitis

This develops when the bronchial tube becomes irritated or inflamed. As a consequence of the inflammation, the bronchial tube lining may produce an excessive amount of mucus. The mucus makes respiration challenging. The symptoms include wheezing, frequent coughing with mucus, chest tightness, and a fever. Here are its types. 

• Acute bronchitis: The inflammation in acute bronchitis generally occurs due to an infection. It gets better within a few days.

• Chronic bronchitis: It is caused by chronic exposure to allergens such as cigarette smoke or pollutants. Chronic bronchitis is not curable.

4. Pneumonia

Pneumonia is caused by a virus, bacteria, or some other pathogen that leads to the small air sacs in the lungs to fill with pus or fluid. These air sacs are responsible for the transfer of oxygen and other gases between the air we breathe in and the blood. The body's ability to exchange gases decreases when these chambers are filled with fluid.

There are several types of pneumonia, such as viral pneumonia, bacterial pneumonia, fungal pneumonia, etc. The symptoms may include fever and chills, cough with mucus, shortness of breath, pain in the chest when you cough or breathe, nausea, vomiting, and diarrhoea.

5. Lung cancer

Lung cancer develops when malignant cells in the lungs divide erratically, resulting in tumour growth. Tumours can impair a person's breathing and can spread to other areas of the body.

Small-cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) are the two main forms of lung cancer based on how they are seen under a microscope. The symptoms may include pain in the chest, breathing difficulties, chronic cough with blood in the mucus, loss of weight, wheezing, exhaustion, face and neck edema, etc.

Pulmonary function tests (PFTs) and their types

Pulmonary function tests are helpful diagnostic tools for patients with probable or confirmed cases of respiratory disorders. They help in diagnosis, monitor response to treatment, and give recommendations about additional treatment and action. Different types of PFT may include the following.

1. Spirometry

Spirometry is very useful in the diagnosis of asthma and COPD. This is because it measures how much air you can expel from your lungs after taking a deep inhale and how quickly you can blow it out.

2. Cardiopulmonary exercise test

A cardiopulmonary exercise test (CPET) is a specialised exercise stress test used to assess your ability to exercise and find out what is restricting your activity levels. The factors that are evaluated by CPET during physical exertion are the lungs, the heart, the blood vessels, and the muscles. It also determines what quantity of oxygen your body can absorb when exercising.

3. Bronchial provocation test

A bronchial provocation test assesses your lungs' receptivity. It is used to diagnose or exclude asthma. The examination has three forms.

• Irritant challenge: Your doctor will test your airways by exposing you to an asthma trigger, such as smoke or a chemical.

• Exercise challenge: You work out on a treadmill or stationary bicycle to see whether the airways respond to physical activity.

• The methacholine challenge: In this challenge, you are asked to inhale higher doses of the chemical methacholine. This chemical causes the narrowing of airways at low doses in individuals with asthma and at high doses in normal people.

4. Exhaled nitric oxide test

An exhaled nitric oxide test involves breathing deeply through a mouthpiece attached to a monitor that observes the amount of nitric oxide in your breath. A high level of nitric oxide in your breath indicates airway inflammation and may indicate allergic asthma.

5. Pulse oximetry study

A pulse oximetry study determines the level of oxygen saturation in your red blood cells. It is a noninvasive test in which a pulse oximeter is usually placed on a finger. If your oxygen saturation levels are above 95%, then your lungs function healthily. However, if oxygen levels go below this threshold, it may indicate asthma, COPD, pneumonia, or another respiratory ailment.

6. Diffusion capacity test

This test determines to what extent the little air sacs, or alveoli, inside the lungs are functioning. You will be instructed to inhale carbon monoxide as part of a pulmonary function test. You may additionally inhale "tracer gas" for a single inhalation. 

What are the different Pulmonology treatments?

The various treatment options in Pulmonology may include the following.

1. Medication

There are several drugs available to treat respiratory conditions, such as asthma, COPD, pulmonary fibrosis, and pulmonary hypertension. These drugs act by relaxing the contracted muscles in the airways, lowering inflammation, and increasing oxygen flow to the lungs.

2. Oxygen therapy

Patients with low blood oxygen levels due to lung disorders such as COPD, pulmonary fibrosis, and pulmonary hypertension are usually treated with oxygen therapy. This treatment involves administering supplemental oxygen through a nasal tube or a face mask to raise blood oxygen saturation and boost breathing.

3. Pulmonary rehabilitation

Pulmonary rehabilitation is a comprehensive treatment plan that involves physical activity, breathing methods, and education. Its goal is to improve lung function and general health in people with chronic lung disorders.

4. Bronchodilators

Bronchodilators are medications that help expand or dilate the air channels in the lungs, allowing for better breathing. They are often prescribed to treat respiratory problems.

5. Corticosteroids

Corticosteroids are drugs that help prevent asthma attacks by reducing inflammation in the airways. To treat asthma, they are often prescribed together with bronchodilators.

6. Antibiotics

Antibiotics prevent bacterial growth.

7. Surgery

Surgery may be required in some circumstances to address lung disorders such as lung cancer, emphysema, and pulmonary embolism. Lung removal, transplantation of the lungs, and pulmonary thromboendarterectomy are all examples of common surgical procedures.

8. Mechanical ventilation

Mechanical ventilation includes applying a machine to help patients who cannot breathe independently due to end-stage lung disease or damage.

Frequently Asked Questions

Here are some of the frequently asked questions on Pulmonology.

What are the five most common lung diseases?

Asthma, bronchitis, COPD, pneumonia, and lung cancer are the most common lung diseases.

When to See a Pulmonologist?

You must see a Pulmonologist if you have persistent symptoms, as mentioned below.

• A cough that is persistent and does not go away even with medication

• When you feel out of breath, even if you do a mild activity

• Trouble breathing

• Chest pain and wheezing

• Severe exhaustion with blood in the mucus

• Asthma that does not get controlled

• Recurrent bronchitis

How to prevent respiratory diseases? 

Following are some tips to prevent respiratory illness and manage your lung health.

• Quit smoking or if you don’t smoke, never start

• Avoid second-hand smoking

• Stay away from allergens

• Always stay physically active

• Eat a balanced diet

• Stick to your treatment plan

• Perform breathing exercises

• Get vaccinated

• Manage weight

Sources: 

• https://www.cancer.gov/publications/dictionaries/cancer-terms/def/Pulmonology

• https://www.ncbi.nlm.nih.gov/books/NBK538321/#:~:text=The%20internal%20intercostal%20muscle%20forms,to%20the%20external%20intercostal%20muscles.

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8965594/

• https://www.who.int/health-topics/chronic-respiratory-diseases#tab=tab_1

• https://www.cancer.gov/publications/dictionaries/cancer-terms/def/respiratory-disease

• https://www.nhlbi.nih.gov/health/asthma/causes#:~:text=Common%20triggers%20for%20asthma%20include,intense%20anger%2C%20crying%2C%20or%20laughing

• https://www.nhlbi.nih.gov/health/copd

• https://www.nhlbi.nih.gov/health/bronchitis

• https://www.nhlbi.nih.gov/health/pneumonia

• https://www.cancer.gov/publications/dictionaries/cancer-terms/def/lung-cancer

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229853/

• https://www.ncbi.nlm.nih.gov/books/NBK560526/

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6118879/

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.