Obstructive lung disease

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Obstructive lung disease
A video discussing bronchial hyperresponsiveness studies of firefighters involved in rescue efforts after the September 11 attacks
SpecialtyPulmonology

Obstructive lung disease is a category of

wheezing, they are distinct conditions in terms of disease onset, frequency of symptoms, and reversibility of airway obstruction.[1] Cystic fibrosis is also sometimes included in obstructive pulmonary disease.[2]

Types

Asthma

Main article: Asthma

Asthma is an obstructive lung disease where the

bronchial tubes (airways) are extra sensitive (hyperresponsive). The airways become inflamed and produce excess mucus and the muscles around the airways tighten making the airways narrower. Asthma is usually triggered by breathing in things in the air such as dust or pollen that produce an allergic reaction. It may be triggered by other things such as an upper respiratory tract infection, cold air, exercise, or smoke. Asthma is a common condition and affects over 300 million people around the world.[3]
Asthma causes recurring episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning.[4]

  • Exercise-induced asthma
    is common in asthmatics, especially after participation in outdoor activities in cold weather.
  • Occupational asthma – an estimated 2% to 5% of all asthma episodes may be caused by exposure to a specific sensitizing agent in the workplace.
  • Nocturnal asthma is a characteristic problem in poorly controlled asthma and is reported by more than two-thirds of sub-optimally treated patients.

A

peak flow meter can record variations in the severity of asthma over time. Spirometry, a measurement of lung function, can provide an assessment of the severity, reversibility, and variability of airflow limitation, and help confirm the diagnosis of asthma.[3]

Bronchiectasis

Main article: Bronchiectasis

Bronchiectasis refers to the abnormal, irreversible dilatation of the bronchi caused by destructive and inflammatory changes in the airway walls. Bronchiectasis has three major anatomical patterns: cylindrical bronchiectasis, varicose bronchiectasis and cystic bronchiectasis.[5]

Chronic obstructive pulmonary disease

Main article: Chronic obstructive pulmonary disease

peak flow meter or by spirometry. Most people with COPD have characteristics of emphysema and chronic bronchitis to varying degrees. Asthma being a reversible obstruction of airways is often considered separately, but many COPD patients also have some degree of reversibility in their airways.[7]

In COPD, there is an increase in

chest X-ray as a flattening of the diaphragm.[citation needed
]

The most common cause of COPD is cigarette

pack-years of smoking. COPD may also be caused by breathing in other particles and gases.[citation needed
]

The diagnosis of COPD is established through

CT scan
.

The main form of long term management involves the use of

anticholinergics) and inhaled corticosteroids. Many patients eventually require oxygen supplementation at home. In severe cases that are difficult to control, chronic treatment with oral corticosteroids
may be necessary, although this is fraught with significant side effects.

COPD is generally irreversible although lung function can partially recover if the patient stops smoking. Smoking cessation is an essential aspect of treatment.

lung volume reduction surgery, with in carefully chosen cases. Lung transplantation is also performed for severe COPD in carefully chosen cases.[10]

Alpha 1-antitrypsin deficiency is a fairly rare genetic condition that results in COPD (particularly emphysema) due to a lack of the antitrypsin protein which protects the fragile alveolar walls from protease enzymes released by inflammatory processes.[citation needed
]

Diagnosis

Diagnosis of obstructive disease requires several factors depending on the exact disease being diagnosed. However one commonality between them is an FEV1/FVC ratio less than 0.7, i.e. the inability to exhale 70% of their breath within one second.[11]

Following is an overview of the main obstructive lung diseases. Chronic obstructive pulmonary disease is mainly a combination of chronic bronchitis and emphysema, but may be more or less overlapping with all conditions.[12]

Condition Main site Major changes Causes Symptoms
Chronic bronchitis Bronchus Hyperplasia and hypersecretion of mucus glands Tobacco smoking and air pollutants
Productive cough
Bronchiolitis
(subgroup of chronic bronchitis) 		Bronchiole Inflammatory scarring and bronchiolitis obliterans Tobacco smoking and air pollutants Cough, dyspnea
Bronchiectasis Bronchus Dilation and scarring of airways Persistent severe infections Cough, purulent sputum and fever
Asthma Bronchus
  • Smooth muscle hyperplasia
  • Excessive mucus
  • Inflammation
  • Constriction
 Immunologic or
idiopathic
 Episodic wheezing, cough, and dyspnea
Unless else specified in boxes then reference is [12]

See also

References

  1. ^ National Asthma Education and Prevention Program. Clinical Practice Guidelines. Expert Panel Report 2. Guidelines for the Diagnosis and Management of Asthma. Bethesda, Md: National Heart, Lung, and Blood Institute, National Institutes of Health, US Dept of Health and Human Services; 1997. NIH publication 97-4051.
  2. PMID 17716384. Archived from the original
    (PDF) on 2017-04-10. Retrieved 2008-07-21.
  3. ^ a b "GINA – the Global INitiative for Asthma". Retrieved 2008-05-06.
  4. ^ "Asthma". The Lecturio Medical Concept Library. 25 November 2020. Retrieved 1 July 2021.
  5. ^ "What Is Bronchiectasis?". NHLBI. June 2, 2014. Archived from the original on 10 August 2016. Retrieved 10 August 2016.
  6. ^ Kleinschmidt, Paul. "Chronic Obstructive Pulmonary Disease and Emphysema". Retrieved 2008-04-19.
  7. ^ BTS COPD Consortium (2005). "Spirometry in practice – a practical guide to using spirometry in primary care". pp. 8–9. Archived from the original on 26 August 2014. Retrieved 25 August 2014.
  8. ^ "GOLD – the Global initiative for chronic Obstructive Lung Disease". Archived from the original on 2011-02-16. Retrieved 2008-05-06.
  9. ^ "What is chronic obstructive pulmonary disease (COPD)?". Archived from the original on 2008-06-14. Retrieved 2008-04-19.
  10. ISBN 9780323523714
    .
  11. PMID 28128970
    .
  12. ^
    ISBN 978-1-4160-2973-1
    . 8th edition.

External links

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