When we are healthy, we take our breathing for granted, never fully appreciating that our lungs are essential organs for life. But when our lung health is impaired we realise that nothing else but our breathing is what really matters. That is the painful reality for those suffering from lung disease – a condition that affects people of all ages in every corner of the world. Lung diseases kill millions and cause suffering to millions more. Threats to our lung health are everywhere, and they start at an early age when we are most vulnerable. Fortunately, many of these threats are avoidable and their consequences treatable. By acting now, we can save ourselves and many others.

The respiratory disease causes an immense health burden. It is estimated that worldwide 235 million people suffer from asthma, more than 200 million people have chronic obstructive pulmonary disease (COPD), 65 million endure moderate-to-severe COPD, 1–6% of the adult population (more than 100 million people) experience sleep-disordered breathing, 9.6 million people develop tuberculosis (TB) annually, millions live with Pulmonary Hypertension and more than 50 million people struggle with occupational lung diseases, totalling more than 1 billion people suffering from chronic respiratory conditions. At least 2 billion people are exposed to the toxic effects of biomass fuel consumption, 1 billion are exposed to outdoor air pollution and 1 billion are exposed to tobacco smoke. Each year, 4 million people die prematurely from chronic respiratory disease.1

The scenario in India is equally worrisome. Some of the Indian cities are currently featured among the most polluted cities in the world and we are seeing the ill effects of it. In Assam, cigarette smoking is very much prevalent and rising pollution is leading to many respiratory diseases.

When we talk about the symptoms of respiratory diseases; cough, shortness of breath, chest pain and hemoptysis (blood in the sputum) are the predominant symptoms. The cough may present for a long time along with expectoration and sometimes hemoptysis. The presence of blood in the sputum is an ominous finding and the patient should be investigated properly. Asthma patients usually present with cough with expectoration along with easy fatigability may have a seasonal variation. COPD patients are present with cough with expectoration and easy fatigability which are gradually progressive unless properly treated. Tuberculosis is a very common disease and patients usually present with cough, expectoration, hemoptysis, weight loss and myriad other symptoms.

Lung cancer is currently the second most common cancer in both men and women. Cigarette smoking is the predominant cause of lung cancer . In non-smokers, it may develop due to radon exposure, air pollution, and asbestos exposure, etc. Lung cancer patients are usually present with cough, hemoptysis, weight loss, accumulation of fluid in the pleural cavity, etc. The prognosis is usually grave if the patients are in the late stage of their disease.

So it’s prudent to say that if any patient is having these symptoms then they should visit a pulmonologist. Many of these patients need investigations like chest X-ray, CT scan, bronchoscopy, pleural biopsies, polysomnography (for patients with sleep disorders) and many other sophisticated tests.

General practitioners get a lot of cases of respiratory diseases in their day to day practice. When a patient is suffering from COPD with frequent exacerbation, severe asthma, ILD, radiologically suspicious of tuberculosis but sputum is negative for tuberculosis, non-resolving pneumonia then these cases should be referred to a pulmonologist. The latter two conditions will need bronchoscopy for further evaluation and other advanced tests.

Preventive measures: The most important cause of respiratory diseases around the world is cigarette smoking . So cessation of smoking is extremely important. Air pollution is also a significant problem in today’s world, so the use of a face mask is also strongly recommended. In some patients, an asthma attack may be triggered by eating some specific foods or on exposure to cold. For this reason avoidance of these situations is suggested for those patients.

To conclude, respiratory diseases cause serious problems in society and effort from all doctor community and society is needed to reduce the challenges posed by these diseases.