Pulmonology

Pulmonology

Pulmonology is a sub-speciality of Internal Medicine that deals with the health of the respiratory tract. In particular, the health of the lower airway, lungs and breathing control as well as their effect on the oxygenation of blood.

The term “Pulmonology” has its origins in the Latin language. The word “pulmo” means lungs and “logos” is study, making it the study of lungs. In some countries, it is referred to as chest medicine or respiratory medicine. The discipline deals with various respiratory conditions and lung disorders.

The respiratory system includes your:

• Mouth and nose
• Sinuses
• Throat (pharynx)
• Voice box (larynx)
• Windpipe (trachea)
• Bronchial tubes
• Lungs and things inside them like bronchioles and alveoli
• Diaphragm

Some short-lasting illnesses of your lungs like flu, or cough can be managed with the help of primary care. But if shortness of breath, cough, pneumonia, or other symptoms do not get better, you might need to consult a doctor who can treat your chest. A doctor who looks after your lung's well-being is known as a pulmonologist, and they are responsible for lung disease treatment.

The Pulmonologists work in association with Bariatric Surgeons and ENT. The specialists treat breathing problems due to allergy & asthma, conditions such as chronic obstructive pulmonary disorder, snoring, etc.

The sub-speciality is also referred to by other names such as Respiratory Medicine, Thoracic Medicine, Chest Medicine, Respirology. Pulmonology also has extensive overlap with Critical Care along with Anesthesia and Internal Medicine contributes to the core competencies in the sub-speciality. A doctor who is specialized in pulmonology is known as a pulmonologist, and they are responsible for lung disease treatment.

The Pulmonologists work in association with Bariatric Surgeons and ENT's. The specialists treat breathing problems due to allergy & asthma, conditions such as chronic obstructive pulmonary disorder, snoring etc.

Why NH?

Once the pulmonologist has an accurate diagnosis, a treatment plan based on the condition will be created. Narayana Health the best hospital for lung treatment in India, includes treatment plans that will consist of medications, therapies and pulmonary rehabilitation programs to help you get back to your normal life.

As lung diseases can be severe and debilitating, a pulmonologist will also work with your family and healthcare team to deliver long-term care. Narayana Hospitals will also be able to modify your treatment plans to work with your situation and coordinate your care with other team members, respiratory therapists, pulmonary rehab programs and support groups.

Pulmonology: diseases and causes

Pulmonology is related to diagnosing and treating all diseases affecting the respiratory system that includes the nose, mouth, pharynx, larynx, trachea, bronchi, alveoli, lungs, and the respiratory muscles. This medical speciality deals with any disorders that affect the lungs, airways, or respiratory muscles. The following are some of the common diseases related to the respiratory system that are treated by pulmonologists-

1.Asthma: This is a chronic health condition that is characterized by difficulty in breathing, coughing, tightness in the chest, and wheezing (where a whistling sound can be heard). Asthma can happen as a sudden attack that lasts for a few minutes or hours. It can be a chronic condition that can last for many days; asthma can also occur as a result of an allergy (to dust, pollen, smoke, pet dander, etc.).

Asthma occurs due to physical exertion, like exercise. It’s more common during winters, when the weather is cold or it can be an allergic reaction to medicine. Smoking, being overweight, or a family history of asthma, can worsen the symptoms. Asthma causes inflammation in the airways, and the airways become constricted. This causes the body to expel mucus, thereby resulting in a coughing attack.

As the airways constrict, breathing becomes difficult and it leads to a wheezing sound and discomfort in the chest. In severe cases, the airways close completely and the patient will need urgent medical attention. Asthma can be managed by treating the symptoms and through holistic treatment plans.

2.Interstitial lung disease: This is a disease affecting the alveoli, which are the sacs in the lungs. It causes inflammation and scarring that results in dry cough and difficulty in breathing, even when at rest. There are nearly 200 conditions that form a part of interstitial lung disease. Some of the prominent ones are:

• Asbestosis
• Chronic silicosis
• Bronchiolitis obliterans
• Sarcoidosis
• Pulmonary fibrosis

Some of the interstitial diseases are autoimmune disorders caused by the immune system attacking the lung. Generally, these diseases occur due to exposure to chemicals, coal dust, animal proteins, tobacco smoke, etc.

3.COPD: Chronic Obstructive Pulmonary Disease is a lung disease that leads to obstruction of air flow within the lungs. Smoking is one of the main causes of COPD. Exposure to smoke from wood fire can also cause COPD. It leads to symptoms like shortness of breath, wheezing, tightness in the chest, excess mucus in the lungs, fatigue, blue tint in the lips or fingernails, and swollen legs.

Two common conditions causing COPD are bronchitis and emphysema. Chronic bronchitis is where the bronchial tubes become inflamed and constricted, and the lungs produce mucus. Emphysema is a disease that affects the alveoli and can collapse the airways, this leads to damaged lungs.

4.Pneumonia: This is a lung infection, where the air sacs are inflamed. It can cause coughing with blood discharge, fever, and severe breathing problems. Bacterial infection is the cause of pneumonia, but viruses can also lead to this disease. A weakened immune system can worsen the symptoms and it can be quite fatal if not treated in time. Pneumonia causes fluids to accumulate in the lungs and it results in difficulty in breathing.

Causes

The main cause of pulmonary disease or disease related to the respiratory system is the use of tobacco. In some cases, your lungs may also get affected because of airway obstruction due to smoke and other irritants, while a few of the cases generate on account of genetic inheritance.

When should you see a pulmonologist?

If you’re witnessing any unusual signs, you should meet with your primary care doctor. Only after a medical exam, your overall condition can be assessed. They may refer you to a pulmonologist if you:

• have difficulty breathing
• have a persistent cough
• regularly cough up blood or mucus
• smoke
• have unexplained weight loss
• have trouble exercising due to breathing problems

Diagnosis

Your first step to tackle a respiratory disease should be to get it accurately diagnosed. A pulmonologist may ask you to go through the following tests and exams to determine any lung-related disease.

- Physical examination This is the first test for diagnosis. A physical examination of the chest area is done by the pulmonologist to understand the signs and symptoms.

- Blood tests to check the levels of oxygen and other substances in the blood

- Spirometry to measure how well you can inhale and exhale the air out of your lungs

- CT scan to obtain detailed images from inside your chest

- Bronchoscopy. A thin and flexible tube with a camera on end is advanced through the mouth or nose into the windpipe to identify any issues in the trachea, lower airways, throat or larynx.

- Thoracentesis to obtain sample fluid from around your lungs

- Chest ultrasound to determine the conditions of the organs and other chest structures

- Pleural biopsy. A procedure to remove a small tissue sample from the pleura

- Pleuroscopy. The pulmonologist makes a small incision in the chest wall advances a pleuroscope into the chest cavity. Unlike bronchoscopy, it can also enable the doctor to examine the outside edges of the lungs.

- Pulse oximetry test that determines the level of oxygen saturation in your blood

- Sleep study to identify any sleep disorders

- Peak flow meter: This is a device used to find out how hard the patient exhales. This can help to find out if lung conditions like asthma are getting worse or not. Peak flow readings are taken during the treatment and monitored to understand the progress of treatment.

- Imaging tests: Imaging tests are used to get a picture of the chest region. Commonly, an X-ray is used to look for problems in the lung. For some diseases, a CT-Scan (Computerized tomography scan) is used to carry out a clear scan of the lungs and also the sinus cavities.

- Nitric oxide test: This is one of the tests to check for asthma. Higher nitric oxide levels in the breath are an indication of inflammation, which could be asthma.

- Sputum test: The sputum sample from the lungs is taken and this is analyzed in the lab to check for bacteria to detect pneumonia.

Treatment and Prevention

Each of the diseases of the respiratory system is treated in a different way. The following explains about treatment and prevention of diseases-

Asthma:

The common treatment for asthma is medication. Bronchodilators are prescribed to dilate the airways making it easy to breathe. They may be prescribed as oral medication or through inhalers than directly reach the lungs. Anti-inflammatory medication, including steroids can be helpful in reducing inflammation. Beta agonists and leukotriene modifiers are other medicines used to treat asthma.

Immunotherapy is an option helpful for those who have asthma due to allergy. Allergy injections are given to ensure that the immune system does not react strongly to allergens. In severe cases, bronchial thermoplasty can be used for treatment to heat the airways by using an electrode; this reduces inflammation and constriction of the airways.

Prevention of asthma is possible by identifying allergens and preventing exposure. Cardio exercises strengthen the heart and lungs and can help cope up with an asthma attack. Reducing weight is important for preventing asthma attacks. Breathing exercises, as in Yoga can help to strengthen lungs.

Interstitial lung disease:

Corticosteroids and medications to slow down pulmonary fibrosis are given to treat the symptoms of lung disease. Oxygen therapy may be required when breathing becomes very difficult. It can help improve both lung and heart functions. Exercise, use of breathing techniques, healthy diet, and counseling can be helpful. Vaccination for flu and pneumonia is recommended. Prevention can be done by stopping smoking and exposure to chemicals.

COPD:

COPD is treated through medicines like bronchodilators and corticosteroids. Infections may be treated through antibiotics. Oxygen therapy may be needed in extreme cases. Surgery may be needed in some cases to remove damaged lung tissue. Prevention of symptoms can be done by avoiding smoking and exposure to smoke and pollution. Consistent exercise to strengthen the lungs and a healthy diet is recommended.

Pneumonia:

Pneumonia is usually caused by bacteria and antibiotics are the preferred mode of treatment. Medicines to treat cough, like cough suppressants, are given to provide relief from cough symptoms; the fever needs to be treated by analgesics. In severe conditions, ventilation may be needed to help make breathing easy, it’s important to be hydrated, and rest.

Vaccination for pneumonia is recommended for people who are at risk of developing the disease. Avoiding smoking, consuming a healthy diet, and exercise are recommended to help prevent pneumonia.

Pulmonology FAQ's