• Shruti GOCHHWAL

Respiratory Diseases

The pathological conditions which affect the respiratory system of the body are known as respiratory diseases. They are also called lung diseases. The main function of the respiratory system is to ensure that the exchange of oxygen and carbon dioxide takes place.

Respiratory diseases are among the most common diseases in the world and can range from mild disorders to life-threatening conditions.

The most prevalent respiratory diseases are:

Asthma

Asthma is a condition in which the airway through which the exchange of oxygen and carbon dioxide takes place in the form of breathing is inflamed. This inflammation results in obstruction which causes breathing difficulties.

The meaning of the word asthma is Greek is laboured breathing and it is one of the oldest diseases which was 1st identified over 3000 years ago.

The World Health Organization estimated that 300 million people worldwide are suffering from asthma today.

Causes of Asthma

There is much debate over the exact cause of asthma. However, it is widely accepted that the symptoms of asthma are caused by the following conditions:

  1. Airway Hyperresponsiveness: When the tendency of the airway to react to different stimuli is increased, its called airway hyperresponsiveness.

  2. Bronchoconstriction: It is defined as the narrowing of the airway resulting in obstruction of airflow.

Symptoms of Asthma

  1. Breathing difficulty.

  2. Shortness of breath.

  3. Tiredness and fatigue.

  4. Whistling or wheezing sound while breathing.

  5. Coughing.

Possible Triggers of Asthma

  1. Environmental Pollutants: Cigarette smoke and traffic fumes are one of the biggest triggers of asthma.

  2. Allergens: There are some allergens which when inhaled while breathing can trigger asthma. Examples include dust mites, pollens, and mould.

  3. Chemicals: The manufacturing process of certain chemicals such as paints, aluminium, and hair sprays can release substances which trigger asthma.

  4. Food Items: Asthma being triggered by food items is a rare condition. However, it has still been observed. Examples of food which can trigger asthma are seafood, nuts, and food colouring agents.

  5. Miscellaneous triggers: A few other triggers are cold air, hyperventilation, cotton and dust.

Asthma Attack

An asthma attack is defined as a condition in which a sudden onset of symptoms of asthma is observed. In this condition, the lining of the airways becomes inflamed and there is an increase in mucous production. In some cases, the muscles around the airway also tighten. This results in extreme difficulty in breathing and can be fatal.

Treatment of Asthma

The treatment of asthma is used in two forms. One is to treat asthma on an everyday basis and the other is for rapidly treating an asthma attack.

Long Term

  1. Corticosteroids: Corticosteroids are anti-inflammatory drugs which are used to decrease the inflammation in the airways. They are available in inhaled as well as oral forms. In the case of long-term asthma, inhaled corticosteroids are preferred. Common examples are fluticasone and beclomethasone.

  2. Leukotriene Modifiers: These drugs act by blocking the action of leukotrienes and are effective in relieving the symptoms of asthma. Examples include zafirlukast and montelukast.

  3. Beta Agonists: These are also called beta-adrenergic agonists and act by relaxing the muscles of the airways which results in widening of the airway. They make breathing easier. Salmeterol and Formoterol are widely used, beta-agonists.

  4. Bronchodilators: Bronchodilators are drugs which relax the muscles in the airway as well as the lungs and help in breathing. Theophylline is one of the most used bronchodilators to treat asthma.

Credits: Pixabay Caption: Many kinds of medication are available to treat asthma.

Immediate Treatment of Asthma

Immediate treatment which is also known as a rescue treatment is used in case of asthma attacks.

  1. Short Term Beta Agonists: They are similar to beta-agonists but their onset of activation is quite fast. They act within minutes of administration. The most used short term beta-agonists are albuterol and levalbuterol.

  2. Oral and Intravenous Corticosteroids: These agents decrease the inflammation of the airway rapidly. However, they can produce serious side effects if they are prescribed for long term treatment. They should only be used for immediate treatment. Prednisolone and methylprednisolone are the choice of drugs used.

Chronic Obstructive Pulmonary Disease

COPD is a group of lung diseases which are progressive. These disorders obstruct the airflow from the lungs. It is the 4th highest cause of death in the world.

There are two major types of COPD:

  1. Emphysema: It is a condition in which the air sacs in the lungs are damaged. Over time, this damage increases.

  2. Chronic Bronchitis: Long term inflammation along with the narrowing of the bronchial tubes results in mucus build-up. This mucus causes difficulty in breathing.

Most individuals with COPD suffer from both these conditions.

Causes of COPD

  1. Tobacco smoking

Credits: Pixabay Caption: Tobacco smoking is one of the primary causes of COPD.

  1. Exposure to chemicals

  2. Genetic factors

  3. Fumes produced due to burning.

Stages of COPD

The stages of COPD are classified based on the Gold Staging system by the Global Initiative for Chronic Obstructive Lung Disease. It uses a pulmonary function test to measure the forced expiratory volume in one second or FEV1 for classification.

According to GOLD, COPD has the following stages

  1. Stage 1: Mild COPD with FEV1 greater than 80%.

  2. Stage 2: Moderate COPD with FEV1 between 50% and 80%.

  3. Stage 3: Severe COPD characterized by severe emphysema with FEV1 between 30% and 50%.

  4. Stage 4: End-stage COPD with less than 30% FEV1. It can also be caused by low blood oxygen level.

Treatment of COPD

COPD is a progressive disease which means that it gets worse over time. It does not have a cure. However, treatment is necessary to ensure that progress is slow.

One major aspect of the treatment is to avoid stimulants such as tobacco smoke and chemical fumes to ensure that they do not make the disease worse.

The other treatments include:

  1. Bronchodilators: Examples include albuterol and albuterol sulfate.

  2. Oxygen Therapy: Oxygen therapy refers to a technique which increases blood oxygen level. In some cases of COPD, the blood oxygen level becomes very low and requires this.

Pneumonia

Pneumonia is a disease which is characterized by an infection in the lungs. The infection results in filling the air sacs present in the lung with a fluid. This causes breathing difficulties.

The cycle of Pneumonia usually lasts for 3 weeks in healthy individuals. However, in Individuals with other underlying conditions or weak immunity, it can last for a longer period.

Types, Causes and Treatment of Pneumonia

The type and treatment of pneumonia depend on its cause.

  1. Bacterial Pneumonia: This type of pneumonia is caused by bacterial infections. Mycoplasma Pneumonia is the most common bacteria which causes pneumonia. The treatment involves Antibiotics for bacterial infection and Antipyretics in case of fever.

  2. Viral Pneumonia: Viral Pneumonia is caused by different types of viruses. These include flu viruses, cold viruses and RSV viruses. In this condition, medication is only given for the fever. Rest is an essential part of the treatment of pneumonia.

Symptoms of Pneumonia

  1. Fever

  2. Sweating

  3. Chills

  4. Loss of appetite.

  5. Vomiting and Nausea

  6. Fatigue

  7. Cough with the presence of phlegm

  8. Breathing difficulty.

Tuberculosis

Tuberculosis or TB is a disease which is caused by a bacterium called Mycobacterium Tuberculosis. It is an infection which affects the lungs.

According to the World Health Organization, 1.5 million people in the world died due to TB IN 2018. It is in the top 10 causes of death worldwide.

Tuberculosis is a communicable disease. When an infected person coughs, talks or sneezes, the droplets containing the bacteria can be released into the air. If these droplets are inhaled by another individual, then they can get TB.

Credits: Pixabay Caption: TB is a communicable disease and the transmission can be reduced if the sufferer wears a face mask.

Types of Tuberculosis

Latent TB: In this condition, the patient has acquired that bacteria that causes tuberculosis, but the immune system ensures that it does not spread.

This means that no symptoms are observed. Treatment is only required in case of people who are at a high risk of activating it due to their compromised immune system or underlying conditions.

Active TB: Active TB that the infection is multiplying in the body. Active TB is communicable and requires immediate treatment.

Symptoms of Tuberculosis

Latent TB does not have any symptoms. The following can be symptoms of active TB.

  1. Cough lasting for more than 3 weeks.

  2. Coughing up blood.

  3. Sweats

  4. Fever

  5. Loss of Appetite

  6. Chest Pain

Treatment of Tuberculosis

The treatment of TB is long. The average duration is 6-9 months. Proper treatment is necessary and missed doses can cause significant damage. There are two types of medications used to treat TB:

  1. First-Line Agents: These are the agents which have high efficacy and low toxicity. Examples include isoniazid and ethambutol.

  2. Second Line Agents: These are the drugs which have toxicity. These are only used in severe cases where first-line agents do not work. Commonly used second-line agents are cycloserine and ethionamide.

Acute Respiratory Distress Syndrome

It is a condition in which there is a build-up of fluid in the air sacs due to leakage from the blood vessels. This syndrome is serious and is fatal in most cases. It is caused by the presence of an underlying condition. The following conditions can cause acute respiratory distress syndrome:

  1. COVID 19

  2. Sepsis

  3. Inhalation of chemical fumes

  4. External Injuries

The treatment focuses on the use of ventilators to help in breathing while the underlying cause is treated.

Diagnosis of Respiratory Diseases

Respiratory diseases have different origins and require many types of investigations. The common diagnostics tests which are used in diagnosing respiratory diseases are:

  1. Detailed Medical History.

  2. Pulmonary Function Tests

  3. Chest X-ray

Credits: Pixabay Caption: A chest X-ray

  1. Bronchoscopy

  2. Thoracoscopy

  3. Serological Tests

  4. Histological Tests

  5. Lung Capacity and Airway Resistance

  6. CT Scan

  7. Ultrasonography

Takeaway

Respiratory disorders are of various types and can turn into serious conditions. If you notice any symptoms of respiratory disorders, then you should seek immediate medical help.

There are many different forms of treatment available for respiratory disorders. Making lifestyle changes such as quitting smoking can be very beneficial and should be explored.

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