All About Respiratory Medicine
Respiratory Update is an online portal dedicated to respiratory medicine and pulmonology. We only post verified medical data from reliable sources. We do this for informational purposes only and our site is not intended for the diagnosis and treatment of any respiratory diseases.
What is pulmonology?
Pulmonology is a field of medicine that studies the human respiratory system, the diagnosis of pathologies and their treatment. It was first identified as an independent industry only in the second half of the last century. Until that time, science had accumulated and expanded knowledge about the respiratory apparatus, so the diseases that the pulmonologist now treats were treated by various doctors – surgeons, therapists, etc.
The human respiratory system includes:
- Respiratory tract (upper – nose, pharynx and lower – larynx, trachea, bronchi);
- Lungs (right and left);
- Pleura (visceral membrane lining the chest cavity from the inside and the outer surface of the lungs);
- Muscles involved in the act of breathing;
- The respiratory center in the medulla oblongata, which is responsible for timely exhalation and inhalation.
A pulmonologist is a doctor who is engaged in the study and treatment of pathologies of the respiratory tract, lungs, and pleura. This specialist considers all departments of the system in close interconnection.
What type of diseases does a pulmonologist treat?
The doctor’s competence extends to a fairly wide list of diseases, from chronic rhinitis (runny nose) to lung cancer, however, in some cases, help will be limited only to the consultation of a pulmonologist and diagnosis of the disease – for further treatment the patient is referred to narrower specialists.
So, a pulmonologist treats:
- Chronic and obstructive (with a difficult discharge of sputum) bronchitis;
- Alveolitis (inflammation of the alveoli – the smallest structural units of the lung);
- Pleurisy (inflammation of the membranes of the lung);
- COPD (chronic obstructive pulmonary disease);
- Allergic diseases (including pneumoconiosis, silicosis);
- Hemo- and pneumothorax (effusion into the pleural cavity or air penetration);
- Emphysema (pathological expansion of the bronchioles) and empyema (“ulcers”);
- Abscesses (purulent destruction of lung tissue);
- Sarcoidosis, cystic fibrosis and other fibrosis (proliferation of connective tissue).
A pulmonologist can diagnose but does not cure:
- Tuberculosis (a patient is being treated by a TB specialist);
- Diseases of the upper respiratory tract (they are treated by otolaryngologists);
- Lung cancer (treated by an oncologist).
When to see a pulmonary specialist?
Usually, a general practitioner refers a patient to a pulmonologist since it is quite difficult to determine a disease without a medical education due to the similarity of symptoms: cough may be accompanied by flu, pharyngitis and laryngitis (inflammation of the larynx), which do not require a pulmonologist.
You should see a pulmonologist if you have the following symptoms, one way or another associated with a cough reflex:
- Unproductive cough accompanied by symptoms of respiratory failure;
- Lingering cough with or without sputum;
- Change in the nature of sputum: the appearance of pus, blood, drops of blood when coughing; discharge of pink foam;
- Acute chest pain, aggravated by breathing and accompanied by increasing respiratory failure;
- Fever due to cough, shortness of breath, weakness, wet sweat and other signs of intoxication;
- Choking, increased cough in the evening/night;
- Cramps, difficulty breathing under certain conditions (smells, dust pollution, changes in air temperature);
- Constant irritation of the upper respiratory tract, prolonged profuse runny nose with clear discharge, laryngospasms (“intercepts” breathing).
How is a diagnosis made?
A pulmonologist has in his or her arsenal a wide range of diagnostic methods, which include analysis of biological fluids (blood, sputum) for the presence of bacteria and markers of inflammation and visual hardware studies.
- Radiography and fluoroscopy are two methods of radiation diagnosis. As a result of the first, a static picture (“photograph”) of the lungs is obtained, in the second case, the organ is translucent for a while and the result is transmitted to the screen in real time – it is possible to evaluate the function of respiration, the distribution of contrast across the vessels;
- Bronchoscopy is endoscopic imaging that allows a medical specialist to examine the mucous membrane of the bronchi from the inside, take material for research, introduce a drug;
- Computed tomography is a cross-sectional snapshot of organ tissues, target: search for neoplasms (abscesses, fibrous cysts, cavities, foci of necrosis or purulent fusion, tumors, etc.);
- Functional diagnostics: peak fluorometry (assessment of expiratory flow rate), spirometry (assessment of volume and respiratory rate), spirography and others.
- A clinical blood test shows the presence of inflammation (with an increase in the erythrocyte sedimentation rate – ESR), the acute or chronic phase of the process (according to the leukocyte formula), the presence of allergic reactions (with an increase in eosinophils), the general weakness of the body (decrease in hemoglobin or red blood cells);
- Sputum bacterial inoculation will help isolate pathogenic microflora and determine the causative agent of the disease in order to choose the most effective antibiotic;
- Allergological tests will establish a spectrum of allergens that provoke deterioration;
- Genetic diagnosis will help identify mutations characteristic of cystic fibrosis.
A pulmonologist can prescribe a radical (surgical) or conservative (drug, hardware) treatment, adherence to a certain regimen and diet, according to the results of the study, and may refer for further examination to other specialists if the problem goes beyond his or her competence (for example, if a tumor is detected or tuberculosis is suspected).
Drug treatment can also be very diverse and include:
- Antibacterial therapy (for bronchitis and pneumonia of bacterial etiology);
- Anti-inflammatory with the use of NSAIDs and steroids (with severe edema);
- Antitussive (suppressing the cough reflex when) or, conversely, expectorant drugs (increasing the secretion of the bronchi);
- Drugs that eliminate bronchospasm and expanding bronchi – adrenergic agonists, anticholinergics, antispasmodics;
- The introduction of antiseptics can be carried out endoscopically or using pleural puncture (with pleurisy, pneumothorax).
Hardware and instrumental treatment may include:
- Electrophoresis with various drug solutions;
- Warming up;
- Bronchoscopy with the introduction of antiseptics;
- Pleural puncture (performed by a thoracic surgeon) with pumping out fluid or pus, washing the cavity with antiseptic solutions, intracavitary administration of antibiotics.
Any prescription is made by a doctor after a thorough examination of each case of the disease. Many procedures are performed only in a hospital and some diseases require prolonged hospitalization.
Consultation with a pulmonologist can be preventive in nature. So, chronic patients visit a pulmonologist regularly. The purpose of these visits is to assess the current state of the body, extend the period of remission (absence of symptoms) and mitigate the symptoms of future relapses (exacerbations).
To avoid bronchopulmonary diseases, a doctor can advise all patients without exception:
- No smoking;
- Protect yourself from infections (vaccination and personal hygiene will help);
- Avoid potential allergens;
- Eliminate the influence of damaging factors (when working in a factory with high levels of dust or toxic substances, carefully observe safety precautions, use protective equipment);
- Eat well;
- Train the respiratory system (using breathing exercises, singing, playing wind instruments);
- Lead an active lifestyle.
Remember that only a doctor can choose an effective treatment option in a specific case after a thorough diagnosis. Do not self-medicate!