Interstitial lung disease

Interstitial lung disease! Interstitial lung disease actually describes a group of disorders, most of which cause progressive scarring of lung tissue. This affects the ability to breathe and have enough oxygen in the blood. These disorders vary greatly.
Definition

Interstitial lung disease actually describes a group of disorders, most of which cause progressive scarring of lung tissue. This affects the ability to breathe and have enough oxygen in the blood. These disorders vary greatly.

Most cases of interstitial lung disease develop gradually, but some sudden appearance. The doctor can determine why some cases of interstitial lung disease occur, but many people have no cause.

In any case, once lung scarring occurs, often irreversible. Sometimes medication can slow the damage of interstitial lung disease, but many people never regain full use of the lungs. Researchers hope that newer drugs, many people still experimental, may eventually prove effective in the treatment of interstitial lung disease.



Symptoms

Signs and symptoms of a variety of disorders classified as interstitial lung disease may include:

A feeling of shortness of breath, especially during or after physical activity.

Dry cough.

Wheezing.

Chest pain.

Nails on the top curve (club).

Shortness of breath and dry cough are often early signs and symptoms. Because these issues are vague and tend to develop gradually - often long after lung injury can not be reversed - that can be caused by aging, overweight asthma, or smoking, or the kind of lasting impact of an upper respiratory infection.

Symptoms tend to become progressively worse. Finally can see the breath in the regular activities - dressing, talking on the phone, even eating. At this point, breathing becomes difficult not to be missed.

Go see a doctor when

By the time signs and symptoms such as shortness of breath and cough appear, irreversible lung damage has occurred often. However, it is important to see a doctor at the first sign of difficulty breathing. Many other conditions with interstitial lung disease can affect the lungs, and get early and accurate diagnosis is critical for appropriate treatment.

Cause

Whenever inhale, air enters the lungs through the large airways called bronchi. Inside the lungs, bronchi split into smaller airways (bronchioles) that finally end in clusters of tiny air sacs (alveoli). In the walls of the air sacs are small blood vessels (capillaries) where oxygen is added to the blood and carbon dioxide - a waste product of metabolism - is removed.

Scars of tiny air pockets

In interstitial lung disease, the walls of the air sacs can become inflamed and the tissue (interstitium) and line the pockets support becomes increasingly thickening and scarring. Normally, the airbags elastic, expanding and contracting as small bubbles with each breath. But scarring (fibrosis) caused tissue, alternating thin and thick hardened, making the air bag less flexible. Instead of soft and elastic texture airbags scars of a hard sponge, which makes it hard to breathe and difficult for oxygen into the bloodstream through the thick walls.

Abnormal healing reaction

Scarring in interstitial lung disease seems to occur when an injury to the lungs causing an abnormal healing response. Normally, the body makes an amount to repair tissue damage. But in interstitial lung disease, the repair process goes awry, creating more scar tissue that interferes with lung function.

Another disorder, many causes

Because interstitial lung disease has a variety of causes, determine the reason for the initial lung tissue injury may be difficult. Some may have many contributing factors include:

Labor and environmental factors. Long-term exposure to some toxins or pollutants can lead to serious lung damage. Workers often inhale silica dust, asbestos fibers, hard metal dust are especially at risk of serious lung diseases. So, those who are exposed to certain chemical fumes and ammonia or chlorine gas.

Exposure to a variety of chronic nature, many of them organic, can also damage the lungs. Among these are grain, sugar cane, and dust and animal droppings. Other substances, such as mold or can be a problem when they cause a hypersensitivity reaction in the lungs (hypersensitivity pneumonitis). Even bacterial or fungal overgrowth in humid and hot tub can cause lung damage.

Infections. These include viral infections such as cytomegalovirus, a particular problem if you have a weakened immune system, a number of bacterial infections including pneumonia, fungal infections such as histoplasmosis and parasitic infections.

Radiation. Some people receive radiation therapy for lung cancer or breast cancer signs of lung damage long after the end of radiotherapy. The severity of losses may depend on how much of the lung exposed to radiation, the total number of received radiation, chemotherapy can also be used and whether the lung disease.

Drugs. Some drugs can damage lung tissue lines. Those who are more likely to cause lung problems, including chemotherapy drugs, drug treatment of arrhythmias and other cardiovascular problems, certain psychiatric medications and some antibiotics.

Other medical conditions. Interstitial lung disease can occur with other disorders. Typically, these conditions do not directly attack the lungs, but instead affects cells throughout the body. Of these, lupus, scleroderma, rheumatoid arthritis, dermatomyositis, polymyositis, Sjogren's syndrome and sarcoidosis. Some researchers think that gastroesophageal reflux disease (GERD) - a chronic lung which eat small amounts of substances stomach - can lead to pulmonary fibrosis.

The cause is not known

Although doctors can determine why some people with interstitial lung disease, in many cases the cause is unknown. Disorder without a cause are grouped together under the label idiopathic pulmonary fibrosis, idiopathic interstitial lung disease. Although some patients may spontaneously common features, each has its unique characteristics.

Usual interstitial pneumonia, also known as idiopathic pulmonary fibrosis, the most common of the idiopathic interstitial lung disease. Because usual interstitial pneumonia developed in patches, some areas of the lungs are normal, the rest is still inflamed and other places marked by scar tissue. The disease affects more men than women and usually develops in people over 50 years old.

Other, less common types of idiopathic pulmonary fibrosis include:

Nonspecific interstitial pneumonia.

Bronchiolitis obliterans with organizing pneumonia (Boop).

Related respiratory bronchiolitis - interstitial lung.

Desquamative interstitial pneumonia.

Bach interstitial pneumonia.

Acute interstitial pneumonitis.

Risk Factors

Factors that may make you more vulnerable to interstitial lung disease, including:

Age

Interstitial lung disease is more likely to affect adults, infants and children, although sometimes develop the disorder. Spontaneous forms of the disease usually develops in people older than 50.

Exposure to toxins labor and environmental

If you work in agriculture, mining, construction, or for any reason exposed to pollutants known lung injury, interstitial lung disease risk increases significantly.

Radiation and chemotherapy

Having a chest radiation therapy or use some chemotherapy drugs makes it more likely to develop lung disease.

Oxygen

Continue breathing in high levels of oxygen therapy for more than 48 hours can be harmful to the lungs.

Risk factors for idiopathic interstitial lung disease

Researchers have identified certain factors that seem to increase the risk of spontaneous lung disease, although the cause of this disorder is unknown:

Smoke. Some forms of interstitial lung disease are more likely to occur in people with a history of smoking and active smoking may make the situation worse. This risk appears to increase with the number of years of smoking and number of cigarettes. However, with rare exceptions, smoking does not directly cause interstitial lung disease.

Heredity. Rare idiopathic interstitial lung diseases run in families. Called pulmonary fibrosis family, it is similar to other forms of the disease. Although research is being done on lung fibrosis families, researchers have yet to identify the genes that may be involved.

Gastroesophageal reflux disease (GERD). Researchers are investigating a possible link between idiopathic interstitial lung disease and gastroesophageal reflux disease of the esophagus. In GERD, stomach acid or occasionally bile salts back into the esophagus and then into the lungs.

Complications

Formation of scar tissue in the lungs can lead to a variety of life-threatening complications, including:

Low blood oxygen levels (hypoxia)

Because interstitial lung disease reduces the amount of oxygen in the blood and go on, there are more likely to develop low blood oxygen levels to normal. Lack of oxygen can seriously disrupt basic functions of the body.

High blood pressure in the lungs

Unlike high blood pressure system, this condition affects only the arteries in the lungs. It started when scar tissue limiting the smallest blood vessels, restricting blood flow in the lungs. This will increase the pressure in the pulmonary artery. Pulmonary hypertension is a serious condition gradually became worse.

Heart Failure

Serious condition that occurs when the right heart chamber weaker - less muscular than the left - must pump harder than usual to move blood through the pulmonary artery obstruction. Finally, more stress right ventricle.

Respiratory failure

In the final stage of chronic interstitial lung disease, severe respiratory distress occurs when low blood oxygen levels, along with increased pressure in the pulmonary arteries causing heart failure.

Tests and diagnosis

Identify and determine the cause of interstitial lung disease can be extremely difficult. An unusually large number of disorders of this type of accommodation. Moreover, the difference between interstitial lung disease and to identify the unknown cause, the cause is not always clear.

In addition, the signs and symptoms of a variety of medical conditions - including chronic obstructive pulmonary disease (COPD), heart failure and asthma - can mimic interstitial lung disease, and the doctors have to type subtracted before making a definite diagnosis.

To help cut through the confusion and exclusion of other possible diseases, your doctor may start with a detailed medical history and physical examination period. Once certain conditions have been removed, the doctor will recommend tests such as:

X - ray

Although this is usually the first test given in cases of suspected lung disease, X - ray is not effective as a computerized tomography (CT) scanning in the diagnosis of interstitial lung disease. It can, however, help to eliminate the conditions that cause signs and symptoms similar to interstitial lung disease, including emphysema and lung lobar collapse.

High resolution computerized tomography (HRCT) scan

While traditional chest X - ray producing two-dimensional images of the lungs, a CT scan using X - ray sensors and a large computer to create cross-sectional images are far more detailed. Further HRCT scan showed lung tissue in great detail and provide more information than conventional CT scans.

Pulmonary function tests (PFTs)

The noninvasive tests of lung function test well. For testing, often require blowing into a simple device called a spirometer, how much air the lungs can hold and the flow of air out of the lungs. Scarring becomes worse, it could take into the air and blowing out less. Some pulmonary function tests measure the amount of gas exchange between the alveolar membrane and capillary blood vessels.

Exercise testing

Because the symptoms of interstitial lung disease is worse when in operation, the doctor can assess lung function during exercise, usually on a fixed bike or treadmill. Although various specific tests, blood pressure and oxygen levels in the blood are often monitored as increasing the difficulty of exercise.

Bronchoscopy (transbronchial biopsy)

In many cases, interstitial lung disease can be definitively diagnosed only by examining a small amount of lung tissue (biopsy). In transbronchial biopsy, the doctor passes a flexible fiber-optic tube (bronchoscope) through the mouth into the lungs and remove a sample of tissue or more, about the size of a pinhead. Then be tested in the laboratory. Bronchoscopy is performed on an outpatient basis using local anesthesia.

Bronchoalveolar lavage

In this procedure, doctors inject saline through the bronchoscope and then suck it off immediately. The recovered solution containing cells from the air sacs. Although bronchoalveolar lavage samples a larger area of ​​the lung than other procedures, it can not provide enough information to diagnose a specific interstitial lung disease. Instead, doctors often use it to check the progress of a lung disorder or to help determine the best treatment.

Video thoracoscopic surgery support

When less invasive tests do not provide a specific diagnosis, thoracic surgeons can perform surgical lung biopsy. In this procedure, a flexible tube with a camera (endoscope) is passed through a small incision between the ribs, allowing the lung surgeon watching on a video screen. Surgical instruments are then inserted through another incision, and surgeons removed the tissue in the lungs.

Treatments and drugs

Interstitial lung disease caused by toxins or drugs can sometimes be reversed when no longer exposed to the substance. But in those cases is not promising, less promising. Because these treatments are currently available drugs can have serious side effects and are often ineffective.

Treatment for interstitial lung disease often include a combination of the following medications:

Corticosteroids

The anti-inflammatory medications help a few people with interstitial lung disease. Those who are most likely to benefit disorder with a cause and reverse the changes in their lungs. Corticosteroids are rarely improves lung function in people with idiopathic pulmonary fibrosis, and these benefits are often temporary.

Done for a long time or in large doses of corticosteroids can cause some side effects, including glaucoma, osteoporosis, high blood sugar leads to diabetes, slow wound healing and increased susceptibility to infection.

Azathioprine

This cytotoxic drug, commonly used to prevent organ removed after transplantation, can also be used in combination with corticosteroids for the treatment of interstitial lung disease. Azathioprine can cause serious side effects, including decreased production of blood cells and increase the risk of infection and cancer. A cytotoxic drug, cyclophosphamide can try if azathioprine ineffective. However, the side effects associated with cyclophosphamide is even more serious.

Acetylcysteine

This medication belongs to a class of drugs called antioxidants. Oxidation is a natural process that leads to cell and tissue damage. The process may play a role in the development of scarring in the lungs (pulmonary fibrosis). Results from a clinical trial shows that, when combined with corticosteroids and azathioprine acetylcysteine ​​improves lung function in people with idiopathic pulmonary fibrosis. No significant changes were seen in mortality.

Anti - fibrotics

These drugs are sometimes used to help reduce the development of scar tissue. In clinical studies, the drug pirfenidone and bosentan showed promising slow the progression of lung injury. Subscribe studies to obtain information about the risks and benefits of these drugs in the treatment of interstitial lung disease was made. The other type of anti-fibrosis have been studied as possible treatments for this condition - including colchicine, penicillamine and interferon gamma - 1b - has not found effective.

Oxygen therapy

Depending on the severity of the symptoms and activity level, your doctor may recommend treatment with oxygen. Although oxygen can not stop lung damage, it can make breathing and exercise easier and prevent or reduce complications from low oxygen levels in the blood. Oxygen therapy may also improve sleep and feeling of well being. It can also reduce blood pressure in the right side of the heart.

Pulmonary rehabilitation

This is an official program for people with chronic lung disease including medical management. The goal of pulmonary rehabilitation is not only to treat a disease or even improve daily operations, but also to help people with pulmonary fibrosis live full, satisfying lives. The program pulmonary rehabilitation exercise focuses on teaching how to breathe more effectively, educational and emotional support and nutritional counseling.

Typically, multi-faceted approach requires a team of health care providers that may include a doctor, nurse, rehabilitation specialist, dietitian and social worker. The program can be very different, however. Doctors usually can tell the program to restore lung function in the region.

Lung transplant

This may be an option for people with severe interstitial lung disease, those who do not have the ability to benefit from other treatment options.

To be considered for transplant, agreed to quit smoking if you smoke, healthy enough to undergo surgery and treatment after transplant, willing and able to comply with the health program launched by the group for rehabilitation and transplantation, patience and mental strength and support to go through the wait for a donor organ. Finally is particularly important because donor organs are in short supply.

Lifestyle and home remedies

To participate in treatment and to stay as healthy as possible is essential to living with interstitial lung disease. Take the following steps to healthy:

Stop smoking

There is a relationship between smoking and some types of idiopathic interstitial lung disease, the most serious form and potentially fatal disorder. Talk to your doctor about the options for stop smoking, including smoking cessation programs, using a variety of techniques have been proven to help people quit smoking.

Enrolled in a rehabilitation program in lung function

These programs are very different, but they generally focus on improving the ability to exercise and perform normal operations, management, difficulty breathing with breathing techniques, improve appetite and nutritional status, dealing with the psychological aspects of life difficult with lung disease, and improve overall quality of life.

Exercise regularly as prescribed by your doctor

Exercise is a double-edged sword for people with lung disease, it requires an increased amount of oxygen, and it makes the symptoms worse. At the same time, exercise is essential to maintain lung function, reduce stress and depression, and maintaining overall health and happiness. Ask your doctor for a referral to a rehabilitation program in lung function before starting or continuing to perform.

Eating well

People with lung disease may lose weight because it is not comfortable to eat and therefore need more energy to breathe. However, a diet that contains enough nutrient-rich calories needed. The type of food, time of day, and eat of the portion size may play a role in nurturing needs.

Because it is often easier to breathe when the stomach is not completely full, may wish to eat small meals during the day instead of two or three large meals. Also can try lighter choices such as fruits and vegetables, rather than foods high in fat, which has more energy to digest. A dietitian can provide further guidance for healthy eating.

If you are overweight, losing weight only to gain a healthy body mass index (BMI) can have a huge impact on the ability to breathe and exercise tolerance.

Coping and support

Living with a chronic lung disease is emotionally and physically challenging. Daily routines and activities may need to be adjusted, sometimes completely, as breathing problems worse or health care should be a priority in life. Feelings of anger, fear and sadness are normal grieving the loss of the old life and worry about what's next for themselves and their families.

These suggestions can help you cope with interstitial lung disease:

Share feelings with your loved ones and your doctor

Talk openly and can help loved ones cope with the emotional challenges of the disease. In addition, clear communication helps family and plan effectively for the needs if the disease progresses.

Consider joining a support group

In a support group, will be with those who are facing similar challenges. Group members can share coping strategies, exchange information about new treatments, or simply listen to express emotions. If not for a group, may want to talk with a mental health provider or clergy members.