Pulmonology: diseases — симптомы, диагностика и лечение

Bronchial asthma is a chronic inflammatory disease of the respiratory tract, in which the bronchi become overly sensitive and narrow in response to irritants. Hence the attacks of shortness of breath, wheezing and coughing. The main misconception that prevents you from being treated correctly is the belief that asthma can be treated with an inhaler “when it strikes.” This inhaler relieves an attack, but does not affect inflammation; the disease continues to progress. The real treatment is a daily basal inhaler, which many people skip precisely because it doesn't provide immediate relief.

Pneumonia is an inflammation of the lung tissue, in which the alveoli are filled with inflammatory fluid and cease to participate in gas exchange. Unlike bronchitis, where only the respiratory tract is affected, the lung tissue itself is affected, resulting in shortness of breath and decreased oxygen saturation in the blood. Pneumonia remains one of the leading causes of death from infections, especially in the elderly. At the same time, most patients are successfully treated at home - it is important to recognize the disease in time and correctly assess the severity.

COPD is a chronic disease in which the airways become persistently narrowed and lung tissue is destroyed. The main reason is smoking, including passive smoking, as well as prolonged inhalation of smoke from stoves and industrial dust. COPD differs fundamentally from asthma: the narrowing of the bronchi is not completely reversible and progresses slowly. The key fact that determines everything: quitting smoking is the only intervention proven to slow the progression of the disease. No inhalers do this, although they significantly relieve symptoms.

Bronchitis is inflammation of the bronchial mucosa. Acute bronchitis in the vast majority of cases is caused by viruses and is, in fact, a continuation of the common cold, which has descended further. This is why antibiotics are not needed in most cases - and this is why they are most often prescribed unjustifiably. The main thing that the patient should know is that cough after acute bronchitis normally lasts up to 3 weeks, and sometimes longer, and this does not mean that the treatment is not working or that another antibiotic is needed.

Bronchitis in children is an inflammation of the bronchial mucosa, which in the vast majority of cases is caused by respiratory viruses. The disease usually begins like a common cold, and after a few days a cough develops: first dry and persistent, then wet. The bronchial mucosa is restored slowly, so a residual cough can last up to two to three weeks even with a successful course, and this does not mean that the treatment does not work. In some children, inflammation is accompanied by narrowing of the bronchi: wheezing and difficulty exhaling. Antibiotics for viral bronchitis do not speed up recovery, and the decision to prescribe them is made only by the doctor.

Coughing is a protective reflex that clears the airways of mucus, germs and foreign particles. It is very common in children and in the vast majority of cases is associated with common viral infections. The mere presence of a cough does not indicate the severity of the disease: its nature, duration and accompanying symptoms, especially the child’s breathing, are much more important. A barking cough with noisy inhalation, attacks with respiratory arrest, wheezing and a cough that began suddenly during a game require completely different actions, including calling an ambulance.

Pulmonary fibrosis is the replacement of normal lung tissue with dense scar tissue. A thickened connective tissue layer appears between the alveoli and capillaries, through which it is more difficult for oxygen to pass into the blood, and the lungs become rigid and expand worse when inhaling. This causes a dry cough and shortness of breath, which at first only bothers you during exertion. Fibrosis can be the result of inflammation, inhalation of dust, taking certain medications, radiation therapy, or a manifestation of rheumatic diseases. A separate form is idiopathic pulmonary fibrosis, when the cause cannot be determined. Scars do not resolve, but modern approaches can slow down progression and maintain quality of life.

Shortness of breath is a feeling of lack of air, difficulty or rapid breathing. During intense exercise, it is natural, but if it becomes difficult for a person to climb to a floor that previously did not cause difficulties, or there is not enough air at rest, this is a symptom that requires examination. Most often, shortness of breath is associated with diseases of the lungs and heart: bronchial asthma, COPD, pneumonia, heart failure, coronary heart disease. It can also be caused by anemia, obesity, thyroid disease, anxiety disorders and detraining. Sudden shortness of breath with chest pain may mean a heart attack, pulmonary embolism or pneumothorax - in this case you should immediately call 103.

Pleurisy is an inflammation of the pleura, the thin membrane that covers the lungs from the inside of the chest. Normally, between its leaves there are only a few milliliters of liquid, which ensures sliding during breathing. When the leaves become inflamed, they become rough and rub against each other—a sharp pain occurs in the side, which intensifies with inhalation and coughing. If a lot of fluid accumulates, the pain subsides, but shortness of breath appears because the effusion compresses the lung. Pleurisy is almost always secondary: it is followed by pneumonia, tuberculosis, thromboembolism, tumor, heart or kidney failure. Therefore, treatment begins with finding the cause, and not with pain relief.