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What Is Respiratory Disease; Type, Causes, Treatment

What Is Respiratory Disease/Respiratory disease or lung disease is a medical term that encompasses pathological conditions affecting the organs and tissues that make gas exchange difficult in air-breathing animals. They include conditions of the respiratory tract including the trachea, bronchi, bronchioles, alveoli, pleurae, pleural cavity, and the nerves and muscles of respiration. Respiratory diseases range from mild and self-limiting, such as the common cold, to life-threatening diseases such as bacterial pneumonia, pulmonary embolism, acute asthma, and lung cancer.^[rx]

Types of Respiratory Disease / Lung Disease

Sinuses

Sinusitis nose

Rhinitis

Vasomotor rhinitis
- Atrophic rhinitis
- Hay fever
Nasal polyp
Rhinorrhea
nasal septum

Nasal septum deviation

Nasal septum perforation
Nasal septal hematoma tonsil
Tonsillitis
Adenoid hypertrophy
Peritonsillar abscess
pharynx

Pharyngitis Neck

Strep throat
Laryngopharyngeal reflux (LPR)
Retropharyngeal abscess larynx

Croup

Laryngomalacia
Laryngeal cyst
Laryngitis
Laryngopharyngeal reflux (LPR)
Laryngospasm

Vocal cords

Laryngopharyngeal reflux (LPR)
Vocal fold nodule
Vocal fold paresis
Vocal cord dysfunction epiglottis

Epiglottitis trachea

Tracheitis
Laryngotracheal stenosis

Bronchial/obstructive Acute

Acute bronchitis chronic COPD
Chronic bronchitis
Acute exacerbations of chronic bronchitis
Acute exacerbation of COPD
Emphysema)
Asthma (Status asthmaticus
Aspirin-induced
Exercise-induced
Bronchiectasis

Unspecified

Bronchitis
Bronchiolitis
obliterans
Diffuse panbronchiolitis

External agents/ occupational lung disease

Pneumoconiosis

Aluminous
Asbestosis
Baritosis
Bauxite fibrosis
Berylliosis
Caplan’s syndrome
Chalicosis
Coalworker’s pneumoconiosis
Siderosis
Silicosis
Talcosis
Byssinosis

Hypersensitivity pneumonitis

Bagassosis
Bird fancier’s lung
Farmer’s lung
Lycoperdonosis

Others

ARDS
Combined pulmonary fibrosis and emphysema
Pulmonary edema
Löffler’s syndrome/Eosinophilic pneumonia
Respiratory hypersensitivity
- Allergic bronchopulmonary aspergillosis
Hamman-Rich syndrome
Idiopathic pulmonary fibrosis
Sarcoidosis

By Pathogen

Viral
Bacterial
- Pneumococcal
- Klebsiella)
Atypical bacterial
- Mycoplasma
- Legionnaires’ disease
- Chlamydiae
Fungal
- Pneumocystis
Parasitic
noninfectious
- Chemical/Mendelson’s syndrome
- Aspiration/Lipid

By Route/ Vectors

Community-acquired
Healthcare-associated
Hospital-acquired
Broncho-
Lobar
UIP
DIP
BOOP-COP
NSIP
RB

Others

Atelectasis
circulatory
- Pulmonary hypertension
- Pulmonary embolism
Lung abscess
Pleuritis/pleurisy
Pneumothorax
Hemopneumothorax

Pleural effusion

Hemothorax
Hydrothorax
Chylothorax
Empyema/pyothorax
Malignant
Fibrothorax
Mediastinitis
Mediastinal emphysema
Respiratory failure
Influenza
SARS
Idiopathic pulmonary haemosiderosis
Pulmonary alveolar proteinosis

Tumors

The major histological types of respiratory system cancer are:

Small cell lung cancer
Non-small cell lung cancer
- Adenocarcinoma of the lung
- Squamous cell carcinoma of the lung
- Large cell lung carcinoma
Other lung cancers (carcinoid, Kaposi’s sarcoma, melanoma)
Lymphoma
Head and neck cancer
Pleural mesothelioma, almost always caused by exposure to asbestos dust.
Pulmonary hamartoma
Congenital malformations such as pulmonary sequestration and congenital cystic adenomatoid malformation (CCAM).

Obstructive lung disease

Asthma,
chronic bronchitis,
bronchiectasis and
chronic obstructive pulmonary disease (COPD) are all obstructive lung diseases obstruction.
This limits the amount of air that is able to enter alveoli because of constriction of the bronchial tree, due to inflammation.
A common cause of COPD including emphysema, and
Chronic bronchitis is tobacco smoking, and common causes of bronchiectasis include severe infections and cystic fibrosis.

Restrictive lung diseases

Age-standardized disability-adjusted life year (DALY) rates from respiratory diseases by country (per 100,000 inhabitants).
Restrictive lung diseases are a category of respiratory disease characterized by a loss of lung compliance,^[4] causing incomplete lung expansion and increased lung stiffness, such as in infants with respiratory distress syndrome.

Chronic respiratory disease

Chronic respiratory diseases (CRDs)
asthma,
chronic obstructive pulmonary disease, and
acute respiratory distress syndrome.
CRDs are not curable; however, various forms of treatment that help dilate major air passages and improve
shortness of breath can help control symptoms and increase the quality of life.^[5]

Respiratory tract infection

Upper respiratory tract infection

The most common upper respiratory tract infection is the common cold.
However, infections of specific organs of the upper respiratory tract such as sinusitis, tonsillitis, otitis media, pharyngitis, and laryngitis are also considered upper respiratory tract infections.

Lower respiratory tract infection

The most common lower respiratory tract infection is pneumonia, an infection of the lungs which is usually caused by bacteria, particularly Streptococcus pneumoniae in Western countries.
Worldwide, tuberculosis is an important cause of pneumonia.
Other pathogens such as viruses and fungi can cause pneumonia, for example, severe acute respiratory syndrome and pneumocystis pneumonia.
Pneumonia may develop complications such as a lung abscess, a round cavity in the lung caused by the infection, or may spread to the pleural cavity.

Pulmonary vascular disease

Pulmonary vascular diseases are conditions that affect the pulmonary circulation. Examples are

Pulmonary embolism – a blood clot that forms in a vein, breaks free, travels through the heart and lodges in the lungs (thromboembolism).
fat embolism (particularly after bony injury),
amniotic fluid embolism
Pulmonary arterial hypertension – elevated pressure in the pulmonary arteries. Most commonly it is idiopathic (i.e. of unknown cause) but it can be due to the effects of another disease, particularly
cor pulmonale.
Pulmonary edema
Pulmonary hemorrhage
granulomatosis with polyangiitis and Goodpasture’s syndrome.

Causes Of Respiratory Disease / Lung Disease

Since any process that reduces airway dysfunction, below are some of the many of the conditions that can cause lung disease

Asthma – This condition, in which your airways narrow, swell, and make extra mucus, can make it hard to breathe.
Allergic reactions – to pollen, chemicals, pet dander, dust, foods, or insect stings
Acute or chronic bronchitis and COPD – which can produce excess mucus in the respiratory tract and cause the lungs’ passageways to become blocked
Pneumonia – An infection that inflames the air sacs in your lungs, and they fill with fluid or pus
Bronchiolitis –This lung infection that inflames the airways and causes congestion usually affects children.
Emphysema – a lung condition that causes shortness of breath
Smoking, or breathing in smoke – can make you wheeze.
Respiratory syncytial virus – This virus can lead to bronchiolitis, a lung infection that inflames the airways and causes congestion or pneumonia.
Cystic fibrosis – an inherited disease that damages your lungs and makes the mucus extra sticky and thick
Obstruction of an airway – by a foreign body that has been inhaled (such as a coin)
Panic – A panic attack can cause a person’s throat to tighten and make breathing difficult.
Bronchitis – Bronchitis is an inflammation of the bronchial tubes that are often caused by a viral or bacterial infection.
Cold and flu – Infections that cause the common cold or flu can cause inflammation and breathing problems.
Pneumonia – Pneumonia is an infection of the lungs.
Tumor in the lungs
Congestive heart failure
Respiratory infections (croup, laryngitis)
Obstructive airway diseases (asthma,
chronic obstructive pulmonary disease, anaphylaxis, bronchiolitis)
Pulmonary peribronchial edema (congestive heart failure)
Vocal cord dysfunction (paradoxical vocal fold motion, vocal cord paralysis)
Postnasal drip
Airway compression – Intrinsic or extrinsic (squamous cell carcinomas, goiter)
Hyperdynamic airway collapse (tracheobronchomalacia)
Carcinoid tumors
Foreign body inhalation
Forced exhalation by normal individuals[rx][rx][rx]
Emphysema
Gastroesophageal reflux disease (GERD)
Heart failure
Epiglottitis (swelling of the “lid” of your windpipe)
Lung cancer
Medications (particularly aspirin)
Sleep apnea, obstructive (a condition in which breathing stops and starts during sleep)
Pneumonia
Respiratory syncytial virus (RSV) — especially in young children
Respiratory tract infection (especially in children younger than 2)
Smoking
Vocal cord dysfunction (a condition that affects vocal cord movement)
Lung cancer
Sleep apnea
Vocal cord dysfunction
Bronchitis
Pneumonia
Respiratory tract infection
Reaction to smoking
Inhaling a foreign object
Anaphylaxis
Bronchiolitis, a viral respiratory infection

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Symptoms Of Respiratory Disease / Lung Disease

Shortness of breath after exertion or due to a medical condition
Feeling smothered or suffocated as a result of breathing difficulties
Labored breathing
Tightness in the chest
Rapid, shallow breathing
Heart palpitations
Coughing
Clearly audible, loud, labored breathing
An anxious, distressed facial expression
Flaring nostrils
Protrusion of the abdomen and/or chest
Gasping
Cyanosis (pale or blue face, mouth, lips, or extremities)
Anxiousness,
Bloody sputum,
Chest injury
Chest pain,
Chest tightness
Cough
Dizziness
Fainting,
Fatigue
Heart palpitations,
Labored breathing,
Neck pain,
Pain with inspiration (pleurisy)

Diagnosis Of Respiratory Disease / Lung Disease

Other tests you might have include

Pulse oximetry – a device is clipped to your finger or ear lobe, and a light on it measures how much oxygen is in your blood.
Blood tests, including a complete blood count (CBC) – to see if you have anemia (when your body doesn’t make enough red blood cells) or infection and other tests to check for a blood clot or fluid in your lungs.
Chest X-ray or a computerized tomography (CT) scan – to see if you have pneumonia, blood clot in your lung, or another lung disease. A CT scan puts several X-rays taken from different angles together to make a more complete picture.
Electrocardiogram (ECG) – to measure the electrical signals from your heart to see if you’re having a heart attack and find out how fast your heart is beating and if it has a healthy rhythm.
Patients should be tested for electrolyte abnormalities – endocrine disorders (specifically hyperthyroid) drug-induced causes, infections, drug or chemical withdrawal, and echocardiography to check for structural heart disease. In patients presenting with ischemic stroke and with no prior history of AF, 72-hour Holter monitoring improves the detection rate of silent paroxysmal.[rx]
Screening spirometry – Can assess how much air you can breathe
Complete pulmonary function testing – Can evaluate your breathing capabilities in more detail than screening spirometry by measuring how much air you can breathe in and out, as well as how quickly
Arterial blood gas measurement – Provides a measure of the oxygen content of your blood, which alerts your doctors if you are becoming low in oxygen
Echocardiography – May be ordered if your EKG suggests that you have heart disease
Standard exercise treadmill testing – Evaluates your breathing when you have increased oxygen demands
Complete cardiopulmonary exercise testing – Evaluates your heart and lung function in detail.
Chest CT scanning – A CT scan is more sensitive than a chest radiograph in the evaluation of small pneumothoraces and pneumomediastinum, although the clinical significance of these occult pneumothoraces is unclear, particularly in the stable non intubated patient.[rx] The occult collapsed lung is being diagnosed more frequently as methods of evaluating and diagnosing trauma patients become more sensitive. At present, CT scan is the gold standard for detecting occult traumatic collapsed lung not apparent on supine chest X-ray radiograph.[rx]
Ultrasonography – Use of bedside ultrasonography in the diagnosis of the collapsed lung is a relatively recent development. In some trauma centers, collapsed lung detection is included as part of their focused abdominal sonography for trauma (FAST) examination.[rx] Ultrasonographic features used in the diagnosis of the collapsed lung include the absence of lung sliding (high sensitivity and specificity), absence of comet-tail artifact (high sensitivity, lower specificity), and presence of lung point (high specificity, lower sensitivity). In a study, ultrasonography performed on patients with blunt thoracic trauma had 94% sensitivity and 100% specificity for collapsed lung detection compared with spiral CT scanning[rx,rx].
Arterial blood gas analysis – Arterial blood gas (ABG) does not replace physical diagnosis nor should treatment be delayed while awaiting results if the symptomatic collapsed lung is suspected. However, ABG analysis may be useful in evaluating hypoxia, hypercarbia, and respiratory acidosis.
Electrocardiography – In left-sided pneumothorax electrocardiogram (ECG) shows rightward shift of the frontal QRS axis, diminution of the precordial R voltage, decrease in QRS amplitude, and precordial T-wave inversion. With right collapsed the lung, ECG may show diminution of the precordial QRS voltage, right axis deviation, and a prominent R wave in V2 with associated loss of S wave voltage, mimicking posterior myocardial infarction. All these changes are thought to be due to mechanical effects and should not be taken for cardiac ischemia or infarction.

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Treatment Of Respiratory Disease / Lung Disease

Initial Stage

An important step in managing lung disease the cause, such as the tumor or a blood clot/ COPD. The doctor may also recommend the following to help relieve your symptoms

Receiving extra oxygen
Sitting in front of a fan
Breathing cooler air by lowering the temperature in a room
Breathing cleaner air by opening a window, using a humidifier, or getting rid of smoke and pet dander
Getting a sense of open space by seeing a view of the outside, opening windows, or being in an empty room
Keeping your head lifted, for example, by using pillows so that you are nearly sitting
Practicing techniques that take your focus away from the problem, such as relaxation and meditation
Bronchodilator to open your airways
Clean the air – Use an air cleaner with a HEPA filter. This will help cut down on allergens that often lead to asthma attacks.
Try breathing exercises – They can help your lungs work better, which helps with asthma symptoms like wheezing. Try these:
- Pursed lip breathing – Breathe in through your nose, and breathe out twice as long, with your lips pursed.
- Belly breathing – Breath in through your nose. Pay attention to how your belly fills with air (put your hands on it). Breathe out through your mouth for at least 2 to 3 times as long as you breathed in.

Pharmacological Treatment

Taking pain medications, such as morphine, nitroglycerin, montelukast that help control the central nervous system.
Bronchodilators to open your airways
Steroids to help reduce swelling in the lungs
Antianxiety medicines to help break the cycle of panic. This cycle can lead to more breathing problems.
Pain medicines to make breathing easier

Asthma: Your doctor will likely prescribe

Bronchodilator – This medication eases inflammation and opens your airways.
Inhaled corticosteroids to ease inflammation
Leukotriene receptor antagonists that help prevent asthma and allergy symptoms

There are pharmacologic and non-pharmacologic treatments. Pharmacologic interventions can be thought of as disease-modifying when they treat the underlying disease that triggered the lung disease. A symptom-based approach aims to reduce awareness of the intensity and discomfort of dyspnea.[rx][rx]

Antibiotics – If your doctor or healthcare provider suspects that you have a lung infection, he or she may order antibiotic pills or intravenous (IV), depending on how severe your illness is, and your overall health status. Commonly prescribed antibiotics for bronchitis, pneumonia and respiratory (wheezing) problems include azithromycin and levofloxacin. If you are prescribed antibiotic pills, take the full prescription. Do not stop taking pills once you feel better.
Antianxiety medications – If you are experiencing anxiety with your dyspnea, depending on the cause, your healthcare provider may prescribe an anti-anxiety medication, called an anxiolytic. These medications will help you to relax. These may include lorazepam or alprazolam. It is important to take these medications only when you are feeling anxious. Do not operate heavy machinery, or drive an automobile while taking these. These medications must be used very cautiously if you have severe dyspnea. Discuss the risks and benefits of taking this medication with your doctor or healthcare provider.
Anticholinergic agents – these drugs are given to persons with chronic bronchitis, emphysema, and chronic obstructive lung disease (COLD). Anticholinergic agents work in a complex manner by relaxing the lung muscles, which will help you to breathe easier. A commonly prescribed drug is ipratropium bromide.
Bronchodilators – These drugs work by opening (or dilating) the lung passages, and offering relief of symptoms, including shortness of breath. These drugs, typically given by inhalation (aerosol), but are also available in pill form.
Beta-adrenergic receptor agonists (beta-agonists) – Beta-agonists can be considered bronchodilators, as these drugs relax airway smooth muscle, and block the release of substances that cause bronchoconstriction, or narrowing of your lungs if you are having a lung “spasm.” Drugs such as albuterol, or terbutaline, are commonly used.
Corticosteroids – Steroids work by decreasing inflammation and swelling, which may be present with certain lung disorders. People may benefit from steroids, either inhaled, by pill form, or in the vein (IV).
Beclomethasone – an inhaled steroid, is useful in the treatment of chronic asthma and bronchitis. Inhaled steroids act directly on the lung tissue, so there are fewer long-term side effects, compared with a pill or IV form. People who have an outbreak of severe shortness of breath and airway inflammation may be ordered a steroid pill, such as prednisone, for a short period of time. This is usually given with inhaled steroids. Patients with severe asthma may require IV administration of another steroid, methylprednisolone.
Cough medications/Decongestants – may help you to be more comfortable if you are coughing a lot. Guaifenesin is an active ingredient in many cough medications, may be given alone, but is often combined with other drugs, such as codeine, to help your cough. Guaifenesin may also be combined with pseudoephedrine as a decongestant, or anyone of many medications, depending on your symptoms. Another common medication you may receive is Hydrocodone Bitartrate-Homatropine Methylbromide. This is a narcotic antitussive (anti-cough medication), which will help relieve your cough.
Diuretics – may be known as “water pills” as they work to prevent or treat lung congestion by making you urinate out extra fluid. Some examples of this medication may include furosemide and Hydrochlorothiazide. You may receive this medication alone or in combination with other medications.
Oxygen therapy – If you are experiencing shortness of breath at rest, or on exertion, your healthcare provider may see if oxygen therapy is right for you. You may take oxygen when your symptoms are at their worst. For example, some people are only on oxygen at nighttime, and not during the day. Some take oxygen when they are performing activities, but not all the time.

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Physiotherapy Management of Respiratory Disease / Lung Disease

To reduce work and difficulty of breathing

Body positioning
Breathing control
Relaxation technique

To improve ventilation

Localized thoracic expansion exercise

Sputum mobilization techniques

Postural drainage
Deep breathing exercise
Percussion, shaking, and vibrations

Sputum removal techniques

Coughing and huffing
Airway suctioning

Physiotherapy outcome evaluation includes

Respiratory rate
Breathing pattern
Sputum quantity
Auscultation
Cough sound
Oxygen requirement
SpO2
Arterial blood gases
Chest x-ray changes
Muscle strength
Functional performance

References

Respiratory disease

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What Is Respiratory Disease; Type, Causes, Treatment

What Is Respiratory Disease; Type, Causes, Treatment

Types of Respiratory Disease / Lung Disease