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Lung Fibrosis

By Dr. Inder Mohan Chugh in Pulmonology

Jul 19 , 2022 | 4 min read

1

Lungs are the organs responsible for supplying our bodies with oxygen. Every time we breathe in air, the lungs expand and fill with oxygen. When we breathe out, the carbon dioxide produced in our bodies is expelled. Lung fibrosis refers to the scarring (stiffening) of the lungs.

It gets difficult for the lungs to fill and expand with oxygen. Hence a person with lung fibrosis may find it difficult to breathe. The breathlessness may worsen over time. There is a drop in oxygen levels; blood tissues and cells may not get the right amount of oxygen they need. This can lead to the patient feeling tired and less active.

The risk factors for developing lung fibrosis include:

  1. Smoking

  2. Advancing age

  3. Rheumatoid arthritis

  4. Genetic

  5. Breathing in harmful chemicals

  6. Continued exposure to dust

  7. Fumes inhaled by stone cutters or polishers

  8. Viral infections

  9. Exposure to radiation during cancer treatment

  10. Some medications, such as anticancer medicines

The common symptoms of a person with lung fibrosis include:

  1. Difficulty in breathing or breathlessness, especially after exercise

  2. Breathing in short, shallow spurts

  3. A persistent dry cough

  4. Unexplained weight loss

The doctor arrives at the diagnosis of lung fibrosis by:

  1. Conducting blood tests to rule out other diseases

  2. X-ray, CT scan

  3. Breathing tests to test lung function, oxygen saturation testing after a 6-minute

  4. A biopsy (a piece of lung tissue is taken and examined under the microscope to see the changes in the lung tissue)

The complications of lung fibrosis include:

  1. Development of lung cancer

  2. Heart failure

  3. High blood pressure in the lungs

Lung fibrosis is not reversible. But, we have drugs that can help reduce the progression of lung fibrosis. They may relieve the symptoms of breathlessness and improve the patient's quality of life. Oxygen therapy is another option. Finally, lung rehabilitation provides a unique exercise program to help perform daily routine activities with minimized breathlessness.

A person with lung fibrosis must vaccinate against common infections such as influenza. They may have reduced immunity, so they must avoid contacting people with a viral infection.

Currently, there is no cure for lung fibrosis. But ongoing research may bring hope to future lung fibrosis patients!

Idiopathic Pulmonary Fibrosis (IPF)

Idiopathic pulmonary fibrosis (IPF) is a kind of lung disease. It is associated with scarring of lung tissue which makes the lungs stiff. It can be difficult for patients to breathe in and take in oxygen. The term 'idiopathic' means the cause is not known.

The risk factors for developing IPF are:

  1. Advancing age

  2. Smoking

  3. Viral infections

  4. Long periods of exposure to asbestos dust or metal dust

  5. Air pollution

  6. Bird droppings

  7. Some gases

The doctor arrives at the diagnosis of lung fibrosis by conducting:

  1. Blood tests to rule out other diseases, infections

  2. X-ray, CT scan

  3. Breathing tests to test lung function

  4. Biopsy (a piece of lung tissue is taken and examined under the microscope to see the changes in the lung tissue)

The diagnosis of IPF is often delayed as it is mistaken that the breathlessness may be due to asthma or heart disease. IPF cannot be cured. However, treatment can help control the disease and improve symptoms. There are two drugs currently available globally and in India to reduce lung fibrosis or stiffening of the lungs in patients with IPF.

These drugs are nintedanib and pirfenidone. They slow down the stiffening process in the lungs, reduce or slow down the decrease in lung function and help improve life expectancy. Most patients can tolerate this therapy. Both nintedanib and pirfenidone reduce the decline in lung function in patients with IPF.

Supplemental oxygen

Can help oxygenate your blood even more. Some people may need to use oxygen at all times. Others may need it when they sleep or exercise. Oxygen therapy keeps the oxygen level in the blood above a certain level, reducing breathlessness. Therefore, it can help people with IPF stay more active throughout the day. The amount of oxygen required for each patient will vary and is decided by the doctor. 

Breathing methods

These can help the patient cope with shortness of breath.

Pulmonary rehabilitation

This exercise and education program can help the patient gain strength and independence.

Lifestyle changes

Stopping smoking is important. Adopting a healthy diet and an exercise program can help improve the immunity and overall health of the patient with IPF.

HP- How pigeon breeding leads to HP, and it is a common ritual in India, followed by management

We often see people feeding pigeons in India. But beware! Pigeon feeding can cause harm to humans due to the release of certain fungi in their droppings. Inhaling or coming in contact with the droppings can cause harmful diseases.

The people at high risk of developing life-threatening infections and diseases are people with diabetes, the elderly, or those with low/weak immunity.

Hypersensitivity pneumonitis (HP) is a disease associated with breeding/feeding pigeons. Inhalation of materials released into the air by breeding pigeons can lead to lung injury and pneumonia secondary to an allergic reaction. This can cause stiffening of the lung tissues.

HP can occur in two forms- the acute form occurs within a few hours of exposure to pigeons. The person complains of high-grade fever with chills, dry cough and tiredness or fatigue. HP can be fatal if it becomes a chronic disease. The patient has symptoms such as cough, progressive breathlessness after mild to moderate exertion, fatigue, and weight loss. Chronic HP may lead to respiratory failure.

The doctor can make a diagnosis by taking the patient's history, X-rays, CT scan of the lungs, some blood tests and testing the fluid aspirated from the air passages in the lungs.

Treatment of the acute type of HP is by advising the patient to avoid exposure to pigeons. Sometimes drugs such as steroids may be used to provide relief from symptoms. In patients with chronic HP, lung fibrosis may occur. These patients may also be given steroids and require oxygen therapy if lung fibrosis occurs.

Hence it is crucial to AVOID Pigeon feeding or breeding!

Keep your Lungs safe!!


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