There are many different respiratory diseases, all of which manifest as shortness of breath, coughing and declining performance. Smoking and air pollution are the number one causes, but even nonsmokers in low-pollution environments can get sick. Some respiratory diseases are infections, others have an autoimmune cause, and for some rare diseases science has not yet found answers.
What are respiratory diseases?
Respiratory diseases can affect the upper and lower airways, thus extending from the trachea through the bronchial system to the pulmonary alveoli. Some also subsequently affect the blood supply to the lungs, leading to pulmonary hypertension. Accordingly, respiratory diseases can vary in severity. A rough distinction is made between obstructive and restrictive respiratory diseases. Common complaints are cough, sputum, shortness of breath and decreasing performance.
Causes
From the perspective of the underlying cause, it is useful to distinguish obstructive from restrictive airway disease. In this context, obstruction refers to a narrowing or blockage of the airways, such as may be present in an asthma attack, chronic bronchitis, or an inward-growing brochnial tumor. Restrictive, in contrast, means that the distensibility of the lung tissue, the basis of each individual breath, is reduced and thus simply less air can be drawn into the lungs. This problem is mainly present in diseases of the lung tissue such as pneumoconiosis or pulmonary fibrosis. Not included in this scheme are diseases such as pneumonia, in which there is a combination of both problems, or pulmonary embolism, in which the blood supply to the lungs is cut off by a blood clot. Strictly speaking, therefore, it is also a circulatory disease or an absolute emergency rather than a respiratory disease in the strict sense.
Symptoms, complaints, and signs
Respiratory diseases are very diverse and can therefore have very different symptoms. However, all types of respiratory diseases have in common that breathing becomes difficult. This can be due, for example, to increased mucus production, swelling of the airways, or pain in the airways. In most cases, there is also a cough with varying degrees of sputum. Depending on the localization of the disease, different symptoms occur. Sinus infections, for example, are accompanied by congestion. Mucus is also secreted. Sinus involvement can also trigger pain. Respiratory diseases of the throat and trachea, on the other hand, tend to be accompanied by a scratchy feeling and – occasionally – severe pain. The latter are usually due to coughing, which becomes more severe the more irritated the airways are. Involvement of the bronchi and lungs is generally associated with more severe symptoms than upper respiratory tract infection. In severe cases, there is shortness of breath and hoarseness, which extends to temporary loss of voice. The breathing rhythm is disturbed in most cases. Respiratory diseases that are or become chronic can also lead to permanently reduced performance because the oxygen supply to the body is not optimal. In severe cases, this can also affect the heart and other organs.
Forms and types
The “classic example” of an obstructive respiratory disease is bronchial asthma: here, for mostly genetic reasons, there is an allergy to certain substances or a hypersensitivity to cold air, stress or harmless infections, which leads to a constriction of the smallest bronchial tubes. Seizure-like shortness of breath is the result. The problem is then not so much taking a breath – the diaphragm is initially strong enough to overcome the resistance – but rather exhaling the air. This is where asthmatics have the greatest difficulty; overinflation of the lungs and impaired oxygen transport are the result. Chronic obstructive pulmonary disease, also known as chronic bronchitis or COPD (chronic obstructive pulmonary disease), has the same problem. The cause in the vast majority of cases is smoking. If COPD affects a non-smoker, it is usually caused by an alpha-1 antitrypsin deficiency.This leads to a permanent disturbance of the bronchial self-cleaning function, resulting in a chronic cough with mucous sputum and frequent infections. In the long term, many people with COPD will eventually need to be supplied with an oxygen cylinder at home. In the short term, both the asthmatic and the COPD sufferer are helped by emergency sprays of bronchodilator agents and by continuous therapy with glucocorticoid sprays to suppress inflammation. Restrictive airway diseases include idiopathic pulmonary fibrosis. The word “idiopathic” always signals in medicine that no one knows the cause of this disease. However, fibrosis, i.e. a thickening of the lung tissue, occurs, which massively impedes the transport of oxygen across the walls of the alveoli, leads to chronic irritable cough and, in the long term, causes high pressure in the pulmonary bloodstream. Suppression of the immune system with sprays or tablets is often the only therapeutic option for this disease.
Complications
The possible complications of respiratory disease depend on which condition is present. Acute bronchitis usually has no complications and heals completely within a few days to weeks. In the case of a descending (descending) infection, there is a risk of pneumonia. The most serious complications of pneumonia are acute progressive respiratory distress syndrome (ARDS) and sepsis. Frequent recurrences of acute bronchitis can damage the bronchial mucosa, promoting chronicity of the disease. Sudden deterioration (excerbation) is the most common complication of chronic bronchitis. Increased secretion production can lead to bacterial infection, which acutely worsens the clinical picture. The transition of chronic bronchitis to chronic obstructive pulmonary disease (COPD) is feared. If the infection descends into the alveoli, damage can occur, leading to emphysema. Obstruction additionally promotes the development of right heart failure (cor pulmonale). The greatest danger of COPD is the occurrence of acute exacerbations that result in permanent loss of lung function. The most dangerous complication of bronchial asthma is status asthmaticus. This is a very frequent or long-lasting, severe attack that is not infrequently life-threatening. As a consequence of bronchial asthma, pulmonary emphysema and right heart strain or right heart failure may develop.
When should you see a doctor?
Respiratory diseases are among the most common illnesses. In young children, parents should always consult a physician. A child’s immune system is not yet fully developed. Childhood respiratory illness can take a dramatic course with high fever and whistling breath. In this case, rapid and professional treatment must be given. Some things that seem like respiratory illness can be caused by an object stuck in the nose. In adults, colds with coughs and runny noses can be self-treated at first. Bed rest and inhalations are often good remedies for cold-related respiratory symptoms. A visit to the doctor is only necessary in the case of a more serious respiratory illness, for example because of a sick leave. However, the situation is different in the case of chronic obstructive pulmonary disease (COPD), asthma or incipient pneumonia. Here, visits to the doctor are absolutely necessary. Such diseases can be recognized by the more dramatic symptoms. If an initially normal respiratory disease worsens or does not improve in the usual time, a doctor should be consulted urgently. Sometimes self-treatment is not fruitful. In this case, it is necessary to investigate whether more appropriate measures need to be taken. A respiratory illness that has been spread, such as a true flu, can have consequences such as pleurisy or myocarditis. Asthma can also be caused by allergies. In this case, a pulmonary specialist or allergist may need to be consulted.
Treatment and therapy
Connections with dust exposure in the city, in the countryside or at the workplace are proven to many other restrictive lung diseases, which are often named after their origin: Thus, there is dust lung, farmer’s lung, quartz lung, cheese washer’s lung, vintner’s lung, and many more.Here, too, immunosuppression and, of course, elimination of the triggering dust is the therapy of choice. Pneumonia and acute bronchitis are infections of the respiratory tract. Bronchitis takes place higher up, is almost always viral in origin and leads primarily to a dry and painful cough. In pneumonia, viruses and bacteria can be involved, so it can usually be treated specifically with antibiotics. In addition to the cough, which can also be productive, fever, chills and sometimes shortness of breath are the main symptoms. An x-ray can usually provide information. The flu and the common cold are also acute respiratory diseases. Bronchial carcinoma, the most common cancer of the lung, is strictly speaking counted among tumor diseases and less among respiratory diseases. Nevertheless, it should be listed here because it is mostly also promoted by inhaled toxins (smoking) and can cause the same symptoms as the respiratory diseases listed above.
Outlook and prognosis
The prognosis for respiratory diseases is highly variable. For example, there are many different respiratory diseases that can be chronic or acute. Furthermore, there are those that are due to direct damage to the respiratory tract and those that have pathologic causes. In general, most acute respiratory diseases have a good prognosis. If appropriate sparing behavior is endeavored, infections in particular can heal quickly. Clean air and, if necessary, medication, accelerate this additionally. This applies, for example, to acute bronchitis or a cold. Most people are affected several times a year by a mild form of a chewy respiratory disease. Chronic conditions, such as bronchial asthma or chronic bronchitis, on the other hand, have a different prognosis. In most cases, it is to be expected that the condition of the affected person will not improve, but that therapy will merely suppress the condition symptomatically. Accordingly, such respiratory diseases imply a permanent limitation. To what extent life expectancy is reduced is also a question of the exact disease. A progressive disease (COPD, tuberculosis, etc.) means more need for therapy. In severe cases, ongoing deterioration of the condition is to be expected. Damage to the tissue in the respiratory tract, further worsens the prognosis. Lastly, there are numerous allergies that directly affect the respiratory tract. These, too, will usually accompany the affected person for the rest of his or her life and usually cannot be cured causally. Equipped with the right medication, however, a normal life is possible.
Prevention
For general prevention of respiratory diseases, the very first thing is definitely not smoking. The connection between cigarettes and lung cancer is now common knowledge, but the fact that there are other agonizing diseases such as COPD that are directly related to smoking is not known to most smokers and, from the perspective of society as a whole, should increasingly become part of health education in the future. In addition, exposure to pollutants in the workplace is an enormous risk factor for many respiratory diseases. Prescribed respiratory masks should therefore be worn without fail, a company doctor should monitor the employer’s compliance with protective measures and can also be consulted by employees for advice in case of doubt.
Aftercare
When a respiratory illness has been overcome, follow-up examinations are very important and significant to prevent a recurrence of this illness. If a bacterial infection of the respiratory tract was present, then at least one follow-up examination should take place. Only such a follow-up examination can exclude further complications. Even in the subsequent healing process, the respiratory disease can break out again. In particularly bad cases, a new infection may even occur if the disease is not properly healed. However, anyone who decides to have at least one follow-up visit for a respiratory illness can expect a smooth healing process. No major complications are likely to occur in the process, as long as the instructions of the respective doctor are followed. After a respiratory illness has been overcome, at least one follow-up examination should take place.Only such an examination can prevent possible complications.
What you can do yourself
The options for self-help in respiratory diseases depend on the type of disease. In respiratory diseases caused by infections, drinking sufficient amounts and taking in mucus-forming substances help to cough up the pathogens and thus remove them from the body. For example, chamomile, eucalyptus oil and spicy foods are considered to be mucus-forming. Gargling with warm salt water can also help mucus production in the throat. Likewise, this salt water can also be applied to nasal douches, which are supportive in this area. Coughs resulting from respiratory diseases can be soothed by sucking throat lozenges as needed. In addition, these candies are also available with various active ingredients that can be antibacterial, antispasmodic, analgesic and much more. Steam baths and inhaling essential oils and medicinal plants in hot water also help to soothe the respiratory tract and stimulate mucus production. Respiratory diseases that are chronic or result from damage to the respiratory tract are also helped by decongestive measures and, if necessary, pain relief from the outside by warm compresses and the like. It is especially important to avoid substances that can further irritate and weaken the respiratory system. Cigarette smoke, dust and chemical fumes should be avoided. If necessary, simple respiratory masks may be used to protect a diseased respiratory system. Controlled and relaxed breathing is still important and should be practiced.
