Pulmonary fibrosis is a disease that manifests itself in the formation of scar tissue in the lungs that impairs respiratory function. It reduces the elasticity of the organ, due to which oxygen is more difficult to pass through the alveoli, in which air contacts the blood. And unfortunately, the reverse process of regeneration of connective tissue into the lung is not possible.
What causes fibrosis? What symptoms indicate its presence? What to do if the diagnosis is confirmed? This is what will be discussed now.
Causes
As a rule, pulmonary fibrosis occurs as a complication after infectious or catarrhal diseases. In some cases, external factors may play a role. The list of provoking factors is as follows:
- Tuberculosis.
- Complications after SARS and influenza.
- Pneumonia.
- Atrophy of the sclera.
- Rheumatoid arthritis.
- Infectious liver diseases (usually hepatitis or cirrhosis).
- Lupus.
- Genetic predisposition to cancer.
- Polluted environment. For example, the content in the air of asbestos dust, heavy metals, emissions from heating plastic, crumbs of lead and zinc.
- The abuse of alcohol, nicotine and drugs.
- Chemotherapy and enhanced antibiotic treatment.
But sometimes there is also no cause of pulmonary fibrosis. What is it then? This phenomenon is called an idiopathic disease. Such cases are studied especially carefully, and the patient has to undergo a complete diagnosis so that at least the experts can detect the prerequisites. Because the treatment of the disease without identifying its cause is impractical.
Pulmonary fibrosis - cancer or not?
Many people ask this question. The fact that fibrosis is cancer is actually a delusion. Yes, lung scars are a pathology. Healthy tissue is replaced by connective tissue due to increased collagen production. The process develops, and as a result, a rough scar forms.
But! Connective tissue in this disease extends only to a certain limit. It does not give screenings and does not cause foci in other organs. So fibrosis cannot be cancer in any way.
initial stage
Talking about what it is - pulmonary fibrosis, and how to treat this disease, it is necessary to consider the symptoms indicating its presence.
The initial stage usually proceeds without any manifestations. This significantly complicates the early diagnosis, and therefore it is impossible to start timely treatment.
A person should be alert for shortness of breath, which appears at the time of exercise. The problem is that not everyone pays attention to it. And shortness of breath is a common symptom among other diseases that are not associated with the lungs.
Therefore, each person is recommended to undergo fluorography once a year, which helps to detect signs of this ailment.
Early manifestations
Depending on the cause of pulmonary fibrosis and the breadth of its spread, symptoms have varying degrees of severity. As a rule, the disease manifests itself in the following signs:
- Dry cough. Subsequently, purulent sputum appears.
- Pallor of mucous membranes and skin. In the worst cases, cyanosis (cyanosis) occurs.
- Shortness of breath, which occurs even with minor exertion. In the worst cases, after waking up.
- Severe chest pain.
- Difficulty breathing, severe wheezing.
- Weakness, headaches and dizziness. This is due to a lack of respiratory activity and a deficiency of oxygen in the blood.
- Frequent occurrence of colds. At times, such severe as emphysema, pneumonia and bronchitis.
- Swelling of the nail phalanges on the hands.
- Sweating.
In especially severe cases, the development of heart failure begins.
Types of disease
Since we are talking about what it is - pulmonary fibrosis, how to treat this disease, and what symptoms indicate its presence, it should also be noted that there are several types of ailment. Namely:
- Interstitial. The reason for its development is the impact of negative external factors.
- Perilobular Connective tissue appears against lobar ligaments.
- Perivascular. It is characterized by the localization of connective tissue around the inflamed vessels.
- Alveolar. It appears in the thickening of the alveolar membrane.
- Peribronchial. It is formed on tissues near the bronchi.
What type of disease struck the lungs of a person, will be determined during the diagnosis. The doctor will also tell you what form of the disease he has. There are only two of them, and each of them will be briefly described now.
Focal form
As already mentioned, the symptoms of the disease, regardless of its type, are almost identical. But focal pulmonary fibrosis does not attract attention to itself the longest. For months, or even years, he may not manifest himself in any way. All because of its local size.
But over time, foci grow more and more. Quite often, they combine with each other in complexes of connective tissue. And when this happens, focal pulmonary fibrosis makes itself felt - all of the above symptoms begin to appear.
This is a dangerous form of the disease. Long ignoring the ailment often leads to pneumocirrhosis - a condition where the lung is completely replaced by connective tissue. In this state, it, of course, is completely incapable of ensuring the circulation of oxygen in the body. Therefore, in order not to bring this up, it is necessary to immediately begin treatment of focal pulmonary fibrosis.
It is important to make a reservation that most often this form of the disease occurs due to sarcoidosis, which manifests itself in the formation of nodular formations (granulomas).
Diffuse shape
This disease is also called total pulmonary fibrosis. It is characterized by uniform tissue involvement by the pathological process.
People who are diagnosed with this ailment rarely have a good prognosis. Patients with focal pulmonary fibrosis (linear or otherwise) are more likely. Because with a diffuse disease, the symptoms develop rapidly, and you need to act quickly.
Diagnostics
The first thing a pulmonologist learns from a patient is whether he has shortness of breath, general weakness, persistent cough, and asymptomatic weight loss.
Then he inquires about when the person noticed the first symptoms and whether there was an increase in their intensity. The doctor will also ask if the patient was sick with pneumonia, tuberculosis, systemic scleroderma, rheumatoid arthritis.
To establish an accurate diagnosis, a pulmonologist necessarily carries out instrumental and laboratory studies:
- Listening to the lungs (auscultation).
- Tapping (percussion).
- Detection of lung volume and respiratory function (spirography).
- Roentgenography. It helps to detect if there is a change in lung tissue.
- MRI or computed topography. Using this method, it is possible to identify the details of pathological changes and study their nature.
- Biopsy. Histological examination helps confirm or rule out the presence of cancer cells and examine in detail the condition of the lungs.
After that, the doctor will be able to give competent recommendations to the patient and prescribe adequate, effective therapy.
It must be remembered that the diagnosis takes time, and it is very valuable when it comes to such a serious disease. Therefore, you need to go to the doctor at the slightest manifestations of the disease.
Treatment
Fibrosis of the roots of the lungs cannot be cured. As mentioned earlier, connective tissue is not able to regenerate back to healthy. However, to improve the quality of human life is real.
Therapy is prescribed by a highly qualified specialist pulmonologist after a full examination. Immunosuppressants, cytostatics and glucocorticoids help to cope with a severe form of the disease.
Also, since lungs affected by fibrosis are a good environment for the development of pathogenic microorganisms and inflammation, it is necessary to drink antibacterial drugs. Cardiac glycosides and oxygen inhalations also help.
If a patient with pulmonary fibrosis suffers from a severe cough and shortness of breath, then you will have to drink bronchodilator drugs.
But one drug treatment in the case of this pathology will not work. Therapy is supported by respiratory therapeutic exercises and oxygen therapy.
Unfortunately, to date, there are no specific treatment methods. The pathological process is irreversible, but the doctor’s task is to prevent its progression and the attachment of any infection.
Operation
Continuing to talk about the prognosis, symptoms and treatment of pulmonary fibrosis, it should be noted that in especially severe cases, transplantation cannot be dispensed with. Of course, organ transplant surgery is not suitable for everyone, since in many patients the age exceeds the upper limit for its implementation. Moreover, it is indicated only with total fibrosis.
The operation is performed to replace one or both of the lungs at once - in the event that they are not able to carry out the transfer of oxygen and carbon dioxide.
There are a number of contraindications. These, in addition to age, include:
- Ongoing infections.
- Hepatitis and HIV.
- Cancerous disease (current or previous).
- Diseases of the kidneys, heart and liver of a chronic nature.
In order to receive a referral for transplantation, a person will have to undergo a series of tests that will help give a full assessment of his general health and to understand whether he is suitable for transplantation.
Diet and regimen
A person with pulmonary fibrosis will have to completely reconsider his lifestyle if he really wants to extend it. Here's what you need to learn:
- Drugs taken to treat the disease reduce immunity. Therefore, annual vaccinations against influenza and once every 5 years against pneumococcus will have to take place.
- With an increase in temperature and deterioration, bed rest is indicated. It is necessary to observe it until normalization of health.
- It is necessary to provide a constant flow of fresh air to the room where a person spends time. And walk regularly.
What about diet? Diet for this disease is aimed at accelerating oxidative and immunobiological processes in the body, improving blood formation and the cardiovascular system, reducing protein loss and increasing lung repair.
As a rule, doctors prescribe a diet No. 15 or No. 11. If we talk about general recommendations, it is necessary to include in the diet products with a high content of ascorbic and folic acids, copper, potassium, calcium, vitamins A and B.
You need to eat often, but in small portions. You will also have to abandon table salt, as it retains fluid.
Forecast
Unfortunately, with pulmonary fibrosis, life expectancy cannot be the same as in a completely healthy person. After all, this ailment causes malfunctions of the respiratory function. And this provokes irreversible pathological changes that affect the quality of life.
Of 10 patients, 2 are diagnosed with an acute form of the disease. With her, life expectancy is about 1 year, during which the person’s condition worsens. He has severe breathing problems, can lose 15-20 kilograms in a couple of months.
Persistent fibrosis (chronic, persistent) does not develop so quickly. With him, life expectancy is about 5 years.
The best predictions are given to patients with a slowly progressing illness. In this case, the life expectancy reaches 10 years.
However, these figures are hardly objective. It all depends on the neglect of the case, the effectiveness of treatment, patient compliance with the recommendations.