What are respiratory conditions?
They are any condition that affects the respiratory system (the nose, throat, windpipe and lungs).
In children, the conditions may be chronic or congenital such as asthma or cystic fibrosis and require lifelong management. Other conditions are short lived and treatable such as viral or bacterial infections e.g. croup or bronchiolitis.
In Adults, the conditions may be a result of lifestyle choices (e.g smoking), environmental factors, allergies, acute infections or chronic conditions such as asthma or bronchiectasis.
Obstructive Conditions
What is Asthma?
Asthma is a common respiratory condition resulting in a chronic inflammatory disorder, causing obstruction of airways. Irritants such as dust, allergens, viruses or even just cold air can trigger an inflammatory response, or cause constriction of the smooth muscles of the bronchial walls. When this happens, the small airways of the lungs become occluded, making it hard to breathe. Management with medication such as an inhaler is generally easy and effective, as well as clearance and breathing techniques.
What is Bronchiectasis?
Bronchiectasis describes permanent dilation of the airways of the lungs and affects the elasticity of the smooth muscle and cellular wall of the larger upper airways.
This results in greater difficulty clearing secretions from the lungs, which in turn leads to greater frequency of infection. This begins a cycle of further damage, inflammation, greater mucus production and retention, ultimately leading to more infections. Management with medication, daily clearance techniques and a PEP device can help greatly with this condition.
What is Chronic Obstructive Pulmonary Disease (COPD)?
The presentation of COPD varies between individuals but is generally some combination of symptoms typical of Chronic Bronchitis, Emphysema and Asthma. For a case to be clinically defined as COPD the individual must present with a chronic productive cough for a total of 3 months each year, for at least 2 consecutive years.
COPD is a permanent degenerative condition that requires continual management of symptoms through therapy and medication. Some sufferers may require oxygen therapy, while others are well managed with inhalers.
People with COPD describe shortness of breath on exertion, and can also have trouble clearing secretions. Management under a Respiratory specialist, focussing on medication, exercise (pulmonary Rehabilitation), clearance techniques and strengthening programs (including IMT) is recommended to maximise function.
What is Cystic Fibrosis?
Cystic fibrosis is the result of a genetic defect, the specific gene affected being responsible for coding a specialised protein that controls the secretion of chloride across epithelial cell walls and the corresponding absorption of sodium and water.
The poor control of chloride and sodium across the cell walls lining the lungs, means the mucus coating these walls is more viscous and stickier. More bacteria is caught in the sticker mucus, but its thicker consistency makes it hard to clear from the lungs. The trapped bacteria that cannot be effectively cleared leads to higher frequency of infection and corresponding bouts of inflammation.
What is Emphysema?
In people with emphysema, the air sacs, or alveoli, of the lungs are damaged. This causes the small airways to collapse when air is breathed out, which makes it hard for air to flow into the lungs and even harder for it to flow out. Over time, the lung tissue becomes stiff and cannot take oxygen into the body as effectively.
People with emphysema typically experience shortness of breath on exertion, and benefit from pulmonary rehabilitation and breathing control techniques. Inspiratory muscle training may also help to reduce dyspnoea, and hand held fans can reduce the sensation of breathlessness during and after performing a task.
Restrictive Conditions
A restrictive respiratory condition leads to the inability to effectively fill the lungs with air.
The resulting effect is that insufficient air enters the lungs with each breath, leading to increased respiratory rate and the use of accessory muscles during breathing. This compounds the problem by making the act of breathing less efficient and tiring.
Many of the symptoms of obstructive and restrictive respiratory illness are similar. Shortness of breath is common and has the most immediate effect on the patient. For most people the restriction is only evident with exertion, however, with severe conditions shortness of breath can occur even at rest. A persistent cough and excess sputum production can also be symptoms.
What is Pleural Effusion?
The pleural space is a thin layer of fluid between the inner wall of the chest cavity and the outer wall of the lungs. The layer of fluid acts as a lubricant between the two surfaces as they move up and down in relation to one another.
Pleural effusion occurs when excess fluid builds up within the pleural space. This either results from increase production of fluid or an inability to properly drain it. The effect is an increased separation of the pleural layers reducing the effectiveness of the chest wall. Depending on severity it can result in partial collapse of some lower airways, reducing the available lung space for gas exchange. It can cause fatigue and breathlessness, with increased risk of developing further infections.
What is Pleurisy?
The lungs are covered by a close fitting, thin lining called the visceral pleura. A second thin lining, called the parietal pleura, covers the inner wall of the chest cavity. Between these two layers is a small amount of pleural fluid to reduce friction as the two surfaces move against each other during the action of breathing.
Pleurisy describes sharp chest pains that result from inflammation of the pleural layers and the subsequent friction as these layers rub together. Pleurisy can symptomatic of other underlying conditions.
What is Pneumonia?
Pneumonia is a serious infection of the respiratory system. It can be viral or bacterial. Usually recovery from pneumonia can be slow, with shortness of breath, secretion production and persistent cough sometimes lasting for a few months after treatment.
What is a Pulmonary Embolism?
Small clots form in the blood stream all the time, made of red blood cells, platelets and some fibrin. These may travel some distance through the circulatory system before they break apart again. They form an important quick response to the bodies clotting needs in the event of injury.
In the case of a pulmonary embolism the blood clot usually forms in the larger vessels of the lower limbs before being swept along, passing through the right-hand chambers of the heart and entering the lungs.
Once the large clot reaches the lungs it can become trapped in the narrower vessels where gas exchange takes place. This blockage can cause a drop in oxygen passing into the blood inducing hyperventilation, along with increased vascular resistance straining the right side of the heart. If the pressure on the heart is severe, from multiple blockages, then heart failure can occur.
What is Pulmonary Fibrosis?
Pulmonary Fibrosis (PF) is a type of rare lung disease that causes the tissue (interstitium) around the air sacs (alveoli) within the lungs to become thickened and scarred – this is called fibrosis. This scarring makes the lungs stiff which makes it increasingly difficult to breathe deeply. This stops the efficient delivery of oxygen into the bloodstream where it is needed to be transported to the rest of the body.
There are many types of PF. Some people with PF may already have features of other associated conditions such as rheumatoid arthritis or scleroderma. Idiopathic Pulmonary Fibrosis (IPF) is a specific disease where the underlying cause is unknown.
Pulmonary rehabilitation can help you manage symptoms and improve daily functioning. Pulmonary rehabilitation programs focus on:
- Physical exercise to improve your endurance
- Breathing techniques that may improve lung efficiency
- Counselling, education and support