Pulmonology

Pulmonary Diseases is a medical specialty that examines and treats issues related to the respiratory system and the chest cavity.

Physicians specialized in this field are called pulmonologists. They deal with diseases of organs such as the lungs, bronchi, pleura, and mediastinum. They also manage conditions involving the respiratory muscles.

Common diseases treated by pulmonologists include:

• Asthma

• Chronic Obstructive Pulmonary Disease (COPD)

• Pneumonia

• Tuberculosis

• Lung cancer

• Pulmonary embolism

• Sleep apnea

Pulmonologists use diagnostic methods such as pulmonary function tests, bronchoscopy, computed tomography (CT), and lung biopsy to diagnose diseases and prepare appropriate treatment plans.

Pulmonary disease specialists deal with various illnesses. These include COPD, asthma, lung cancer, pneumonia, interstitial lung diseases, and respiratory infections. These diseases can seriously affect quality of life.

Smoking and environmental factors cause lung damage. This includes bronchiectasis, sarcoidosis, pulmonary hypertension, pleural diseases, sleep apnea, and other respiratory obstructions. These conditions fall under the scope of pulmonary disease specialists. They also cover chest wall deformities and rare lung diseases.

Pulmonologists use advanced imaging techniques to diagnose diseases. These methods include computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography. Additionally, modern diagnostic tools such as pulmonary function tests, bronchoscopy, pleural biopsy, and sleep studies are utilized.

After diagnosis, they prepare treatment plans tailored to patients’ needs. Treatments may include medication, oxygen therapy, and respiratory devices. Pulmonary rehabilitation and surgical interventions are also applied when necessary.

Pulmonary medicine also involves preventive health measures and lifestyle changes alongside disease treatment. Particularly, some preventive strategies are crucial for maintaining a healthy respiratory system. These strategies include smoking cessation counseling, vaccination programs, and protection from environmental factors.

Pulmonary diseases encompass disorders and illnesses related to the respiratory system. These diseases can affect the lungs, bronchi, trachea, and other respiratory pathways.

Some main categories and examples of pulmonary diseases include:

• Common Cold: Usually affects the upper respiratory tract and presents with symptoms such as runny nose and sore throat.

• Influenza (Flu): A more severe viral infection characterized by fever, muscle aches, and cough.

• Pneumonia: Inflammation of the lungs that can be caused by bacteria, viruses, or fungi.

• Asthma: A disease marked by inflammation and narrowing of the airways, causing symptoms like shortness of breath, coughing, and wheezing.

• Chronic Obstructive Pulmonary Disease (COPD): Caused mainly by long-term smoking or air pollution, this disease restricts airflow in the lungs. Symptoms include persistent cough and sputum production.

• Primary Lung Cancer: Cancer originating in the lungs, often linked to smoking. Early symptoms may be vague.

• Metastatic Lung Cancer: Cancer that has spread to the lungs from other organs.

• Sleep Apnea: Temporary pauses in breathing during sleep, leading to poor sleep quality and daytime drowsiness.

• Bronchiectasis: Permanent enlargement and chronic inflammation of the bronchi, typically causing cough and sputum production.

• Pulmonary Fibrosis: Thickening and stiffening of lung tissue, causing shortness of breath and dry cough.

• Sarcoidosis: An inflammatory disease affecting multiple organs, including the lungs.

• Pleuritis (Pleurisy): Inflammation of the membranes surrounding the lungs, characterized by chest pain and shortness of breath.

• Pleural Effusion: Accumulation of fluid around the lungs, which may cause difficulty breathing and chest pain.

• Pulmonary Embolism: Blockage of a lung artery, usually caused by a blood clot, with symptoms such as shortness of breath, chest pain, and sometimes cough.

Symptoms of pulmonary diseases vary depending on the type and severity of the underlying condition. Common symptoms include chronic cough, shortness of breath, and chest pain. However, there are also more specific and important symptoms to watch for.

Common symptoms of pulmonary diseases include:

• Chronic Cough: A cough lasting longer than three weeks may indicate a serious respiratory issue.

• Shortness of Breath (Dyspnea): Feeling breathless especially during activity or at rest can suggest decreased lung function.

• Wheezing: May occur due to airway obstruction seen in asthma or COPD.

• Chest Pain or Tightness: Could be a sign of pleuritis (inflammation of the lung lining), pulmonary embolism, or lung cancer.

• Blood in Sputum (Hemoptysis): May indicate tuberculosis, lung cancer, or bronchiectasis and requires urgent medical attention.

• Prolonged Sputum Production: Could be a symptom of chronic bronchitis or bronchiectasis.

• Rapid or Difficult Breathing: May indicate acute respiratory failure or pneumonia.

• Fatigue and Weakness: Common in many respiratory diseases.

• Night Sweats: Can be a symptom of tuberculosis or lung infections.

• Loss of Appetite and Weight Loss: May suggest lung cancer or chronic infections.

• Recurrent Respiratory Infections: May point to immune system weakness or chronic lung disease.

• High Fever (In Infections): Seen in pneumonia or lung abscesses.

• Swelling of Fingertips (Clubbing): Seen in advanced stages of chronic lung diseases.

• Decreased Exercise Tolerance: Indicates reduced lung function.

• Pain When Taking Deep Breaths: May indicate pleuritis or pulmonary embolism.

Anyone experiencing these symptoms should consult a pulmonologist as soon as possible. Early diagnosis plays a critical role in the effective treatment of respiratory diseases.

Diagnosis of pulmonary diseases is established through a careful combination of the patient's complaints, clinical findings, and advanced diagnostic methods. The first step involves taking a detailed medical history and performing a comprehensive physical examination. Then, various radiological examinations are employed to determine the source of the disease.

• Chest X-rays, computed tomography (CT), and magnetic resonance imaging (MRI) provide detailed images of the lungs and surrounding tissues.
• Pulmonary function tests (PFT) and blood gas analysis assess lung capacity and airway status. These tests help evaluate the risk of respiratory failure.
• If infection is suspected, sputum culture and blood tests identify the microorganisms responsible.
• Bronchoscopy is an important diagnostic tool for direct examination of the airways and, if needed, obtaining biopsies.
• Skin tests (such as the tuberculin test) detect infections like tuberculosis, while allergy tests identify allergens causing respiratory symptoms.
• Pulmonary angiography is an imaging test used to examine lung vessels and detect blood clots.
• Echocardiography evaluates the impact of lung diseases on the heart.
• Laboratory tests assess infections, inflammation, or other diseases.

This comprehensive approach is vital for accurate diagnosis and the development of an effective treatment plan.

The treatment of chest diseases is carefully planned according to the type, severity of the disease, and the patient's health condition. This involves a multidisciplinary approach. The treatment methods aim to improve the patient's quality of life and control the disease.

The treatment methods include:

• Bronchodilators: They widen the airways to make breathing easier. Commonly used in conditions such as asthma and COPD (for example, short- and long-acting beta-agonists, anticholinergics).
• Corticosteroids: They reduce inflammation. Used in asthma, COPD, and some interstitial lung diseases (available as inhalers, oral, or intravenous forms).
• Antibiotics: Used to treat bacterial lung infections, such as pneumonia.
• Antivirals: Can be used to treat viral lung infections, such as influenza and COVID-19.
• Antifungals: Used to treat fungal lung infections.
• Mucolytics and Expectorants: Help loosen and clear mucus, providing symptomatic relief in conditions like bronchitis.
• Leukotriene Modifiers: Help control asthma symptoms.
• Immunotherapy (Allergy Shots): Applied in some patients with allergic asthma to reduce sensitivity to allergens.
• Biological Agents: Targeted treatments used in severe asthma or certain interstitial lung diseases.

• Bronchoscopy: A method used to visualize the inside of the airways, take biopsies, or remove foreign bodies. It can also be used therapeutically in some cases (e.g., laser treatment of tumors).

• Thoracentesis: A procedure performed to drain fluid accumulation in the pleural space.

• Lung Biopsy: Samples are taken from lung tissue for diagnosis using various methods (bronchoscopic, percutaneous, surgical).

• Lung Surgery: Surgical intervention may be necessary for lung cancer, lung transplantation, or other severe lung diseases. This may involve tumor removal or lung transplantation.

• VATS (Video Assisted Thoracic Surgery): A minimally invasive thoracic surgery technique performed through small incisions.

• Bronchoscopic Volume Reduction: A procedure applied to reduce over-expanded areas of the lung in patients with severe emphysema.

• Smoking Cessation: The most important step for lung health.

• Healthy Nutrition: Important for overall health and immune system support.

• Regular Exercise: Can improve lung capacity and overall fitness (under medical supervision).

• Vaccinations: Important for protection against infections such as influenza and pneumococcal diseases.

• Psychological Support: Management of anxiety and depression is crucial for patients with chronic lung diseases.

The Lung is managed by the Department of Chest Diseases (Pulmonology). This department deals with the diagnosis and treatment of all kinds of diseases related to the respiratory system and lungs.

There can be many causes of chest pain. Therefore, it is important to first consult a Cardiology (Heart Diseases) specialist, as one of the most serious causes of chest pain is heart problems.

The primary department to consult for asthma is the Chest Diseases (Pulmonology) department. Chest disease specialists are experts in the diagnosis, treatment, and management of asthma.

The Chest Diseases department generally provides diagnosis, monitoring, and treatment services for the following health issues:

• Asthma and allergic lung diseases

• Chronic obstructive pulmonary disease (COPD)

• Lower respiratory tract and lung infections such as bronchitis, bronchiolitis, tracheitis, pneumonia

• Lung cancer and benign lung tumors

• Tuberculosis

• Sleep apnea

• Pulmonary embolism

• Pulmonary hypertension

• Interstitial lung diseases (such as pulmonary fibrosis)

• Pleural diseases (such as pleurisy)

• Occupational lung diseases (such as silicosis, asbestosis)