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Bronchiectasis is a chronic condition where the airways (bronchi) of your lungs are inflamed, infected, and permanently damaged.
If your lungs are injured, there will be inflammation and/or infection present in your bronchi. This leads to the accumulation of mucus and thickening of the walls of your bronchi. The condition finally results in a cycle of bacterial infection, a pool of mucus in your lungs, blockages in your bronchi, and gradual decline in your lung function over time. In the end, you will have difficulty with breathing.
Any sort of lung injury can lead to bronchiectasis and it can sometimes affect your whole body. You may also develop bronchiectasis if you have any of the following conditions:
Bronchiectasis not only affects your lungs, but it may also have an impact on your pancreas and liver resulting in repeated infections and poor functioning of these organs.
Symptoms of typical bronchiectasis may take several months or even years to develop and manifest. Therefore, you should see your doctor for diagnosis and treatment if you:
Your doctor will first listen to your lungs and check for airway blockage or any abnormal sounds while you breathe. Several tests may be ordered to diagnose the condition, including:
Bronchiectasis cannot be cured. However, it can be managed and kept under control by the following methods:
With early diagnosis and appropriate treatment, you can lead a normal life.
In most cases, the exact cause of bronchiectasis cannot be found. Apart from vaccination, avoiding smoking or polluted air or toxic fumes or dust seem to be the best way to prevent bronchiectasis and save your lungs.
A chronic cough is defined as a cough lasting three weeks or more and requires medical
evaluation. While chronic cough is often due to non-serious and treatable causes, it is crucial to
determine the underlying cause to provide appropriate treatment.
- Asthma
- Rhinitis and sinusitis
- Postnasal drip
- Acid reflux
- Chronic bronchitis
- Upper-Airway Cough Syndrome (UACS)
- Infections
- Bronchiectasis
The first step involves a thorough medical history and physical examination to identify potential
causes.
Depending on initial findings, tests such as blood tests, allergy screens, CT scans, and lung
function tests may be necessary to pinpoint the exact cause.
Most cases of chronic cough can be diagnosed and treated effectively based on these
evaluations. In some instances, no physical cause can be identified.
By following this approach, the underlying cause of a chronic cough can often be determined
and managed appropriately, leading to significant improvement in symptoms.
For more specific advice and consultation, consider reaching out to a specialist who can provide
personalized care based on your medical history and symptoms.
COPD is a progressive and chronic inflammatory disease of your lungs. The condition leads to obstructed airflow from the lungs making it harder for you to breathe.
There are two common forms of COPD.
If you have COPD, you are likely to experience both these conditions.
The topmost contributor of COPD is tobacco smoking. The other factors include long-term exposure to:
You are at risk of developing COPD if you:
COPD is a condition that takes a long time to develop. Sometimes, you may not able to notice the progressing COPD until the lungs are damaged significantly. Symptoms of COPD may vary from person to person and can be mild initially but will get progressively worse over time.
The common symptoms of COPD are:
There is no single test to detect COPD. The diagnosis will begin with a physical examination, based on which, your doctor will order the following tests to get a complete picture of the condition.
These diagnostic tests will help your doctor to determine the degree of COPD.
COPD is known to disturb the airflow to and from the lungs. If untreated, the condition can lead to faster progression of the disease and eventually result in severe respiratory infections, depression, increased risk of heart diseases and lung cancer.
COPD has no cure but is treatable and manageable. The treatment will ease symptoms, reduce the chance of complications, lower the risk of other associated conditions and improve the quality of your life.
Treatments for COPD include but are not limited to the following:
Though COPD requires longterm management, the first and best way to prevent COPD is to avoid anything that might harm your lungs or cause a flare-up of already overtaxed lungs. For example, you can quit smoking, or use respiratory protection masks to guard against fumes, dust, etc. Following your doctor’s advice will go a long way in keeping your lungs healthy.
Shortness of breath, also known as dyspnea, is discomfort or difficulty in breathing or the inability to get enough air to breathe. It can occur suddenly or gradually over a period of time and can be classified into acute or chronic shortness of breath respectively.
The most common causes of shortness of breath are associated with heart and lung conditions and may include:
Symptoms of shortness of breath that require attention by your physician include:
Some of the commonly known risk factors for shortness of breath may include:
To determine the underlying cause of your shortness of breath, your doctor will review your symptoms and medical history, perform a physical examination, and may recommend certain diagnostic tests for further verification, including:
Treatment options for shortness of breath are dependent upon the underlying cause and include:
Things you can do to prevent and manage shortness of breath include:
Cancer is a disease that results from abnormal growth and division of cells that make up the body's tissues and organs.
Under normal circumstances, cells reproduce in an orderly fashion to replace old cells, maintain tissue health and repair injuries. However, when growth control is lost and cells divide too much and too fast, a cellular mass or 'tumour' is formed.
If the tumour is confined to a few cell layers and it does not invade surrounding tissues or organs, it is considered benign. By contrast, if the tumour spreads to surrounding tissues or organs, it is considered malignant, or cancerous. In order to grow further, cancer develops its own blood vessels and this process is called angiogenesis. When it first develops, a malignant tumour may be confined to its original site.
If cancerous cells are not treated, they may break away from the original tumour, travel and grow within other body parts. This process is known as metastasis.
Lung cancer is a growth of abnormal cells inside the lung. These cells reproduce at a much faster rate than normal cells. The abnormal cells stick together and form a cluster or growth, known as a tumour. If the abnormal cells began growing in the lung, this is known as a primary lung tumour.
Depending on how the cells look under a microscope, cancers that begin in the lung are divided into 2 major types:
Non-small cell lung cancer generally spreads to other organs in the body at a slower rate than small cell lung cancer. Non-small cell lung cancer is the most common type of lung cancer, accounting for almost 80 per cent of lung cancers. Small cell lung cancer accounts for about 20 per cent of all lung cancers.
Cigarette smoking is the major cause of lung cancer. Up to 90 per cent of cases of the disease are caused by smoking, and one in 10 smokers will develop lung cancer. The longer a person has been smoking and the more packs of cigarettes smoked per day, the greater the risk. However, it is not known why one smoker develops lung cancer while another does not.
Research has also demonstrated the link between passive smoking and lung cancer.
Workers exposed to industrial substances such as asbestos, nickel, chromium compounds, arsenic, polycyclic hydrocarbons, and chloromethyl, have a significantly high risk of developing lung cancer.
Lung cancer is very difficult to detect at an early stage. Common symptoms include:
There are various treatment options available for lung cancer (with different aims), which include: surgery, chemotherapy, radiotherapy, and laser treatment.
Those non-small cell lung cancers which are amenable to surgery are those where the cancer is confined to a lump in the lung or to the draining lymph nodes immediately next to the lump, but where the lymph nodes in the centre of the chest are involved, it is usually considered not suitable for surgery alone. Investigations include chest X-rays and CT scans. Surgery may involve removal of the lung or part of the lung. For those cancers that spread to the centre of the chest, a combined treatment approach may involve chemotherapy with radiotherapy and surgery. Patients who present with widespread disease or later develop widespread non-small cell lung cancer may undergo chemotherapy which improves the chances of survival
Radiotherapy is used to alleviate the symptoms from primary cancer or other sites of disease, such as the bone.
Small cell lung cancer is primarily treated with chemotherapy. The best outcome is if the disease is confined to the chest, but chemotherapy is still used when the disease is widespread at presentation. Radiotherapy may be used to consolidate the local chest area or to prevent metastases occurring in the brain. Radiotherapy can also be used for palliation of painful localized areas, such as in the bone.
Air is supplied to the lungs for purification through narrow tubes. When these tubes get inflamed and narrowed, it leads to a chronic condition called asthma.
Asthma can be triggered by allergens (pollen, mold and fur), cold air and changes in weather, exercise, flu, and the common cold.
Asthma is primarily managed with medication and by avoiding triggers that bring on symptoms. Medication may include long-term control medicines that should be taken on a daily basis seasonally and short-acting bronchodilators that act as a rescue medication for immediate relief. Asthma medication is delivered through a metered-dose inhaler, dry powder inhaler or a nebulizer, which converts liquid medicine into a fine mist.
Chronic respiratory failure is the inability to carry out the fundamental functions of respiration. The lungs function to deliver oxygen to the blood while eliminating carbon dioxide from the blood. It is a condition that usually occurs from narrow or damaged airways that develop gradually over time with a progressive underlying process that requires long-term treatment.
Conditions and diseases that affect your breathing can cause chronic respiratory failure and may include:
Symptoms of chronic respiratory failure develop over an extended period of time and may include:
Your healthcare provider will be able to diagnose chronic respiratory failure based on:
One of the main objectives of the treatment is to get oxygen to your lungs and other organs and remove carbon dioxide from your body. The common treatment options used to achieve these may include:
There is no permanent solution for chronic respiratory failure, however, symptoms can be handled by continuous long-term breathing treatments prescribed by your healthcare provider and diligently following the provided prescriptions.
Coronaviruses belong to a large group of viruses that are known to cause severe respiratory illness ranging from the common cold to more serious illnesses such as Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS) in humans. Coronaviruses are commonly found in animals such as civet cats and camels and are known to be transmitted between animals and humans.
Coronavirus disease COVID-19 is caused by a novel (new) coronavirus (2019-nCOV) that was first discovered in Wuhan, China, in 2019. It has never been previously detected in humans. COVID-19 is highly infectious and one of the most lethal types of coronavirus diseases that has affected people across the globe with total cases of over 766 million and a death rate of over 0.9% to date with no vaccines or medications yet available to treat the deadly virus. Animals as the potential source of COVID-19 have not been confirmed yet and are still under investigation.
Some of the common symptoms of coronavirus (COVID-19) include the following:
COVID-19 spreads from one person to another through the respiratory droplets. The transmission occurs when:
The time taken between getting infected and exhibiting symptoms of COVID-19 ranges from 1 to 14 days, but most commonly around 5 days.
Older people and individuals with pre-existing illnesses such as diabetes, high blood pressure, lung diseases, heart conditions, and cancer are more prone to develop serious illnesses than others due to coronavirus infection.
Some of the standard recommendations to protect and prevent the spread of infection include the following:
For more in-depth information and the current status of COVID-19, we have listed some authoritative websites below for your reference.
Non-invasive ventilation (NIV) refers to the administration of mechanical ventilation to the lungs using methods such as a face mask, without the need of an invasive artificial airway, such as an endotracheal tube (ETT) or tracheal tube (TT).
Invasive ventilation is application of mechanical ventilation via an endotracheal or tracheotomy tube.
Non-invasive ventilation has been used as an alternative to invasive mechanical ventilation (being placed on a ventilator) for people with respiratory failure or chronic respiratory insufficiency who can no longer breathe adequately on their own. In acute settings, NIV delivers effective therapy with less risk of infection and improved survival in patients with respiratory failure.
The growing use of non-invasive ventilation over the last 2 decades to treat respiratory distress has made NIV an integral part in the management of both acute and chronic respiratory failure, in both the home setting and in the hospital setting. The flexibility and comfort offered by non-invasive ventilation make it a valuable addition in the management of patients with respiratory failure.
There are two main types of non-invasive ventilation; positive-pressure and negative-pressure non-invasive ventilation.
In positive pressure non-invasive ventilation, positive pressure is applied to the airway to inflate the lungs directly through a nasal mask, face mask, or nasal plugs. It is the most commonly used non-invasive ventilator mode in the intensive care unit (ICU). CPAP (continuous positive airway pressure) and BiPAP (Bilevel Positive Airway Pressure) are the most common examples of positive-pressure ventilation.
In negative-pressure non-invasive ventilation, negative pressure is applied to the thorax and abdomen to draw air into the lungs through the upper airway using a device that encases the thoracic cage starting from the neck, with devices ranging from a whole-body tank to a cuirass shell. Iron lung or tank ventilator is the most common example of a negative-pressure ventilator.
Some of the common indications for non-invasive ventilation include:
Some of the common contraindications for non-invasive ventilation include:
Some of the criteria that need to be fulfilled prior to beginning NIV treatment include:
Failure to fulfil any one of these criteria contributes to the patient being considered ineligible for NIV.
The favourable effects of non-invasive ventilation in patients with acute respiratory distress include:
Some of the benefits of non-invasive ventilation when compared with invasive ventilation include:
Some of the risks and complications associated with non-invasive ventilation include:
Bronchoscopy is a procedure used to evaluate the airways, lungs or lymph nodes in the chest for abnormalities and to treat conditions such as abnormal growths or foreign bodies causing airway obstruction.
There are two types of bronchoscopes that may be used: Flexible and Rigid.
Flexible bronchoscopy uses a long, thin, flexible lighted tube that can access the small airway branches. A sample of tissue or a biopsy may be obtained through the bronchoscope for laboratory study.
Rigid bronchoscopy involves the use of a rigid, straight, hollow metal tube. Rigid bronchoscopy is indicated when the airway is obstructed by blood or foreign objects.
Bronchoscopy is commonly performed to evaluate abnormal findings on a chest X-ray or CT scan and obtain biopsies for further studies. It may also be used to diagnose airway problems such as:
Inform your doctor if you are pregnant or allergic to any medications. Other tests may also be ordered prior to the procedure. To reduce the risk of bleeding, you will have to discontinue taking blood thinning medications and non-steroidal anti-inflammatory drugs a few days before the procedure. You should abstain from food and drink after midnight before the procedure and if instructed to take medications, you should do so only with a sip of water.
During a bronchoscopy, your blood pressure, oxygen level and heart rate are continually monitored.
Flexible bronchoscopy may be performed with you lying on your back or in a reclined or upright position. A sedative will be administered to help you relax and an intravenous line will be inserted for additional medications. A local anesthetic will be sprayed into your nose and mouth to reduce your gag reflex and minimize discomfort from insertion of the bronchoscope. In case of narrow nasal passages, the tube may be inserted through your mouth. The bronchoscope is gently inserted past the vocal cords and trachea into your lung while your doctor looks for abnormalities. Instruments are passed through the bronchoscope and guided by X-ray imaging to obtain tissue and fluid samples or to perform other procedures. Your airway will then be washed with a saline solution.
A rigid bronchoscopy is performed under general anesthesia. Your neck is extended and the bronchoscope is gently inserted through your mouth and windpipe. Biopsy samples are obtained and the airway is washed with saline.
Following the procedure, you should avoid drinking or eating for at least 2 hours. Starting with small sips of water you can then gradually resume a normal diet. Avoid smoking for at least 24 hours after the procedure. You should not drive, drink alcohol or operate machinery for 24 hours after receiving the sedative. You may experience a sore throat which can be soothed by warm salt water gargles or throat lozenges. Consult your doctor immediately if you have breathing problems, persistent fever, or significant bleeding.
Bronchoscopy is generally a safe test but as with any procedure complications may occur and can include:
A chest infection is an invasion of pathogens affecting the bottom part of your respiratory tract (lungs) including the windpipe, bronchi, and lungs. Infections can range from mild to severe. Pathogens may include bacteria, viruses, fungi and parasites that are not normally present within the body.
There are two common types of chest infection, including:
Chest infection is mostly caused by viruses, but occasionally by bacteria or fungi. Bronchitis is mostly caused by a virus, while bacteria cause pneumonia in most cases.
Sections of the people who are more prone to chest infection include:
Additionally, those who have chronic health conditions such as COPD, asthma, diabetes, heart/kidney disease, weakened immune system, etc., are also at a higher risk of chest infection.
There are several symptoms you are likely to experience if you have a chest infection. However, the major symptoms are a high temperature with difficulty in breathing and coughing up yellow or green mucus. You may have a chest infection if you experience:
There are several ways your doctor can diagnose a chest infection. To start with, your doctor uses a stethoscope and listens to your heart and lungs while you breathe. Subsequently, you doctor may conduct the following evaluations based on the severity of the condition:
Home remedies/self-help
Sometimes, if the infection is bronchitis, it may go away on its own or else you may visit a pharmacist who will help you with some over-the-counter (OTC) decongestant medications. Other remedies include:
Medical treatment
If the infection is severe and cannot be cured by a home remedy, you must visit your doctor for further treatment. The cause of the infection is the basis for the type of treatment prescribed.
If a virus has caused the infection, antibiotics will be ineffective. The treatment should focus on easing your symptoms until you start to get better. In case the infection is of bacterial origin, your doctor can treat you with relevant antibiotics till you recover fully. You may be given tablets if the infection is mild. If not, hospital admission may be necessary for IV antibiotics treatment.
Most symptoms usually go away within 7 to 10 days, although a cough can last up to three weeks. If the infection is viral in nature, it will settle over time. If it is bacterial, you will start feeling better one or two days after starting on antibiotics. Even though you may begin to feel better, always remember to complete the full course of antibiotics.
Some of the tips that can help you prevent a chest infection include:
Sleep apnea describes a sleep disorder characterized by frequent pauses in breathing due to collapse or obstruction of the airway. It can result in snoring, disturbed sleep, daytime lethargy and poor concentration and productivity.
Sleep apnea can be treated by making certain lifestyle changes and using a specialized breathing apparatus while sleeping. Long-term treatment is usually necessary.
Surgery for certain conditions such as enlarged tonsils and adenoids, or obesity can improve symptoms. Apart from these, a soft tissue implant may be placed within your soft palate to prevent obstruction and snoring.
Early detection of lung cancer following lung health screening has higher rate of survival.
Currently, lung cancer screening is not currently available on the NHS to all; private lung cancer
screening can be useful for at high-risk who don’t show any symptoms.
Screening means testing people for early stages of a disease. This is before they have any
symptoms.
• Individual who are aged between 55 and 74
• and either smoke or used to smoke
Possible benefits of lung cancer screening
There is evidence that screening people based on their risk of lung cancer can save lives. The
initial assessment helps to work out who is at higher risk of lung cancer and might benefit from
having a CT scan.
Diagnosing lung cancer early means that treatment is more likely to work.
• having a new cough or a cough most of the time
• getting out of breath doing the things you used to do without a problem
• coughing up phlegm (sputum) with blood in it
• feeling tired all the time (fatigue)
• having an ache or pain in the chest or shoulder
Early detection makes it more likely that treatment can begin before the cancer has spread, so
survival rates are much higher.
Major US-based organisations, including the American College of Chest Physicians, the
American Cancer Society, the National Comprehensive Cancer Network and the American
Society of Clinical Oncology, reviewed the evidence early in 2012.
On the basis of this review, they now recommend that people should be screened for lung
cancer using low-dose CT scans and follow up if they:
The National Health Service has started to roll out screening programme too.
Early detection of lung cancer through screening significantly increases survival rates. While
comprehensive lung cancer screening is not universally available on the NHS, private screening
can be particularly beneficial for high-risk individuals, even if they show no symptoms.
What is it ?
Screening involves testing people for early stages of a disease before they exhibit any
symptoms.
Who should consider it?
Individuals aged between 55 and 74 who either currently smoke or have smoked in the past.
Benefits:
Evidence suggests that screening based on lung cancer risk can save lives by facilitating early
diagnosis and treatment.
- Persistent new cough or a long-standing cough.
- Shortness of breath during activities that were previously manageable.
- Coughing up blood-tinged phlegm.
- Constant fatigue.
- Chest or shoulder pain.
Major US organizations such as the American College of Chest Physicians, the American
Cancer Society, and others have recommended lung cancer screening using low-dose CT scans
based on evidence that early detection improves survival rates. The NHS is also beginning to
implement a screening program.
Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) is a minimally invasive but highly effective procedure used to diagnose and stage lung cancer and other diseases affecting the lungs. EBUS allows physicians to perform needle biopsies of lymph nodes and masses within the chest without the need for more invasive surgical procedures. This test can:
- Determine if an abnormal area is cancerous.
- Assess the size of the cancer.
- Evaluate if the cancer has spread within the lung or to other areas outside the lung.
Dr Diwanji has extensive experience with EBUS, having performed over 1,500 procedures, making him highly skilled in this diagnostic technique.
For more detailed information, you can visit Cancer Research UK
https://www.cancerresearchuk.org/about-cancer/tests-and-scans/endobronchial-ultrasound