No potential conflict of interest was reported. National Center for Biotechnology Information , U. Journal List Clinics Sao Paulo v. Clinics Sao Paulo. Rodrigo Athanazio. Find articles by Rodrigo Athanazio. Author information Article notes Copyright and License information Disclaimer. E-mail: rb. Received Sep 27; Accepted Sep This article has been cited by other articles in PMC. Abstract Airway diseases are highly prevalent worldwide; however, the prevalence of these diseases is underestimated.
Epidemiology Because of the variability in the definition of COPD in epidemiological studies, an accurate prevalence of this disease is difficult to determine.
Risk factors Patients with asthma and COPD can usually be distinguished according to the classic risk factors that are associated with each disease.
Open in a separate window. COPD: Chronic obstructive pulmonary disease. Physiopathology Asthma, COPD and bronchiectasis are diseases that cause chronic inflammation of the airways but have distinct characteristics. Diagnosis Characterizing the physiological and phenotypic differences between patients with obstructive diseases is important for obtaining a greater understanding of the evolution of these diseases and the therapeutic implications.
Symptoms Asthmatic patients who exhibit bronchoconstriction are characterized by wheezing, breathlessness, chest tightness and coughing. Imaging tests Chest radiography is not sufficiently sensitive for the diagnosis of airway diseases, and this test is recommended for the differential diagnosis of a patient with respiratory symptoms. Figure 1. Table 2 Important clinical characteristics in the differentiation of patients with asthma, COPD and bronchiectasis. Treatment Asthma treatment guidelines aim for the appropriate control of symptoms through a strategy of phased measures that focus on the severity of the disease and the daily complaints of the patient.
Beta2-agonists Bronchodilators with a direct action on beta-adrenergic receptors can be classified as short- or long-term depending on the half-life. Anticholinergics The release of acetylcholine by vagal stimulation triggers a bronchoconstrictor response and an increased production of pulmonary secretions. Corticosteroids The underlying inflammatory process in obstructive diseases has always been the focus of therapeutic interventions that aim to reduce disease progression, improve lung function and reduce symptoms and exacerbations.
Other pharmacological agents Xanthines, such as theophylline, have moderate bronchodilator effects, immunomodulatory properties and anti-inflammatory effects, which increase sensitivity to corticoids in the nucleus of inflammatory cells through the histone deacetylase pathway. Other nonpharmacological therapies Nonpharmacological measures are important in the management of patients with an obstructive disease.
Footnotes No potential conflict of interest was reported. J Bras Pneumol. Obstructive lung disease and low lung function in adults in the United States: data from the National Health and Nutrition Examination Survey, Arch Intern Med. Cad Saude Publica. National Heart, Lung, and Blood Institute. Global Initiative for Asthma. Bronchiectasis: not an orphan disease in the East. Int J Tuberc Lung Dis. Population impact of different definitions of airway obstruction.
Eur Respir J. The proportional Venn diagram of obstructive lung disease: two approximations from the United States and the United Kingdom. Prevalence of respiratory symptoms related to chronic obstructive pulmonary disease and asthma among middle aged and older adults. Chronic cough and phlegm in young adults. Characteristics of adults dying with COPD. Jackson H, Hubbard R.
Detecting chronic obstructive pulmonary disease using peak flow rate: cross sectional survey. Barker AF. N Engl J Med. Association of asthma with serum IgE levels and skin-test reactivity to allergens. Relation between airway responsiveness and serum IgE in children with asthma and in apparently normal children. Comparative epidemiology of atopic and non-atopic wheeze and diagnosed asthma in a national sample of English adults.
Occupational asthma dicitionnaire des allerge'nes. Environmental assessment of an asthma education program: Relationship between airborne fungi and IgE levels in children and adults. Peden DB. Influences on the development of allergy and asthma. Occupational dust exposure and chronic obstructive pulmonary disease. A systematic overview of the evidence. Am Rev Respir Dis. Cadmium fume inhalation and emphysema. Woodsmoke exposure and risk for obstructive airways disease among women.
Increased risk of respiratory symptoms and chronic bronchitis in women using biomass fuels in Nigeria. American Thoracic Society. Evaluation of the exhaled carbon monoxide levels in smokers with COPD. Respiratory symptoms as health status indicators in workers at ceramics manufacturing facilities.
Gender bias in the diagnosis of COPD. Women and smoking: Risks, impacts, and challenges. Clinical characteristics and quality of life of smokers at a referral center for smoking cessation. Determinants of smoking experimentation and initiation among adolescent students in the city of Salvador, Brazil. Attitudes of Brazilian pulmonologists toward nicotine dependence: a national survey. Larsson C. Natural history and life expectancy in severe alpha1- antitrypsin deficiency, Pi Z.
Acta Med Scand. Barnes PJ. Genetics and pulmonary medicine. Molecular genetics of chronic obstructive pulmonary disease. Tumor necrosis factor-alpha gene polymorphism in chronic bronchitis. Association between polymorphism in gene for microsomal epoxide hydrolase and susceptibility to emphysema.
An investigation into causative factors in patients with bronchiectasis. Longitudinal evaluation of the association between pulmonary function and total serum IgE. Am J respir Crit Care Med. A community-based study of the epidemiology of asthma. Incidence rates, — Bjornson CL, Mitchell I.
Gender differences in asthma in childhood and adolescence. J Gend Specif Med. The impact of aging and smoking on the future burden of chronic obstructive pulmonary disease: a model analysis in the Netherlands. Gender-related differences in severe, early-onset chronic obstructive pulmonary disease. Gender differences in predictors of health status in patients with COPD. Predictors of asthma and persistent wheeze in a national sample of children in the United States.
Association with social class, perinatal events, and race. Relation of birth weight and childhood respiratory infection to adult lung function and death from chronic obstructive airways disease.
Acute lower respiratory illness in childhood as a predictor of lung function and chronic respiratory symptoms. Respiratory syncytial virus infection: its role in aeroallergen sensitization during the first two years of life. Pediatr Allergy Immunol. Dietary n-3 polyunsaturated fatty acids and smoking-related chronic obstructive pulmonary disease. Other steps to reduce the risk include :. Smoking can worsen any lung condition.
People with bronchiectasis should avoid smoking or quit if they already smoke. A doctor can advise on how to do this. Some conditions that cause bronchiectasis may respond to treatment. Early treatment for these conditions might stop the disease from progressing, or even reverse it.
The outlook depends on several factors but mainly on how well treatment can manage or prevent infections and possible complications. The NHLBI note that, with proper treatment, a person with bronchiectasis can enjoy a good quality of life. Read this article in Spanish. Learn how COPD and pneumonia are connected, how they are diagnosed, and what treatments are available. Also learn how to improve respiratory health. Pulmonary hypertension is high blood pressure in the blood vessels of the lungs.
We cover the symptoms and possible causes of pulmonary hypertension…. Mold can cause a lot of damage in the home, spreading across walls and eating away at wood and fabric. But what effect does it have on the body? Chronic obstructive pulmonary disease COPD refers to two lung diseases that cause difficulty breathing.
Smoking is the most common cause. Learn more…. Pneumonia is an infection of the lungs caused by bacteria, viruses, fungi, or parasites. Anyone can develop pneumonia, but certain groups of people…. What is bronchiectasis? Medically reviewed by Vincent J. Symptoms Causes Risk factors Diagnosis Treatment Complications Prevention Outlook Bronchiectasis happens when irreversible damage affects the bronchi, which are part of the respiratory system.
Share on Pinterest A person with bronchiectasis will have a persistent cough. Risk factors. Share on Pinterest People with asthma have a higher risk of developing bronchiectasis. Overview of the management of postoperative pulmonary complications. Accessed July 20, Goldman L, et al. Bronchiectasis, atelectasis, cysts, and localized lung disorders.
In: Goldman-Cecil Medicine. Accessed July 23, Smetana GW, et al. Strategies to reduce postoperative pulmonary complications. Accessed August 20, Bope ET, et al.
In: Conn's Current Therapy Restrepo RD, et al. Current challenges in the recognition, prevention and treatment of perioperative pulmonary atelectasis. Expert Review of Respiratory Medicine. In people who have allergic bronchopulmonary aspergillosis, using corticosteroids appropriately—and sometimes an antifungal drug such as itraconazole —may reduce the bronchial damage that results in bronchiectasis. Giving the enzyme alpha-1 antitrypsin to people with alpha-1 antitrypsin deficiency may help prevent the disorder from becoming more severe.
Avoiding toxic fumes, gases, smoke, and injurious dusts also helps prevent bronchiectasis or reduce its severity. Watching what children put in their mouth can help prevent them from inhaling foreign objects into the airways.
Avoiding oversedation due to drugs or alcohol and seeking medical care for neurologic symptoms such as impaired consciousness or gastrointestinal symptoms such as difficulty in swallowing and regurgitation or coughing after eating may help to prevent aspiration.
Avoiding use of mineral oil or petroleum jelly in the nose may prevent accidental inhalation of these substances into the lungs. Drainage of airway secretions with therapies that promote cough such as, chest physical therapy, regular exercise, other techniques. Sometimes, oral or inhaled antibiotics to suppress certain bacteria and prevent recurring infections. Treatment of bronchiectasis is directed toward reducing the frequency of infections when possible, preventing certain infections with vaccines and sometimes antibiotics, decreasing the buildup of mucus, decreasing inflammation, and relieving airway blockage.
Early, effective treatment can reduce complications such as hemoptysis, low oxygen levels in the blood, respiratory failure, and cor pulmonale Cor Pulmonale Cor pulmonale is enlargement and thickening of the ventricle on the right side of the heart resulting from an underlying lung disorder that causes pulmonary hypertension high pressures in the Treatment of underlying conditions that cause or contribute to flares is also needed.
Flares exacerbations are treated with antibiotics, bronchodilators, and chest physiotherapy Chest Physical Therapy Respiratory therapists use several different techniques to help treat lung disease, including Postural drainage Suctioning Breathing exercises The choice of therapy is based on the underlying Chest physiotherapy includes such techniques as postural drainage Postural drainage Respiratory therapists use several different techniques to help treat lung disease, including Postural drainage Suctioning Breathing exercises The choice of therapy is based on the underlying Sometimes antibiotics are given for a long period to prevent recurring infections, especially in people who have frequent flares or cystic fibrosis.
Most people with cystic fibrosis benefit from treatment with a cystic fibrosis transmembrane regulator CFTR modulator, which can decrease exacerbations. Inflammation and the buildup of mucus may be helped by humidification of the air and inhaling a salt water solution. Drugs that thin the thick sputum mucolytics may also be given to people who have cystic fibrosis Cystic Fibrosis read more.
In other people, the effectiveness of mucolytics is uncertain. Bronchial blockage can be detected and treated by bronchoscopy Bronchoscopy Bronchoscopy is a direct visual examination of the voice box larynx and airways through a viewing tube a bronchoscope. Significant bleeding with cough is sometimes treated with a technique called embolization instead of surgery.
In embolization, doctors use a catheter to inject a substance that blocks the vessel that is bleeding. The lungs take oxygen from the air and transfer it to the bloodstream see Exchanging Oxygen and Carbon Dioxide.
Oxygen is needed Appropriate use of oxygen may help prevent complications such as cor pulmonale Cor Pulmonale Cor pulmonale is enlargement and thickening of the ventricle on the right side of the heart resulting from an underlying lung disorder that causes pulmonary hypertension high pressures in the If people have wheezing or shortness of breath, bronchodilators and sometimes inhaled corticosteroids often help.
If a person has a flare, usually these drugs and an antibiotic are given, and oral corticosteroids are added in severe cases. Respiratory failure Respiratory Failure Respiratory failure is a condition in which the level of oxygen in the blood becomes dangerously low or the level of carbon dioxide in the blood becomes dangerously high.
Rarely, part of a lung needs to be surgically removed. Such surgery usually is an option only if the disease is confined to one lung or, preferably, to one lung lobe or segment. Surgery may be considered for people who have recurrent infections despite treatment or who cough up large amounts of blood.
Advanced bronchiectasis in some people—mostly those who also have advanced cystic fibrosis—can be treated with lung transplantation. Heart-lung transplantation Pulmonary function as measured by the amount of air in the lungs and the rate and amount of air moving in and out of the lungs with each breath usually improves within 6 months, and the improvement may be sustained for at least 5 years.
Prognosis for people with bronchiectasis depends on its cause and on how well infections and other complications are prevented or controlled. People with coexisting conditions, such as chronic bronchitis Chronic Obstructive Pulmonary Disease COPD Chronic obstructive pulmonary disease is persistent narrowing blocking, or obstruction of the airways occurring with emphysema, chronic obstructive bronchitis, or both disorders.
Many disorders can cause pulmonary hypertension. The following are English-language resources that may be useful. American Lung Association: Bronchiectasis : Complete discussion of symptoms, diagnosis, and treatment, and tips on questions to discuss with the doctor.
National Heart. Lung, and Blood Institute: Bronchiectasis : Complete discussion of symptoms, diagnosis, and treatment, and tips on questions to discuss with the doctor. Merck and Co. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. The Manual was first published in as a service to the community. Learn more about our commitment to Global Medical Knowledge.
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