Respiratory Disease

Overview

The respiratory system is highly susceptible to a number of mild to chronic health diseases, infections, and allergies. Individuals with respiratory disease usually experience breathing difficulties. If not diagnosed and treated on time, this could result in severe complications and eventually death. 

Defenses of the Respiratory System

Because it is exposed to the outside environment, the respiratory tract has a complex but comprehensive set of defenses against inhaled material. Large particles of debris are filtered out by cilia and mucus secreted by the mucous membrane lining the nasal cavity as air passes through the nose. The air then passes through the pharynx, the final portion of the upper airway, the larynx, the beginning of the lower airways, and into the trachea.

The air is further filtered as it passes through the trachea's cilia and sticky mucus layers. Furthermore, lymphatic vessels in the tracheal wall transport immune system cells such as lymphocytes and macrophages that act to trap and destroy foreign particles. Muscle bands that surround the tracheal cartilage play an important role in narrowing the airway during coughing, providing a powerful defense mechanism that allows sputum and other substances to be quickly expelled from the respiratory tract.

Cilia in the bronchial tree beat in unison, moving substances up and out of the airways. A thin layer of fluid covers the cilia in the bronchioles and small bronchi, which thickens and becomes layered with mucus as the small bronchi converge into the large bronchi. Foreign particles are transported through the fluid and mucus layers when the cilia beat. The mucociliary escalator transports debris to the pharynx, where the fluid and mucus are swallowed and the debris is eliminated by the digestive system.

In the smaller branches of the airways, macrophages serve as the first line of defense. These cells, which are found in the lungs' alveoli, ingest and destroy bacteria and viruses, as well as remove small particles. They also secrete chemicals that attract other immune cells, such as white blood cells, to the site, triggering an inflammatory response in the lung.

Particles picked up by macrophages are carried into the lung's lymphatic system and stored in lymph nodes in the lung and mediastinum (the region between the lungs). Soluble particles are removed from the bloodstream and excreted by the kidneys.

Common diseases of respiratory system

The respiratory disease has a massive health impact. It is estimated that 235 million people worldwide suffer from asthma, more than 200 million have chronic obstructive pulmonary disease (COPD), 65 million have moderate-to-severe COPD, 1-6% of the adult population (more than 100 million people) have sleep-disordered breathing, 9.6 million people develop tuberculosis (TB) each year, millions have pulmonary hypertension, and more than 50 million suffer from occupational lung diseases, totaling mo

At least 2 billion people are exposed to the toxic effects of using biomass fuel, 1 billion to outdoor air pollution, and 1 billion to tobacco smoke. Chronic respiratory disease kills 4 million people prematurely each year.

A number of conditions usually develop and affect the tissues and organs that make up the respiratory. Others occur as a result of irritants from the air that one regularly breathes in. it can include bacteria or viruses that lead to a respiratory system infection. However, some are caused by other underlying health diseases or problems and old age. 

These disorders can affect the respiratory system in various ways and cause pain, inflammation, irritation, or swelling. Some of the common types of respiratory disease include the following; 

Upper respiratory tract infection

The upper airway includes all of the structures that connect the glottis to the mouth and nose. The common cold is the most common upper respiratory tract infection. Upper respiratory tract infections include infections of specific upper respiratory tract organs such as sinusitis, tonsillitis, otitis media, pharyngitis, and laryngitis.

Epiglottitis is a laryngeal bacterial infection that causes life-threatening swelling of the epiglottis, with a mortality rate of 7% in adults and 1% in children. Even with vaccinations, Haemophilus influenzae remains the leading cause. Drooling, stridor, difficulty breathing and swallowing, and a hoarse voice are all symptoms.

Pulmonary vascular disease

Pulmonary vascular diseases are disorders of the pulmonary circulation. Here are some examples: 

• Pulmonary embolism, a blood clot that forms in a vein, escapes, travels through the heart, and becomes lodged in the lungs (thromboembolism). Large pulmonary emboli are fatal, resulting in instant death. Other substances that can embolise (travel through the bloodstream) to the lungs are much less common: fat embolism (especially after bony injury), amniotic fluid embolism (with complications of labor and delivery), and air embolism (iatrogenic – caused by invasive medical procedures).
• Pulmonary arterial hypertension is characterized by increased pressure in the pulmonary arteries. It is most commonly idiopathic (cause unknown), but it can be caused by the effects of another disease, particularly COPD. Cor pulmonale is a condition that causes strain on the right side of the heart.
• Pulmonary edema is the leakage of fluid from lung capillaries into the alveoli (or air spaces). It is typically caused by congestive heart failure.
• Blood leaking into the alveoli due to pulmonary hemorrhage, inflammation, and damage to capillaries in the lung. This may result in the coughing up of blood. Auto-immune disorders such as granulomatosis with polyangiitis and Goodpasture's syndrome can cause pulmonary hemorrhage.

Chronic obstructive pulmonary disease (COPD)

This is a severe inflammatory lung condition associated with obstructed airflow from the lungs that causes breathing difficulties. The common medical conditions that trigger COPD include chronic bronchitis and emphysema. These disorders mostly develop together but tend to differ in severity among people with COPD. 

Chronic bronchitis refers to the inflammation of the bronchial tube lining. These tubes transport oxygen to and from the alveoli or air sacs of the lungs. The common symptoms associated with chronic bronchitis are constant coughing and production of mucus or sputum. 

On the other hand, emphysema is characterized by damage to the alveoli or the air sacs within the lungs. This usually results in shortness of breath, among other symptoms. Prolonged exposure to cigarette smoke or various irritable gases and matter contributes to emphysema. 

COPD is generally a progressive condition that tends to worsen with time. However, it’s treatable, and proper management is vital to ease the associated symptoms and promote life quality. This also helps minimize the risks of other related disorders. 

Asthma

Asthma is a disorder that causes the air paths to swell and narrow down or sometimes produces excess mucus. This usually results in breathing difficulties, coughing, wheezing when breathing out, and breath shortness. 

While asthma can be a minor issue for some people, it’s a major health problem for others. This is because it tends to impact the usual day-to-day activities and can sometimes result in a fatal asthma attack. 

Pneumonia

Pneumonia is an inflammation of the lungs caused by a bacterial, viral, or fungal infection. Pneumonia causes fluid or pus to fill the tiny air sacs inside the lungs. This can result in symptoms such as coughing, chest pain, and difficulty breathing.

Anyone of any age can get pneumonia, but it is more common in children under the age of four and the elderly. Pneumonia can manifest itself suddenly or gradually. With the right treatment, you should be able to recover in seven to ten days.

Allergies

Allergies develop when your body misidentifies a harmless substance (known as an allergen) as harmful. Your immune system reacts to the false alarm by producing antibodies against the allergen. The antibodies then signal the release of allergic chemicals into the bloodstream the next time you come into contact with the substance, resulting in allergy symptoms.

Respiratory allergies have an impact on the respiratory system. The two types of respiratory allergies are allergic asthma and allergic rhinitis. Allergic rhinitis (also known as hay fever) causes nasal symptoms as well as itchy, watery eyes, whereas allergic asthma causes airway constriction.

Lung cancer

Lung cancer is one of the most fatal and deadliest types of cancer in both males and females. It can occur in any part of the lungs, and might takes a few years before the associated signs and symptoms appear. While smokers are at a higher risk of developing lung cancer, it can also affect people who don’t smoke. 

Cystic Fibrosis

Cystic fibrosis is a genetic disease that affects the lungs, pancreas, and other organs over time. Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene cause the CFTR protein to become dysfunctional in people with CF. When the protein isn't working properly, it can't help move chloride — a salt component — to the cell surface. Without chloride to attract water to the cell surface, mucus in various organs thickens and becomes sticky.

Mucus clogs the airways and traps germs like bacteria in the lungs, resulting in infections, inflammation, respiratory failure, and other complications. As a result, avoiding germs is a top priority for people with CF. Mucus buildup in the pancreas inhibits the release of digestive enzymes that help the body absorb food and key nutrients, resulting in malnutrition and poor growth. The thick mucus in the liver can clog the bile duct, resulting in liver disease. CF can impair men's ability to have children.

Tuberculosis

Tuberculosis (TB) is a disease caused by the bacterium Mycobacterium tuberculosis. Because it primarily affects the lungs, pulmonary disease is the most common presentation. The respiratory system, the gastrointestinal (GI) system, the lymphoreticular system, the skin, the central nervous system, the musculoskeletal system, the reproductive system, and the liver are also commonly affected organ systems.

There has been a concerted global effort to eradicate tuberculosis over the last few decades. Despite advances in tuberculosis control and a decrease in both new cases and mortality, the disease continues to carry a massive morbidity and mortality burden globally.

Restrictive lung diseases

Restrictive lung diseases are a type of respiratory disease that causes incomplete lung expansion and increased lung stiffness, such as in infants with respiratory distress syndrome. There are two types of restrictive lung diseases: those caused by intrinsic factors and those caused by extrinsic factors.

Restrictive lung diseases caused by intrinsic factors occur within the lungs, such as tissue death caused by inflammation or toxins. Extrinsic lung diseases, on the other hand, are caused by conditions that originate outside the lungs, such as neuromuscular dysfunction and irregular chest wall movements.

Symptoms of Respiratory Disease

The signs and symptoms of respiratory disease can vary from one person to another. This usually depends on the type of condition, severity, age, and overall health. Whereas some symptoms are mild and can improve with time, others are chronic and require immediate medical attention. 

These are thus the common respiratory disease symptoms you need to watch out for; 

• Breathing difficulties:

 Usually, people can experience shortness of breath, especially when exercising. However, if the situation persists or occurs even when relaxing, it could be a respiratory disease sign. It’s thus essential to see a physician immediately if you experience alarming breathing difficulty. 

• Stubborn coughs:

 While coughs can be a sign of minor infection, constant coughing that doesn’t clear up after three or more weeks is considered serious. This could signify any type of respiratory disorder, including asthma, pneumonia, and allergies. You should thus see a doctor if you experience chronic and stubborn cough. 

• Constant chest pain: 

Chest pain can be an early symptom of lung disease, but it is most often associated with a pneumonia attack, in which case it is caused by an inflammation of the pleura that occurs after the pneumonic process begins. When taking a deep breath, pain associated with pleural inflammation is typically felt. When fluid accumulates in the pleural space, a condition known as pleural effusion, the pain goes away.

Acute pleurisy with pain may indicate a pulmonary vessel blockage, resulting in acute congestion of the affected part. Pleurisy can be caused by pulmonary embolism, which is the occlusion of a pulmonary artery by a fat deposit or a blood clot that has become dislodged from another location in the body. A blood vessel that becomes suddenly blocked injures the lung tissue to which it normally delivers blood.

Furthermore, severe chest pain may result from the spread of malignant disease to the pleura or from a tumor that arises from the pleura itself, as in mesothelioma. Severe and intractable pain caused by such conditions may necessitate surgery to cut the nerves supplying the affected segment. Fortunately, such severe pain is rare.

• Production of excessive mucus:

 It’s natural for the body to produce mucus; besides, they help prevent infections and various irritants. However, if you constantly cough up phlegm or feel drainage in the chest for several weeks, it could signify respiratory disease. 

• Noisy breathing:

 In most cases, wheezing and noisy breathing indicates obstruction of the air paths. While this could result from any respiratory disease, it’s crucial to seek medical attention as soon as the sign begins. 

• Blood coughs:

 Blood traces in the coughs mostly come from the respiratory tract or the lungs. Regardless of the underlying cause and origin, coughing up blood is a chronic condition that requires immediate diagnosis and treatment. 

Many lung diseases are known to have a generally debilitating effect. As the first sign of active lung tuberculosis or lung cancer, a person may be aware of only a general feeling of malaise, unusual fatigue, or seemingly minor symptoms. Loss of appetite and weight, a lack of physical activity, general psychological depression, and some symptoms that appear unrelated to the lung, such as mild indigestion or headaches, may all be signs of lung disease.

Not infrequently, the patient may experience symptoms similar to those experienced when recovering from an influenza attack. Because the symptoms of lung disease are variable and nonspecific, a physical and radiographic examination of the chest is an important part of evaluating people who have these complaints.

Respiratory Disease Diagnosis 

Sometimes, certain respiratory diseases can be misdiagnosed or can go undetected until it reaches the advanced level. However, it’s highly recommended to visit a healthcare facility if you experience any signs or notice changes in the breathing habit. 

The first diagnosis procedure involves a physical examination of the associated signs and symptoms. It also includes assessing the medical history to check if there is a record of respiratory illness and exposure to possible triggers. Inquiring about the family history is also essential. This helps to determine if you are at a higher risk of developing respiratory conditions and cancers. 

Other additional diagnostic tests and procedures can include the following; 

• Chest x-ray: 

This is an imaging test that doctors use to check for health issues like pneumonia and COPD. These diseases mostly cause the fluid to accumulate in the lungs. A chest x-ray is also essential in diagnosing cancer or accumulation of scar tissue called pulmonary fibrosis in the lungs. 

• Chest ultrasound: 

This diagnostic test utilizes high-frequency sound waves to create detailed images of the lungs and respiratory tract. This makes it easy for the doctor to check if there is fluid accumulation inside or around the lungs. 

• Computerized tomography (CT) scan: 

This is an advanced type of imaging test that doctors use to check abnormalities that can’t be seen using an x-ray. Examples of such conditions include cancers of the lung or respiratory system. CT scan uses a series of x-ray images taken at varying angles placed together to create a clearer picture. 

• Bronchoscopy:

 This involves the use of a bronchoscope device attached to a light source and small camera. The doctor performs the procedure by sliding the device into the air paths. This makes it easy to view the passages and check for signs such as blood, mucus, and tumors. 

• Pleural biopsy: 

This involves the use of a small needle to obtain tissue samples from the respiratory tract. The procedure is done by inserting the needle into the chest regions between the ribs at the back. The obtained sample is then taken to the lab for more tests. 

Asthma Tests

If you have allergic asthma symptoms, allergy tests can help you identify your triggers. This way, you can avoid them and avoid future allergic reactions.

In addition to allergy testing, asthma testing includes:

• Spirometry: This test measures how much air moves in and out of your lungs.
• Peak airflow: This test measures how quickly you expel air when you forcefully exhale after a deep inhalation.
• Fractional exhaled nitric oxide (FeNO) test: A FeNO test measures the amount of nitric oxide in your breath, which can help determine the level of inflammation in your airways.
• Provocation test: This test measures lung function after exposure to specific triggers.

Respiratory Disease Treatment

The purpose of treatment is to help manage the condition, ease the associated symptoms, and minimize the complications or exacerbation. Respiratory disease treatment also enhances the ability to live a normal healthy life. 

Depending on the type of respiratory disease, the treatment option can include the following; 

Medication

Various types of medications help treat the illness and ease the symptoms and complications. Examples of these medications are; 

• Bronchodilators: These are the most common inhaled medication that helps relax the muscles within the air paths. They also ease shortness of breath and coughing, hence making the breathing process easy. 
• Inhaled steroids: These forms of medications help ease air path inflammation and prevent additional complications and aggravation. 
• Oral steroids: These are mostly recommended for patients with a respiratory illness that worsens or becomes severe. The use of oral steroids can help ease the condition and prevent exacerbation. 

Other types of vital medications include; 

• Antibiotics 
• Theophylline 
• Phosphodiesterase-4 inhibitors

Lung therapy

Doctors can sometimes recommend additional lung therapy for patients with severe and moderate conditions. Examples of lung therapy treatment include oxygen therapy and pulmonary rehabilitation course. 

Refrain from smoking

This is usually the first essential factor for a respiratory disease treatment plan. Quitting smoking prevents the condition from worsening and enables the treatment to work effectively. 

Surgery

In rare cases, surgery might be necessary to address chronic respiratory diseases, including emphysema that doesn’t respond to other treatment forms. Examples of surgical interventions are lung volume reduction procedures, bullectomy, and lung transplants. 

How to prevent Respiratory Diseases?

The most important cause of respiratory diseases around the world is cigarette smoking. So, cessation of smoking is extremely important. Air pollution is also a significant problem in today’s world, so the use of a face mask is also strongly recommended. In some patients, an asthma attack may be triggered by eating some specific foods or on exposure to cold. For this reason avoidance of these situations is suggested for those patients.

Conclusion 

Every person is prone to respiratory diseases that can affect various parts of the respiratory tract. These conditions also interfere with the ability to breathe normally and can result in life-threatening complications. Early diagnosis and treatment are thus essential to prevent additional health issues. 

The respiratory system refers to a network of tissues and organs that facilitate breathing. It mainly comprises the lungs, blood vessels, and air paths. The system also enables the body to absorb oxygen in the air to allow the organs to works and function normally. Furthermore, it cleans and keeps off waste gases, including carbon dioxide, from the blood.