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Obstructive lung disease

obstructive lung disease, obstructive lung disease symptoms
Obstructive lung disease is a category of respiratory disease characterized by airway obstruction Many obstructive diseases of the lung result from narrowing of the smaller bronchi and larger bronchioles, often because of excessive contraction of the smooth muscle itself It is generally characterized by inflamed and easily collapsible airways, obstruction to airflow, problems exhaling and frequent medical clinic visits and hospitalizations Types of obstructive lung disease include; asthma, bronchiectasis, bronchitis and chronic obstructive pulmonary disease COPD Although COPD shares similar characteristics with all other obstructive lung diseases, such as the signs of coughing and wheezing, they are distinct conditions in terms of disease onset, frequency of symptoms and reversibility of airway obstruction1 Cystic fibrosis is also sometimes included in obstructive pulmonary disease2


  • 1 Diagnosis
  • 2 Types
    • 21 Asthma
    • 22 Bronchiectasis
    • 23 Chronic obstructive pulmonary disease
  • 3 See also
  • 4 References


Diagnosis of obstructive disease requires several factors depending on the exact disease being diagnosed However one commonalty between them is an FEV1/FVC ratio less than 07, ie the inability to exhale 70% of their breath within one second

Following is an overview of the main obstructive lung diseases Chronic obstructive pulmonary disease is mainly a combination of chronic bronchitis and emphysema, but may be more or less overlapping with all conditions3

ConditionMain siteMajor changesCausesSymptoms
Chronic bronchitisBronchusHyperplasia and hypersecretion of mucus glandsTobacco smoking and air pollutantsProductive cough
subgroup of chronic bronchitis
BronchioleInflammatory scarring and bronchiole obliterationTobacco smoking and air pollutantsCough, dyspnea
BronchiectasisBronchusDilation and scarring of airwaysPersistent severe infectionsCough, purulent sputum and fever
  • Smooth muscle hyperplasia
  • Excessive mucus
  • Inflammation
  • Constriction
Immunologic or idiopathicEpisodic wheezing, cough and dyspnea
Unless else specified in boxes then reference is 3


Play mediaA video discussing bronchial hyperresponsiveness studies of firefighters involved in rescue efforts after the September 11 attacks


Main article:Asthma

Asthma is an obstructive lung disease where the bronchial tubes airways are extra sensitive hyperresponsive The airways become inflamed and produce excess mucus and the muscles around the airways tighten making the airways narrower Asthma is usually triggered by breathing in things in the air such as dust or pollen that produce an allergic reaction It may be triggered by other things such as an upper respiratory tract infection, cold air, exercise or smoke Asthma is a common condition and affects over 300 million people around the world4 Asthma causes recurring episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning

  • Exercise-Induced Asthma — is common in asthmatics, especially after participation in outdoor activities in cold weather
  • Occupational Asthma — An estimated 2% to 5% of all asthma episodes may be caused by exposure to a specific sensitizing agent in the workplace
  • Nocturnal Asthma — is a characteristic problem in poorly controlled asthma and is reported by more than two thirds of sub-optimally treated patients

A peak flow meter can record variations in the severity of asthma over time Spirometry, a measurement of lung function, can provide an assessment of the severity, reversibility, and variability of airflow limitation, and help confirm the diagnosis of asthma4


Main article:Bronchiectasis

Bronchiectasis refers to the abnormal, irreversible dilatation of the bronchi caused by destructive and inflammatory changes in the airway walls Bronchiectasis has three major anatomical patterns:cylindrical bronchiectasis, varicose bronchiectasis and cystic bronchiectasis

Chronic obstructive pulmonary diseaseedit

Main article:Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease COPD,5 also known as chronic obstructive airways disease COAD or chronic airflow limitation CAL, is a group of illnesses characterised by airflow limitation that is not fully reversible The flow of air into and out of the lungs is impaired6 This can be measured with breathing devices such as a peak flow meter or by spirometry The term COPD includes the conditions emphysema and chronic bronchitis although most patients with COPD have characteristics of both conditions to varying degrees Asthma being a reversible obstruction of airways is often considered separately, but many COPD patients also have some degree of reversibility in their airways

In COPD, there is an increase in airway resistance, shown by a decrease in the forced expiratory volume in 1 second FEV1 measured by spirometry COPD is defined as a forced expiratory volume in 1 second to forced vital capacity ratio FEV1/FVC that is less than 077 The residual volume, the volume of air left in the lungs following full expiration, is often increased in COPD, as is the total lung capacity, while the vital capacity remains relatively normal The increased total lung capacity hyperinflation can result in the clinical feature of a "barrel chest" - a chest with a large front-to-back diameter that occurs in some individuals with COPD Hyperinflation can also be seen on a chest x-ray as a flattening of the diaphragm

The most common cause of COPD is cigarette smoking COPD is a gradually progressive condition and usually only develops after about 20 pack-years of smoking COPD may also be caused by breathing in other particles and gases

The diagnosis of COPD is established through spirometry although other pulmonary function tests can be helpful A chest x-ray is often ordered to look for hyperinflation and rule out other lung conditions but the lung damage of COPD is not always visible on a chest x-ray Emphysema, for example can only be seen on CT scan

The main form of long term management involves the use of inhaled bronchodilators specifically beta agonists and anticholinergics and inhaled corticosteroids Many patients eventually require oxygen supplementation at home In severe cases that are difficult to control, chronic treatment with oral corticosteroids may be necessary, although this is fraught with significant side-effects

COPD is generally irreversible although lung function can partially recover if the patient stops smoking Smoking cessation is an essential aspect of treatment8 Pulmonary rehabilitation programmes involve intensive exercise training combined with education and are effective in improving shortness of breath Severe emphysema has been treated with lung volume reduction surgery, with some success in carefully chosen cases Lung transplantation is also performed for severe COPD in carefully chosen cases

Alpha 1-antitrypsin deficiency is a fairly rare genetic condition that results in COPD particularly emphysema due to a lack of the antitrypsin protein which protects the fragile alveolar walls from protease enzymes released by inflammatory processes

See alsoedit

Restrictive lung disease


  1. ^ National Asthma Education and Prevention Program Clinical Practice Guidelines Expert Panel Report 2 Guidelines for the Diagnosis and Management of Asthma Bethesda, Md:National Heart, Lung, and Blood Institute, National Institutes of Health, US Dept of Health and Human Services; 1997 NIH publication 97-4051
  2. ^ Restrepo RD September 2007 "Inhaled adrenergics and anticholinergics in obstructive lung disease:do they enhance mucociliary clearance" PDF Respir Care 52 9:1159–73; discussion 1173–5 PMID 17716384 
  3. ^ a b Table 13-2 in:Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K; Fausto, Nelson 2007 Robbins Basic Pathology:With STUDENT CONSULT Online Access Philadelphia:Saunders ISBN 1-4160-2973-7  8th edition
  4. ^ a b "GINA – the Global INitiative for Asthma" Retrieved 2008-05-06 
  5. ^ A Guide To Understanding Congenital Lobar Emphysema copd-stagescom; 2014 cited 19 May 2014
  6. ^ Kleinschmidt, Paul "Chronic Obstructive Pulmonary Disease and Emphysema" Retrieved 2008-04-19 
  7. ^ "GOLD – the Global initiative for chronic Obstructive Lung Disease" Retrieved 2008-05-06 
  8. ^ "What is chronic obstructive pulmonary disease COPD" Archived from the original on 2008-06-14 Retrieved 2008-04-19 

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Obstructive lung disease

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