Restrictive lung diseases are a very large group of diseases that have in common a decrease in lung volumes as seen in pulmonary function tests. These diseases are also called interstitial lung diseases. This is because it mainly affects the interstitial tissues of the lung. This label is misleading
D Often these diseases also affect the small airways and alveoli.
In some patients, the disease is acute and its symptoms last for days or weeks only, then the disease turns into a permanent chronic disease in some patients, while the symptoms of the disease disappear in others with or without treatment, or once exposure to the factor that caused the disease, such as: medications, is avoided.
As for another part of the patients, weeks and months pass before the disease is diagnosed, and for the remaining part, the disease is chronic. Months and even years may pass before the diagnosis is made, and then the disease is known as chronic lung disease.
Most of the interstitial lung diseases are chronic and cannot be cured, as the course of the disease is characterized by being chronic, and the symptoms are exacerbated by the background of the course of the chronic and advanced disease in the patient, where the health of most patients is poor and they are restricted in terms of their activities and have a low quality of life.
Symptoms of restrictive lung disease
The most common symptoms include
Shortness of breath, especially with exertion.
Inability to catch their breath or breathe adequately.
A chronic or prolonged cough, usually dry, but sometimes with white sputum or mucus.
Weight loss.
Source.
breathing.
Tiredness or extreme exhaustion without a logical reason.
depression.
anxiety.
Causes and risk factors for restrictive lung disease
Restrictive conditions are defined by inhalation filling of the lungs that is much lower than would be expected in a healthy person.
Restrictive lung disease is characterized by a decrease in total lung capacity or total residual volume combined with forced vital capacity, as this occurs because the lungs are difficult to fill completely in the first place.
Restrictive lung diseases can be the result of internal, external, or neurological factors. The most prominent causes and risk factors for restrictive lung disease include the following:
1. Intrinsic restrictive lung disease
Intrinsic restrictive disorders are those caused by a restriction in the lungs that is often sclerosis, and include the following:
Pneumonia.
Respiratory distress syndrome in adults.
Eosinophilic pneumonia.
Tuberculosis.
Sarcoidosis.
Pulmonary fibrosis and idiopathic pulmonary fibrosis.
Lung cancer surgery.
2. External Restrictive Lung Disease
External restrictive disorders refer to those that arise outside the lungs. The most common causes of these disorders include:
Scoliosis.
Obesity.
hypoventilation syndrome.
Pleural effusion.
Malignant neoplasms.
sy
Rib fractures.
3. Restrictive neurological lung disease
Restrictive neurological disorders are those caused by disorders of the central nervous system that interfere with the movements needed to draw air into the lungs. Among the most common causes are:
Diaphragm paralysis.
Guillain-Barré syndrome.
myasthenia gravis.
muscle atrophy.
Amyotrophic lateral sclerosis.
Complications of restrictive lung disease
The most prominent complications include the following
Hypoxemia results from advanced restrictive lung disease which can only be compensated for by an increased respiratory rate.
Excessive energy expenditure in breathing leads to muscle wasting and weight loss.
Chronic respiratory failure that results once compensatory mechanisms fail and hypoxia worsens.
Sleep disorders including obstructive sleep apnea, which are common in patients with external pulmonary restriction due to obesity.
Pulmonary and cardiopulmonary hypertension due to chronic respiratory failure and malformation of the lung structure.
Diagnosis of restrictive lung disease
A doctor usually performs or orders a lung function test to assess total lung capacity, or the total amount of air the lungs take in when a person inhales, as total lung capacity is usually decreased in restrictive lung diseases.
Other tests may be necessary for a complete diagnosis and to ensure the correct treatment plan is arranged, as the specific tests used are usually determined by whether the suspected cause of the restrictive lung disease is internal or external.
Tests that show impaired lung function may indicate that scarring, hardening or inflammation is affecting a large portion of the lungs.
Commonly used tests for restrictive lung disease include
1. Forced vital capacity test
Which involves inhaling and filling the lungs with as much air as possible and then exhaling as forcefully as possible, as the forced vital capacity test is usually reduced for those with restrictive lung disease.
A screening value less than or equal to 80% of what is expected can be a sign of restrictive disease.
2. Forced expiratory volume test in one second
Which measures the amount of air exhaled during the first second of the test. Most people expel about three-quarters of the inhaled air during this initial period of exhalation, but in restrictive diseases the forced expiratory volume test in one second will be relatively lower.
3. Test the ratio of the forced expiratory volume test in 1 second to the forced vital capacity test
This compares the amount of air expelled during the first second of exhalation to the total amount of air exhaled during a forced vital capacity test, which is often normal or even increased in people with restrictive lung disease.
4. Imaging tests
They include the following
Chest X-ray: This s images of the entire chest and lung area for evaluation.
Computed tomography: which produces more detailed images of the chest and lung than a chest X-ray.
5. Bronchoscopy
A flexible tube equipped with a camera is ed through the nose or mouth into the airways of the lung for examination.
Treatment of restrictive lung disease
Few medications are available to treat most causes of restrictive lung disease. In cases of restrictive lung disease caused by persistent inflammation, medications that suppress the immune system may be used, including:
Corticosteroids.
Azathioprine.
Cyclophosphamide.
Methotrexate.
Supplemental oxygen therapy may be necessary and mechanical assistance with breathing may be beneficial for some people who have difficulty breathing due to restrictive lung disease.
In cases of obesity-related lung disease, weight loss and exercise can help reduce breathing resistance caused by excess fat.
Prevention of restrictive lung disease
The most important methods of prevention include the following
Doing exercises at home
Make some lifestyle changes such as a healthy diet.
Respiratory conditioning.
Continuous lip breathing.
Deep slow breathing or abdominal breathing.
