Fibrosis is a diagnosis indicating the formation of scars, pulmonary fibrosis is the formation of scars in the lungs. In patients with this diagnosis, the elastic properties and extensibility of the lung tissue are reduced, and the passage of oxygen through the walls of the alveoli is difficult. The disease is extremely difficult to treat and can lead to irreversible consequences. Pathology is found in most cases in people over 60 years of age.
Symptoms of fibrosis
Among the pronounced symptoms of pulmonary fibrosis:
- shortness of breath, which worsens after physical activity,
- bouts of dry cough,
- persistent pain in the chest area,
- wheezing,
- change in color of lips and limbs,
- increase in phalanges,
- weight loss,
- fatigue and general weakness.
Other diseases of the respiratory system also have similar symptoms, so if unpleasant signals appear, it is best to immediately consult a doctor. An accurate diagnosis will help you quickly make the most correct decision on a treatment regimen and begin to implement it.
Diagnostic measures
Diagnosis of pulmonary fibrosis begins with collecting complaints, studying anamnesis and an objective examination of the patient. It is important to identify the presence of chronic diseases that can provoke the development of this pathology, as well as pay attention to typical clinical manifestations.
To confirm the diagnosis, the specialist prescribes a number of laboratory and instrumental studies, namely:
- General and biochemical blood tests.
- General urine analysis.
- Spirography. This research method allows you to evaluate the peak expiratory air flow rate, as well as the vital capacity of the lungs.
- Plain radiography of the chest organs, in at least two projections. In the image, the doctor reveals deformation and strengthening of the pulmonary pattern, especially in the lower sections.
- Computed and magnetic resonance imaging. Like the previous method, they can reveal structural changes in the lungs. However, with their help it is possible to conduct a more detailed and clear assessment of the pathological process.
Causes of the disease
Pathology can be caused by various reasons:
- hereditary predisposition,
- inflammatory processes in the lungs,
- infectious diseases,
- negative impact of the environment,
- work in hazardous industries,
- the effects of radiation therapy,
- chronic autoimmune diseases,
- complication of lung diseases,
- treatment with various drugs.
Bad habits, such as smoking, can also cause dangerous pathology. However, there are cases of the disease developing without any clear cause. Each individual patient must undergo a full examination to identify the factors that influenced the occurrence of the pathology, this will help to choose the right treatment that will significantly improve the condition.
How to remove negative consequences after “corona”
The rehabilitation process after Covid-19 includes three main steps:
- Establishing oxygen supply to lung tissue.
- Elimination of symptoms of poor lung function.
- Improvement of general physical and psychological condition.
To solve these problems, patients are prescribed:
- Drug therapy. Involves taking medications that increase blood supply to the lungs, accelerate the resorption of fibrous lesions, and relieve inflammation. Medicines should be selected on a purely individual basis. It is unacceptable to take medications unless prescribed by a doctor, since self-medication very often leads to dire consequences.
- Physiotherapeutic procedures. They allow you to destroy pathogenic microflora, remove inflammation, and increase local immunity. In the post-Covid period, the following have proven themselves to be excellent: pulsed and low-frequency magnetic therapy, SMT, the use of an ultra-high frequency electromagnetic field and polychromatic polarized light, electrophoresis, ultrasound, and inductothermy. It is very important that the patient undergoes a whole course of physiotherapy and does not miss sessions. Only then will physical treatment be highly effective and ensure rapid positive dynamics.
- Special diet. After coronavirus, you need to eat a lot of protein foods. The basis of the diet should be low-fat dairy products, meat, fresh vegetables and fruits.
- Therapeutic exercise. Moderate physical activity promotes the resorption of stagnant lesions. You should start gymnastics with the simplest exercises. As performance improves, it will be possible to complicate the techniques used. If the patient is far from sports and does not want to engage in exercise therapy, cycling or long walks in a forested area are suitable for him.
Don't worry if your doctor has diagnosed negative changes in your lungs after coronavirus. Take care of your health, and soon the situation will improve.
Treatment of fibrosis
Treatment of the disease is prescribed by a professional specialist, taking into account the results of the examination and the characteristics of the patient’s disease. There are a number of drugs that help prevent the occurrence of various infections and the development of inflammation. Treatment of fibrosis is supported by therapeutic breathing exercises and the complete exclusion of provoking factors. In case of the total form of the disease, surgical intervention is recommended.
In the early stages of the disease, therapy is used to help reduce scarring. You can consult with a pulmonologist and make an appointment by calling our clinic or using the form on the website.
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Changes in the lungs after coronavirus
After viral agents enter the body, the structure of the pulmonary alveoli changes. Then full gas exchange becomes impossible. Even with an asymptomatic course of the disease, doctors often observe signs of viral pneumonia on x-rays.
As a result of the destruction of the inner layer of the alveoli, the vacated space is filled with pathological cells, lymphocytes and red blood cells. Ventilation of the lungs is impaired. Clinically, this is manifested by severe shortness of breath. X-ray images show darkened areas called “ground glass.”
If the patient’s immunity is weakened and Covid-19 is not treated, pathological foci begin to increase in size and connect with each other. Every day the percentage of damaged lung tissue increases. Then the patient has difficulty breathing. He is worried about the feeling of lack of air. A person cannot take a deep breath. Many people with such symptoms have to be connected to a ventilator, as their life is at risk.
Next, dense “partitions” consisting of connective tissue are formed between the pulmonary lobules. This complication after coronavirus on the lungs is considered very dangerous. It leads to fibrosis.
Medicines
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The main drugs used in the treatment of pulmonary fibrosis are:
- glucocorticoids;
- cytostatics;
- antifibrotic agents.
The administration of systemic glucocorticoids (prednisolone, dexamethasone) alleviates the general condition of the body. It is also believed that drugs in this group can influence the replacement of normal lung tissue with connective tissue, inhibiting this process. However, there is also a negative side to taking glucocorticoids. In the treatment of fibrosis, glucocorticoids are prescribed for a long period of time; in some cases, the course of treatment can reach up to 3 months. Such prolonged use is dangerous for the development of side effects. These include:
- increased blood pressure, which is especially dangerous for people suffering from arterial hypertension. While taking glucocorticoids, resistance to early antihypertensive therapy may occur;
- exacerbation of peptic ulcer of the stomach or duodenum;
- osteoporosis, which leads to increased bone fragility;
- weight gain;
- hyperglycemia. Therefore, when taking glucocorticoids, it is important to monitor glycemic levels. Particular attention should be paid to people with diabetes.
The appearance of these symptoms is the reason for contacting your doctor, who, in turn, either adjusts the dosage of the drug or discontinues it.
The use of cytostatics (azathioprine, cyclophosphamide) is also accompanied by some side effects: the function of the gonads is disrupted, hematopoiesis is inhibited, undesirable effects from the gastrointestinal tract, nephro- and hepatotoxicity are observed. The most gentle drug in this group in this regard is azathioprine. This drug is able to block cell division and degeneration of tissue into fibrous tissue, which has a significant role in the treatment of pulmonary fibrosis. Taking the drug is strictly prohibited during pregnancy and lactation, and is also undesirable if you have existing renal or liver failure.
Colchicine also belongs to antifibrotic drugs, which can inhibit the production of fibronectin. With long-term use, a picture of myelosuppression can be detected, that is, a decrease in leukocytes in the blood, and thrombocytopenia (decrease in platelets), temporary alopecia, myopathy, peripheral neuritis, etc. is not a rare case. The drug is contraindicated in cases of severe impairment of liver and kidney function, cardiovascular pathology, purulent infections, pregnancy and lactation. In all other cases, the use of the drug is justified.
Prevention of pulmonary fibrosis
Pneumofibrosis often develops against the background of infectious and inflammatory diseases in the lungs, when inhaling toxic substances and polluted air (dust).
To prevent the disease, you should completely stop smoking, lead an active lifestyle, and promptly identify and treat diseases.
If your line of work requires you to work with toxic substances, dust and other pollutants, you must adhere to safety precautions and use respirators.
Not just the lungs
— Why is pulmonary fibrosis dangerous?
MK: The trouble is that not only the lungs suffer from lung disease. It is known that when oxygen supply is limited, if gas exchange does not occur, complications in the functioning of the cardiovascular and nervous systems subsequently arise. The heart begins to work harder: deformation appears, various pathologies are formed throughout the cardiovascular system, since lung damage does not occur separately from vascular damage. And then - increased pressure with possible hypertension, and blood clots may also break off.
Then a nervous rollback begins, because depression develops from a lack of oxygen, and people simply lose the desire to live. Memory fails: a person may be asked to leave work because labor productivity is falling. If left untreated, this condition may not be limited to 6 months or a year, but will persist forever.
The process of rehabilitation of such patients is a new direction, we must now develop and develop it. Psychologists, cardiologists, neurologists, and endocrinologists will have to work here.
Diagnosis of pneumofibrosis
Pneumofibrosis is diagnosed based on symptoms and a thorough medical examination.
If pulmonary fibrosis is suspected, the patient is referred for consultation to a pulmonologist.
The main diagnostic tool for this pathology is x-ray, which will help establish the sclerotic nature of changes in lung tissue and distinguish pulmonary fibrosis from a tumor in the lungs.
If necessary, the doctor may prescribe a computed tomography, tomography, or radiography.
Description
Pulmonary fibrosis is a process characterized by the replacement of lung tissue with fibrous (scar) tissue, which is accompanied by impaired respiratory function.
Thanks to the work of our lungs, the blood is saturated with oxygen necessary for energy consumption, as well as the release of carbon dioxide, which is formed as a by-product during the life of cells. The development of pulmonary fibrosis leads to a decrease in the volume of normally functioning lung tissue, and as a result, breathing efficiency decreases.
Replacement of pulmonary connective tissue can occur in one lung or in both at the same time. Depending on this, unilateral and bilateral fibrosis are distinguished. In addition, pulmonary fibrosis is divided into focal, in which a small area of lung tissue is affected, and total, in which the pathological process spreads to almost the entire lung.
The reasons for the development of pulmonary fibrosis are varied:
- diseases of the respiratory system (chronic bronchitis with broncho-obstructive syndrome, pneumonia, tuberculosis, chronic obstructive pulmonary disease);
- connective tissue diseases (rheumatoid arthritis, systemic lupus erythematosus, systemic scleroderma);
- exposure to production factors that negatively affect the respiratory system. For example, with prolonged inhalation of silicate dust in production, silicosis occurs. Occupational diseases also include asbestosis, which occurs due to inhalation of asbestos dust;
- long-term use of certain medications (antiarrhythmic drugs, drugs used to treat malignant tumors);
- the presence of vasculitis (a disease accompanied by inflammation of the walls of blood vessels);
- idiopathic or primary pulmonary fibrosis, the exact cause of which has not been established.
The prognosis of the disease is relatively unfavorable; progression of the pathological process leads to the development of pneumosclerosis and then cirrhosis of the lungs, which significantly reduces a person’s quality of life and can lead to disability. In addition, this condition leads to such serious complications as chronic respiratory failure, pulmonary hypertension, and chronic heart failure. Therefore, it is extremely important to contact a specialist as early as possible, who, in turn, will prescribe the necessary range of diagnostic procedures and necessary treatment.
Procedures and operations
During any exercise, the heart and lungs work actively. Special breathing exercises are aimed at increasing the functionality of the lungs, reducing shortness of breath and increasing exercise tolerance. The complex should include exercises for training diaphragmatic breathing and exercises with forced exhalation. You can take breathing exercises according to the method of P. A. Buteyko as a basis. The duration of breathing exercises is 10 minutes, and you need to perform it 3-5 times during the day. The ideal option is individually selected gymnastics. If the condition of the respiratory system allows, you can engage in race walking.
Among the procedures, oxygen replacement therapy is indicated, which is carried out when the blood oxygen pressure decreases to less than 60 mm Hg. Art. In case of chronic respiratory failure, oxygen therapy is carried out at home for a long time (18 hours a day) in a low-flow (2-5 l/min) oxygen supply mode. In case of severe respiratory failure, helium-oxygen mixtures are used. Oxygen concentrators are used at home.
To remove circulating immune complexes from the blood (especially in bronchial asthma ), hemosorption .
Classification of IBL
Currently, the classification developed in 2002 by the American Thoracic Society (ATS) and the European Respiratory Society (ERS) is adopted as the basis. According to this classification, there are interstitial lung diseases. With established etiology:
- Radiation, medicinal, toxic;
- Pneumomycoses associated with HIV infections
- Interstitial lung diseases against the background of collagenosis and pneumoconiosis;
- Interstitial lung diseases due to infections;
- Interstitial lung diseases against the background of allergic alveolitis.
Idiopathic interstitial pneumonia:
- Nonspecific, lymphoid, acute, desquamative, cryptogenic organizing;
- Idiopathic pulmonary fibrosis.
- Granulomatous: interstitial diseases against the background of sarcoidosis, exogenous allergic alveolitis, hemosiderosis.
Associated with other diseases:
- Pathology of the liver, intestines, kidneys;
- Hereditary diseases;
- Malignant neoplasms.
Other: associated with primary pulmonary amyloidosis, pulmonary proteinosis.
Pathologists distinguish the following types of fibrosis in interstitial lung diseases:
- Simple;
- Desquamative;
- Lymphocytic;
- Bronchiolitis obliterans with pneumonia;
- Giant cell.
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Literature:
- Pathogenesis of Covid-19 / Abaturov A.E., Agafonova E.A., Krivusha E.L., Nikulina A.A./ 2021 / Journal “Child Health”.
- Expert analysis of the treatment of acute respiratory infections by local pediatricians / Zemlyakova E. I., Shakirova E. M., Safina L. Z. / 2012 / Journal “Practical Medicine”.
- Fundamentals of physical rehabilitation and physiotherapy / N. B. Serova; Ministry of Education and Science of the Russian Federation, Ural Federal University named after. the first President of Russia B. N. Yeltsin, [Institute of Physical Culture, Sports and Youth Policy]. - Ekaterinburg: Ural University Publishing House, 2021. - 220 p.
The text was checked by expert doctors: Head of the socio-psychological service of the Alkoklinik MC, psychologist Yu.P. Baranova, L.A. Serova, a psychiatrist-narcologist.
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