Physician Focus: November 2011
by Ronald Sen, M.D.
Respiratory illnesses affect millions of people around the world
and can result in severely impaired quality of life, lifelong
illness, and life-threatening conditions. Here are snapshots of
five of the most common conditions.
Chronic Obstructive Pulmonary Disorder (COPD)
affects more than 12 million people, claims more than 125,000 lives
year each, and is the third leading cause of death in the U.S.,
according to the U.S. Centers for Disease Control.
COPD includes chronic bronchitis, where the lining of the
airways becomes irritated and inflamed, and emphysema, where the
walls between the air sacs in the lungs are damaged. The condition
develops slowly (most patients are over 40 when symptoms appear),
and gets worse over time. No cure exists, but treatments such as
bronchodilators, which relax the muscles around the airways, and
inhaled steroids can relieve symptoms. Lifestyle changes like
exercise also help patients feel better, remain active, and slow
the progression of the disease. Tobacco use, including second-hand
smoke, is the primary cause of COPD. Indoor and outdoor air
pollution and environmental hazards such as chemical fumes or dust
are additional causes.
Asthma, another lifelong illness, inflames and
narrows the airways, causing wheezing, breathlessness, chest
tightness, and coughing. Asthma continues to increase: it now
affects 1 in 12 adults and 1 in 10 children in the U.S. It's
unclear why it's increasing, but we do know that it's brought on by
different "triggers," such as allergies, sinus problems, acid
reflux, or job conditions, as well as smoking, mold, or pollution.
No cure exists, but medications can relieve symptoms. A key factor
in treating asthma is identifying the triggers, then reducing or
eliminating them so that fewer attacks occur.
Pneumonia is a lung infection caused by
bacteria or viruses whose symptoms include coughing, fever, rapid
breathing or shortness of breath, chills, or chest pain. It can
often be prevented with vaccines and is treatable with antibiotic
and antiviral medicines. Adults 65 and older, children under 5 and
those with underlying conditions such as diabetes or HIV/AIDS are
most at risk. Despite vaccines and medicines, pneumonia causes more
deaths annually than any other infectious disease, claiming more
than 50,000 lives in the U.S. and more than one and half million
children under 5 worldwide.
Tuberculosis is a common lung disease
throughout the world, causing nearly 1.5 million deaths and
sickening millions more each year. Caused by bacteria, it's spread
through the air from person to person. Two TB conditions exist. One
is a latent TB infection, which can lay dormant in your body
without causing symptoms or sickness. (Knowledge of this condition
only comes through a skin test.) The second is active TB disease,
where the bacteria grow. Treatment includes a regimen of drugs
taken over several months. While declining in the U.S. with less
than 12,000 cases annually, TB remains a serious threat, especially
for those infected with HIV, as TB is one of the leading causes of
death for those with HIV.
Influenza, perhaps the most publicized illness,
is a contagious, seasonal disease caused by a virus that can affect
anyone regardless of age or health status. Each year, flu leads to
200,000 hospitalizations and 30,000 deaths in the U.S. Most at risk
are the elderly, young children, and those with chronic illnesses
such as diabetes. An annual flu shot, now recommended for everyone
six months of age and older, is the best prevention, as well as
good hygiene habits like hand washing.
Respiratory health is critical to our overall well-being. To
preserve and maintain it, here are three prudent steps I recommend
for patients:
- Get immunized. Whether a shot for the flu or pneumonia,
vaccines are some of the best preventive measures medicine has
available.
- Avoid smoking. Tobacco use is the single largest preventable
cause of death, disability, and disease. We've made progress in
reducing smoking, but tobacco use remains a problem: nearly 47
million adults 18 and older and 3.5 million teens still
smoke.
- Recognize the six hallmark signs of respiratory illness -
cough, shortness of breath, wheezing, coughing up blood, sputum
(mucus or phlegm) production, and chest pain - and see a physician
if you experience any of these.
For more information, visit the American Lung Association at www.lungusa.org. For a video
discussion, visit www.physicianfocus.org
Ronald Sen, M.D. is a primary care physician, specialist in
pulmonary and critical care medicine, and Chief of the Division of
Pulmonary Disease at Melrose-Wakefield Hospital in Melrose,
Massachusetts. Physician Focus is a public service of the
Massachusetts Medical Society. Readers should use their own
judgment when seeking medical care and consult with their physician
for treatment. Send comments to PhysicianFocus@mms.org
