Introduction:
Restrictive lung disease is a condition in which lung disorders prevent the expansion of the lungs. As a result, the person experiences difficulty in breathing. The progression of restrictive lung disease is rapid. In severe cases, the lung collapses, causing pneumothorax. Restrictive lung disease is reversible with appropriate treatments. The decrease in the elasticity of the lungs affects the functional capacity of the lungs. Eventually, it decreases the total volume of air inside the lungs.
What Are the Two Types of Restrictive Lung Disease?
Restrictive lung diseases are classified into two types based on the causes. They are extrinsic and intrinsic.
1. Intrinsic Restrictive Lung Disease: This disease arises within the lungs. It produces inflammation in the connective tissue of the lungs and damages the numerous capillaries in the lungs as well as the tiny air sacs (alveoli). The interstitial tissue is present in layers inside the lungs to support the respiratory mechanism. The intrinsic factors alter the functions of interstitial tissue and produce scars inside the lungs. This makes the lung stiff and decreases the function of air passages. Various conditions that cause intrinsic restrictive lung diseases are as follows:
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Pulmonary Fibrosis: Thedeposition of fibers causes inflammation in the alveoli. The thickening of air sacs decreases breathing capacity. This fibrosis produces permanent scars in the lungs. It is also known as chronic fibrosing alveolitis.
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Sarcoidosis: The accumulation of inflammatory cells produces clumps and results in granulomas, also known as sarcoidosis. They are produced by the immune system in response to the irritation or allergic reaction in the lungs.
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Scleroderma: It is an autoimmune disorder produced due to excess deposition of a protein called collagen in the connective tissue. It produces fibrosis in the internal organs like the lungs and kidneys. It decreases blood circulation to vital organs.
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Drug-Induced Lung Disease: Chemotherapeutic drugs and sulfa drugs damage the lung tissue due to allergic reactions. It produces bleeding in the alveoli inside the lungs. This condition is called alveolar hemorrhage.
2. Extrinsic Restrictive Lung Disease: This disease exists outside the lungs. It affects the respiratory muscles, chest wall, and pleura. The pleura is the outer covering of the lungs. Extrinsic restrictive lung diseases impair the function of the lungs and result in respiratory failure. The conditions causing extrinsic restrictive lung disease are as follows:
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Neuromuscular Disorders: Neuromuscular disorders like muscular dystrophy and amyotrophic lateral sclerosis (AML) affect the lungs. Muscular dystrophy is the degeneration of muscle cells that ends in muscle weakness. The respiratory muscle becomes weak, and the lungs are incapable of breathing. Amyotrophic lateral sclerosis (AML) is the destruction of nerve cells in the brain. These nerve cells are responsible for muscle movements. The signal to the muscles is altered due to damage to the nerve cells. In severe cases, the respiratory muscles degenerate and cause breathing problems.
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Pleural Effusion: It is a condition in which the fluid fills the pleural space around the lungs. This fluid compresses the lung tissue. This affects the expansion of the lungs during respiration.
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Other External Factors: Fractures in the ribs due to road traffic accidents and paralysis of the diaphragm due to nerve degeneration restrict the lungs from breathing. The respiratory muscles cannot contract during inspiration and produce restrictive lung disease.
What Are the Symptoms of Restrictive Lung Disease?
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Breathing Difficulty - The person affected by restrictive lung disease has shortness of breath. They have exertion after any physical activity.
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Gasping for Breath - The compression in the lungs makes it stiffer during respiration. The patient gasps for breath during the respiratory mechanism. The inhalation of oxygen by the lungs is reduced. But the body requires oxygen for metabolism. So there is an increase in the respiratory rate to meet the requirement.
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Fatigue - Due to reduced functional capacity in the lungs, the oxygen delivery to all the vital organs is diminished. As a result, the person becomes tired more easily.
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Cough - The symptoms of cough last for more than a month.
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Anxiety - The patient affected by restrictive lung disease has increased anxiety and depression. They cannot carry out day-to-day activities due to breathing problems.
What Are the Diagnostic Procedures for Restrictive Lung Disease?
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Pulmonary Function Test - It measures the total lung capacity. The person affected by restrictive lung disease should inhale the air as much as possible. The force exerted during exhalation is calculated as a forced vital capacity (FVC) test. The amount of expired air is calculated after one second. This is referred to as forced expiratory volume in one second. Both these test results are compared to analyze the progress of restrictive lung disease.
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X-rays - X-rays are used to determine the abnormality in the chest wall. The fracture in the ribs or altered shape of the lungs can be identified by the medical professional using X-rays.
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Bronchoscopy - A camera attached to the bronchoscope is used to detect the dysfunction of respiratory muscles and airways.
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CT-Scan (Computed Tomography) - The cross-sectional images of the lungs are used to identify the thickening of the lung tissues and muscle elasticity of the lungs. Any abnormality in the size and shape of the lungs, airways, and blood vessels can be observed through a CT scan.
What Are the Treatment Methods for Restrictive Lung Disease?
The main aim of the treatment is to slow down the progress of the disease by eliminating the cause. It improves life expectancy.
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Oxygen Therapy: The person affected by severe restrictive lung diseases requires ventilatory support to breathe. Oxygen therapy is provided to them by the medical professional in the hospital.
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Surgery: Though the thickening in the lung tissue is irreversible, surgery is attempted by doctors to repair the lungs. In rare cases, the patient requires lung transplants to increase life expectancy.
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Drugs: Intrinsic lung diseases are usually treated with immunotherapeutic drugs, corticosteroids, and anti-fibrotic drugs. Immunotherapeutic drugs are used to reduce inflammation in the lungs. Anti-fibrotic drugs reduce the deposition of fibers in the lung tissue.
Conclusion:
Breathing exercise and a healthy lifestyle improve the quality of life for patients affected by restrictive lung diseases. Significantly, the exercise for respiratory muscle strengthening and meditation for relaxation increase breathing efficiency. Do not stay in surroundings filled with dust and irritants, as it damages the airways and the lungs. A person with restrictive lung disease must avoid smoking to live a long life.
