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Restrictive Vs. Obstructive Lung Disease - WebMD
Doctors may classify lung conditions as obstructive lung disease or restrictive lung disease. Obstructive lung diseases include conditions that make it hard to exhale all the air in your lungs. People with restrictive lung disease have trouble fully expanding their lungs with air.
Obstructive and restrictive lung disease share the same main symptom: shortness of breath when you exert yourself.
People with obstructive lung disease have shortness of breath because it's hard for them to exhale all the air from their lungs. Because of damage to the lungs or narrowing of the airways inside the lungs, the exhaled air comes out more slowly than it should. At the end of a full exhalation, too much air may linger in the lungs.
The most common causes of obstructive lung disease are:
Obstructive lung disease makes it harder to breathe, especially when you're exercising or otherwise being active. As your breathing rate increases, you have less time to breathe all the air out before you inhale again.
People with restrictive lung disease can't fully fill their lungs with air. Their lungs are restricted from fully expanding.
Restrictive lung disease most often results from a condition that causes stiffness in the lungs themselves. In other cases, stiffness of the chest wall, weak muscles, or damaged nerves may restrict how much your lungs can expand.
Some conditions causing restrictive lung disease are:
Most often, people with obstructive or restrictive lung disease see a doctor because they feel short of breath.
Doctors identify restrictive and obstructive lung diseases using pulmonary function tests. In pulmonary function testing, you blow air forcefully through a mouthpiece. As you go through various breathing exercises, a machine records the volume and flow of air through your lungs. Pulmonary function testing can show whether you have obstructive lung disease or restrictive lung disease, as well as how serious they are.
A doctor's interview (including smoking history), physical exam, and lab tests may provide additional clues to the cause of obstructive lung disease or restrictive lung disease.
Imaging tests are almost always part of the process of diagnosing restrictive and obstructive lung disease. These may include:
Sometimes, your doctor may recommend a bronchoscopy to help them figure out what's causing obstructive or restrictive lung disease. In a bronchoscopy, your doctor uses an endoscope (a flexible tube with a camera and tools on its tip) to look inside your airways and take samples of lung tissue (biopsy).
Obstructive lung disease and restrictive lung disease cause shortness of breath. In their early stages, you get short of breath only when you exert yourself. If the underlying lung condition gets worse, it might happen with very little activity, or even when you're at rest.
Cough is a common symptom for both types of lung diseases. Usually, the cough is dry or brings up white sputum (mucus). People with chronic bronchitis, a type of obstructive lung disease, may cough up larger amounts of colored sputum.
Many people with obstructive or restrictive lung disease also have symptoms of depression and anxiety. These symptoms are more likely when lung disease seriously limits your activities and lifestyle.
Obstructive lung disease treatments work by helping to open narrowed airways. Your airways may be narrowed because you have spasms in the smooth muscles that line their walls. These are called bronchospasms.
Medicines that relax these smooth muscles and improve airflow are called bronchodilators and are inhaled. These include:
Theophylline (Theo-Dur and other brand names) is a rarely used bronchodilator taken as an oral tablet.
Inflammation also contributes to airway narrowing in obstructive lung disease. Inflamed airway walls may be swollen and filled with mucus, obstructing airflow. Various medicines help reduce inflammation in obstructive lung disease, including:
A program of regular exercise will improve symptoms of breathlessness in virtually all people with obstructive lung disease. Oxygen therapy may be necessary for some people.
In severe cases of end-stage, life-threatening obstructive lung disease, lung transplantation can be considered as a treatment option.
Few medicines are available to treat most causes of restrictive lung disease.
The FDA has approved two drugs, Esbriet (pirfenidone) and Ofev (nintedanib)to treat idiopathic pulmonary fibrosis. They act on several pathways that may be involved in causing scars to your lung tissue. Studies show both medications can slow down restrictive lung disease, as measured by pulmonary function tests.
If you have restrictive lung disease caused by long-lasting inflammation, your doctor may prescribe medicines that suppress your immune system, like:
You might also need oxygen therapy. Mechanical breathing assistance may help some people who have breathing problems due to restrictive lung disease. Non-invasive positive pressure ventilation (BiPAP) uses a tight-fitting mask and a pressure generator to help you breathe. BiPAP can help people with obesity hypoventilation syndrome and some nerve or muscle conditions that cause restrictive lung disease.
In cases of obesity-related lung disease, weight loss and exercise can help reduce breathing problems.
If you have very serious restrictive lung disease (such as idiopathic pulmonary fibrosis), you may need a lung transplant.
Regular exercise improves shortness of breath and quality of life in almost everyone with restrictive lung disease.
Treatment Options For Restrictive Lung Disease - Healthline
If your lungs can't hold as much air as they used to, you may have a restrictive lung disease. This breathing problem occurs when the lungs grow stiffer. Sometimes the cause relates to a problem with the chest wall. When your lungs can't expand as much as they once did, it could also be a muscular or nerve condition.
The symptoms of restrictive lung disease include:
There are a variety of treatments that can help ease some of those symptoms. Your doctor will determine the treatment you need by the type and severity of the restrictive lung disease you have. Your age, medical history, and overall health are also key factors to consider. In general, treatment focuses on making breathing easier and slowing the progression of the disease.
These handheld devices can deliver quick blasts of corticosteroids or medications into your bronchial tubes to relax them. These medications also fight inflammation in the lungs. If you have a type of restrictive lung disease known as interstitial lung disease, the walls of the air sacs in your lungs become inflamed. Over time, the walls can become scarred. This causes the lungs to become stiff. Inhalers may be effective in controlling inflammation and reversing the disease.
Some examples of inhaled corticosteroids include:
Some types of restrictive lung diseases stem from autoimmune connective tissue disorders. An autoimmune disease causes the body's immune system to attack healthy cells. An immune system that goes after connective tissue can affect the lungs, other organs, and the lining of your joints, scarring them and making them harder. Some of these disorders include rheumatoid arthritis (RA), scleroderma, and Sjogren's syndrome.
Medications known as immunosuppressants act by blocking the action of the body's immune system. People who have advanced lung disease and need a lung transplant usually take immunosuppressants. These drugs help prevent your body from rejecting a new lung. People can receive these medications through an IV or take them as capsules.
Some examples of immunosuppressants include:
Certain types of restrictive lung diseases, such as pneumoconiosis, can cause a buildup of phlegm and mucus in your airways. Breathing in certain kinds of dust particles can cause pneumoconiosis. People who work in factories and mines are at higher risk. When the lungs can't get rid of the dust they become scarred.
Expectorants come in pill or liquid form. These medications make it easier to clear your airways of mucus. Some examples of expectorants are:
If your restrictive lung disease is limiting the amount of oxygen reaching your organs, muscles, and other tissue through your bloodstream, you may need oxygen therapy. Many types of lung conditions are treated with oxygen therapy.
This treatment works by pumping oxygen from a portable tank through a tube to a mask worn over your nose or mouth. Or, oxygen travels through smaller tubes placed in the nostrils. There are larger, non-portable oxygen tanks for home or hospital use. The goal is to increase the amount of oxygen you inhale.
People with a restrictive lung disease, such as idiopathic pulmonary fibrosis (IPF), can benefit from oxygen therapy. Your doctor may determine how much oxygen therapy you need based on your condition and activity level.
Symptoms of low blood oxygen include fatigue, shortness of breath, and confusion. If you're experiencing these symptoms, tell your doctor immediately. You may notice a big improvement once you start oxygen therapy.
In the most serious restrictive lung disease cases, it may be necessary to have a lung transplant. Your doctor will only recommend this kind of major surgery if medications and other treatments aren't effective. Usually new lungs come from an organ donor who has recently died. You may receive one lung, both lungs, or lungs and a donor heart.
Any type of organ transplant has risks. It's possible the body could reject the new lung or lungs. This can lead to serious health complications, which is why organ recipients receive immunosuppressant drugs.
Sometimes the cause of your restrictive lung disease is unrelated to inflammation or scarring of your lungs and airways. You may, for example, have a condition called pleural effusion, which is a buildup of fluid in the lungs. One of the causes of pleural effusion is a lung infection that can be treated with antibiotics. Once the infection clears, the effusion and difficult breathing symptoms go away.
Obesity hypoventilation syndrome can also restrict breathing. It usually occurs in people who are morbidly obese. Too much fatty tissue surrounding the chest muscles makes it hard for the lungs to work properly. Treatment for this condition focuses on significant weight loss.
You may be familiar with a common, but serious lung problem known as chronic obstructive pulmonary disease (COPD). Instead of making it difficult to breathe in, obstructive lung disease makes it difficult to exhale all the air that's in your lungs. In a way, obstructive and restrictive lung diseases are opposites.
There are four main categories of restrictive lung disease:
Some medications, such as corticosteroids and expectorants, are used for both obstructive and restrictive lung diseases. People with either condition can use oxygen therapy.
Quick Facts: What Is The Difference Between Obstructive And Restrictive ...
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