DEAR READER: When responding to readers’ questions, I may be guilty of generalizing, hitting on the most common yet overlooked possibilities. Many coughs are tied to irritants or pollutants, postnasal drip, reflux, COPD, medication reactions and a host of other reasons. Because the reader mentioned only the nagging cough, I failed to cover pulmonary fibrosis caused by an inflammatory response to an unknown substance or substances.

Idiopathic pulmonary fibrosis affects about 200,000 people, with almost 50,000 new cases reported each year. It is a condition in which the deep tissue in the lungs becomes scarred, stiff and thick. The scarring process causes the lungs to lose their ability to circulate oxygen through the bloodstream. Progression of the disease varies between individuals, with people developing either gradually, rapidly or remaining relatively stable. Heredity plays a role, as does asbestos exposure.

Symptoms include cough, dyspnea, exercise intolerance, occasional chest pain, abnormal crackling breath sounds and clubbing (fingernails that curl over the tips of the fingers).

Treatment options are somewhat limited; however, corticosteroids have been found to decrease symptoms. Diagnosis might be made through bronchoscopy, CT scan or biopsy. Patients should be under the care of a pulmonologist. Research, as with most diseases, remains ongoing. Scientists are investigating the use of several prescription medications to slow the progression of the disease.

To provide related information, I am sending you a copy of my Health Report “Pulmonary Disease.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

My doctor had told me that this is normally a slow moving disease but for some reason it is accelerating in my case. Everything I have read is terribly frightening. Can you provide any information or suggestions about treatment?

DEAR READER:
Pulmonary fibrosis is a respiratory disorder in which lung tissue becomes thickened and stiff or scarred. Over time the lungs’ ability to move oxygen into the bloodstream becomes compromised. It is a serious condition with no cure.

There is no known cause but certain risk factors can increase the chance of developing pulmonary fibrosis. Cigarette smoking, certain viral infections, exposure to environmental pollutants and certain medications increase this risk. Genetics may play a role, but the extent is unclear at this time.

Another finding is that 9 out of 10 sufferers also have gastro-esophageal reflux disease (GERD). Researchers speculate that some GERD patients inadvertently breathe in tiny drops of stomach acid on a regular basis. This acid may, over time, damage lung tissue leading to pulmonary fibrosis. This is only a theory which needs more research for confirmation.

Treatment is aimed at preventing more scarring, improving symptoms, and maintaining the ability to get around and stay healthy.

Medications, such as prednisone, to reduce inflammation are most commonly administered. Your doctor may also want to suppress the immune system with medication in an attempt to reduce further damage. It is also beneficial for most sufferers to receive yearly flu and pneumonia vaccines, take anti-reflux medications and include supplemental calcium and vitamin D to prevent bone loss due to corticosteroid treatment.

Oxygen therapy is used to increase blood oxygen levels and reduce shortness of breath. Pulmonary rehabilitation may be of help by conditioning the lungs and body to keep as healthy as possible for as long as possible.

Lung transplant is a final option. It is primarily reserved for those younger than 65 that are not helped by medication and have no other medical issues.

I suspect you are already under the care of a pulmonologist (lung specialist). This specialist is most familiar with diagnosis and treatment of this disorder and will be your best resource for the newest updates in treatment. He or she should also be able to help you with referrals to specialized rehabilitation programs which may increase your existing lung capacity and keep the rest of your body as physically fit as possible.

To give you related information, I am sending you a copy of my Health Report “Pulmonary Disease”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.