Pulmonary fibrosis is an irreversible damage to the interstitial tissue of the lung that causes difficulty in breathing. Symptoms, causes, supportive treatments ....find out below.

What is pulmonary fibrosis?

Pulmonary fibrosis is an alteration in the deep part of the lungs. "The deep part of the lungs allows the passage of oxygen from the lungs to the bloodstream, allowing oxygen transport to the organs. In pulmonary fibrosis, the deep lung changes its structure, thickens, stiffens, and becomes a scar. Through this scar, oxygen is less well transported to the bloodstream ". The severity of the disease is related to the extent of this scar and the rate at which it spreads. Advanced forms of pulmonary fibrosis can cause pulmonary hypertension and chronic respiratory failure requiring the supply of oxygen. Pulmonary fibrosis reduces life expectancy. "However, the evolution is very variable between the different patients; some fibrosis evolves only very slowly (over several years) while others are much more aggressive. Some patients have an evolution marked by exacerbations which correspond to rapid changes in the disease which can be life-threatening in the short term ".

Symptoms of pulmonary fibrosis

The main symptoms are shortness of breath and a dry cough. People with pulmonary fibrosis first complain of shortness of breath (dyspnea) on exertion, then at rest. The slightest movement becomes difficult due to the decrease in oxygenation of the tissues.

The fingernails can take on a peculiar domed "watch glass" appearance called digital hippocratism. The blue coloring of the skin can be seen as the disease progresses and heart failure can set in.

When the fibrosis is at an advanced stage and has not been managed, there is a deterioration in the patient's general condition with anorexia and weight loss.

The course of the disease is chronic and may be interspersed with accelerating phases of fibrosis.

Pulmonary fibrosis causes

Pulmonary fibrosis is due to a progressive puncture of the pulmonary alveoli. The lungs are then weakened in oxygen, and breathing difficulties appear.

Each individual can be affected by this kind of disease. However, the people most at risk are people over the age of 70 and smokers.

The exact cause of such an ailment is unknown. In addition, pulmonary fibrosis can be linked to:

- Exposure to certain dust, in particular metals or wood

- Viral infection

- Genetics: for 1 in 20 cases, it is a hereditary transmission

- Gastroesophageal reflux disease

- Tobacco consumption.

How is pulmonary fibrosis detected?

First, possible causes and medical history are asked.

Due to the many potential triggers, some investigations may then follow. The lungs are listened to with a stethoscope. In the case of fibrosis, crackling can be heard. The frequency of respiration can be observed.

An x-ray or CT scan should provide information about the condition of the lungs and heart. Sometimes the lung is also assessed from the inside by bronchoscopy. Blood and allergy tests can also be helpful, as can a lung function test.

Evolution

"The course of pulmonary fibrosis is variable depending on the causes of fibrosis. Mortality at 2 years from forms of idiopathic pulmonary fibrosis is estimated at less than 15%. For other forms of fibrosis, the course is generally associated with that disease-causing fibrosis. When fibrosis is linked to exposure to a drug or to "allergenic" molecules, the course usually stops when the exposure stops, "explains the pulmonologist. For all the causes of fibrosis, the course of the disease will be marked by an increased shortness of breath and, from a particular stage, a need to receive long-term oxygen.

Treatment and Prevention

When the lesion is formed, it is irreversible and cannot be eliminated. The treatment is therefore aimed at slowing the progression of the condition and improving the symptoms.

Currently available treatments are unfortunately limited. The only treatments that can be offered to many people with pulmonary fibrosis are those that only relieve symptoms, such as oxygen therapy. In addition, a lung transplant may be offered to people who are still relatively young.

With pulmonary fibrosis caused by conditions like rheumatoid arthritis, the best course of action is to treat the condition causing it, which usually reduces inflammation in the lungs.

In idiopathic pulmonary fibrosis, immunosuppressive drugs can prevent new lesions from appearing, but most of these drugs have limited effectiveness. A corticosteroid, prednisone *, is usually prescribed. Other immunosuppressants, such as cyclophosphamide *, can sometimes help. Pulmonary rehabilitation is an integral part of the treatment of people with pulmonary fibrosis. It usually consists of a program of physical activity, breathing exercises, and stress management.

Exercise can improve tissue oxygenation and maximize the efficiency of healthy lung tissue. In advanced pulmonary fibrosis, oxygen equipment may be necessary to maintain sufficient oxygen supply to the circulation.

People with pulmonary fibrosis should quit smoking.

It is difficult to prevent disease when you do not know the cause, so there is no effective prevention of pulmonary fibrosis. However, people engaged in an activity that increases their risk of pulmonary fibrosis (e.g., farmers in contact with hay, miners, welders, sandblasters, and demolishers) should take all necessary measures to reduce their exposure to the minimum (e.g., wearing a mask).