Idiopathic pulmonary fibrosis (IPF) is a type of lung disease that results in scarring (fibrosis) of the lungs for an unknown reason. Over time, the scarring gets worst and it becomes hard to take in a deep breath and the lungs cannot take in enough oxygen.

IPF is a form of interstitial lung disease, primarily involving the interstitium (the tissue and space around the air sacs of the lungs), and not directly affecting the airways or blood vessels. There are many other kinds of interstitial lung disease that can also cause inflammation and/or fibrosis, and these are treated differently. It is important to work with your doctor to determine if you have IPF or another form of interstitial lung disease.

The alveoli (air sacs) and the blood vessels within the lungs are responsible for delivering oxygen to the body, including the brain, heart, and other organs. All of the body’s functions depend upon delivery of a steady supply of oxygen. As lung tissue becomes scarred and thicker, it is more difficult for the lungs to transfer oxygen into the bloodstream. As a result, the brain, heart, and other organs do not get the oxygen they need to function properly.

In some cases, doctors can determine the cause of the fibrosis (scarring), but in many cases the cause remains unknown. When there is no known cause for the development of pulmonary fibrosis (and certain radiographic and/or pathologic criteria are met), the disease is called idiopathic pulmonary fibrosis or IPF.

Most people with IPF develop symptoms of cough and shortness of breath between the ages of 50 and 70 years. IPF is not common under the age of 50 years. Historically, more men have been diagnosed with IPF than women, but IPF in women appears to be on the rise. Occasionally, IPF occurs in members of the same family. When this happens, the disease is called Familial Pulmonary Fibrosis. The fact that PF runs in certain families has led many experts to believe that having certain genes (genetics) may be why some people get PF..

Causes

The term ‘idiopathic’ means the cause is not known. So it’s important to remember that no one is sure why you have developed this condition. We do know that IPF is more common in people who are smokers, or in people who have smoked in the past.

Environment – It is also more common if you have been exposed through your occupation to dust from wood, metal, textile or stone, or from cattle or farming.

Infection – Infection might be another cause. In some studies, IPF has been linked to certain viruses, including the Epstein Barr virus, which causes glandular fever. The herpes virus and hepatitis C have also been suggested as possible causes.

Acid Reflux – Doctors have noticed that some people with IPF also have a condition called gastro-oesophageal reflux disease (GORD). This is when the stomach contents leak back up into the oesophagus (gullet), causing the symptoms of heartburn. Reflux is very common in patients with any type of lung fibrosis, as the gullet becomes stretched by the fibrosis in the lung. Some experts think there could be a link between the two conditions.

Genetics (family history): Up to 20% of people with IPF have another family member with an interstitial lung disease. If more than one member of your family has IPF, the disease is called familial pulmonary fibrosis.

Symptoms

The two main symptoms of IPF are:

Breathlessness (also known as shortness of breath or dyspnea) – Usually the breathlessness of IPF first appears during exercise. Breathlessness can affect day-to-day activities such as showering, climbing stairs, getting dressed and eating. As scarring in the lungs gets worse, breathlessness may prevent all activities.

Chronic cough – About 85% of people with IPF have a chronic cough that has lasts longer than 8 weeks. This is often a dry cough, but some people may also cough up sputum or phlegm.

Other symptoms may include:

• Chest pain or tightness
• Unexplained weight loss
• Loss of appetite
• Tiredness and loss of energy
• Change of finger shape called “clubbing”

Treatment

Pulmonary rehabilitation can help you to cope with breathlessness and is an important part of treatment.

It includes –

• A physical exercise programme, designed individually for you; and
• Advice and information on keeping your lungs healthy and coping with breathlessness.

Sessions are held in hospitals, health centres and in places such as community halls. The groups are led by a qualified professional.

As well as providing support and reassurance, pulmonary rehabilitation can have a positive impact on your condition. It may help to increase the distance you can walk, help you feel less breathless and improve your sense of well-being.

Oxygen Therapy – Most patients with IPF require oxygen for getting about outside when their condition is more advanced. You might have an oxygen concentrator installed in your home. The concentrator takes normal air from the room and makes it richer in oxygen before you breathe it in. The machine is attached to tubing all around the house, so you are not confined to one room.

Medications – Steroid medication may be tried, usually in combination with immunosuppressant medicines. Previous studies showed that steroid medication improved symptoms in about 1 in 4 affected people. However, some doctors now wonder if the people for whom the steroids worked actually had another type of lung disease. If steroids are prescribed, a high dose is used at first and then reduced to a lower maintenance dose. If there is no improvement after a few months then the steroids are stopped. Some people who take steroids develop side-effects.

Prednisone, azathioprine (A-zah-THI-o-preen), and N-acetylcysteine (a-SEH-til-SIS-tee-in) have been used to treat IPF, either alone or in combination. However, experts have not found enough evidence to support their use.

A lung transplant may be an option. This is becoming more common, particularly in younger people who develop severe disease despite medication.

Alternative Treatment

Serrepeptase – This enzyme helps to thin mucous so it can be expelled from the lungs and the lymph system, reduce inflammation, and in the long term help reduce the actual fibrosis itself. Furthermore it will have some calming effect on the immune system that is attacking the lungs.

Colloidal Silver – This has many knock on effects throughout the body – (a) Metabolic energy and tissue oxygenation is improved, (b) cellular and liver detoxification is facilitated and (c) the T cell side of the Immune system is improved.

Liquorice – These are possibly the most effective supplement to  calm down the overactive B cells so that the immune system stops attacking the lungs. It promotes healthy production of natural steroids from the Adrenal. These steroids are more effective than drug steroids and are in the form the body needs to help overcome inflammation, restore adrenal function and re-balance the immune system. Liquorice also has the property of being a good lung expectorant.

Hemp Oil – The correct balance of raw cold pressed essential fatty acids any health restoration programme will be limited in its scope, and they are known to be one aspect of resolving inflammation.

Organic Silicon – This form of silicon is by far the most effective in getting sufficient quantity to be absorbed into the body, possibly a six to 9 months course of this may be sufficient to build up the silica reserves of the body. Silica is important for repair, especially of collagen (this is involved in the lining of the lungs, expelling foreign particles/toxins, restoring elasticity to the collagen (e.g blood vessels, lining of the lungs etc) and facilitating lymph detoxification.

Organic Germanium – This helps to promote oxygenation of the tissues, and is a powerful aid to promoting cell detoxification and resolution of stubborn health disorders

Powerful pulmonary improving antioxidants, concentrated vitamin D3 in high dosages, N-Acetyl Cysteine, Alpha Lipoic Acid, Acetyl L-Carnitine and systemic enzymes are  to name just a few.

Reference –

http://www.coalitionforpf.org/wp-content/uploads/2013/03/RecentAdvancesinIPFNothMartinezChest2007.pdf

https://www.blf.org.uk/Page/Idiopathic-pulmonary-fibrosis-IPF

http://www.nhlbi.nih.gov/health/health-topics/topics/ipf/causes

http://www.lung.ca/lung-health/lung-disease/idiopathic-pulmonary-fibrosis/symptoms

https://www.blf.org.uk/Page/Causes-and-symptoms-of-IPF

http://www.nhs.uk/Conditions/pulmonary-fibrosis/Pages/Symptoms.aspx

http://www.modernmedicine.com/tag/idiopathic-pulmonary-fibrosis-resource-center-0

http://www.wsj.com/articles/new-treatments-for-deadly-idiopathic-pulmonary-fibrosis-1442251585

Hepatopulmonary syndrome (HPS) is considered present when the following triad exists  –

• Liver disease
• Impaired oxygenation
• Intrapulmonary vascular abnormalities, referred to as intrapulmonary vascular dilatations (IPVDs)

The unique pathological feature of hepatopulmonary syndrome (visualized by autopsy) is gross dilatation of the pulmonary precapillary and capillary vessels, as well as an absolute increase in the number of dilated vessels. A few pleural and pulmonary arteriovenous shunts and portopulmonary anastomoses may also be seen.

The hepatopulmonary syndrome results from the formation of microscopic intrapulmonary arteriovenous dilations in patients with chronic liver disease. The mechanism is unknown but is thought to be due to increased hepatic production or decreased hepatic clearance of vasodilators. The vascular dilations cause overperfusion relative to ventilation, leading to hypoxemia, particularly because patients have an increased cardiac output resulting from systemic vasodilation. Because the lesions frequently are more numerous at the lung bases, the hepatopulmonary syndrome can cause platypnea (dyspnea) and orthodeoxia (hypoxemia), which occur when the patient is seated or standing and are relieved by recumbency. Most patients also have characteristic findings of chronic liver disease, such as spider angiomas. About 20% of patients present with pulmonary symptoms alone.

The condition is said to be in two forms:

• Type I – The condition involves the right to left shunting of the lungs. This is known as the most common type of hepatopulmonary syndrome which basically involves dilatation of the capillaries during the exchange of oxygen. As a result, there is less oxygen containment in the alveoli- where gas exchange is the primary role, and the ventilation process is altered.
• Type II – This accumulates about 10% of hepatopulmonary syndrome cases. The oxygen exchange is yet again not attained normally, as arteriovenous shunts in the circulatory system have not attained its purpose. The anatomic shunts place the ineffective oxygen exchange, making this type of the syndrome as very grave one.

Causes

Presence of an arteriovenous shunt – This shunt is basically a product from a surgical intervention that provides a vessel indicated to provide a pathway for blood exchange between an artery and vein. This is highly indicated for patients for hemodiaysis.

Impaired function of the alveolocapillary in maintaining the diffusion-perfusion process – The pulmonary vessels are quite affected when a vasodilator takes place and acts in desaturating the oxygen. Making the erythrocytes incapable of providing adequate oxygenated blood.

Ventilation and perfusion process is uneven – When there is an underlying lung condition, it is expected that one will suffer from perfusion problems. In cases of liver cirrhosis, there shall be adecrease in perfusion in specific lung areas as ventilation is poor.

Others – Portal hypertension is considered a significant cause of hepatopulmonary syndrome. The chronic use of substances for vasodilatation can induce the syndrome.

Symptom

Those with hepatopulmonary syndrome are expected to present pulmonary symptoms as well as liver problem manifestations. The following present the characteristics of the disease –

• Hypoxemia is a prominent presentation. This is most recognizable especially when a person is suffering from liver cirrhosis.
• Cyanosis is noted among patients. This is described as the bluish or purple discoloration of our skin. The inside membranes or tissues of our body is also affected of the discoloration and is primary caused by a deficient flow of oxygenated blood.
• Digital clubbing (a known manifestation of hypoxemia and is described as the fingers’ tips are enlarged) is observed. This is due to the lack of oxygenation.
• Plethora of spider nevi is noted. This is identified as spider angioma where there are small angiomata on the skin. This is the spider-like appearance of the vessels visible on the skin. This is basically a manifestation of a hepatic problem.
• Platypnea is noted or simply known as dyspnea upon standing.
• Orthodeoxia is a manifestation. This is the sudden fall of the partial oxygen of the patient while in standing position.
• Increased Nitric oxide levels. This is noted due to its vasodilator component.
• Esophageal varices might develop. These are dilated veins found in the esophagus.
• Increased heart rate is noted as a sign of compensation from hypoxemia.

Treatment

Supplemental O 2 – The main treatment is supplemental O 2 for symptoms. Other therapies, such as somatostatin to inhibit vasodilation, are of modest benefit in only some patients. Coil embolization is virtually impossible because of the number and size of the lesions. Inhaled nitric oxide synthesis inhibitors may be a future treatment option. Hepatopulmonary syndrome may regress after liver transplantation or if the underlying liver disease subsides. Prognosis is poor without treatment.

Nitrous oxide inhibitor is provided. Even though there has been less support with this treatment, it has been found to reverse vasodilatation.

Control of the  hypertension. Providing the suitable treatment for the client is a great help in managing the disease.

Orthotopic liver transplantation. This is considered as a treatment of choice when no other interventions seem to work. This is simply known as liver transplant.

Studies show that there is about 24 months to 5 years of survival rate among the reported cases of HPS. When surgical intervention such as liver transplant has not been performed, the survival rate shall be lower than expected.

Reference –

http://www.hindawi.com/journals/bmri/2013/670139/

http://www.atsjournals.org/doi/full/10.1164/rccm.201302-0245LE#.VrHI8_l97IU

http://lifeinthefastlane.com/ccc/hepatopulmonary-syndrome/

http://www.nature.com/nrgastro/journal/v9/n9/pdf/nrgastro.2012.123.pdf%3FWT.ec_id%3DNRGASTRO-201209

http://ehjcimaging.oxfordjournals.org/content/8/5/408

http://www.thelancet.com/pdfs/journals/lancet/PIIS0140673604161072.pdf

https://www.msdmanuals.com/professional/pulmonary-disorders/pulmonary-hypertension/hepatopulmonary-syndrome

Emphysema, a type of Chronic Obstructive Pulmonary Disease (COPD), occurs when the walls of the alveoli (air sacs) in the lungs are damaged, becoming less elastic and, therefore, less able to exchange carbon dioxide for oxygen. The disease develops and worsens over time, and although it is not reversible, its progress can be slowed with therapy.

When a person breathes, air travels to the lungs through airways called bronchi. The bronchi divide into smaller airways, called bronchioles, which end in clusters of tiny air sacs, called alveoli. Emphysema, the fourth leading cause of death in the United States, affects the walls of the millions of tiny air sacs in the lungs, which become inflamed and loose elasticity, causing the bronchioles to collapse. As a result, air becomes trapped in the air sacks, which become overstretched and may rupture, greatly affecting a person’s ability to breathe normally.

When emphysema develops, the alveoli and lung tissue are destroyed. With this damage, the alveoli cannot support the bronchial tubes. The tubes collapse and cause an “obstruction” (a blockage), which traps air inside the lungs. Too much air trapped in the lungs can give some patients a barrel-chested appearance. Also, because there are fewer alveoli, less oxygen will be able to move into the bloodstream.

The leading cause of emphysema is cigarette smoking. Other risks factors include air pollution, occupational exposure to dust and chemicals, frequent lower respiratory infections and second hand smoke. In rare cases, the genetic disorder alpha-1 antitrypsin (AAT) deficiency causes emphysema.

Over 3 million people in the United States have been diagnosed with emphysema. Over 11 million Americans have COPD. Emphysema is most common in men between the ages of 50 and 70.

Causes

Cigarette smoking, air pollution, work hazards, and lung infections cause emphysema. Cigarette smoking is the most important of these factors. Cigarette smoking alters the structure and function of the lungs causing them to increase in size and lose their elasticity.

Cigarette smoking increases the number of inflammatory cells in the lungs. These cells release enzymes and other products that destroy the lung tissue. As a result, the lungs develop bullae (holes) and lose elasticity.

Alpha-1 antitrypsin deficiency is a disease caused by a genetic defect that leads to decreased levels of the protective protein, alpha-1 antitrypsin. Alpha-1 antitrypsin protects the lungs from the destructive effects of enzymes called elastates. Patients with alpha-1 antitrypsin deficiency may develop emphysema at an early age.

Risk Factors

• Low body weight
• Childhood respiratory disorders
• Exposure to passive cigarette smoke
• Air pollution
• Occupational dust (mineral dust, cotton dust, for example)
• Inhaled chemicals (coal, grains, isocyanates, cadmium, for example).

Symptoms

Symptoms may be slightly different for each person. The following are the most common symptoms for pulmonary emphysema.

Early symptoms of pulmonary emphysema may include –

• Shortness of breath (most common symptom), which gets worse with activity
• Cough
• Rapid breathing
• Sputum production
• Wheezing

Other symptoms may include –

• Fatigue (extreme tiredness)
• Over-inflation of the lungs
• Anxiety
• Sleep problems
• Heart problems
• Weight loss
• Depression

The symptoms of pulmonary emphysema may look like other lung conditions or health problems. See a healthcare provider for a diagnosis.

Complications

• Collapsed lung (pneumothorax) – A collapsed lung can be life-threatening in people who have severe emphysema, because the function of their lungs is already so compromised. This is uncommon but serious when it occurs.
• Heart problems – Emphysema can increase the pressure in the arteries that connect the heart and lungs. This can cause a condition called cor pulmonale, in which a section of the heart expands and weakens.
• Large holes in the lungs (giant bullae) – Some people with emphysema develop empty spaces in the lungs called bullae. Giant bullae can be as large as half the lung. In addition to reducing the amount of space available for the lung to expand, giant bullae can increase your risk of pneumothorax.

Treatment

Anti-inflammatory medication – These medications reduce inflammation in the airways. However, long-term side effects of these drugs include osteoporosis, hypertension, high blood sugar, and fat redistribution.

Oxygen therapy – Oxygen therapy is prescribed for patients whose lungs are not getting enough oxygen to the blood (hypoxemia). These patients can’t absorb enough oxygen from the outside air and need to get more oxygen through a machine (a nasal catheter or a facemask).

Lung volume reduction surgery – Lung volume reduction surgery involves removing a portion of diseased lung tissue, then joining together the remaining tissue. Doing this may relieve pressure on the breathing muscles and help improve lung elasticity (or stretch). The results of the surgery have been very promising. Not all patients with emphysema are candidates for this surgery.

Bronchodilator medications – These medicines relax the muscles around the airways. They are often used to treat asthma. Bronchodilators, given through hand-held inhalants, produce more immediate results and have fewer side effects than oral medications.

Quitting smoking – If a person smokes, he should quit. This is the most important step that can be taken to protect the lungs. It is never too late to quit.

Avoidance of pollutants, lung irritants, and secondhand smoke.Try to avoid exposure to air pollution, which can worsen emphysema symptoms. Stay indoors when ozone levels are unhealthy and pollution levels are high. However, when indoors, avoid secondhand smoke, smoke from faulty wood-burning appliances and any other source of indoor air pollution.

Alternative Treatment

Bromelain – A supplement created from the enzymes found in a pineapple’s stem and juice, bromelain is said to reduce inflammation associated with emphysema. However, according to the National Institutes of Health, scientific evidence to support this claim is lacking.

Coenzyme Q10 – An antioxidant that is naturally produced by the body, coenzyme Q10 has been said to increase cell activity and ease inflammation in people with emphysema. Researchers have found that people living with emphysema have especially low levels of coenzyme Q10; however, studies have not proven that taking the supplement improves conditions.

L-Carnitine – Typically produced by the body, L-carnitineis used to burn fat and boost energy. In COPD patients, this supplement appears to help strengthen muscles and improve endurance when exercising. Further, research has proven that those people who take L-carnitine supplements do significantly better during walking exercise programs.

N-acetylcysteine – An antioxidant available as an over-the-counter dietary supplement, N-acetylcysteine has been researched for its role in breaking down the mucus that can clog the lungs of people living with emphysema. To date, research has showed mixed results on the supplement’s effectiveness.

Antioxidant vitamins – With properties of antioxidants, vitamins A, C and E have been said toimprove the lung function in people with emphysema. Studies have shown that people living with emphysema have low levels of these antioxidant-rich vitamins, and this deficiency can result in decreased pulmonary function. Further, studies have proven that emphysema patients whose diets are rich in fruits and vegetables—a good source of vitamins A, C and E—saw improved lung function.

Reference –

http://www.medicalnewstoday.com/articles/8934.php

http://www.webmd.com/lung/copd/what-is-emphysema

http://www.mayoclinic.org/diseases-conditions/emphysema/basics/definition/con-20014218

https://www.nlm.nih.gov/medlineplus/emphysema.html

http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/emphysema/?referrer=https://www.google.co.in/

https://my.clevelandclinic.org/health/diseases_conditions/hic-emphysema

http://emphysema.org/

http://www.emphysema.net/bindex.asp

http://oac.med.jhmi.edu/res_phys/Encyclopedia/Emphysema/Emphysema.HTML

http://www.nytimes.com/health/guides/disease/emphysema/print.html

http://www.nhlbi.nih.gov/news/press-releases/supplement/national-emphysema-treatment-trial-participating-sites

http://umm.edu/programs/thoracic/conditions/emphysema

Cystic fibrosis (CF) is a chronic, progressive, and frequently fatal genetic (inherited) disease of the body’s mucus glands. “Inherited” means the disease is passed from parents to children through genes. People who have CF inherit two faulty genes for the disease—one from each parent. The parents likely don’t have the disease themselves. CF mainly affects the lungs, pancreas, liver, intestines, sinuses, and sex organs.

Cystic fibrosis causes various effects on the body, but mainly affects the digestive system and lungs. The degree of cystic fibrosis involvement differs from person to person. However, the persistence and ongoing infection in the lungs, with destruction of lungs and loss of lung function, eventually causes death in the majority of people who have cystic fibrosis.

Cystic fibrosis affects at least 30,000 people in the United States; between 900 and 1,000 new cases are diagnosed every year. One in 29 people of Caucasian ancestry is an unaffected carrier of the CF gene mutation. In the United States, cystic fibrosis occurs at a rate of 1 in 3,400 births. While it occurs in persons of all racial and ethnic backgrounds, it is most common in Caucasians of Northern European ancestry. Historically, half of affected individuals were diagnosed by five months of age, though the average age at diagnosis was five years, and some individuals were not diagnosed until adulthood. CF worsens with age. If you have CF, you usually experience a small decline in lung function each year.

Affects of CF

Cystic fibrosis can affect the whole body. Cystic fibrosis affects a specific protein called cystic fibrosis trans-membrane regulator (CFTR) that controls the normal movement of sodium (Na), chloride (Cl), as well as water in and out of the cells in different parts of the body. People with CF either have too little or abnormal CFTR. When CFTR is absent or defective, the mucus normally secreted by the cells in the pulmonary airways (breathing tubes), pancreatic ducts, gastrointestinal tract, and reproductive system becomes thickened. This thickened mucus causes blockages (obstructions), frequent infection, and loss of function in the affected organs.

In the lungs, absence of CFTR leads to thick mucus that obstructs the airways. When mucus is not cleared, it creates an environment for bacteria to grow and infect the airways. This leads to a vicious cycle with more mucus, more airway blockage and more infections. Over the course of many years, this damages the airways and eventually the lung tissue.

CF also affects other organs and systems in the body. For example:

• In the pancreas, ducts become blocked, causing fibrosis (scarring) of the pancreas. This leads to reduced absorption of fat and vitamins. And it can also cause a type of diabetes referred to as “cystic fibrosis-related diabetes.”

• In the digestive tract, intestinal secretions can be much thicker than normal. This causes blockages in the intestines and sometimes requires surgery.

• In the liver, ducts can be blocked causing damage to the liver cells and cirrhosis.

• In the reproductive tract, increased mucus can cause decreased fertility or infertility in both men and women.

Causes

Genetic Factor – CF gene mutations are divided into classes based on how damaged the CFTR protein function is. Classes I, II, and III are generally more severe causing “classic CF.” Classes IV and V are usually milder. Also, other genes called modifier genes  can affect a person’s symptoms and outcome.

Cystic fibrosis is a genetic disease that occurs when a child inherits two abnormal genes, one from each parent. Approximately, one in 25 Americans carry an abnormal version of the gene responsible for cystic fibrosis. Carriers do not have cystic fibrosis, nor do they exhibit any of the symptoms of the disease.

In case where two parents who are carriers have a child, there is a 25 percent chance that the child will be born with cystic fibrosis; there is also a 50 percent chance that the child will be a carrier; and a 25 percent chance that the child will neither be a carrier nor have cystic fibrosis.

Environmental Factors – Environmental exposures worsen CF lung disease. Children who are exposed to tobacco smoke have lower lung function and more pulmonary exacerbations than those who live in smoke-free environments. High levels of air pollution are associated with an increased rate of adverse pulmonary events.

Lifestyle Factors – People with CF need to consume a very large number of calories to maintain weight and grow, which can be difficult to achieve. Physical activity is also important to help keep lungs healthy.

Symptoms

The type and severity of CF symptoms varies from person to person. In some people not identified with CF through newborn screening, there may be health problems that indicate the presence of CF, such as –

• Salty-tasting skin
• Slow weight gain, failure to thrive, even with good appetite
• Wheezing, coughing, pneumonia
• Abnormal bowel movements

Lungs – Almost everyone with Cystic Fibrosis will sooner or later develop lung disease. However, when it occurs and how bad it is differs from person to person. The thickened mucus builds up in the bronchioles and reduces airflow, making the patient short of breath and wheeze with exercise. This mucus can build up to such an extent that it plugs the smaller airways of the lungs and can then harbor bacteria which cause infection.

Digestive Symptoms – Cystic Fibrosis mainly affects the digestive system by mucus blocking the pancreas, stopping the digestive enzymes produced from making their way to the gut to digest food. This complication can cause malnutrition and malabsorption even though the patient has good appetite. Symptoms of malabsorption include poor weight gain, frequent foul-smelling stools, stomach ache, and excessive gas. Enzyme supplements, supplementary feeding, and vitamin replacement all assist with compensating for decreased activity of the pancreas.

Other

• Cystic Fibrosis has no effect on brain or sensory function, or mental acuity.
• A small percentage of the CF population may be affected by mucus blockage in the small ducts within the liver, reducing liver function.
• Adults with CF are also prone to osteoporosis (thin, brittle bones) due to nutritional problems and the adverse effects of steroid medications.
• In most men with CF, the tubes that carry the sperm are blocked or have never developed (Absence of the Vas Deferens), this can cause fertility problems, but does not cause sexual impotency.
• Women with CF may have irregular menstrual cycles related to nutritional issues, but they do produce healthy fertile eggs, so effective contraception is necessary.

Treatment

Physiotherapy and exercise – Regular chest physiotherapy is very important. This helps to clear the airways of the thick mucus. A physiotherapist usually shows parents how to do this for their children. It involves a special way to firmly pat the chest whilst the child lies head-down to encourage mucus and sputum to be coughed out.

Medications – In CF, the doctor may prescribe antibiotics, anti-inflammatory medicines, bronchodilators, or medicines to help clear the mucus. These medicines help treat or prevent lung infections, reduce swelling and open up the airways, and thin mucus. In case of mutations in a gene called G551D, which occurs in about 5 percent of people who have CF, the doctor may prescribe the oral medicine ivacaftor (approved for people with CF who are 6 years of age and older).

Antibiotics are frequently needed to treat bacteria that grow in the mucus. These can be given in one of three ways –

• Orally or by mouth – this is the easiest and cheapest route.
• By inhalation – this is more expensive but very effective.
• Intravenously (IV) – this is usually reserved for those who are sicker.

Antiinflammatory medications have also been found to be helpful in CF. Two medications are currently in use, ibuprofen and azithromycin (an antibiotic that’s used as an antiinflammatory agent in CF).

Pulmonary Rehabilitation – R doesn’t replace medical therapy. Instead, it’s used with medical therapy and may include –

• Exercise training
• Nutritional counseling
• Education on your lung disease or condition and how to manage it
• Energy-conserving techniques
• Breathing strategies
• Psychological counseling and/or group support

Alternative Treatment

Omega-3 fatty acids, such as fish oil, 1 to 2 capsules or 1 tablespoonful of oil twice daily, to reduce inflammation and improve immunity. Fish oils may increase bleeding in sensitive individuals, such as those taking blood-thinning medications (including aspirin).

A multivitamin daily, containing the antioxidant vitamins A, C, D, E, K, the B-vitamins and trace minerals, such as magnesium, calcium, zinc, and selenium.

Digestive enzymes

Coenzyme Q10, 100 for antioxidant and immune activity.

N-acetyl cysteine (NAC) for antioxidant effects. Alternative health care practitioners may use higher dosages.

Probiotic supplement for maintenance of gastrointestinal and immune health.

Methylsulfonylmethane (MSM) to help reduce inflammation.

Whey protein helps to support of immunity and weight gain, when needed. Whey protein can interact with some medications, particularly Levodopa.

Green tea (Camellia sinensis) standardized extract, helps in antioxidant and immune effects. You may also prepare teas from the leaf of this herb.

Cat’s claw (Uncaria tomentosa) standardized extracthelps in inflammation, immune and antibacterial or antifungal activity. Cat’s claw may interact with certain medications, including blood pressure medications.

Milk thistle (Silybum marianum) seed helps in detoxification support. Milk thistle may have an estrogen-like effect, so people who have a history of hormone-related cancers should use milk thistle with caution. Milk thistle is in the same family as ragweed and may cause allergic reactions in people who are sensitive to ragweed.

Bromelain (Ananus comosus) helps in pain and inflammation. Bromelain may increase bleeding in sensitive individuals, such as those taking blood-thinning medications, including aspirin.

Ground Ivy (Hedera helix) standardized helps to reduce mucous production and to loosen phlegm. Ground ivy can be particularly toxic to the liver and kidneys.

Reference –

http://cfnz.org.nz/about-cf/treatments-for-cystic-fibrosis/

http://www.cysticfibrosis.ca/about-cf/what-is-cystic-fibrosis/

http://www.webmd.com/lung/what-is-cystic-fibrosis?page=2#1

http://www.nhs.uk/Conditions/cystic-fibrosis/Pages/Causes.aspx

http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/cystic-fibrosis/cystic-fibrosis-symptoms-causes-risks.html

http://www.medicinenet.com/cystic_fibrosis/article.htm

https://www.cysticfibrosis.org.au/

http://www.prevention.com/mind-body/natural-remedies/alternative-medicine-saved-our-lives

Chronic Obstructive Pulmonary Disease or COPD is a progressive lung disease that makes it difficult to breath. Progressive because the disease worsens over time. It is a collection of lung diseases, which includes chronic bronchitis, emphysema and chronic obstructive airways disease. COPD involves inflammation and thickening of the airways and also destruction of the tissue of the lung where oxygen is exchanged.

To understand the effect of COPD on the lungs and breathing, it becomes extremely important to first understand how the lungs work? Every time a human body breathes in, air passes through the windpipe into the lung airways called bronchial tubes. In the lungs, these bronchial tubes branch into thousands of smaller tubes called bronchioles. At the end of these bronchial, are air sacs called alveoli, which are like little balloons. When the body breathes in, these sacs stretch and get filled with air, and once the body breathes out, they shrink back down. The walls of these air sacs are filled with tiny blood vessels called capillaries. When the air sacs are filled with air, oxygen goes into the capillaries, which further carries it through the blood stream to all parts of the body. At the same time, carbon dioxide (a waste material) passes out of the capillaries into the air sacs and then the body breathes out.

COPD is a condition in which the bronchial tubes become inflamed and narrowed and the air sacs get damaged. Smoking cigarettes is the most common cause of lung injury. As the lungs become more damaged over time, the difficulty in breathing increases. If the damage becomes severe, it may result in disturbance to the oxygen flow in the bloodstream make it difficult to get rid of the excess carbon dioxide.

COPD causes the following changes in the lungs and airways:

• Air sacs and airways lose their ability to stretch
• The walls of the air sacs are destroyed
• The walls of the airways become thickened and inflamed
• Airways become clogged with mucus (a slimy substance)

There are two main forms of COPD:

• Chronic Bronchitis – the lining of the airways is constantly irritated and inflamed. This causes the lining to thicken. Lots of thick mucus forms in the airways, making it hard to breathe.
• Emphysema – the walls between many of the air sacs are damaged. As a result, the air sacs lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. If this happens, the amount of gas exchange in the lungs is reduced.

Both forms of COPD cause damage to your airways and interfere with the absorption of oxygen and the release of carbon dioxide.

How severe is COPD?

COPD is the third leading cause of death in the US. It causes serious long-term disability and early death. In the United States more than 11 million people are known to have COPD and up to 24 million may have the disease due to some not even knowing it. The number of people dying from COPD is growing. Its prevalence increases with age. Men are more likely to have the disease, but the death rate for men and women is about the same.

Causes

• Smoking – The major cause of COPD is smoking. The poisons in the cigarette smoke weaken the lung’s defense against infections, narrow air passages, cause swelling in air tubes and destroy air sacs. About 80-90% of all COPD is caused by cigarette smoking. Passive smoking may also increase the risk of COPD.
• Genetic – A small number of people have a rare form of COPD called alpha-1 deficiency related emphysema. This form of COPD is caused by an inherited lack of a protective protein in the blood.
• Occupations – Research suggest that numerous occupations are linked with a possible increases chance of getting COPD –
  • Agriculture
  • Brick making
  • Mining
  • Construction
  • Plastics
  • Petroleum
• Toxic Chemicals – Exposure to toxic chemicals such as silica and cadmium
• Environmental Factors – Air pollution may be an additional risk factor for COPD.

Symptoms

Symptoms of chronic obstructive pulmonary disease (COPD) usually develop over a number of years, and hence the individual may not be aware you have the condition. COPD does not usually become noticeable until after the age of 35 and most people diagnosed with the condition are over 50 years old.

Symptoms include the following:

• Cough, usually worse in the mornings and productive of a small amount of colorless sputum
• Acute chest illness
• Breathlessness: The most significant symptom, but usually does not occur until the sixth decade of life
• Wheezing: May occur in some patients, particularly during exertion and exacerbations
• Weight loss
• Extreme tiredness
• Swollen ankles

The symptoms may worsen in the winter season. These symptoms may not always caused by COPD, but if the individual has them, it’s advisable to diagnose it.

Severe Symptoms of COPD

• Blue or gray lips or fingernails (signs of low blood oxygen)
• Lack of mental alertness
• Rapid heartbeat
• Difficulty breathing and talking
• Symptoms get worse

Treatment

• Conventional Treatment

Conventional treatment depends on the cause and the severity of the symptoms of COPD. The first and the most essential step for smokers with this condition id to ‘Quit Smoking’. The treatment includes:

• Avoidance of pollutants, lung irritants, and secondhand smoke
• Yearly influenza vaccination and vaccination against pneumonia (usually every five years).Getting the flu or pneumonia may worsen emphysema and its symptoms.
• Bronchodilators – These medications help open constricted airways and are best for mild emphysema. It includes the inhalers albuterol and Atrovent and the drug theophylline.
• Steroids – Steroids can be consumed via inhaler or pill form and reduce inflammation; however, they can have side effects – such as weakened bones and increased risk of high blood pressure and diabetes – when used for long periods of time.
• Antibiotics – Antibiotics can relieve the increased shortness of breath that can occur with respiratory infections such as bronchitis and pneumonia but can increase antibiotic resistance when used continually.
• Supplemental oxygen – Additional oxygen may help people who have severe emphysema with lowered oxygen levels. Supplemental oxygen is an entirely symptomatic treatment, and will not affect the progression of the disease.
• Surgery – In a procedure called lung volume reduction surgery, physicians remove small portions of diseased lung tissue, which may help remaining lung tissue work more efficiently. In extremely severe cases, people with COPD may require a lung transplant.
• Pulmonary rehabilitation – This type of rehabilitation program helps people with COPD learn how to cope with the disease with a combination of education, exercise, breathing techniques, and behavioral intervention.

• How we treat COPD?

At our center we believe in killing the root cause of the disease. We find our comprehensive approach extremely useful for COPD, where we study the life history of the patient and carefully evaluate for every possible trigger in the diet, workplace and home environment. Then testing is performed, including comprehensive allergy testing. Breathing tests may be utilized during allergy testing to help confirm the effect of triggers. Each inhalant, food, or chemical is tested individually at our Center, so patients can often see for themselves the effects of different substances on their breathing capacity.  The treatment includes:

• Quit Smoking
• Mucolytic – Mucolytics are medicines that make the mucus (sputum), which is made in your lungs, less thick and sticky and easier to cough up. These are available as capsules, tablets or oral liquids.
• Restore Anti-oxidant Defense – Long-term exposure to irritants—from smoking in most cases but also from secondhand smoke or environmental pollutants—creates a storm of free radical damage and inflammation that narrows the airways and destroys the alveoli, the tiny, honeycomb-like sacs in the lungs where the capillaries pick up oxygen and release carbon dioxide. So restoring anti oxidant defense becomes a logical treatment option. It includes: CoQ-10 (Product)
  • Glutathione – nebulized glutathione treatments are a tremendous help to stabilize the airway
  • Green tea (EGCG)
  • Resveratrol
  • Vitamin A
  • Vitamin C
  • Vitamin E
• Chinese Herbs – Chinese medicinal mushroom cordyceps, which is nontoxic and may be useful in slowing the progression of chronic lung disease. Cordyceps has also been studied for improving lung efficiency in athletes, and might offer benefits for those with compromised functions. Eucalyptus oil is a common expectorant. Adding a few drops to the humidifier may help you breathe easier.
• Increase dietary sources of carotenes, such as carrots, sweet potatoes, yellow squash and leafy green vegetables
• Omega-3 fatty acids – These help in decreasing inflammation. This may help improve the breathing. For example – flaxseed, soybeans, canola oil, walnuts, and cold-water fatty fish like salmon, herring, mackerel, and sardines.

It may also includes

• Yoga Breathing techniques
• Acupuncture                            

With our dedication and commitment and a lot of help from you as patients, we are able to treat COPD in the best way possible and ultimately help the patient live a healthy life……..

Costochondritis, also called Tietze’s Syndrome is an inflammation of the cartilage that attaches the inner end of the upper ribs to the flat bone in the middle of the chest (known as the sternum). Cartilage is a type of tissue that helps form many important body structures. For example, the ears are mostly made of cartilage.

Cartilages attach the ribs to the breastbone (sternum) and the sternum to the collarbones (clavicles). The joints between the ribs and the cartilages are called the costochondral joints. Those between the cartilages and the breastbone are called costosternal joints. Those between the sternum and the clavicles are called the sternoclavicular joints. The prefix ‘costo’ simply means related to the ribs. ‘Chondr-‘ means related to the cartilage and ‘-itis’ is the medical ending (suffix) that means inflammation. In costochondritis, there is inflammation in either the costochondral, costosternal or sternoclavicular joints (or a combination). This causes pain and tenderness, that tends to be worse with movement and pressure.

Most patients with costochondritis experience pain over the front of the chest (the area of the sternum). Costochondritis should only be diagnosed after excluding other more serious problems such as heart disease. Costochondritis pain is usually worsened by activity or exercise. Often the pain is worsened when taking a deep breath due to stretches of the inflamed cartilage. Pressing on the area can be extremely painful for the patient. Because of the many nerves that branch away from the chest, pain may be experienced in the shoulder or arms as well.

When called Tietze’s Syndrome, the pain from costochondritis is accompanied by redness and or swelling in the areas most tender.

Causes

The cause of costochondritis may be unknown, or it may be caused by any of the following –

Chest injury – An injury to your chest may cause costochondritis.

Strain – Activities that strain your chest wall muscles can lead to costochondritis. This includes hard coughing. Strain can also occur while you are playing sports with repeated arm movements, such as rowing, weightlifting, and volleyball.

Infection – Lung or chest infections can increase your risk of costochondritis.

Inflammatory diseases – Diseases that cause swelling around your joints, such as rheumatoid arthritis, increase your risk of costochondritis.

Risk Factors

There is no particular person more at risk of costochondritis than another. It does tend to affect younger people, especially teenagers and young adults. It can affect children. People performing repetitive movements that strain the chest wall, particularly if they are not used to it, might be considered more at risk of getting this condition. People with fibromyalgia tend to develop costochondritis more often than others. Fibromyalgia is a long-term (chronic) condition that causes widespread body pains and fatigue. (See separate leaflet called Fibromyalgia for more information.)

• Race – A study indicates Hispanics may have an increased prevalence of costochondritis, but most studies do not mention race as a factor.
• Sex – Studies of chest pain in children demonstrate that males and females are affected equally. There are no recent studies evaluating the effect of gender in costochondritis.
• Age – No data support an association between age and costochondritis; the condition is well described in children of all ages, including infants.
• Injury – A blow to the chest
• Physical strain – Heavy lifting and/or strenuous exercise
• Arthritis – In some people, costochondritis has been linked to specific problems, such as osteoarthritis, rheumatoid arthritis and ankylosing spondylitis.
• Joint infection – The rib joint itself can become infected by viruses, bacteria or fungi. Examples include tuberculosis, syphilis and aspergillosis.
• Tumours – Non-cancerous and cancerous tumours also can cause costochondritis. Cancer may travel to the joint from another part of the body, such as the breast, thyroid or lung.

Symptoms

The main symptoms of costochondritis are pain and tenderness at the junction of the ribs and the breastbone. The pain increases with movement and deep breathing, and decreases with rest and quiet breathing. Pressure placed directly on the affected area will also cause significant pain.

The pain can vary in intensity but is often severe. It is often described as sharp, aching or pressure-like in nature. It is usually located on the front of the chest, but can radiate to the back, abdomen, arm or shoulder.

The pain usually occurs on only one side of the chest, most commonly the left, but can affect both sides of the chest at the same time.  Symptoms of costochondritis usually last for between one and three weeks.

Costochondritis is similar to a condition called Tietze syndrome, which affects the same area. However, with Tietze syndrome there is swelling as well as the pain and tenderness. Swelling is not a symptom of costochondritis.

Treatment

Medications

• Acetaminophen – This medicine decreases pain. Acetaminophen is available without a doctor’s order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
• NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor’s order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask if NSAIDs are safe for you. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child’s healthcare provider.

Other Treatment

Rest – Affected person may need to rest and avoid painful movements and activities. Do not carry objects, such as a purse or backpack, if this causes pain. Avoid activities such as weightlifting until your pain decreases or goes away.

Heat – Heat helps decrease pain in some patients.

Ice – Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel and place it on the painful area for 15 to 20 minutes every hour or as directed.

Stretching exercises – Gentle stretching may help your symptoms.

Alternative Treatment

Acupuncture is a well known Chinese technique used to alleviate pain, especially bone and joint pains. Acupuncture is very useful in repeated episodes of costochondritis.

Glucosamine is naturally found in the cartilage of joints. Glucosamine sulfate is also found in the synovial fluid that surrounds all joints. Glucosamine supplements have shown the most promise in the treatment of osteoarthritis of the knee, but some feel it may have some benefit in the treatment of costochondritis.

Omega 3s – It is vitally important for a strong immune system and fighting inflammation.

An anti-inflammatory diet is recommended comprising of healthy and wholesome foods.  Salmon, sardines, herring, anchovies, flaxseed, hempseed and walnuts are a great source of anti-inflammatory Omega 3s. In addition, other anti-inflammatory fats include extra-virgin olive oil, avocado oil, flaxseed oil, hempseed oil and walnut oil.

Turmeric – A great natural pain reliever as well as being anti-inflammatory. Turmeric contains Curcumin and Curcuminoids which act in the same way as prescribed NSAIDs (non-steroidal anti-inflammatory drugs). Turmeric needs to be supplemented to reap the full benefits but can also be used topically and added to food.

Burdock Root – Burdock contains anti-inflammatory fatty oils and is great as a natural pain reliever.

Aloe Vera – Aloe Vera boosts the immune system and energy levels, providing the body with the right agents to restore and repair itself.

Refined carbohydrates are pro-inflammatory.

Vitamin D is integral for bone health, and severe deficiency can cause rickets in children and osteomalacia in adults. Although osteomalacia can cause severe generalized bone pain, there are only a few case reports of chest pain associated with vitamin D deficiency.

Noni fruit acts as an anti-inflammatory and is an excellent natural remedy for Costochondritis.  We have had reports from customers who have experienced rapid relief from Costochondritis in just a few days.  Two traditional names for Noni have been ‘painkiller tree’ and ‘headache’ tree. Research has show that noni is completely safe, and does not exhibit any toxic effects.

Serrapeptase also has anti-inflammatory properties and has had wide clinical use, spanning over twenty-five years throughout Europe and Asia.  It is a viable, natural alternative to salicylates, ibuprofen and the more potent NSAIDs. Unlike these drugs, Serrapeptase is a naturally occurring, physiologic agent with no inhibitory effects on prostaglandins and is devoid of gastrointestinal side effects.  Serrapeptase would also then be indicated as a natural remedy for Costochondritis.

Reference –

https://www.southerncross.co.nz/AboutTheGroup/HealthResources/MedicalLibrary/tabid/178/vw/1/ItemID/190/Costochondritis-causes-symptoms-treatment.aspx

http://www.healthdirect.gov.au/costochondritis

http://emedicine.medscape.com/article/808554-overview

http://www.netdoctor.co.uk/conditions/aches-and-pains/a2864/costochondritis-tietzes-syndrome/

http://myheartsisters.org/2013/12/26/chest-pain-costochondritis/

http://patient.info/health/costochondritis

http://www.nhs.uk/conditions/Tietzes-syndrome/pages/introduction.aspx

http://www.healthline.com/health/costochondritis#Overview1

http://www.webmd.com/pain-management/costochondritis?print=true

https://www.nlm.nih.gov/medlineplus/ency/article/000164.htm

http://www.mayoclinic.org/diseases-conditions/costochondritis/basics/definition/con-20024454

http://www.emedicinehealth.com/costochondritis/article_em.htm

https://umm.edu/health/medical/ency/articles/costochondritis

http://www.regenerativenutrition.com/natural-supplements-cure-costochondritis.asp

http://hubpages.com/health/Costochondritis-treatment

Coughing is normal occasionally, especially if a person suffers from cold, allergies or flu. It has a purpose, as it is body’s way of keeping unwanted stuff from getting into the lungs i.e. it is a reflex action. Coughing helps clear extra mucus from the airways (small tubes in your lungs). This extra mucus could be caused by smoking, a cold, nasal or sinus problems, a lung infection or a lung disease like asthma or COPD.

A chronic cough is more than just an annoyance. Chronic cough is defined as lasting eight weeks or longer in adults, four weeks in children.

While it can sometimes be difficult to pinpoint the problem that’s triggering a chronic cough, the most common causes are tobacco use, postnasal drip, asthma and acid reflux — the backflow of stomach acid that can irritate your throat. Chronic cough typically disappears once the underlying problem is treated.

Chronic coughing is common, so frequent that it rates as one of the most common reasons for seeing a doctor. Although both patients and doctors rightly focus their attention on finding the cough’s cause, the cough itself is responsible for significant problems. In addition to worry about the diagnosis, patients experience frustration and anxiety, especially if diagnosis and treatment stretches out over weeks, which is often the case.

Coughing interrupts sleep, producing fatigue and impairing concentration and work performance. In this age of scary new viruses, social interactions are likely to suffer. And coughing can also have important physical consequences, ranging from urinary incontinence to fainting and broken ribs. Between medical tests, lost productivity at work, remedies that don’t help, and treatments that do, coughing is also expensive.

Causes

Chronic cough is usually caused by these health problems-

• Smoking – Smoking is the number one cause of chronic cough.
• Asthma – This is the second most frequent cause of chronic cough. Shortness of breath and wheezing are by-products of asthma. These breathing difficulties can result in a chronic cough. On the other hand, chronic cough may be the only symptom of asthma.
• Acid reflux – Gastroesophageal reflux disease (GERD) occurs when stomach acid backs up into the esophagus. Symptoms of GERD include heartburn, chest pain, wheezing and shortness of breath. Irritation caused by these symptoms can lead to chronic cough.
• Sinusitis and post nasal drip – Recurrent sinus infections can cause post-nasal drip, sometimes called ‘a tickle in the back of the throat,’ drainage can trigger chronic cough. The ‘tickle’ occurs when a larger-than-normal amount of mucus runs down the back of the throat.
• Allergies – Chronic cough can result from inhaling dust, pollen, pet dander, chemical/industrial fumes (over many years), molds, freshly cut grass, and other irritants.
• Bronchitis – Inflammation of these airway passages can trigger shortness of breath and wheezing and result in chronic cough.
• Upper respiratory infections – Lengthy bouts of colds, the flu, pneumonia or other infections can lead to the development of chronic cough. Whooping cough (pertussis) occurs more commonly in infants and young children.
• Chronic obstructive pulmonary disease (COPD) – This is a lung condition that occurs most often in smokers. It is caused by a build-up of mucus in the lungs, which the body tries to clear by coughing. COPD includes the related conditions, emphysema and chronic bronchitis.
• High blood pressure drugs – ACE inhibitors are a specific category of drugs used to treat high blood pressure. A side effect of these drugs is chronic cough. Some common ACE inhibitors are lisinopril (Prinivil, Zestril), enalapril (Vasotec), peridopril (Aceon), captopril, (Capoten), and ramiparil (Altace).
• Lung or other airway cancers – Rarely, chronic cough can be a sign of either a lung cancer or cancer in the upper airway.

Symptoms

A chronic cough can occur with other signs and symptoms, which may include –

• A runny or stuffy nose
• A feeling of liquid running down the back of your throat
• Frequent throat clearing and sore throat
• Hoarseness
• Wheezing and shortness of breath
• Heartburn or a sour taste in your mouth
• In rare cases, coughing up blood
• Fever (higher than 101°F®)
• A drenching overnight sweat

Complications

• Physical exhaustion
• Insomnia (inability to sleep)
• Disruption of the daily routine
• Muscle discomfort
• Hoarse voice
• Headache/dizziness
• A drenching sweat
• Urinary incontinence (loss of bladder control)
• Minor bleeding in the eye
• Hernia
• Broken ribs

Treatment

Medication

In case of Asthma – drugs such as inhaled bronchodilators and/or steroids are prescribed. These drugs help reduce airway inflammation and wheezing.

Cough medicines – Cough suppressants for a dry cough or expectorants for a wet, productive cough that brings up mucus, are available over the counter and by prescription.

Antihistamines – Can temporarily relieve a runny nose by drying up nasal secretions; they may help if your cough is due to allergies. Non-drowsy antihistamines available over the counter include loratadine (Claritin), fexofenadine (Allegra), and cetirizine (Zyrtec).

Bronchodilators – Increase airflow by opening airways and help make it easier to breathe.

GERD – several non-drug treatments and prescription medications are tried. Non-drug treatments include using pillows to prop up the head when lying down, avoiding foods that cause acid reflux (such as chocolates, colas, red wines) and not eating right before bedtime. Prescription medicines, such as cimetidine (Tagamet), famotidine (Pepcid), ranitidine (Zantac), esomeprazole (Nexium), lansoprazole (Pravacid®), and omeprazole (Prilosec), are prescribed to reduce stomach acids.

Bacterial Pneumonia or bronchitis, antibiotics, such as azithromycin (Azithrocin, Zithromycin), cefuroxime (Ceftin) or cefprozil (Cefzil), are prescribed.

Post-nasal drip, over-the-counter decongestants, such as diphenhydramine or pseudoephedrine, may help relieve post-nasal drip symptoms. Antibiotics may be prescribed if the cause of the chronic cough is sinusitis. Nasal spray, such as ipratopium (Atrovent) can relieve runny nose, sneezing and post-nasal drip. A nasal glucocorticoid, such as fluticasone (Flonase) can also reduce post-nasal drip.

High blood pressure medicines (ACE inhibitor drugs), other high blood pressure drugs can be prescribed instead.

Lifestyle

Avoid allergens -If the chronic cough can be traced back to nasal allergies, try to avoid the substances that cause your symptoms.

Quit smoking – The most common cause of chronic bronchitis, smoking irritates the lungs and can worsen coughs caused by other factors.

Reduce acid reflux – A cough caused by acid reflux can often be treated with lifestyle changes alone. This includes eating smaller, more frequent meals; waiting three to four hours after a meal before lying down; and elevating the head of the bed at night.

Alternative Treatment

Probiotics – These may help overcome underlying conditions. Research suggests that Lactobacillus may help prevent colds and flu, and possibly reduce allergy to pollen. Several studies that examined probiotics combined with vitamins and minerals also found a reduction in the number of colds caught by adults, although it is not possible to say whether the vitamins, minerals, or probiotics were responsible for the benefit.

Quercetin – Quercetin is a flavonoid, a plant pigment responsible for the colors found in fruits and vegetables. Studies suggest that quercetin inhibits the production and release of histamine, which causes allergy symptoms, such as a runny nose and watery eyes.

Bromelain – Some studies show that bromelain may help reduce symptoms of sinusitis and relieve swelling and inflammation caused by allergies.

Peppermint – Peppermint is widely used to treat cold symptoms. Its main active agent, menthol, is a good decongestant.

Licorice – Licorice root is a traditional treatment for sore throat and cough, although scientific evidence is lacking. Licorice interacts with a number of medications.

Thyme – Thyme has traditionally been used to treat respiratory illnesses, such as bronchitis, and to treat cough. Two preliminary studies suggest that thyme may help treat acute bronchitis and relieve cough.

Phosphorous – For chest tightness associated with a variety of coughs, particularly a dry, harsh cough with a persistent tickle in the chest and significant chest pain; symptoms tend to worsen in cold air and when the individual is talking; this remedy is most appropriate for individuals who are often worn out and exhausted, suffer from unnecessary anxiety (even fear of death), and require a lot of reassurance.

Vitamins

Reference –

http://www.nationaljewish.org/healthinfo/conditions/cough/

http://www.emedicinehealth.com/coughs/article_em.htm

http://bestpractice.bmj.com/best-practice/monograph/69/diagnosis/differential-diagnosis.html

http://www.pdrhealth.com/diseases/cough

http://www.fpnotebook.com/lung/Sx/ChrncCgh.htm

http://www.aafp.org/afp/2011/1015/p887.html

http://www.everydayhealth.com/symptom-checker/cough

http://www.aaaai.org/conditions-and-treatments/conditions-dictionary/chronic-cough.aspx

http://www.avogel.co.uk/health/immune-system/cough/persistent/

Asthma is the common chronic respiratory disease in childhood. Approximately 6.5million, or 9 percent of children under the age of 18, have asthma; that makes it the most common chronic condition in childhood. In fact, asthma is one of the leading reasons kids are hospitalized.

Unlike a cold or other respiratory illness, asthma isn’t contagious; hence a child will not catch it from his or her friends. It is a chronic inflammatory disorder of the airways, known as bronchial tubes, in which many cells and cellular elements play a role. The bronchial tubes are lined on the inside with mucous membranes and encased by smooth, sensitive muscles on the outside. The chronic inflammation is associated with airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning. These episodes are usually associated with widespread, but variable, airflow obstruction within the lung that is often reversible either spontaneously or with treatment.

The inner lining of the bronchial tubes contains special cells, called inflammatory cells, which release chemicals after exposure to irritants. These chemicals cause the bronchial muscle constriction, mucous secretion, swelling of the bronchial tube inner lining, and coughing. Some of these chemicals also tell the body to send more inflammatory cells into the area. The lining of the bronchial tubes of asthmatics contain more of these special cells. In addition, in asthmatics, the inflammatory cells release their chemicals after exposure to things the person is allergic to — for example, after exposure to dogs, or cats, or ragweed.

The result is a wheezing sound that may be more noticeable when a child exhales. Frequent coughing is a common companion of asthma as well as a tight feeling in the chest.

Causes

Asthma results from an interaction between different environmental and genetic factors.

Environmental Factors – The environmental influences begin during pregnancy: allergic sensitisation has been described before birth, and several studies have demonstrated reduced lung function in newborn infants of smoking mothers compared to those of nonsmoking mothers. Smoking increases the risk of both asthma and poorer lung function throughout childhood. All children should have the right to an environment free from tobacco smoke products both before and after birth.

Allergens – Allergen exposure may cause acute asthma exacerbations, and even in the absence of an exacerbation, may increase airway inflammation and bronchial hyperresponsiveness. Allergens may be encountered both outdoors and indoors, and house dust mites and animal dander are particularly important perennial indoor allergens. Occupational agents play a minor role during childhood, but several types of allergy may influence the choice of education in relationship to later working life. Kindergartens and schools are the working environment of children, and the need for a healthy indoor environment in such institutions should be emphasised. Special consideration should be given to the increased risk of respiratory infections, especially in kindergartens. In schools, precautions may be taken to reduce allergen exposure for allergic asthmatic children.

Medicine – It is widely accepted that antibiotics play a role in asthma attacks and may contribute to its original cause. Many children are so well protected from germs, bacteria and childhood illnesses that their immune systems don’t develop properly. Instead of acquiring the immune cells specific to certain bacteria and viruses, they retain highly reactive immune cells.

Ampicillin, amoxycilllin cephalosporins, erythromycin, spiramycin and tetracycline, both in prescription form and the antibiotic-treated animal products we ingest, worsen asthma attacks. Acetaminophen, aspirin, ibuprofen and naproxen can trigger or worsen asthma attacks. Other drugs such as betablockers, estrogen, NSAIDs and sulfites can trigger or worsen asthma attacks.

Genetic – Asthma, and one of its major causes, allergy, have strong hereditary traits. During recent years, much effort has been put into genetic family studies in order to identify genetic markers. A large number of markers with possible relationships to asthma and airway inflammation have already been identified, but these vary between populations. There has also been increased focus upon epigenetics: the finding that environmental influences may cause DNA methylation and histone formation, and thus change and inactivate the influence of specific genes, has given insight into how the environment may interact with genes, and has shown that this interaction may even be transferred from mother to child.

Infections – Respiratory virus infections are the major cause of acute bronchiolitis in infancy and of acute asthma attacks among older asthmatic children. From 2 years of age, rhinovirus infections are the most frequent precipitators of acute asthma.

Exercise – Throughout childhood, but increasingly during school age, exercise is an important cause of asthma exacerbations (exercise-induced asthma). It has been reported that 30% of all asthmatic children suffer from restriction of physical activity and it is very important to teach asthmatic children to master exercise, by education, advice related to ‘warming up’ and medical treatment.

Risk Factors

Factors that may increase the child’s likelihood of developing asthma include –

• Exposure to tobacco smoke
• Previous allergic reactions, including skin reactions, food allergies or hay fever (allergic rhinitis)
• A family history of asthma, allergic rhinitis, hives or eczema
• Living in an urban area with increased exposure to air pollution
• Low birth weight
• Obesity
• A chronic runny or stuffy nose (rhinitis)
• Severe lower respiratory tract infection, such as pneumonia
• Inflamed sinuses (sinusitis)
• Heartburn (gastroesophageal reflux disease, or GERD)
• Being male
• Pet dander

Symptoms

Breathing problems are common. They can include –

• Shortness of breath
• Feeling out of breath
• Gasping for air
• Trouble breathing out (exhaling)
• Breathing faster than normal
• When the child is has a hard time breathing, the skin of the chest and neck may suck inward.

Other symptoms of asthma in children include –

• Coughing that sometimes wakes the child up at night (it may be the only symptom)
• Dark bags under the eyes
• Feeling tired
• Irritability
• Tightness in the chest
• A whistling sound made when breathing (wheezing).

Complications

Asthma may cause a number of complications, including –

• Severe asthma attacks that require emergency treatment or hospital care
• Permanent narrowing of the airways (bronchial tubes)
• Missed school days or getting behind in school
• Poor sleep and fatigue
• Symptoms that interfere with play, sports or other activities

Treatment

Inhalers – There are different types of inhaler devices, which deliver asthma medication to the airways either in dry powdered form, or as an aerosol form with a propellant.

• Preventers are used to reduce the inflamed areas of the lungs and to prevent the symptoms of asthma occurring. They contain steroid medication to be inhaled usually once or twice a day, and work as a long term treatment to control asthma.
• Relievers (bronchodilators) are used to provide immediate relief from the symptoms of asthma when they develop. These inhalers work by opening up the airways to allow more air into the lungs and make breathing easier. They do not help reduce inflammation or prevent symptoms from occurring in the future. Some medicines work as both a preventer and a reliever.

Nebulisers – Nebulisers are sometimes used to treat emergency situations where asthma has become out of control. They used to be used in children experiencing a particularly severe attack of asthma, but research has shown that inhalers used with a spacer are as effective as nebulisers in delivering medicine. Nebulisers continue to be used by ambulance crews, some GPs and in A&E departments, as they allow oxygen to be given at the same time. However, a hospital may use an inhaler with spacer instead as doing so may allow the child to be discharged from hospital sooner.

Steroids – Steroids work by reducing inflammation. In the case of asthma, when a patient uses an inhaler, steroids are taken directly to the lungs, thereby directly treating the area that is affected by the allergy. The steroids then reduce the swelling of the airways which is the underlying problem in asthma. Also, some allergic responses involve a second (late phase) reaction after the initial allergic reaction. Steroids, unlike anti-histamines, can reduce the symptoms of these late phase reactions, by limiting the activity of the cells responsible for releasing further chemicals in the body. In this way steroids not only reduce inflammation, but they can also stop an ongoing allergic reaction.

Anti-leukotrienes – Leukotrienes are chemicals released by the immune system that cause swelling and secretion, and can cause allergy symptoms to persist. Anti-leukotrienes work by reducing inflammation and mucus production, and work in a similar way to steroids, but with fewer side effects.

Lifestyle Changes for Parents –

• Try to avoid triggers which could makes the child’s asthma symptoms worse (e.g. animal hair) and note down any new ones to discuss with your doctor.
• Do not smoke around the child or allow the child to stay in smoky surroundings.
• Exercise can play an important part for the child. Swimming and sport should be encouraged as long as the child’s asthma is under control.
• Think about any triggers in holiday areas, such as house dust mite or pets. Request a pet-free place to stay if possible, and make sure to give details to any holiday club staff about your child’s condition.

Alternative Treatment

Beta-carotene, the compound that gives fruit and vegetables their orange or red color, reduced asthma attacks in 53% of people in one study. Carotenoids are the basis of vitamin A which is involved in the mucous membranes. Severity of asthma correlates with low vitamin A.

Vitamin B3 and vitamin B12 are commonly low in asthmatics. These nutrients lower antihistamine levels and reduce wheezing.

Folate, or vitamin B9, reduced allergic reactions and inflammation. It lowers wheezing by 40%.

Fish oil – The evidence for using omega-3 fatty acids (found in fish oil) to treat asthma is mixed. At least a few studies have found that fish oil supplements may reduce inflammation and symptoms in children.

Quercetin, a kind of antioxidant called a flavonoid, helps to reduce the release of histamine and other allergic or inflammatory chemicals in the body. Histamine contributes to allergy symptoms, such as a runny nose, watery eyes, and hives.

Coenzyme Q 10 (CoQ10) to act as antioxidants.

Vitamin C is a powerful antioxidant and helps to detoxify the body. Vitamin C reduces wheezing and inflammation.

Magnesium – The idea of using magnesium to treat asthma comes from the fact that people who have asthma often have low levels of magnesium.

Potassium – For healthy immune system.

Coleus forskohlii – Coleus forskohlii, or forskolin, is another herb used in Ayurvedic medicine to treat asthma.

Pycnogenol – French maritime pine bark, called pycnogenol, suggests that it may reduce symptoms and improve lung function in children with asthma

Boswellia (Boswellia serrata) – Boswellia (also known as Salai guggal) is an herb commonly used in Ayurvedic medicine, a traditional Indian system of health care.

Saiboku-to – In three preliminary studies, a traditional Japanese herbal mixture called Saiboku-to has helped reduce symptoms and allowed study participants to reduce doses of corticosteroids.

Reference –

http://www.kidshealth.org.nz/asthma

http://acaai.org/asthma/who-has-asthma/children

http://www.childrenshealthfund.org/child-health-care/special-initiatives/childhood-asthma-initiative

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/asthma-and-young-children

http://www.medindia.net/patients/patientinfo/childhood-asthma.htm

http://www.childhoodasthma.org/

http://www.erswhitebook.org/chapters/childhood-asthma/

http://www.nhs.uk/conditions/asthma/Pages/Introduction.aspx

http://publichealth.lacounty.gov/ha/reports/habriefs/v3i6_asthma/asthm.pdf

http://kidshealth.org/parent/medical/lungs/asthma_basics.html