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Respiratory disorders



Related terms
Background
Treatment
Author information
Bibliography
Causes
Types of the disease

Related Terms
  • ACE inhibitor-associated cough, acute respiratory distress syndrome, airway obstruction, asbestosis, asthma, bronchial congestion, bronchiolitis, chest X-ray, common cold, congestion, cough, croup, decongestant, dyspnea (shortness of breath), eucalyptus aromatherapy, expectorant, FBD, functional breathing disorder, hypoxia, laryngitis, lower respiratory infection, lung cancer, lung infections, nasal congestion, nasopharyngitis, pharyngitis, pulmonary conditions, pulmonary hypertension, recurrent sneezing, respiration, respiratory disease, respiratory distress, respiratory infection, respiratory problems, respiratory syncytial virus, respiratory tract infection, rhinitis, rhinopharyngitis, runny nose, sarcoidosis, sinus congestion, sore throat, strep throat, stuffy nose, tonsillitis, upper respiratory tract infection, vasodilator.

Background
  • Respiratory illnesses are conditions affecting the upper respiratory tract, producing symptoms mainly in the nose and throat. Upper respiratory infections include conditions such as colds, laryngitis, pharyngitis, rhinitis, and sinusitis. Additionally, respiratory conditions include infections of the lower respiratory tract, which may affect the windpipe, airways, and lungs. Lower respiratory tract infections include conditions such as asbestosis, asthma, and sarcoidosis.
  • The respiratory system consists of organs that process air in the body, including the nose, throat, and lungs. The nose is the entrance to the respiratory tract. The throat is the hollow tube inside the neck that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). The lungs are the organs that make it possible for people to breathe; their principal function is to transport oxygen from the atmosphere into the bloodstream and to release carbon dioxide from the bloodstream into the atmosphere.
  • During a normal day, the average person breathes nearly 25,000 times, taking in large amounts of air. According to the American Lung Association, approximately 342,000 Americans die from lung diseases each year; lung disease is the number three cause of death in the United States, responsible for one in seven deaths.
  • Many factors, including genetics, pollutants and irritants, and infectious diseases, may affect the health of the respiratory system.

Treatment
  • Antibiotics: The doctor will prescribe a 10-day treatment of penicillin or amoxicillin (Amoxil®, Trimox®) to treat strep throat. Patients allergic to penicillins may be given erythromycin, azithromycin (Zithromax®), or clarithromycin (Biaxin®). Patients should finish all of the medication even if they start to feel better.
  • Cough medicines: Over-the-counter medicines such as Robitussin DM®, which includes the two medications dextromethorphan and guaifenesin, may be used to relieve cough symptoms. However, according to the American College of Chest Physician's Guidelines, over the counter cough syrups contain drugs in too low a dose to be effective. Additionally, patients may delay treatment for more serious coughs. An antihistamine with a decongestant is the recommended treatment.
  • Combined therapy medicine: Combined therapy involves both a controller (e.g. corticosteroids or long acting beta agonists) and a reliever (e.g. corticosteroids or short acting beta agonists such as Albuterol®). This therapy is used to manage asthma symptoms for long-term therapy.
  • Corticosteroids: Doctors may prescribe corticosteroids such as dexamethasone or prednisone to reduce the upper airway swelling that may occur with croup. Additionally, corticosteroids may be prescribed to keep the lungs working and relieve symptoms in patients suffering from sarcoidosis.
  • Endothelin receptor antagonist (ERA): Letairis® (ambrisentan) was recently approved in 2007 for the treatment of pulmonary hypertension. Ambrisentan works by blocking the effects of a substance called endothelin, which is made by the body in increased amounts in patients with pulmonary hypertension. Endothelin causes blood vessels to narrow (constrict). It also causes overgrowth of the muscle in the walls of the blood vessels in the lungs. By blocking the action of endothelin, ambrisentan can reduce blood pressure in the lungs and improve activity level and well-being in patients. Common side effects of ambrisentan include the following: swelling of the lower extremities, nasal congestion, sinusitis, flushing, palpitations, abdominal pain, and constipation.
  • Medication change: Patients who develop a cough from ACEIs may be switched to other blood pressure medications, such as angiotensin receptor blockers (ARBS), which have a lower incidence of cough and work in a similar way.
  • Nasal decongestants: Nasal decongestants are useful medications for the common cold. Nasal decongestants help dilate (open) swollen mucous membranes of the nasal passages so the individual can breathe easier. Nasal decongestant dosage forms include tablets, sprays, inhalers, and nose drops. Nasal decongestants include the oral decongestant pseudoephedrine (Sudafed®), the nasal sprays oxymetolazone (Afrin®) and phenylephrine (Neo-Synephrine®), and the nasal inhalers propylhexedrine (Benzedrex®) and levmetamfetamine (Vicks Vapor Inhaler®). Nasal sprays containing a decongestant should be used for no longer than 72 hours due to the risk of rebound congestion (nasal spray addiction). They are safe for most patients, but they do have many side effects and conditions in which they should not be used, including in people with heart disease, high blood pressure, thyroid disease, glaucoma (increased pressure in the eyes), diabetes, seizure disorders, enlarged prostate, or by individuals using a monoamine oxidase inhibitor (MAOI, a type of antidepressant). Stinging, burning, sneezing, increased nasal discharge, drying of the nostrils, and altered taste may occur. If these effects continue or become bothersome, a doctor should be consulted. Other side effects include rapid or pounding heartbeat, dizziness, trouble sleeping, shaking of the hands, and tremors. Healthcare professionals recommend not using decongestants while pregnant or breastfeeding. If symptoms get worse, a doctor may need to evaluate the situation.
  • Products containing pseudoephedrine can be purchased without a prescription. However, the products are placed behind the pharmacy counter with limits to the amount that may be purchased in a single day and month. These efforts were established since there is widespread abuse of pseudoephedrine as a drug to make methamphetamine.
  • Pain relievers: Throat pain may be relieved by taking over-the-counter medications such as ibuprofen (Advil®, Motrin®), acetaminophen (Tylenol®), or aspirin (in adults only). Acetaminophen may also be used in patients who have the croup to lower fever, which may improve the child's breathing.
  • Saline nasal drops: Isotonic saline nasal drops are recommended for infants. Healthcare professionals recommend 1-2 drops in each nostril 15 to 20 minutes before feeding and bedtime and repeated 10 minutes later. Adults and children may also use saline nasal drops (Ocean® nasal spray) to relieve dry and inflamed nasal passages.
  • Surfactant replacement therapy: Surfactant may be given right after birth in the delivery room to prevent or treat respiratory distress syndrome. Surfactant is a liquid that coats the inside of the lungs and keeps them open so that the baby can breathe in air once he or she is born. The baby is given surfactant through a tube attached to a breathing machine until the lungs have developed enough to start making their own surfactant.

Author information
  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. American Academy of Family Physicians. .
  2. American Lung Association. .
  3. MedlinePlus. .
  4. Neumours Foundation. .
  5. National Heart Lung and Blood Institute. .
  6. Natural Standard: The Authority on Integrative Medicine. .
  7. Pulmonary Hypertension Association. .
  8. Simoes EA, Groothuis JR, Carbonell-Estrany X, et. al. Palivizumab prophylaxis, respiratory syncytial virus, and subsequent recurrent wheezing. J Pediatr. 2007 Jul;151(1):6-7. .
  9. Barrett B, Harahan B, Brown D, et. al. Sufficiently important difference for common cold: severity reduction. Ann Fam Med. 2007 May-Jun;5(3):216-23. .
  10. Simasek M, Blandino DA. Treatment of the common cold. Am Fam Physician. 2007 Feb 15;75(4):476, 479, 482. .
  11. Williams PR, Phelka AD, Paustenbach DJ. A review of historical exposures to asbestos among skilled craftsmen (1940-2006). J Toxicol Environ Health B Crit Rev. 2007 Sep-Oct;10(5):319-77. .
  12. Barst RJ. A review of pulmonary arterial hypertension: role of ambrisentan. Vasc Health Risk Manag. 2007;3(1):11-22. .
  13. Bolser DC. Cough suppressant and pharmacologic protussive therapy: ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan;129(1 Suppl):238S-249S. .

Causes
  • Asbestosis: Inhaling asbestos fibers may cause scar tissue to develop inside the lungs.
  • Asthma: Individuals who are sensitive to environmental factors (e.g. air pollutants, smoke, chemicals, etc.) and have a family history of asthma are more likely to develop the condition.
  • Common cold: A cold is caused by a viral infection. Viruses that may cause a cold include rhinoviruses, coronaviruses, adenoviruses, echoviruses, respiratory syncytial viruses (RSV), and coxsackieviruses. Although over a hundred different viruses can cause colds, 30-50% are caused by rhinoviruses.
  • Cough: Asthma is a common cause of chronic cough in adults and a leading cause in children. Gastroesophageal reflux disease (GERD) is a common condition where stomach acid flows back into the tube that connects the stomach and the throat (esophagus). This causes constant irritation which may lead to chronic coughing. Blood pressure drugs, such as angiotensin converting enzyme inhibitors (ACE inhibitors), have also been known to cause cough in approximately 20% of patients taking them.
  • Croup: Children may develop croup after breathing respiratory droplets infected with the virus. Croup is usually caused by parainfluenza viruses (viruses causing upper respiratory infections (colds) or lower respiratory infections (pneumonia)).Virus particles may survive on toys or other surfaces.
  • Laryngitis: Laryngitis is usually caused by a virus. Additionally, laryngitis may also be caused by a bacterial infection or the common cold, bronchitis, flu, or pneumonia.
  • Pharyngitis: Viruses (such as those that cause the common cold) and bacteria (which can cause many illnesses such as strep throat) may cause a sore throat. The bacteria group A streptococci causes pharyngitis in 5-15% of adults and 15-30% of children. However, approximately 85% of cases of pharyngitis are caused by a virus.
  • Pulmonary hypertension: Pulmonary hypertension may be caused by diseases of the heart and the lungs, such as chronic obstructive pulmonary disease (COPD) or emphysema, sleep apnea (a sleeping disorder characterized by pauses in breathing), failure of the left heart ventricle, and recurrent pulmonary embolism (blood clots traveling from the legs or pelvic veins obstructing the pulmonary arteries), or underlying diseases such as scleroderma (scar tissue in the organs).
  • Respiratory distress syndrome: Respiratory distress syndrome results from the absence of the liquid coating inside a baby's lungs (called surfactant) that keeps them open so that he/she can breathe in after birth.
  • Respiratory syncytial virus: Individuals may develop respiratory syncytial virus by inhaling respiratory secretions from people coughing or sneezing. Additionally, direct contact (e.g. shaking hands) with infected individuals may spread respiratory syncytial virus.
  • Rhinitis: Airborne substances, known as allergens, may cause allergic rhinitis. These allergens are usually harmless and only cause allergic symptoms in some people.
  • Sarcoidosis: Research is being done to determine the causes of sarcoidosis. Scientists believe that sarcoidosis may develop when the body's immune system responds to something in the environment, such as bacteria, viruses, dust, or chemicals, resulting in inflammation. In this case, there may be a malfunction in the body's natural defense system causing it not to work properly and overreact.
  • Sinusitis: Bacterial infections are usually the cause of acute sinusitis. When the sinuses are blocked for a long time, a secondary bacterial infection may develop, causing sinusitis.

Types of the disease
  • Asbestosis: Asbestosis is a lung condition caused by breathing in asbestos fibers. Usually, when particles in the air are breathed in, they are filtered out by the nose or the upper airways of the lungs. But asbestos particles are very thin and light and sometimes are not filtered out before they reach the lungs. Asbestos can damage lung tissue and is responsible for causing several serious diseases, including cancer.
  • Asthma: According to the American Lung association, approximately 20 million Americans have asthma, which causes about 5,000 deaths each year. Asthma is a chronic, inflammatory lung disease. The air passages within the lungs are constantly swollen, restricting the amount of air allowed to pass through the trachea. Asthmatics have recurrent breathing problems and a tendency to cough and wheeze.
  • Common cold: The common cold, or acute viral nasopharyngitis, is an upper respiratory tract infection caused by a virus, which may involve the nose, throat, sinuses, Eustachian tubes (connects the ears to the throat), trachea (windpipe), larynx (voice box), and bronchial tubes (airways). Colds are one of the leading causes of doctor visits and missed days from school and work. According to the Centers for Disease Control and Prevention (CDC), 22 million school days are lost annually in the United States as a result of the common cold. Over the course of a year, people in the United States suffer one billion colds, according to some estimates.
  • Cough: Coughs can either be classified as acute or chronic. Acute coughs usually begin suddenly and are often due to a cold, flu, or sinus infection. Acute coughs generally go away within two to three weeks. However chronic coughs last longer than two to three weeks.
  • Croup: Croup is a viral infection that causes the upper part of the windpipe (larynx) to swell and is usually caused by one of the cold viruses.
  • Laryngitis: Laryngitis is an inflammation of the voice box (larynx) usually associated with hoarseness or loss of voice. Laryngitis may be classified as acute (lasting for a short amount of time) or chronic (long-lasting).
  • Pharyngitis: Pharyngitis or sore throat is an inflammation of the pharynx, the passageway that connects the oral and nasal cavities. Most cases of pharyngitis occur during the colder months and often spread among family members. Infections of the pharynx usually involve the tonsils (fleshy tissue in the back of the throat that are part of the body's immune defense), and tonsillitis (inflammation of the tonsils) was once a common name for infectious pharyngitis. Infectious pharyngitis accounts for approximately 10 million visits to the doctor's office each year.
  • Pulmonary hypertension: According to the Pulmonary Hypertension Association, over 100,000 people suffer from pulmonary hypertension. Pulmonary hypertension occurs when there is high blood pressure in the lungs. Pulmonary hypertension results from constriction or tightening of the blood vessels that supply blood to the lungs. As a result, it becomes difficult for blood to pass through the lungs, making it harder for the heart to pump blood forward. This leads to enlargement of the heart and eventually fluid may build up in the liver and tissues, such as the in the legs.
  • Respiratory distress syndrome (adults): Adult respiratory distress syndrome (ARDS) is a life-threatening lung condition. It is a form of breathing failure that can occur in very ill or severely injured people. It is not a specific disease. It starts with swelling of tissue in the lungs and buildup of fluid in the tiny air sacs that transfer oxygen to the bloodstream. This leads to low blood oxygen levels.
  • Respiratory distress syndrome (infants): Respiratory distress syndrome is life threatening and one of the most common lung disorders in premature babies. Additionally, nearly all babies born before 28 weeks of pregnancy develop respiratory distress syndrome. According to the American Lung Association, infant respiratory distress syndrome was the seventh leading cause of death in infants under one year of age in the United States, accounting for 3.2 percent of all infant deaths.
  • Respiratory syncytial virus (RSV): RSV is a virus that causes infection of the lungs and breathing passages and is most common among infants and children under one year of age.
  • Rhinitis: Rhinitis affects over 50 million people and is considered one of the most common illnesses in the United States. Rhinitis is the medical term for inflammation of the nose and can be classified as either allergic or non-allergic. Allergic rhinitis occurs when the body's immune system overreacts to an airborne substance (allergen) that is normally harmless, such as mold, pollen, animal dander, or dust mites. Once the allergen is inhaled through the nose, white blood cells of an allergic individual produce an antibody called immunoglobulin E (IgE). This immunoglobulin attaches to the allergen, which triggers the release of histamine and other inflammatory chemicals that cause allergic rhinitis symptoms, such as runny nose and nasal congestion.
  • There are two types of allergic rhinitis: seasonal allergic rhinitis and perennial allergic rhinitis. Seasonal allergic rhinitis, also called pollinosis, hay fever, or nasal allergies, is characterized by several symptoms, predominantly in the nose and eyes. Symptoms occur after airborne allergens like dust, dander, or pollen are inhaled. When pollens cause the allergic symptoms, the allergic rhinitis is commonly referred to as "hay fever." According to the American Lung association, an estimated 26.1 million Americans have hay fever symptoms each year; 14.6 million Americans have asthma, which often accompanies hay fever. Perennial allergic rhinitis is an allergic reaction to allergens (substances that can cause an allergic reaction) that is not seasonal. Instead, symptoms are persistent and generally less severe than seasonal allergic rhinitis. Non-allergic rhinitis usually affects adults and causes year round symptoms, but the immune system is not involved. Several causes of non-allergic rhinitis include the following: infections, irritants (e.g. dust, secondhand smoke, perfumes), weather changes, emotional or physical stress, hormonal changes, certain foods and beverages, certain medications (e.g. aspirin, ibuprofen ), and long-term use of decongestant nasal sprays.
  • Sarcoidosis: Sarcoidosis is commonly found in the lungs and is characterized by the presence of granulomas, small areas of inflamed cells. This may lead to loss of lung volume (the amount of air lungs can hold) and abnormal lung stiffness. Sarcoidosis is most common among African Americans and northern European whites. Additionally, the disease usually affects people between the ages of 20 and 40.
  • Sinusitis: There are three classifications of sinusitis: acute, chronic, and recurrent. Acute sinusitis lasts for less than six months, and it is usually caused by a bacterial infection. Most cases of sinusitis are acute. When symptoms last between four and eight weeks, the condition is considered to be subacute. Symptoms of chronic sinusitis last eight weeks or longer and the severity varies. Symptoms for acute and chronic sinusitis are very similar, except chronic sinusitis symptoms last longer and often cause more fatigue. According to the CDC, chronic sinusitis affects nearly 35 million people in the United States. When an individual suffers from three or more episodes of acute sinusitis per year, the condition is referred to as recurrent sinusitis.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.



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