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Lung Disease: What You Need to Know to Breathe Easy

Your lungs are always at work, but you don’t notice how critical they are until they fail you. We all get the occasional cold or flu and suffer through the coughing and wheezing. Fortunately, these short-term lung problems go away.

Unfortunately, millions of Americans deal with chronic lung disease, which can be life-limiting, painful and even fatal.

So what should you know about the different types of lung conditions, their causes and how to prevent them? Shannon Carson, MD, division chief of Pulmonary Diseases and Critical Care Medicine at the UNC School of Medicine, helps break it down.

1. Respiratory Infection

What it is: An infection that can interfere with normal breathing.

Symptoms of respiratory infection: Rapid onset of flu-like symptoms, shortness of breath and cough.

Risk factors: Everyone is at risk for respiratory infections, but certain conditions can put people at higher risk. These conditions include:

  • Chronic lung disease
  • Heart disease
  • Chronic kidney disease
  • Diabetes
  • Liver disease

How to prevent respiratory infection: “The most common respiratory infections are usually viral in nature, so things that people can do to prevent those include avoiding close contact with people who have respiratory infections and frequent hand-washing, especially during flu season. But the most important preventive measure one can take is to get a flu shot every year,” Dr. Carson says.

Getting a flu shot can help protect against the three or four most common flu viruses each season.

Respiratory infections, such as the flu, are highly contagious. Getting a flu shot can help protect against the three or four most common flu viruses each season. People who have chronic lung diseases, heart or kidney failure, or compromised immune systems and adults over age 65 are also at higher risk of bacterial pneumonias. These individuals should receive vaccinations against pneumococcal pneumonia, the most common cause of pneumonia in adults.

2. Asthma

What it is: Asthma is a chronic condition that causes the airways to swell, narrow and produce extra mucus when inhaling environmental pollutants such as smoke, dust or mold. This narrowing makes it difficult to breathe.

Symptoms of asthma: Increasing shortness of breath with wheezing, chest tightness and cough.

Risk factors:

  • Family history of asthma
  • Viral respiratory infections
  • Allergies
  • Long-term exposure to environmental or occupational pollutants
  • Smoking

How to prevent asthma: Although you can’t prevent asthma, learning what factors make your asthma worse can help prevent asthma attacks. It can also be controlled with medication. Medicine can be given via an inhaler, injection or orally in pill or liquid form. Over-the-counter medications aren’t recommended for asthma, so talk to your pulmonologist about what medication works best for you.

“When people have shortness of breath and wheezing, they should see a pulmonologist for diagnostic testing and to be started on the right medication. A pulmonologist can also help them learn what kind of things might be in their environment that aggravate their asthma symptoms,” Dr. Carson says.

3. Chronic Obstructive Pulmonary Disease (COPD)

What it is: Chronic obstructive pulmonary disease, or COPD, is a chronic, progressive lung disease that makes it hard to breathe. COPD causes inflamed airways, and the tiny air sacs that allow oxygen to get into the blood, called alveoli, are destroyed. This means that less oxygen gets into the body, and it’s harder to get rid of carbon dioxide. COPD is an umbrella term for a group of conditions that includes emphysema and chronic bronchitis.

Symptoms of COPD: Shortness of breath, especially with exertion, which is sometimes accompanied by wheezing and coughing with excess phlegm.

Risk factors:

  • Smoking
  • Environmental or occupational pollutants
  • Alpha-1 deficiency, a genetic disorder that affects the body’s ability to create Alpha-1 proteins that help protect the lungs

How to prevent COPD: About 90 percent of people who experience COPD have smoked, so the condition can be prevented largely by avoiding cigarettes.

“People who do not smoke should never start, and any people who have been smoking should work on smoking cessation,” Dr. Carson says.

4. Lung Cancer

What it is: Lung cancer is cancer that starts in one or both lungs. It most often occurs in people who smoke, but it can also affect nonsmokers. In fact, if lung cancer in nonsmokers had its own category, it would be among the top 10 fatal cancers in the United States, according to the American Cancer Society.

Lung cancer is the leading cancer killer in American men and women.

Lung cancer is the leading cancer killer in American men and women.

Symptoms of lung cancer: Cough with bloody phlegm, shortness of breath or chest pain, or unexplained weight loss.

Risk factors:

  • Smoking
  • Radon exposure
  • Long-term exposure to hazardous chemicals
  • Pollution
  • Family history of lung cancer                                          

How to prevent lung cancer: Stop smoking—now. People older than 50 who smoke or have smoked should consider getting screened, Dr. Carson says. “We are now able to screen for the presence of very early lung cancer, which, if discovered, can lead to a cure in the early stages,” he says. “The key is to get screened before you have symptoms.”

Talk with your doctor to see if lung cancer screening is right for you. We offer lung cancer screening through UNC Cancer Care and UNC REX Cancer Care.

For nonsmokers, limiting your exposure to other lung cancer risk factors such as secondhand smoke, radon, occupational fumes and pollution can help prevent cancer.

5. Pulmonary Hypertension

What it is: Pulmonary hypertension is a type of high blood pressure that occurs in the blood vessels between your lungs and the right side of your heart, which can lead to heart failure.

Symptoms of pulmonary hypertension: Increasing shortness of breath when exercising and eventually while at rest, fatigue, chest pain and dizziness.

Risk factors:

  • Family history of pulmonary hypertension
  • Obstructive sleep apnea
  • Being a woman (especially in childbearing age)
  • Pregnancy

You are also at risk of pulmonary hypertension if you have:

  • Other lung diseases
  • Congenital heart disease
  • Certain rheumatologic conditions
  • Liver disease
  • HIV
  • History of blood-clotting disorders

How to prevent pulmonary hypertension: Although not all cases of pulmonary hypertension can be prevented, lifestyle habits such as avoiding smoking and staying active can help keep the condition at bay. Like asthma, medication can also help manage pulmonary hypertension. “Adults who develop increasing shortness of breath with exercise or even walking should be evaluated,” Dr. Carson says.

6. Obstructive Sleep Apnea

What it is: A sleep disorder that causes breathing to start and stop throughout sleep. This happens when the throat muscles relax and block your body’s airway.

Symptoms of obstructive sleep apnea: Excessive daytime fatigue, loud snoring, when you stop breathing during sleep, or abrupt awakenings with gasping or choking.

Risk factors:

  • Obesity
  • Larger neck circumference
  • Narrowed airway
  • Being a man or an older adult
  • Smoking
  • Drinking alcohol
  • Other substance use

How to prevent obstructive sleep apnea: Excess weight gain is a main contributor to obstructive sleep apnea, Dr. Carson says, which makes maintaining a healthy weight essential to reducing your risk.

How to Reduce Your Risk of Lung Disease

Although not all lung disease is preventable, some habits can help reduce your risk:

  • “By far, cigarette smoking is the most important risk factor,” Dr. Carson says. Don’t smoke if you want to keep your lungs at their healthiest.
  • Exposure to other pollutants such as animal dander, industrial fumes or heavy amounts of dust can predispose you to some conditions, so limit occupational and environmental pollutants when you can.
  • “Regular exercise is most important for good lung health, even in the presence of these conditions,” Dr. Carson says. “Exercise will improve the function of both the heart and the lungs. If both your heart and your lungs are in good condition, breathing will be easier.”

Need a pulmonologist? Find one near you.  

Shannon Carson, MD, is division chief of Pulmonary Diseases and Critical Care Medicine at the UNC School of Medicine.