A pulmonologist that treats children. Pulmonologist - what is this doctor? Analyzes and research

Content

For those who experience difficulties during inhalation-exhalation, who have respiratory diseases, it is recommended to consult a professional pulmonologist. At feeling unwell do not hesitate, and even more so endure the pain. It is better to immediately be in the doctor's office, get a referral for diagnosis and adequate assistance.

Who is a pulmonologist

Do you know what a pulmonologist is? This is a professional therapeutic direction with a specific profile of work - the human respiratory system. The main diseases faced by a pulmonologist include asthma, bronchitis, pneumonia and other pathologies. Perhaps, in childhood, few people heard about such a doctor in the clinic, but as adults, people must be checked at least 2 times every six months by a pulmonologist.

Pediatric pulmonologist

Any cold in childhood is considered harmless. However, the smallest cough should not be started, since the baby's immunity is not as strong as that of an adult. Pulmonologist for children - what does he treat? A normal cough often develops into complications, such as asthma, which can be dangerous to health. That is why going to a pediatric pulmonologist is a very important thing.

Understand what a pulmonologist does - what a doctor treats. In order for the child's respiratory system to work well, the doctor examines the small patient, identifies the disease and prescribes treatment. Here are three signs that should alert every parent and indicate that you need to see a doctor called a pulmonologist:

• unstable breathing during sleep in a child, a confused pace;
• the appearance of severe shortness of breath during running, any children's games, and even while eating.

What does a pulmonologist treat in adults?

The bronchi and lungs are what a pulmonologist treats in adults. Children respond much faster to treatment, cope with the disease than adults. The thing is, kids don't have bad habits. Men and women often like to smoke, which is one of the main reasons for the terrible chest cough, which develops into chronic bronchitis and is not treated. Expectoration of sputum begins, and conventional medicines no longer help.

In many cases, smoking acts as an irritant on the body, the trachea becomes inflamed, causing a person to cough and choke non-stop. This may well outgrow a terrible lung disease - bronchial asthma. Pulmonologist - what does he treat? A lung and bronchial doctor treats all forms of shortness of breath in adults. The pulmonology department is treated not only by smokers, but also by people working in hazardous industries with other respiratory diseases.

Pulmonologist-allergist

The help of a pulmonologist-allergist or phthisiatrician (a doctor can be called both ways) is necessary if the patient has severe shortness of breath when trying to breathe. Perhaps the point is not at all in the lungs, but in the fact that a person develops an allergy, which actively blocks the entry of air into the respiratory tract. Before it's too late, it's important to get checked out by an expert to determine what your body is overreacting to. It can be even the most common household dust, pollen from flowers, mold or animal hair.

Pulmonologist appointment

What does a pulmonologist do before diagnosing a disease? There are a number of important diagnostics that the doctor conducts depending on the patient's condition. It:

• echocardiography;
• CT (abbreviated as computed tomography);
• radiograph.

In addition, the doctor can diagnose in other ways. What does a pulmonologist do at the appointment? The doctor prescribes tests:

• skin tests;
• general blood analysis.

Where does it take

You can contact such a doctor both in a regular clinic of any city, and in a private institution, clinic. The significant difference is only in the number of people and the cost: either a live queue and an acceptable price, or the reception is expensive and is made by appointment. Analyzes and other methods of treatment remain the same, do not differ from where the pulmonologist takes. The main essence of paid service privileges is the speed of diagnostics.

Online pulmonologist consultation

The doctor can also help the patient through the Internet. An online pulmonologist consultation may be considered unreliable, but it is an affordable and very convenient thing if it is not possible to be in the doctor's office during the day. Here you can ask all your questions, describe your symptoms, get answers and sign up for a live consultation. A great way is to go to the site of a specialized doctor, which is in your hometown.

What is pulmonology, what does a pulmonologist treat? The branch of medicine deals with the study and treatment of lung diseases, and the specialist treats the respiratory system. You should never run your condition, always watch your own health. Breath is life. Blood circulation and even the correct heartbeat depend on it. Take care of yourself and go to a specialist doctor if you feel that something is wrong with your airways.

Video

Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment, based on individual characteristics specific patient.

A pulmonologist is a doctor who treats diseases of the lower respiratory tract. Patients with diseases of the bronchi and lungs are referred to him. These organs are responsible for oxygenating the blood. Therefore, it is so important to keep them healthy until old age.

When to consult a pulmonologist

When the patient feels worse, he goes to see a therapist. This general practitioner can determine the pathology of the lungs and bronchi, independently prescribe treatment. But in complex cases requiring additional diagnostic procedures The patient is referred for a consultation with a pulmonologist.

A person can independently contact a pulmonologist if the following symptoms appear:

• bouts of wet cough;
• change in the color of sputum;
• shortness of breath at rest;
• pain in the sternum;
• wheezing and whistling during sleep.

Diseases of the lower respiratory tract are also manifested by general malaise, increased sweating at night, dry mouth in the morning. The patient's body temperature rises, aching muscles and joints appear.

Specialists of a narrow focus

Some patients need a consultation with a specialized pulmonologist.

Pediatric pulmonologist

The specialist treats diseases of the lungs and under 14 years of age. The doctor must know the characteristics of a growing organism, be able to calculate the dosage of the medicine, taking into account the age, general health of the small patient.

Pediatric pulmonary diseases include cystic fibrosis. Pathology is characterized by thickening of all secretory fluids of the body. Another dangerous disease- histiocytosis X (a complication - scar tissue forms in the child's lungs, making it difficult to breathe).

What does a pulmonologist treat?

The doctor treats diseases of the bronchi and lungs in patients with a hypersensitive immune system. The cause of the onset of the disease in such people is not infection with viruses and bacteria, but the body's reaction to an irritant (dust, pollen, feather, fluff).

Therefore, for the treatment of allergies, special ones are prescribed. In addition, a pulmonologist identifies an irritant, helps to make a diet, and provide a hypoallergenic life.

Pulmonologist oncologist

This specialist identifies and treats malignant tumors in the lungs. His patients often become smokers, miners, workers in hazardous industries. The doctor prescribes special tests to confirm the malignant nature of the neoplasm, chooses methods of treatment.

There are several forms and types of lung cancer. A pulmonologist oncologist prescribes procedures to reduce the size of the tumor, and then a method of surgical removal of the neoplasm. Next, he helps the patient undergo chemotherapy, conducts regular examinations damaged organ.

How does an appointment with a specialist work?

First of all, the pulmonologist examines the patient's history. He asks the patient about the features of the symptoms, the intensity and duration of coughing attacks.

The doctor finds out the living conditions of the patient, which chronic diseases bronchi and lungs suffer members of his family. He learns about the professional duties of a person, his lifestyle, bad habits.

Next, the patient removes clothing from the upper torso for examination. chest. The doctor determines the condition of the lower respiratory tract by auscultation (listening with a stethoscope) and percussion (tapping the back with fingers).

In addition, the specialist measures the temperature, blood pressure.

After the examination, the doctor determines how to treat the disease, what drugs to prescribe. If necessary, he explains to the patient how to use the nebulizer, inhaler, breathing simulator.

Diagnostic methods

To confirm the primary diagnosis, the doctor often prescribes laboratory examinations of the respiratory system.

Spirometry. The patient sits on a chair and breathes into the tube of the apparatus, following the instructions of the doctor. The device records the volume, speed of inhaled and exhaled air. Each test is carried out several times, and then the average is calculated. The advantages of the procedure are painlessness and quick results.

Peakflowmetry. The procedure is performed using a compact device - a peak flowmeter. It is a tube with a printed scale. The patient inhales the maximum volume of air through the nose, and then exhales it sharply through the mouth into the apparatus. With the help of the study, the pulmonologist evaluates the degree of narrowing of the airways in order to properly treat bronchial asthma, obstructive pulmonary disease.

In addition to hardware procedures, the pulmonologist often prescribes clinical analysis blood and urine, sputum examination, throat swab.

Radiography. The patient undresses to the waist, removes jewelry, removes hair up. It covers the abdomen with a protective apron and becomes so that the chest is between the ray tube and the receiving device. The picture is taken after a deep breath. The examination allows to identify the area of ​​damage to the tissue of the lungs and bronchi.

Bronchoscopy. Before the procedure, the patient takes a bronchodilator, as well as a sedative and analgesic. During the examination, the patient is injected through the mouth with a bronchoscope - a device equipped with a video camera and a lighting device. With it, you can assess the condition of the mucous membrane of the larynx, trachea, bronchi.

Skin tests for allergens. Various irritants are applied to the patient's forearm, after scratching the skin under them. After a few minutes, a reaction begins at the site of contact with the allergen: redness, itching, swelling. These results indicate which substances should be eliminated from the diet before asthma is treated with drugs.

CT scan of the chest. The person lies down on a couch that slides inside the scanning machine. The tomograph produces X-rays and takes a series of layered images. After deciphering them, the pulmonologist can see the smallest neoplasm, identify the disease in the initial stage, in order to treat it in the most gentle ways.

What diseases does a pulmonologist treat?

Diseases of the bronchi and lungs can be associated with a person's professional activities. The reason for the appearance of such diseases is the deposition in the respiratory system:

• silicon diode - silicosis;
• silicate dust – silicatosis;
• asbestos dust - asbestosis;
• talc dust - talcosis;
• iron dust - siderosis.

The main condition for recovery is a change of profession and a long sanatorium vacation in ecologically clean places.

Bronchitis. Inflammation of the bronchial mucosa develops as a complication colds or contracting a bacterial infection. It is necessary to treat the disease with antibiotics and symptomatic therapy.

Pneumonia. Inflammation of the lungs appears after incorrectly formulated therapy respiratory diseases or weak patient immunity. If the disease is not treated, sputum thickens, becomes a favorable environment for the development of a secondary infection. This condition is already a threat to human life.

Tuberculosis. The cause of the development of the disease is infection with mycobacterium Koch's bacillus. It causes excruciating bouts of coughing, destroys the tissues of the bronchi and lungs. The disease is treated with special anti-tuberculosis drugs, antitussives, and therapeutic breathing exercises.

Pleurisy of the lungs. Pleural sheets become inflamed due to injury, hypothermia of the chest. Weakened tissues become vulnerable to infectious agents. In addition to the fight against pathogens, physiotherapy procedures are used for treatment.

What does this specialist treat, in what cases it is necessary to contact him.

The allocation of diseases of the lower respiratory tract as a separate section of medicine is associated with the accumulation of a large amount of knowledge about these diseases. Due to the vastness and specificity of this area, it became necessary to train narrow specialists who deal exclusively with the respiratory system.

Diseases of the lower respiratory tract treated by a pulmonologist can be by origin:

• infectious (pneumonia);
• hereditary();
• traumatic (pneumothorax);
• allergic (bronchial asthma);
• professional (silicosis).

Since many patients do not know what exactly they are sick with, when choosing a doctor, they often focus on the diseased organ. Therefore, one should know not only who a pulmonologist is, what this doctor treats (what diseases), but also what organs belong to the sphere of his professional interest. A pulmonologist treats diseases:

• lungs;
• bronchi;
• trachea;
• pleural cavity;
• larynx (due to the beginning of the inflammatory process in this department respiratory system with subsequent involvement of the lower sections).

What does a pulmonologist treat in adults?

In most cases, when treating adult patients, a pulmonologist has to treat:

• Tracheobronchitis. It can be viral, bacterial or allergic, acute or chronic.
• Chronic bronchitis. chronic inflammation bronchi develops with a complication of the acute form of the disease or with prolonged exposure to dust and other non-infectious irritants.
• Pneumonia. This term refers to a group inflammatory processes lungs, which differ in etiology, pathogenesis, clinical picture, radiological signs, characteristic data laboratory research and characteristics of therapy. In most cases, pneumonia is of infectious origin. Non-infectious (aseptic) inflammation in the lung tissue is usually referred to as pneumonitis, and with a predominant lesion of the respiratory sections of the lungs, as alveolitis. Against the background of aseptic inflammation, pneumonia of a bacterial, viral-bacterial or fungal nature often develops.
• Bronchial asthma. In this chronic inflammatory disease various cellular elements are involved. The key role belongs to the narrowing of the lumen of the bronchi (bronchial obstruction), which occurs under the influence of specific immunological (sensitization and allergy) or non-specific mechanisms. Reversible partially or completely bronchial obstruction is manifested by the repetition of episodes of wheezing, wheezing, shortness of breath, coughing and a feeling of congestion in the chest. Bronchial obstruction may resolve spontaneously or with treatment.
• Pleurisy. It can be dry (develops with inflammation of the pleural sheets and loss of fibrin on their surface) and exudative (occurs when exudate of a different nature accumulates in the pleural cavity). The nature of pleural changes may remain unclear. Pleurisy can be caused by infections, tumors, and trauma to the chest. The disease can be both primary and develop as a complication of acute and chronic lung diseases.
• Pulmonary embolism. This disease develops when the pulmonary artery or branches of the pulmonary artery are blocked. Most often, blockage (embolism) by blood clots is observed, but blockage by amniotic fluid, fatty particles, air bubbles, tumor cells and foreign bodies is also possible.
• . By components, this tumor does not differ from the lung, but by the degree of differentiation and location of the lung, cartilaginous, fibrous and adipose tissue, as well as vascular structures, it differs from the lung. Has an innate character.
• Idiopathic pulmonary hemosiderosis (brown induration of the lungs). Hemosiderosis develops when the dark yellow pigment hemosiderin, consisting of iron oxide, is excessively deposited in the tissues of the body. Occurs in the presence of disease circulatory system(leukemia, hemolytic anemia), poisoning with hemolytic poisons, infections (brucellosis, relapsing fever, malaria, sepsis), cirrhosis of the liver, Rh conflict and frequent blood transfusions.
• Hemothorax. This term refers to the accumulation of blood in the pleural cavity (it develops with bleeding of the pulmonary vessels, aorta, vena cava, vessels of the chest wall, mediastinum, diaphragm or heart. The cause of hemothorax in most cases is a chest injury (bleeding is possible as a complication of treatment).
• Pneumothorax. Occurs when air or gases accumulate in the pleural cavity. May occur spontaneously ("primary") or as a consequence of lung disease ("secondary"). Often occurs after a chest injury or as a complication of treatment.
• Idiopathic fibrosing alveolitis. This rare disease develops in the presence of autoimmune disorders and causes diffuse damage to the pulmonary interstitium. Subsequently, the patient develops pneumosclerosis, respiratory failure and hypertension of the pulmonary circulation.
• Lung infarction. This disease develops with thrombosis or embolism of the branches of the pulmonary artery (in 10-25% of cases). Usually occurs against the background of previously developed venous stasis.
• Pulmonary hypertension. This group of diseases includes conditions that are accompanied by a progressive increase in pulmonary vascular resistance - arterial pulmonary hypertension, pulmonary capillary hemangiomatosis, pulmonary hypertension caused by lesions of the left heart chambers, hypoxia or pathology of the respiratory system, chronic thromboembolic pulmonary hypertension and multifactorial hypertension. It can be hereditary, idiopathic, caused by toxic and drug effects, associated with other diseases (HIV, connective tissue diseases, etc.).
• Pulmonary alveolar proteinosis. This rare disease of unknown etiology is detected in most cases in middle-aged people and is characterized by the accumulation of a protein-lipoid substance in the alveoli, which is located extracellularly.
• Pulmonary fibrosis. This lesion of the lungs is characterized by the growth of connective tissue. Accompanied by cough and progressive shortness of breath.
• Sarcoidosis is a systemic disease of unknown etiology, in which granulomas form in the affected tissues (lungs, etc.).
• Sleep apnea, in which during sleep for a time (from 10 seconds to 3 minutes) pulmonary ventilation stops, which increases the risk of developing cardiovascular diseases. It is detected in 60% of people over the age of 65; it is rare in children.
• Emphysema of the lungs. For this disease characterized by pathological expansion of the air spaces of the distal bronchioles and destructive morphological changes in the alveolar walls. It can be primary (occurs under the influence of factors that violate the strength and elasticity of the lung structure) and secondary (develops as a result of airway obstruction).

A pulmonologist is also treated for chronic obstructive pulmonary disease, osteochondroplastic tracheobronchopathy, pneumosclerosis and exogenous allergic alveolitis.

In addition, a pulmonologist treats diseases that in most cases develop under the influence of occupational hazards. These diseases include:

• Ornithosis - acute infection which is caused by Chlamydophila Psittaci. The source of infection are birds (wild and domestic), and the bulk of the diseased are farmers, poultry workers, etc. It spreads mainly by airborne dust and is accompanied by general intoxication, fever, damage to the lungs, central nervous system, enlargement of the spleen and liver.
• Silicosis. This disease develops with prolonged inhalation of dust that contains free silicon dioxide (in miners, in foundries, in the production of ceramic products and refractory materials). There is a diffuse proliferation of connective tissue in the lungs, which is accompanied by the formation of characteristic nodules. It provokes tuberculosis, bronchitis and emphysema.
• Silicosis, which develops with prolonged inhalation of silicate dust.
• Asbestosis, which develops with prolonged inhalation of asbestos dust.
• Talcosis, which is provoked by the inhalation of talc dust.
• Anthracosis, resulting from prolonged inhalation of coal dust.
• Siderosis, which provokes the inhalation of iron dust.
• Silicoanthracosis, etc.

A pulmonologist also takes part in the diagnosis of lung cancer.

What does a pulmonologist treat in children?

A pediatric pulmonologist diagnoses and treats diseases of the lower respiratory tract in children. Since children can rarely objectively assess and describe their condition, a pulmonologist working with children should be able to assess the patient's health status by indirect signs and select gentle examination methods.

A pediatric pulmonologist is contacted if a child has:

• chronic bronchitis;
• bronchial asthma;
• pneumonia;
• chronic cough.

Also, it is usually the pulmonologist who works with children who treats:

• Histiocytosis X. This term refers to childhood a group of diseases with unclear etiology, which are accompanied by active reproduction of eosinophils and pathological immune cells histiocytes in lungs and bones. Active reproduction of these cells leads to the formation of scar tissue. The disease includes 3 forms that can flow into one another - Hand-Schuller-Christian disease, Abt-Letterer-Siwe disease, eosinophilic granuloma (Taratynov's disease).
• Cystic fibrosis is a systemic hereditary disease caused by a mutation in the cystic fibrosis transmembrane regulator gene. Accompanied by damage to the glands of external secretion and pathological changes in the lungs (chronic bronchitis, bronchiectasis and diffuse pneumosclerosis). Bronchial lumens contain viscous mucopurulent contents, atelectasis and areas of emphysema are possible. The pathological process in the lungs can be complicated by bacterial infection and the formation of destruction.

When Should You See a Pulmonologist?

Consultation with a pulmonologist is necessary for people suffering from:

• Cough that comes on in the morning and is accompanied by expectoration of viscous sputum. This type of cough is characteristic of smokers with the development of a chronic form of bronchitis (its complications lead to emphysema and respiratory failure).
• Dry or wet cough that lasts for weeks or months.
• Shortness of breath that occurs even with low physical exertion or at rest.
• Shortness of breath, which is combined with difficult exhalation.
• Cough, which is accompanied by a change in the color of the outgoing sputum (acquired a yellowish, greenish, pink tint) or the appearance of blood clots in the sputum.
• Extreme sleepiness during the day, combined with dryness (or pain) in the mouth and throat upon waking.
• Pain in the chest that occurs when breathing.

Patients are often referred for consultation to a pulmonologist by a therapist who doubts the interpretation of fluorography.

It is also worth making an appointment with a pulmonologist for people who have symptoms of bronchial asthma (paroxysmal coughing, sneezing, itchy eyes, feeling short of breath, headaches, vasomotor reactions of the nasal mucosa).

Allergist-pulmonologist

Since bronchial asthma, acute and chronic bronchitis, and chronic obstructive pulmonary disease are often caused by allergic factors, consultation is often necessary in the treatment of these diseases. Although all diseases of the bronchopulmonary system are treated by a pulmonologist, it is the allergist who is able to establish the allergen to which the body of a particular patient reacts, and the elimination of the allergen contributes to the cure.

Most effective treatment diseases accompanied by an allergic component, is carried out under the supervision of one specialist who is well acquainted with the characteristics of the patient. That is why often a doctor who treats these diseases has two interrelated specialties - an allergist-pulmonologist.

This specialist also treats rhinitis and conjunctivitis of allergic origin, household and fungal allergies, hay fever and urticaria.

Stages of a medical consultation

Pulmonologist appointment includes:

• Studying the patient's history. The pulmonologist clarifies the patient's medical history, the nature of complaints, living conditions, the presence of an allergic history, hereditary predisposition, bad habits and occupational hazards, etc.
• An examination in which the doctor listens to breathing in the lungs, which allows you to clarify clinical manifestations diseases (presence of wet or dry rales, weakened breathing, etc.). Pulse oximetry is also performed to detect respiratory failure, and body temperature is measured.
• Determination of further stages of diagnosis and treatment of the disease.

Based on the results of the examination, a diagnosis is made and adequate methods of treatment are selected.

The pulmonologist develops a treatment plan for a specific, strictly defined period of time, and, if necessary, explains to the patient how to properly use inhalers, nebulizers, spacers, peak flow meters and breathing simulators.

The duration of the first consultation takes about 45 minutes.

Diagnostics

To make the correct diagnosis, the pulmonologist directs the patient to:

• blood test (general and biochemical);
• spirometry, respiratory function or body plethysmography, which allow you to explore the functions of external respiration;
• radiography and CT of the lungs;
• bronchoscopy;
• peak flowmetry (allows you to determine the degree of bronchial obstruction);
• microscopy and bacterial culture of sputum;
• an allergological examination, including a conversation with an allergist and the delivery of allergy tests;
• calculation of the diffusion capacity of the lungs (carbon monoxide is used by the single breath method).

To detect the level of autoantibodies, an Eliviscero test is performed, which allows diagnosing autoimmune lung diseases.

In doubtful cases, the differential diagnosis of COPD and bronchial asthma is carried out using a bronchial provocation test - spirometry with inhalation through a special device diluted in various proportions of methacholine.

If necessary, the patient is referred for a consultation with an otorhinolaryngologist.

How to prepare for a bronchoscopy

If the patient is scheduled for bronchoscopy, before the study it is necessary:

• take medications prescribed by a pulmonologist at night;
• in the morning before the procedure, do not eat or drink;
• do not smoke before the examination.

The bladder should be emptied immediately prior to bronchoscopy.

Treatment Methods

After receiving the research data, the pulmonologist prescribes the necessary treatment, which can be:

• Conservative (various antibacterial, bronchodilator, expectorant or cough suppressant drugs are used).
• Physiotherapeutic (includes electrophoresis, magnetic therapy, etc.).
• Inhalation. Appropriate drugs for inhalation are selected and the patient is trained in the use of the inhalation system.
• Endoscopic. With this method of treatment, it is possible to use bronchosanation (cleansing the tracheobronchial tree from pus and mucus using a microirrigator, nasotracheal catheter or instrumental methods) and endoscopic instillation (irrigation of the respiratory medicines).
• Stationary. Includes complex treatment and is used in exacerbation of chronic diseases or in the acute form of the disease.

The treatment of most diseases of the lower respiratory tract requires constant medical supervision, treatment courses and the use of supportive therapy to prevent exacerbations.

The respiratory system consists of the following departments:

• upper respiratory tract- nasal cavity, oral cavity and pharynx;
• lower respiratory tract- larynx, trachea, right and left bronchi and bronchioles ( small bronchi);
• respiratory organ ( gas exchange) - lungs, including the vessels of the lungs;
• organs involved in the act of breathing- pleura ( membrane surrounding the lungs), respiratory muscles ( muscles that change the volume of the chest during inhalation and exhalation), including the diaphragm.

Treatment of diseases of the upper respiratory tract ( as well as the larynx and trachea) an otolaryngologist is engaged ( ENT), diaphragm diseases are treated by a surgeon, and respiratory muscles ( paralysis) is a neurologist. As for the vessels of the lungs, their pathology is usually dealt with by pulmonologists together with cardiologists and rheumatologists.

Among the pulmonologists there are the following narrow specialists:

• pediatric pulmonologist- treats respiratory diseases in children;
• pulmonologist-allergist– deals with allergic diseases that affect the bronchi and lungs;
• pulmonologist-oncologist– specializes in tumors of the pulmonary system;
• pulmonologist-phthisiatrician is a doctor who deals with the problems of one disease, namely tuberculosis.

What does a pulmonologist do?

Respiratory diseases are often called respiratory diseases, meaning that their main symptom is respiratory failure ( respiro - I breathe). However, respiratory medicine and pulmonology are not synonymous. Respiratory medicine is the branch of health care that deals with the problem of respiratory failure, regardless of its cause, and pulmonology is a specialty. Thus, a pulmonologist is one of the specialists who practice respiratory medicine.

A pulmonologist treats the following diseases:

• Chronical bronchitis ;
• bronchial asthma ;
• pneumonia ( acute and chronic);
• abscess and gangrene of the lung;
• pneumoconiosis;
• fibrosing alveolitis;
• pulmonary aspergillosis;
• hemosiderosis;
• tuberculosis;
• pneumothorax.

Chronical bronchitis

The causes of chronic bronchitis are:

• professional hazards ( dust, gases);
• air pollution;
• acute bronchitis ( chronic infection contributes to the long course of the disease).

Chronic bronchitis has the following two forms:

• chronic simple bronchitis- damage to large and medium bronchi without blockage of their lumen;
• chronic obstructive bronchitis ( obstruction - blockage, obstruction) - deep changes occur not only in large and medium, but also in small bronchi ( bronchioles), while shortness of breath joins the cough and sputum.

Bronchial asthma

An allergic reaction of the bronchi to an allergen manifests itself:

• spasm of the bronchi;
• production of a large amount of viscous mucus in the bronchi ( mucosal edema).

pneumonia

In the classical view, pneumonia has the following stages:

• tidal stages ( initial stage) - the appearance of exudate ( inflammatory fluid) in the lungs ( lasts up to 3 days);
• red hepatization stage- lung tissue loses airiness and resembles liver tissue, due to the accumulation of exudate rich in red blood cells ( lasts up to 3 days), while sputum of a “rusty” color is released;
• gray hepatization stage- erythrocytes are destroyed, and leukocytes come in their place, which destroy microbes, forming pus, while purulent sputum is released ( lasts up to 8 days);
• resolution stage- resorption of inflammation and restoration of airiness of the lungs occurs ( lasts up to 12 days).

Pneumonia has a different course and features, depending on the pathogen, so doctors often classify pneumonia by the name of the microorganism, for example, adenovirus pneumonia or mycoplasma pneumonia.

The transition of inflammation from the bronchi to the lungs is called bronchopneumonia.

Abscess and gangrene of the lungs

An abscess, unlike gangrene, is limited from healthy tissue by a membrane that covers the site of necrosis ( destruction, death), thus forming a cavity filled with pus. Gangrene, on the other hand, does not have clear boundaries, therefore it is prone to the rapid capture of new tissues ( decomposition sites are located near healthy tissue).

A lung abscess can occur against the background of pneumonia, and it takes 10 to 12 days to form.

Pleurisy

The causes of bronchiectasis are:

• weakness of the bronchial wall genetically determined underdevelopment of bronchial muscles);
• frequent infectious and inflammatory diseases of the bronchi and lungs in childhood ( can cause bronchial dilatation in the presence of a hereditary predisposition);
• congenital bronchiectasis ( account for 6% of cases).

With this pathology, mainly the bronchi in the lower parts of the lungs are affected, therefore, in such patients, bronchopneumonia is observed, and often in the same place ( which is confirmed by x-ray).

Emphysema

Emphysema can be:

• independent disease- occurs due to a lack of alpha-1-antitrypsin, which maintains the elasticity of the lung tissue ( observed in children, is a hereditary disease);
• due to other diseases- is formed with a long-term obstructive bronchitis ( especially in smokers).

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary diseases include:

• bronchiolitis obliterans ( disease of the small bronchi, which leads to their blockage);
• bronchial asthma;
• emphysema.

• bronchitis- cough with sputum prevails over shortness of breath;
• emphysematous- shortness of breath comes to the fore, the cough is less pronounced, little sputum is secreted.

Pneumoconiosis

Pneumoconiosis can cause:

• mineral dust ( silicosis, asbestosis, talcosis, cementosis);
• metal dust ( siderosis, aluminosis, berylliosis);
• carbonaceous dust ( anthracosis, graphitosis);
• dust of vegetable, animal or synthetic origin ( byssinosis - from the dust of cotton and flax).

Exogenous allergic alveolitis

An allergen or antigen is a protein substance that can cause an allergic reaction in the body, that is, the formation of antibodies ( protective bodies).

The most common forms of exogenous allergic alveolitis

Fibrosing alveolitis

Idiopathic fibrosing alveolitis presumably occurs in the presence of a hereditary predisposition, as well as exposure to the so-called "slow" viruses ( hepatitis C virus, HIV).

Sarcoidosis

Aspergillosis of the lungs

Pulmonary aspergillosis is observed in people whose work is associated with birds ( pigeons), processing of red pepper, hemp and barley, production of alcohol, bread, canning of fish ( aspergillus is common in foods, especially if stored in heat and humidity). Aspergillus, entering the body, release toxins, such as aflatoxin, which affects not only the lungs, but also other organs.

Aspergillosis of the lungs has the following forms:

• allergic bronchopulmonary aspergillosis- manifested by attacks of bronchial asthma;
• aspergillus bronchitis- manifested by cough with sputum ( lumps of gray color, resembling cotton wool);
• aspergillus bronchopneumonia- manifested by small "scattered" on lung inflammatory foci, most often affects the right lung ( the right bronchus is anatomically wider and shorter than the left);
• aspergilloma- a cavity filled with fungal masses ( byssus), has communication with the bronchus.

Hemosiderosis of the lungs

The causes of pulmonary hemosiderosis are poorly understood, but it is believed that the disease is immune in nature ( one form of hemosiderosis is hypersensitivity to cow's milk).

Pulmonary hemosiderosis is often found in children and can occur under the guise of pneumonia, in connection with which improper treatment is carried out, and the body's condition worsens.

cystic fibrosis

As a result of genetic disorders, the mucus formed in the cells of the glandular organs ceases to be fluid and clogs the ducts of the glands. Gradually, scar tissue forms in the organs ( fibrosis).

Pulmonary tuberculosis

With tuberculosis in the lungs, the following changes are observed:

• inflammatory process ( pneumonia);
• formation of specific granulomas ( inflammatory tubercles);
• degeneration of inflammatory elements in cavities filled with cheesy masses ( cavities).

Lungs' cancer

Pulmonary embolism

Depending on the size of the branch that has undergone thromboembolism, the following may occur:

• right heart failure a sharp increase in pressure in the pulmonary artery);
• lung infarction;
• reflex sharp drop in blood pressure ( shock).

Pneumothorax

Pneumothorax develops in the following cases:

• chest trauma;
• destruction of lung tissue and "breakthrough" into the pleura ( abscess, pulmonary gangrene, tuberculous cavity, bronchiectasis, malignant tumors of the lungs);
• increased airiness of the lungs emphysema, especially congenital);
• congenital "weakness" of the pleura;
• spontaneously ( in the absence of pathology or injury, for example, when diving, while flying in an airplane).

What are the symptoms of a pulmonologist?

Symptoms to Seek to a Pulmonologist

What research does a pulmonologist do?

Until the advent of numerous studies, the phonendoscope and chest percussion were practically the only methods for diagnosing lung diseases. To date, methods are considered insufficiently objective, as they depend on the skills of a particular specialist.
In addition, some pathological processes in the lungs cannot be detected in any way, and even more so they cannot be carried out. differential diagnosis (distinguish one disease from another) using a phonendoscope.

In addition, almost all the symptoms and complaints that occur in diseases of the respiratory system can also be observed in diseases of the cardiovascular system. The point is that the respiratory cardiovascular systems closely related, and problems in one of them over time ( and sometimes at the same time) lead to violations in the other. To make a correct diagnosis, a number of instrumental studies are required.

Instrumental research methods prescribed by a pulmonologist

What laboratory tests does a pulmonologist prescribe?

Blood analysis ( general and biochemical)

The main changes in the general and biochemical analysis blood in diseases of the respiratory system

Sputum examination

The following rules for collecting sputum should be followed:

• collection time- sputum should be collected in the morning, before meals, after rinsing the mouth;
• storage method- to store sputum before delivery to the laboratory, special sterile jars are used that have screw caps and horizontal divisions indicating the amount of collected material in milliliters ( such jars can be purchased at the pharmacy).
• delivery time to the laboratory– sputum must be delivered to the laboratory within two hours after its collection, as bacteria begin to multiply in “stale” sputum, and other elements that have importance for diagnosis, are destroyed;
• frequency of passing the analysis- usually sputum is taken for analysis once, but if tuberculosis or a tumor is suspected, sputum is taken three times, that is, 3 days in a row.

• macroscopic examination- signs that can be seen with the naked eye quantity, color, smell, viscosity);
• microscopic examination- study of the composition of sputum under a microscope;
• analysis for microbial flora– staining smears to detect bacteria;
• bacteriological analysis of sputum– tank sowing on nutrient media.

Changes that can be detected by macroscopic and microscopic analysis of sputum

An analysis of the microbial flora helps to identify:

• Gram-positive bacteria- stain blue when stained by Gram ( pneumococci, streptococci, staphylococci);
• Gram-negative bacteria- stained red when stained by Gram ( Klebsiella, Haemophilus influenzae, Aspergillus);
• fungal infection of the lungs- when stained and examined on a glass slide, fungal particles are detected ( actinomycosis, pulmonary candidiasis);
• mycobacterium tuberculosis- are stained red when stained according to Ziehl-Neelsen ( however, even a negative result does not mean that tuberculosis is absent).

Microbiological(bacteriological)sputum examination allows you to determine:

• a specific causative agent of a lung disease;
• pathogen sensitivity to antibiotics.

Examination of bronchial washings

Bronchial lavage analysis includes:

• cytological examination – cellular composition flushing of the bronchi and alveoli ( identical to the composition of sputum) is determined by microscopic examination;
• bacteriological examination- inoculation of wash water on a nutrient medium to identify a specific causative agent of pulmonary infections and determine its sensitivity to antibiotics;
• biochemical research - increased activity of elastase and collagenase enzymes, which violate the elasticity of the lungs ( tuberculosis, sarcoidosis, exogenous allergic alveolitis, chronic bronchitis), a decrease in the amount of alpha-1-antitrypsin, which prevents the action of these enzymes ( emphysema).

• exogenous allergic alveolitis- an increase in the number of neutrophils, lymphocytes;
• sarcoidosis- an increase in the level of lymphocytes and a decrease in the number of macrophages, and during exacerbation - neutrophils ( a lot of neutrophils in sarcoidosis is an unfavorable prognostic sign and indicates lung fibrosis);
• idiopathic fibrosing alveolitis- an increase in the number of neutrophils;
• bronchial asthma- many eosinophils are detected;
• lung tumor- malignant cells;
• hemosiderosis macrophages filled with hemosiderin hemosiderophages);
• pneumoconiosis macrophages filled with dust coniophages).

Examination of the pleural fluid

There are the following types of pleural effusion:

• transudate- non-inflammatory effusion occurs with cardiac or kidney failure );
• exudate- inflammatory effusion indicates pleurisy.), which can be transparent ( serous), cloudy ( purulent) or with an admixture of blood ( hemorrhagic).

Pleural effusion is subjected to the following studies:

• biochemical and immunological analysis– determination of chemicals ( glucose, amylase, rheumatoid factor) allows you to find out the cause of pleural effusion;
• microscopic analysis- a study under a microscope reveals the cellular composition of the pleural fluid, which is identical to the composition of sputum;
• microbiological analysis- detection of gram-positive and gram-negative bacteria, mycobacterium tuberculosis, as well as inoculation on a nutrient medium to identify the causative agent of pleurisy.

Allergy tests

In diseases of the respiratory tract, the following allergy tests are used:

• Skin tests– introduction of known allergens into the skin. Some time after application to the skin ( applications) or injection into the skin ( scratching or puncturing with a thin needle) of several of the most common allergens evaluate the reaction. At the injection site of the “allergen responsible for the disease”, the most pronounced changes appear, namely swelling, redness and itching.
• Inhalation tests- inhalation of a solution with an allergen. The concentration of the inhaled allergen gradually increases until the patient has perceptible difficulty in breathing ( due to allergic bronchospasm).

• bronchial asthma;
• exogenous allergic alveolitis ( e.g. "lung of the poultry farmer");
• tuberculosis ( Mantoux test).

Immunological blood test

Most often, an immunological blood test reveals the following changes:

• decreased activity of T-suppressors, that is, lymphocytes that suppress the body's excessive immune response ( bronchial asthma, exogenous allergic alveolitis, tuberculosis);
• decrease in the number of T-helpers or assistants in the implementation of an adequate immune response ( sarcoidosis, pulmonary hemosiderosis);
• specific IgE antibodies- a special class of immunoglobulins that are detected in atopic ( hereditary) bronchial asthma;
• specific IgG antibodies - are determined with exogenous allergic alveolitis.

Blood culture

Serological blood test

D-dimer

To determine the level of D-dimer, a blood test is taken from a vein. Normal D-dimer values ​​are not more than 500 ng/ml.

General analysis of urine and feces

Small children usually do not spit out phlegm, but swallow it. If there is blood in the sputum ( hemoptysis), a fecal occult blood test may be ordered ( Gregersen reaction). This is often observed in hemosiderosis of the lungs.

Fats are found in the feces of patients with cystic fibrosis ( steatorrhea), muscle fibers, fiber ( dysfunction of the pancreas).

sweat test

The test is based on the effect of the drug pilocarpine to increase mucus secretion from the sweat glands ( in cystic fibrosis, the formation of mucus in all organs is impaired). Pilocarpine is applied to the skin of the arm or thigh, sweat after it is collected and sent for analysis of the content of chlorine ions in it.

In favor of cystic fibrosis, the level of chlorine is more than 60 mmol / l with a triple analysis on different days.

What diseases does a pulmonologist treat?

The respiratory organs can be affected in systemic diseases, that is, diseases that affect several body systems. For example, connective tissue diseases rheumatoid arthritis, systemic lupus erythematosus) affect organs in which there are shells of connective tissue, namely the heart, lungs, joints.
The treatment of such diseases is carried out by a rheumatologist, if necessary, consulting with a pulmonologist.

Diseases treated by a pulmonologist

Pulmonology is a branch of medicine that deals with the treatment and diagnosis of diseases related to the bronchi and lungs. In some countries, this science is known as respiratory or chest medicine.

Diseases of the bronchi and lungs, as a rule, are quite serious, and in case of non-compliance with a medical prescription or ignoring symptoms, they can cause serious forms with a fatal outcome. A pulmonologist deals with the treatment of diseases associated with the respiratory tract and lungs. Professor, who is one of the most famous persons in this area of ​​medicine - Rafael Bauer (born in Israel) believes that pulmonology is one of the highest priority medical sections.

The fact is that the number of people who come with symptoms indicating diseases of the lungs and respiratory tract, unfortunately, is constantly growing. And each of them is taken by a pulmonologist. Who it is, you can find out further. The reason for the increased number of appeals is not only the negligence of people in relation to their health, but also polluted environment, which is typical for large industrial cities, global warming, which is the cause of climate change and the inability of the population to such changes in the weather.

What does a pulmonologist treat?

Let us describe the cases faced by an ordinary doctor of the specialization in question. A pulmonologist is a doctor who treats dangerous diseases such as hemothorax, lung abscess, bronchial asthma, alveolar microlithiasis, hemosiderosis, pulmonary fibrosis, lung hamartoma, sleep apnea, pulmonary infarction, histiocytosis X, idiopathic fibrosing alveolitis, cystic fibrosis, pneumonia, sarcoidosis, lung cancer (diagnosis), tracheobronchitis, pneumothorax, ornithosis, osteochondroplastic tracheobronchopathy, pulmonary alveolar proteinosis, pulmonary hypertension, chronic obstructive pulmonary disease, silicosis, allergic bronchopulmonary aspergillosis, thromboembolism pulmonary artery, pneumoconiosis.

Most often, people who have the following diseases: pneumonia or bronchial asthma. Bronchial asthma is a specificity not only for a pulmonologist, but also for an allergist. A pulmonologist is responsible for diagnosing and treating lung diseases. As a rule, asthma occurs as a result of an allergic reaction to various kinds of irritants - plants, animal hair, dust, etc.

Symptoms that should see a pulmonologist

If you are wondering: “Pulmonologist - who is this?”, Then we advise you to carefully study the proposed material and the symptoms, which indicate that you need to contact this doctor in the near future, or rather, as soon as possible.

Here are the main warning signs:

• severe cough, with phlegm or dry, that does not go away for a long time;
• suffocation, which is characterized by an acute lack of air (sudden suffocation is especially dangerous, do not hesitate to visit a doctor);
• frequent and prolonged cases of ARVI, which occurs more than three times in one year;
• secretion of sputum.

• systematic smoking for more than eight years;
• the presence of shortness of breath and difficulty breathing during inactive physical exertion;
• work in conditions harmful to health;
• the presence of a disease such as rhinitis (both allergic and vasomotor).

It is also recommended that you do not forget to visit a pulmonologist if you have problems with heart failure or in accordance with a preventive examination, since many diseases are on early stage may not be detected.

How does a pulmonologist treat?

In order to get rid of the symptoms and the disease itself, it is necessary to undergo a medical examination. As a rule, the presence of any of the above ailments is determined fairly quickly, provided that an experienced pulmonologist works with you. The polyclinic you contacted must commit itself to providing the full range of services that were originally declared. This suggests that if the course of the disease becomes more complicated, you will be in conditions where there is all the necessary equipment, the necessary equipment, which allows you to study the course of the disease in the appropriate order.

Disease treatment methods

To eliminate ailments, the following methods are used:

• manual therapy;
• drug blockade;
• physiotherapy treatment;
• massage;
• laser therapy;
• reflexology.

Pediatric pulmonologist - who is it?

If we talk about diseases of the lungs and respiratory tract in children, then you should be extremely attentive to the symptoms and, in case of suspicion, immediately go to the doctor. A pediatric pulmonologist has the same diagnostic and treatment specifics, with the only difference that they are focused on the child's body, its characteristics and development.

Based on statistical data, more than five percent of children have a genetic predisposition to bronchial and pulmonary disorders and diseases. First of all, babies with respiratory pathology have a risk of getting sick.

The child's body is primarily susceptible to the following pulmonary diseases:

• bronchitis;
• bronchial asthma;
• laryngitis;
• pneumonia;
• catarrhal cough and, as a result, the development of the above diseases.

Children's symptoms of pulmonary disease

The body of a child, as a rule, gives signals for help in the same way as in an adult. Nevertheless, we list the main symptoms of childhood pulmonological disease:

• intoxication, which can manifest itself in the form of nausea, vomiting, changes in behavior, lack of appetite, lethargy and lethargy;
• cough;
• respiratory failure;
• shortness of breath during light physical exertion.

How do you know if your child has breathing problems? The following signs indicate this:

• expansion of the nostrils;
• pallor and dry skin;
• cyanosis;
• hoarse breathing;
• snoring;
• rapid breathing and heartbeat.

Pulmonologist in Moscow

Trust the treatment of both children and your own body only to an experienced specialist. It is important to be sure that an experienced pulmonologist is working with you, paid services which, starting from the examination and ending with medical procedures and consultations, are completely safe, and even more useful. You should always be sure that you have received the correct diagnosis and appropriate treatment. A pulmonologist is a doctor who treats and diagnoses diseases of the lungs and respiratory tract, and also monitors the rehabilitation process. Being under the supervision of a specialist, you can be sure of your speedy recovery.

There are many experienced pulmonologists in Moscow, real specialists who are ready to see you any day. For example, high-class professionals work in the SM-Clinic institution, whose branches are located throughout the city. Also, special attention should be paid to the clinic "IntegraMedService". It is here that you can make an appointment with an experienced pulmonologist at any time.

Is it worth getting a routine checkup?

Now you know what a pulmonologist does, who he is, and what he treats. Starting from this moment, you can be sure that you have an idea about the specifics of the work of this specialist and the need for a preventive examination. In no case should you ignore the disease and its symptoms, as this can lead to very sad consequences. In addition, you can not self-medicate. Diseases of the lungs and bronchi more often than others are tried to be cured with herbal infusions and decoctions. Is it worth risking your life? Of course, natural remedies will help restore the body after treatment, but it is better not to use them as the only component in the fight against the disease.

Consultation with a doctor will not take much time and effort, however, you will be able to clearly understand why you are sick and how to proceed in the future. This moment is especially important for employees in the service sector and those who, in the course of their official duties, often come into contact with people. You can cause the development of the disease in a passing child or a young mother. Think about it and when the symptoms described above appear, do not hesitate and contact a specialized clinic.