Diagnosis and Treatment Services Provided in Chest Diseases Department
A pulmonologist works with patients facing severe or chronic respiratory problems. Although family doctors can cope with mild or short-term conditions, such as those caused by a cold or respiratory infection, they must first be examined by a pulmonologist to diagnose, treat and manage more complex diseases that affect the lungs.
If you’re dealing with a respiratory illness, accurate diagnosis is the first step. A pulmonologist uses procedures such as spirometry, blood tests, chest x-rays, CT scans, bronchoscopy, and sleep studies to diagnose chronic lung disease. Your pulmonologist may ask you to repeat these tests, even if you have already completed them to confirm the results.
Pulmonologists conduct examinations and tests to help determine a lung-related diagnosis. These include:
- CT scan
- Chest Fluoroscopy
- Chest Ultrasound
- Pleural Biopsy
- Pulmonary function test
- Pulse oximetry test
- Sleep Study
What are Chest Diseases in Adults?
Diseases from different groups are included in the area of interest of Chest Diseases:
- Lung infections: pneumonia (pneumonia), acute bronchitis, tuberculosis (tuberculosis) etc.
- Chronic diseases involving the airways: asthma, COPD, bronchiectasis, cystic fibrosis, etc.
- Lung cancer
- Diseases that disrupt the lung tissue: interstitial lung diseases, sarcoidosis, etc.
- Occupational and environmental lung diseases: silicosis, pneumoconiosis, etc.
- Diseases involving the lung vessels: pulmonary embolism, pulmonary hypertension, etc.
- Pulmonary diseases: pleurisy, pleural effusion, mesothelioma, etc.
- Sleep apnea
Chest physicians evaluate radiological (imaging), spirometric (measurement of respiratory capacity and functions) and bronchoscopic examinations for these diseases when necessary. Approaches such as drugs, respiratory physiotherapy, smoking cessation are used in treatment.
What is Asthma?
Asthma is a chronic or long-term disease of the airways, tubes that carry air into the lungs. It causes inflammation and narrowing of the bronchial tubes leading to airflow limitation. The airways of our lungs are surrounded by muscles and contain mucus glands. These muscles normally relax, but if you have asthma, they are usually sensitive and inflamed.
When asthma patients encounter triggers, these muscles react by further compression, the inner parts of the airways are swollen and it is possible that the airways are filled with mucus. This makes breathing very difficult and leads to asthma symptoms or an asthma attack.
What are the Symptoms of Asthma?
Asthma can cause different symptoms for everyone. Asthma symptoms can change over time with little or no symptoms when asthma is well controlled. The most common symptoms are:
Regular coughing usually occurs at night or early in the morning, but can happen at any time of the day. Cough is an important symptom of asthma, especially in children. Sometimes persistent cough can be the only symptom of asthma.
Wheezing, a breath of difficulty and a whistling sound from the airways.
Shortness of breath gives the feeling that the person cannot breathe sufficiently. There may be difficulty eating, sleeping, or even speaking.
Chest tightness creates an unpleasant feeling of heaviness or pressure in the chest. It can make it difficult to breathe.
Increased mucous production is characterized by high levels of thick fluid that accumulates in the airways.
What are Asthma Inducing Factors (Triggers)?
Inflammatory (allergic) triggers can cause inflammation of the airways of the lungs or tightening of the muscles of the airways. Inflammatory triggers include:
- House dust mites
- Viral infections
- Some air pollutants
Symptom (non-allergic) triggers usually do not cause swelling, but can affect the “twitching” airways, especially if they are inflamed. Symptom triggers include:
- Cold weather
- Other strong-smelling substances such as chemical fumes and perfumes
- Some food additives such as sulfite
- Some air pollutants
- Intense emotions
What are the Protection Methods?
While there is no way to prevent asthma, by working together, you and your doctor can devise a step-by-step plan for living with your disease and preventing asthma attacks.
- Follow your asthma action plan.
- Get your flu and pneumonia vaccinations.
- Observe your breathing.
- Detect and treat attacks early.
- Take your medicine according to the prescription.
- Pay attention to increasing the use of fast relief inhalers.
- Identify and avoid asthma triggers;
- Protection from pet triggers. Furry pets can trigger an asthma attack. If you think a furry pet could cause asthma attacks, you may want to find another home for the pet. If you cannot find or want a new home for the pet, keep it out of the bedroom of the person with asthma. Wash pets every week and keep them outside as much as possible. People with asthma are not allergic to their pet’s fur, so cutting a pet’s fur will not help protect you. If you have a furry pet, vacuum your living space often. If your floors have a hard surface such as wood or tile, they can be cleaned every week with a damp mop.
- Protection from mildew. Breathing in mold can trigger an asthma attack. To control attacks, get rid of mold in your home. The amount of moisture in the air can cause mold to grow. An air conditioner or dehumidifier will help keep the humidity level low. Get a small instrument called a hygrometer to check humidity levels and keep them as low as possible – no higher than 50%.
- Protection from cockroaches. Cockroaches and their droppings can trigger an asthma attack. Get rid of cockroaches in your home by removing as many sources of water and food as possible. Cockroaches are often found where food is eaten and crumbs are left behind. Vacuum or sweep areas that may attract cockroaches at least every 2 to 3 days. Use insect traps or gels to reduce the number of cockroaches in your home.
- Protection from pollen. Pollen is a very common trigger for asthma symptoms. Airborne pollen produced by trees, lawns and weeds can be easily inhaled, especially in hot weather. If you are allergic to pollen, use an air cleaner with a HEPA filter. If you are out on a day with a high pollen count, take a shower and change your clothes.
- Protection from air pollution. Pollution from industrial emissions and automobile exhaust can cause an asthma attack. Pay attention to air quality forecasts on radio, television and the Internet, and if air pollution triggers your asthma, plan your activities for times when air pollution levels will be low.
How Is Asthma Diagnosed?
There is no single test or examination that will determine whether you or your child has asthma. Instead, your doctor will use a variety of criteria to determine whether the symptoms are the result of asthma.
The following can help diagnose asthma:
Medical history. The risk is higher if there are family members with respiratory disorders. The doctor should be warned of this genetic link.
Physical examination. Your doctor will listen to your breath with a stethoscope. They may also perform skin testing by looking for signs of an allergic reaction, such as hives or eczema. Allergies increase the risk of asthma.
Respiratory tests. Your doctor can use pulmonary function tests (PFT) to measure the flow of air into and out of your lungs. Spirometry, the most common test, requires you to blow into a device that can measure the speed of the air.
Treatment goals of asthma:
- Adequately controlling symptoms
- Minimizing the risk of future exacerbation,
- Maintaining normal lung function,
- Maintaining normal activity levels and
- Taking the least amount of medication possible with the least possible side effects.
Inhaled corticosteroids (ICS) are the most effective anti-inflammatory agents available for the chronic treatment of asthma and are the first-line therapy for most asthma guidelines. It is well known that ICS is effective in reducing the risk of asthma exacerbation. Also, the combination of a long-acting bronchodilator (LABA) and an ICS has a significant additional beneficial effect in improving asthma control. Short-acting rescue inhalers are standard care for overcoming symptoms.
Pneumonia is an infection that inflames the air sacs (alveoli) of the lungs. It can fill the air sacs with fluid or pus, causing symptoms such as cough, fever, chills, and shortness of breath.
What are the Symptoms of Pneumonia?
Pneumonia symptoms can be severe enough to require hospitalization and little to go unnoticed. How the body responds to pneumonia depends on the type of microbe that is causing the infection, age, and a person’s general health.
Signs and symptoms of pneumonia can include:
- Cough that can produce mucus that is greenish, yellow or even bloody
- Fever, sweating and shaking chills
- Shortness of breath
- Rapid, shallow breathing
- Sharp or stabbing chest pain that gets worse when breathing deeply or coughing
- Lack of appetite, low energy and fatigue
- Nausea and vomiting, especially in young children
- Confusion, especially in the elderly
Is Pneumonia Contagious?
The germs that cause pneumonia are contagious. This means it can be spread from person to person. Both viral and bacterial pneumonia can be spread to others through sneezing or coughing and inhalation of airborne droplets. It is also possible to get these types of pneumonia by contact with surfaces or objects contaminated with bacteria or viruses that cause pneumonia.
Fungal pneumonia can be transmitted from the environment. However, it does not spread from person to person.
Risk Factors Facilitating the Development of Pneumonia in Adults
Anyone can get pneumonia, but some groups have a higher risk. These groups include:
- Babies from birth to 2 years old
- People aged 65 and over
- People with a weakened immune system due to illness or medication use, such as steroids or certain cancer drugs
- People with certain chronic medical conditions such as asthma, cystic fibrosis, diabetes, or heart failure
- People who have recently had a respiratory infection, such as a cold or flu
- People who have recently been or are currently staying in the hospital, especially those who have been or are currently using a ventilator
- People who have had a stroke, trouble swallowing, or a condition that causes inactivity
- People who smoke, use certain drugs, or drink excessive amounts of alcohol
- People who have been exposed to lung irritants such as pollution, smoke, and certain chemicals
What Are The Ways To Prevent Pneumonia?
The risk of getting pneumonia can be reduced by following a few simple steps. Some ways of protection are as follows:
Get vaccinated. Vaccines are available to prevent some types of pneumonia and flu. Talk to your doctor about getting these vaccines. Vaccination guidelines have changed over time, so be sure to review your vaccination status with your doctor, even if you remember that you have had a pneumonia vaccine before.
Pay attention to your hygiene. To protect yourself against respiratory infections that sometimes cause pneumonia, wash your hands regularly or use an alcohol-based hand rub.
Do not smoke. Smoking damages your lungs’ natural protection against respiratory infections.
Keep your immune system strong. Get enough sleep, exercise regularly and eat a healthy diet.
The first line of defense against pneumonia is vaccination. There are several vaccines that can help prevent pneumonia.
Prevnar 13 and Pneumovax 23
These two pneumonia vaccines help protect against pneumonia and meningitis caused by pneumococcal bacteria. Your doctor can tell you which one might be better.
Prevnar 13 is effective against 13 types of pneumococcal bacteria. Recommended for the following groups:
- Children under 2 years old
- Adults aged 65 and over
- People aged 2 to 64 years with chronic conditions that increase the risk of pneumonia
Pneumovax 23 is effective against 23 types of pneumococcal bacteria. Recommended for the following groups:
- Adults aged 65 and over
- Smoking adults aged 19-64
- People aged 2 to 64 years with chronic conditions that increase the risk of pneumonia
Your treatment will depend on the type of pneumonia you have, how severe it is, and your overall health.
Your doctor may prescribe a medicine to treat pneumonia. Your prescription will depend on the specific cause of pneumonia.
Oral antibiotics can treat most cases of bacterial pneumonia. Always use all antibiotics, even if you are starting to feel better. Failure to do so can prevent the infection from clearing and may be difficult to treat in the future.
Antibiotic drugs are ineffective on the virus. In some cases, your doctor may prescribe an antiviral. However, many cases of viral pneumonia resolve on their own with home care.
Antifungal drugs are used to combat fungal pneumonia. You may need to use this medication for several weeks to clear up the infection.
Istanbul Allergy Chest Diseases Doctors
Specialist Dr. Kürşat Epöztürk completed his specialization training at Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital and worked as a Chest Diseases specialist in Sarıkamış Military Hospital and Erzurum Nihat Kitapçı Chest Hospital. He successfully passed the Turkish Chest Diseases Qualification Board exam in 2011. He also received a sub-specialty training on Immunology and Allergy Diseases. European Respiratory Society (ERS), the Turkish Thoracic Society (TTS) and Turkey Respiratory Society (TRS) is a member.
Chest Diseases specialists are physicians who receive a Chest Diseases Specialist diploma by receiving special training on respiratory system diseases in individuals aged 18 and over. It is appropriate to evaluate and follow-up patients with the above complaints and diseases by Chest Diseases specialists of 18 years of age and above, and Pediatric Chest Diseases specialists for those under 18.