Respiratory diseases are conditions of the airways, lung tissue, the lung's blood vessels and the pleural lining. They fall into a few families: airway diseases such as asthma, COPD and bronchiectasis; infections such as pneumonia and tuberculosis; interstitial lung diseases that scar the lung; pulmonary vascular diseases such as embolism and pulmonary hypertension; sleep-related breathing disorders; and lung cancer.
Different families cause similar symptoms, so a persistent cough or breathlessness needs testing rather than guesswork. Breathlessness also frequently comes from the heart, anaemia, weight or poor fitness. This page is an overview; the specific conditions have their own pages.
Symptoms
- Cough lasting more than 3 weeks
- Breathlessness on exertion or when lying flat
- Wheeze or noisy breathing
- Regularly bringing up phlegm
- Coughing up blood
- Chest pain linked to breathing
- Repeated chest infections
- Loud snoring with daytime sleepiness
- Unexplained weight loss or night sweats
Causes and risk factors
Tobacco smoke is the leading preventable cause, responsible for most COPD and lung cancer. Air pollution, indoor biomass smoke, and workplace exposure to asbestos, silica, coal, grain and chemical fumes cause or worsen many conditions. Allergy drives much asthma. Infections range from common viruses to tuberculosis. Autoimmune diseases such as rheumatoid arthritis and scleroderma can scar the lungs, as can some medicines including amiodarone, methotrexate and nitrofurantoin, and keeping birds. Inherited conditions include cystic fibrosis and alpha-1 antitrypsin deficiency. In idiopathic pulmonary fibrosis no cause is found.
How it is diagnosed
- Spirometry and full lung function: Distinguish obstructive patterns such as asthma and COPD from restrictive patterns such as fibrosis, and measure gas transfer.
- Chest X-ray: A quick first look for infection, fluid, masses and heart size.
- High resolution CT: Shows bronchiectasis, emphysema, scarring patterns, nodules and clots in detail.
- Blood tests and oximetry: Blood count, eosinophils, inflammatory and autoimmune markers, and oxygen levels.
- Bronchoscopy: A flexible camera into the airways to take washings and biopsies, including ultrasound-guided sampling of lymph nodes.
- Sleep study: For suspected sleep apnoea.
- Echocardiogram: To assess the heart and estimate pressure in the lung circulation.
Treatment options
- Smoking cessation: Benefits every respiratory condition and is the priority.
- Inhaled therapy: Bronchodilators and inhaled steroids for asthma and COPD.
- Antimicrobials: Antibiotics for bacterial infection, 6 months of combination treatment for tuberculosis, and long-term strategies for bronchiectasis.
- Airway clearance physiotherapy: Daily techniques for bronchiectasis and cystic fibrosis.
- Antifibrotic and immune-modifying medicines: Nintedanib or pirfenidone slow idiopathic pulmonary fibrosis; steroids and immunosuppressants treat sarcoidosis and autoimmune lung disease.
- Anticoagulation: For pulmonary embolism.
- Pulmonary rehabilitation and oxygen: Exercise training for chronic breathlessness, and oxygen when blood levels are low.
- Surgery and interventional procedures: Resection for early lung cancer, pleural procedures, valves for emphysema, and transplantation in selected end-stage disease.
When it is urgent
Call emergency services locally for sudden severe breathlessness, chest pain, coughing up more than a few streaks of blood, blue lips, confusion, or a swollen painful calf with breathlessness, which may indicate a clot in the lung. Do not wait and do not travel with these symptoms.
Travelling to Türkiye for treatment
Coming to Istanbul makes most sense for diagnosis: an unexplained cough, breathlessness or an abnormal scan can be investigated with CT, lung function, bronchoscopy and specialist review within roughly a working week. Planned thoracic surgery is another legitimate reason. Chronic conditions need regular monitoring and prescriptions from a team near you, so ask for a full English report. People with low oxygen levels, a recent collapsed lung or active tuberculosis should not fly until cleared.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
Frequently Asked Questions
When is a cough worth investigating?
After 3 weeks, or earlier with blood, weight loss, breathlessness or a smoking history. In adults a chest X-ray is the usual first step.
Is breathlessness always from the lungs?
No. Heart disease, anaemia, thyroid problems, obesity, anxiety and deconditioning are all common causes.
Should I have lung cancer screening?
Low dose CT screening is recommended in many countries for people roughly 50 to 80 with a heavy smoking history. Ask whether you qualify.
Are vaping products safe for my lungs?
They are less harmful than cigarettes for smokers who switch completely, but not harmless, and they are not advised for non-smokers.