Pulmonary fibrosis

Scientifically proven: Pneumological rehabilitation helps

Pulmonary fibrosis refers to an increasing accumulation of connective tissue in the lungs. This can happen due to various lung diseases.

Our experienced consultants at Schoen Clinic specialise in treating pulmonary fibrosis. In 2013, together with Ludwig-Maximilians-Universität München, we conducted and published a large study involving more than 400 pulmonary fibrosis patients at our clinic. It showed in a scientifically clear manner: In the case of pulmonary fibrosis, pneumological rehabilitation helps to alleviate the effects of the disease on performance and improve quality of life. There is also the possibility of discussing patients again as part of the hospitalisation by means of an expert committee (ILD Board) consisting of histopathologists, radiologists and pneumologists following consultation with the referring physician.

Causes & symptoms

What is pulmonary fibrosis?

All forms of pulmonary fibrosis involve chronic inflammation of the connective tissue of the lung, causing the alveoli to scar and their delicate wall to become thickened. This makes it more difficult to transfer oxygen into the blood, so the patients’ oxygen uptake is significantly restricted. The scarring of the lung causes the lung to lose elasticity and become stiffened, meaning that more energy has to be used for respiration. 

Pulmonary fibrosis – causes: How the disease can develop

A cause for the development of pulmonary fibrosis can only be found for half of the patients. Patients for whom no cause can be found are said to have pulmonary fibrosis without a recognisable cause (idiopathic pulmonary fibrosis). 

The recognisable causes include:
  • Organic and inorganic dust
    These include quartz dust, asbestos dust and other industrial dust. These are often occupational diseases. Occupational exposure also frequently exists for what is known as organic dust (mould, bird excrement, hay and grain dust).
  • Chronic bacterial or viral infections 
  • Damage caused by medication or radiation
    Certain drugs can cause scarring of the lungs, including various chemotherapeutic agents. Fibrosis can also be triggered in the area of the lung irradiated with radiation as part of tumour therapy.

In addition, there is a whole series of independent diseases that promote the development of pulmonary fibrosis. These include sarcoidosis, scleroderma and rheumatoid arthritis.

Pulmonary fibrosis: Symptoms of the disorder

The scarring of the lungs can often be very gradual, meaning that patients do not experience any symptoms for a long time. The first signs are shallow and accelerated breathing. Many patients report feeling as though they can no longer breathe deeply. The shortness of breath is initially only noticed during physical exertion. If the disease continues to progress, shortness of breath also occurs at rest. There is very often a dry, irritable cough as well as general weakness and reduced performance. In addition to a blue discolouration of the lips, a clubbing of the finger tips often occurs.

Diagnostics

Diagnosis: This is how pulmonary fibrosis is diagnosed

At your pulmonary specialist’s surgery or at a pneumological clinic, pulmonary fibrosis is diagnosed as follows:

Recording of the medical history (anamnesis)

Due to the large number of possible causes, it is very important to record your medical history (anamnesis). Information about your profession, hobbies and previous illnesses as well as their medical treatment can provide information about the cause of your illness. A comprehensive physical examination is also performed, during which ‘Velcro crackles’ can usually be observed when listening to the lungs.

Pulmonary function examination and imaging

A pulmonary function examination and imaging procedures such as X-rays or computed tomography are also necessary. Imaging often shows the way forward.

Bronchoscopy

In addition to various blood tests, a bronchoscopy is performed if necessary for further clarification in order to allow a histological diagnosis to be made.

Lung tissue removal

If no conclusive diagnosis can be made on the basis of all of the examinations, it may be necessary to remove lung tissue as part of a minor surgical procedure.

The results are typically discussed again during a meeting between radiologists, histopathologists and pneumologists. This can also be done during your stay in our clinic if the referring physician supports this procedure.