Cirrhosis of the lungs

Cirrhosis of the lungs is a pathological disease in which irreversible changes occur in the cells and tissues of the organ. Consider the main causes of the disease, symptoms, signs, methods of diagnosis and treatment.

Cirrhosis - tissue growth in organs such as the lungs, kidneys, liver and others, is accompanied by partial or absolute changes in their structure, some seals and various deformations.

The disease is a proliferation of connective tissue in the lungs. Cirrhosis refers to the extreme and most severe stage of pulmonary tuberculosis. With this ailment, the vessels, bronchi and alveoli are completely replaced by connective tissue and collagen, gas exchange functions are violated and the pleura is thickened. Cirrhosis entails the process of fibrous degeneration and sclerosis of the bronchi, which deform, narrow, that is, change their physiological characteristics. It is this factor that makes it possible to recognize this ailment with the help of an X-ray study.

Cirrhosis is characterized by a prolonged course. Pathology can be either one-sided or two-sided. But in the first and second cases, sclerotic changes in the lung tissue are formed. Deformations are affected not only by the bronchi, but also the vessels, the organs of the mediastinum are displaced, and in the regions adjacent to the lungs there is emphysema.

There is a certain classification of cirrhosis of the lungs, that is, cirrhotic tuberculosis:

• Cirrhosis with a local lesion of the lung tissue - most often the upper segments of the organ are deformed. Patients with this diagnosis feel fine, as the disease can not give decades of clinical manifestations. Such patients are dangerous, because they secrete mycobacteria in small amounts. But stress, acute respiratory diseases and a number of other diseases can provoke a relapse of cirrhosis.
• Cirrhosis with frequent relapses - the patient suffers from subfebrile fever, intoxication of the body and dehydration. Fibrous tissue proliferates and can capture all of the lungs. Very often there is a bilateral defeat due to bronchogenic seeding.
• Cirrhosis of the lungs with bronchiectasis - the condition of patients is severe, there is abundant bacterial excretion of sputum. Bronchiectasis is quite extensive, difficult to treat and re-infected. With this form of the disease, surgical treatment is impossible, such patients have a poor prognosis.
• Cirrhosis of the lungs, causing destruction of organ tissues. In the course of a long progression against a background of pulmonary heart failure fibrotic tissue develops. Patients constantly fever, the body is in a state of dehydration. For therapy use infusion therapy.

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Causes of cirrhosis of the lung

The causes of cirrhosis of the lung are diverse, the disease can occur against the background of neglected forms of tuberculosis and other pathologies of the body. In recent years, doctors have noted that prolonged treatment with antibiotic drugs contributes to the formation of cirrhosis. But most often the disease develops against a background of chronic fibro-cavernous and hematogenous-disseminated tuberculosis. Pleurisy and tuberculous lobitis can also be a source of pathology.

Since the main cause of cirrhosis is tuberculosis, it is worth knowing that it is provoked by acid-fast bacteria of the genus Mycobacterium. Cirrhotic tuberculosis develops over a long period of time, often the disease progresses for years, and even decades. But in some cases the disease develops rapidly. In this case, the age-related features of the organism are of great importance. Since in the process of aging the elastic fibers of the lungs are gradually replaced by a connective tissue, which leads to the formation of emphysema.

But the development of cirrhosis of the lungs affects people as average, so young and even childish. The development of the disease affects various complications, for example, damage to the cardiovascular system and lungs, sclerosis in the lymph nodes and tuberculosis foci. A limited form of cirrhosis can occur on the background of focal tuberculosis due to disruption of the ventilation of the lungs and lesions of small bronchi. In the lesion zone, not only sclerosis is formed, but also clustiform swellings.

Cirrhosis can develop after surgery, for example, after resection of the lung. Empyema of the pleura and bronchial fistula, also belong to the risk factors for the development of cirrhosis. Prolonged inhalation of organic and inorganic dust provokes lung lesions that lead to fibrosis. Pathologies of connective tissue, pneumonia, inflammation of the walls of blood vessels and many other diseases can cause cirrhosis of the lungs.

[5], [6], [7], [8]

Symptoms of cirrhosis of the lung

Symptoms of cirrhosis of the lung have a wavy character and may not manifest themselves for a long period of time. So the periods of a normal condition are replaced by exacerbations with signs of intoxication. The patient is intensified coughing and spitting, there is hemoptysis, pulmonary hemorrhage. Against the background of these symptoms, due to contamination with microbacteria, new foci of inflammation form in different parts of the lungs. As progression develops, a violation of all body systems and damage to various organs develops.

Patients complain of shortness of breath, frequent asthmatic attacks, secretion of sputum with an unpleasant odor. Against the backdrop of the development of lung cirrhosis, there is a disruption of the functioning of the cardiovascular system, fluid accumulates in the peritoneal cavity, the liver increases in size. In some cases, cirrhosis is accompanied by amyloidosis, that is, non-tuberculous lesions of the kidneys and liver.

The course of cirrhosis is very slow, can last for years, as it takes a chronic form. The patient can often suffer from chronic bronchitis, against which bronchiectasis is formed and mucopurulent sputum accumulates. If the disease develops from a hematogenous-disseminated type tuberculosis, the predominant symptom of cirrhosis is diffuse emphysema.

Diagnosis of cirrhosis of the lung

Diagnosis of lung cirrhosis presents a number of difficulties, since the clinical symptoms of the disease are difficult to differentiate from a number of other pathologies of the respiratory system. But, despite this, to determine cirrhosis using such methods:

• An anamnesis, that is, an analysis of the complaints of the disease (shortness of breath, general weakness, cough, intoxication). The doctor asks the patient about when the first symptoms of the pathology appeared, about the transferred and existing diseases, working and living conditions.
• At the next stage, the doctor listens to the lungs and determines the extent of the lesion (one-sided or two-sided). In addition, percussion is performed, that is, tapping of the lungs. Also, the patient is waiting for spirography to determine the violations of respiratory function and the volume of the respiratory system.
• After this, the patient is given a chest X-ray, with which it is possible to recognize changes in the lungs, that is, their deformation. As additional diagnostic methods, computer and magnetic resonance imaging is used. These methods allow more accurate determination of the degree of pathological changes in the lungs.
• It is not superfluous to have a biopsy, that is, examination of the lung tissue obtained with the endoscopy of the bronchi. A similar study reveals the proliferation of connective tissue in the lungs at a microscopic level.

In addition to the above methods, the patient must pass a number of tests. First of all, this is a general analysis and a detailed blood test, and an analysis of sputum produced. This will provide information about the course of the inflammatory process and the level of intoxication of the body. Sputum is examined for presence of mycobacteria and increased sensitivity to antibiotics. The data obtained is used to formulate a treatment plan.

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Treatment of cirrhosis of the lung

Treatment of cirrhosis of the lung is a symptomatic therapy that aims to reduce oxygen starvation and maintain cardiac activity. In some cases, surgical treatment is performed, for example, with unilateral cirrhosis. The patient is placed in a hospital and conservative therapy is performed, after which surgical intervention is possible. In addition, it is necessary to conduct constant control studies to assess the correctness and effectiveness of the chosen treatment method.

Antibiotic treatment consists of two phases:

• In the intensive phase, the patient is given combinations of antibiotics to suppress the intensive reproduction of mycobacteria and to prevent the development of resistance to drugs.
• In the phase of continuing therapy, the effect is directed to the dormant and intracellular forms of mycobacteria. The patient is prescribed drugs to stimulate regenerative processes and prevent the reproduction of bacterial microorganisms.

The nutrition of the patient is of special importance. Doctors recommend a special diet with eating foods that are saturated with proteins. This allows you to correct violations in the metabolism. Surgical treatment of cirrhosis is performed in the presence of tuberculosis, single caverns, tricky changes within a few or one lobe of one lung. Resection of cirrhotic areas of the lung is prohibited at severe degrees of cardiac and respiratory failure.

Particular attention is paid to collapse therapy. This method is used only when there are no signs of sclerosis, but there are already caverns and pulmonary hemorrhage. The essence of the treatment is to create an artificial pneumothorax to compress the lungs. Due to this the decay cavities collapse, the risk of dissemination of the infection significantly decreases, and reparative processes improve. As a rule, this method is used for cirrhosis, localized in the lower lobes of the lungs.

Prevention of cirrhosis of the lung

Prevention of cirrhosis of the lung is aimed at preventing the development of diseases that cause pathological lesions of the respiratory system. To do this, it is necessary to treat any inflammatory lung diseases in a timely manner. Vaccination (BCG), that is, the introduction of a weakened strain of mycobacterium tuberculosis for the development of immunity, will not be superfluous. This preventive method is included in the calendar of planned vaccinations for children and lasts for five years. According to doctors, vaccination can be carried out every five years until reaching 30 years.

Do not forget about chemoprophylaxis, that is, taking antibiotics. This method can be used for primary infection with mycobacteria or secondary, that is, for patients who have recovered with mild forms of pulmonary tuberculosis. The main indications for such prevention are professional or household contacts with patients with an open form of tuberculosis. A similar method is necessary for patients with potuberculous changes in respiratory organs receiving immunomodulators or steroid hormones.

Particular attention should be paid to taking medications that can lead to the development of pulmonary fibrosis. Do not forget about quitting smoking and annual fluorography. This screening study can detect not only cirrhosis of the lungs, but also other nonspecific lesions of the respiratory system and even tumors of the chest.

Prognosis of cirrhosis of the lung

The prognosis of cirrhosis of the lung is favorable for life, even if the therapy is of a supportive nature and lasts a very long time. But cirrhosis can cause a number of complications, such as a chronic pulmonary heart, pulmonary hypertension, respiratory failure, or the attachment of a secondary infection.

Cirrhosis of the lungs is accompanied by a strong cough with blood and sputum. It is these symptoms that should be the reason to seek medical help, undergo a series of examinations and start treating respiratory damage. The earlier the cirrhosis of the lungs is detected, the greater the chance of avoiding serious complications that negatively affect the functioning of the whole organism.