Obstructive Lung Disease: Symptoms, Diagnosis, and Treatment


Obstructive lung disease is a type of lung disease that occurs due to blockages or obstructions in the airways.

Blockages damage the lungs and cause their airways to narrow. This damage leads to breathing difficulties.

In this article, we look at the causes, symptoms, diagnosis, and treatment of different types of obstructive pulmonary disease.

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When a person with healthy lungs breathes, gas exchange takes place in air sacs called alveoli.

When a person breathes, air flows through the trachea through a series of tubes called bronchi that gradually shrink. At the end of these tubes are bundles of air sacs called alveoli.

In healthy lungs, the alveoli fill with air and pass oxygen to the blood vessels that line them. At the same time, the blood returns carbon dioxide to the alveoli for exhalation.

In obstructive pulmonary disease, less air flows in and out of the alveoli and less gas exchange can take place. This can happen for many reasons, depending on the type of obstructive pulmonary disease a person has.

Types of obstructive pulmonary disease include:

While many of the symptoms of obstructive lung disease and restrictive lung disease are similar, the causes of the symptoms differ.

When a person has obstructive pulmonary disease, something prevents air from flowing in and out of the airways so freely.

Common factors that impede airflow include:

  • swelling and inflammation in the airways
  • thick mucus in the airways
  • damage to the walls of the air sacs

In restrictive lung disease, a person cannot fill their lungs completely because the lungs are limited. Conditions that cause stiffness in the lungs or the muscles around the lungs cause restrictive lung disease.

Conditions that cause restrictive lung disease include:

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Symptoms of obstructive pulmonary disease include shortness of breath, low energy, and chest tightness.

Shortness of breath is the main symptom of obstructive pulmonary disease. At first, this can only happen with physical activity. However, as the disease progresses, it can occur at any time, including when a person is resting.

Other symptoms of obstructive pulmonary disease include:

  • wheezing
  • chest tightness
  • a chronic cough that can produce mucus
  • a feeling of mucus in the back of the throat, especially early in the morning
  • a loss of energy
  • weight loss
  • a blue tint to the lips or nail beds
  • repeated respiratory infections
  • swelling in the legs and feet

Symptoms and their severity will vary from person to person, depending on how far the disease has progressed. They may also vary based on the specific condition responsible for the obstructive pulmonary disease.

According to the National Heart, Lung and Blood Institute, the main risk factor for obstructive pulmonary disease is smoking. Up to 75 percent of people with COPD smoke or used to smoke.

Environmental exposure to other lung irritants can also cause obstructive pulmonary disease.

Some other lung irritants include:

  • Chemicals
  • dust
  • vaping
  • overexposure to secondhand smoke

There is also a genetic component to obstructive lung disease. People can develop all types of obstructive pulmonary disease without ever having smoked or had significant exposure to environmental irritants.

In some cases, scientists have firmly established the role of genetics in developing obstructive pulmonary disease.

For example, some people have an alpha-1 antitrypsin deficiency. This deficiency is a common genetic risk factor for: emphysema.

Cystic fibrosis also has a genetic basis. The biological parents of a person with cystic fibrosis both carry a mutation in a gene called CFTR.

A doctor will usually perform a lung function test to diagnose obstructive pulmonary disease.

During this test, a person forcibly breathes air through a mouthpiece using a variety of techniques. During each blowing technique, a machine records information about the amount of air that is released and how much air is moving through the lungs.

The doctor will also ask the person about their symptoms and overall health. This includes information about a person’s medical history and their exposure to environmental irritants, such as smoke and pollution.

Diagnosis often includes physical exams and some imaging tests, such as a CT-scan or a chest X-ray.

In some cases, a doctor may look at the lungs with a thin, flexible lighted camera called a bronchoscope. They will use this to check for damage and obstacles.

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The goal of treating obstructive pulmonary disease is to open the airways.

Treatment for obstructive pulmonary disease usually involves opening the airways.

Obstructive lung disease causes bronchospasm, which are spasms of the smooth muscles in the walls of the airways.

There are several medications available to treat these spasms that fall under the bronchodilator category.

Examples of bronchodilators are:

  • combined medicines, such as Combivent Respimat
  • formoterol (Foradil), which people take in combination with an inhaled corticosteroid
  • tiotropium (Spiriva)
  • albuterol (Proventil HFA, Ventolin HFA, AccuNeb, ProAir HFA)
  • salmeterol (Serevent), which people take in combination with an inhaled corticosteroid
  • ipratropium (Atrovent)

Because obstructive lung disease can also cause inflammation, there are medications a doctor can prescribe to help treat the inflammation. Some examples are:

  • singular (montelukast)
  • Qvar (inhaled corticosteroid)
  • Prednisone (oral corticosteroids)
  • Flovent (inhaled corticosteroid)
  • Advair (combination inhaled corticosteroid and long-acting bronchodilator)

In some severe cases, a person may need a lung transplant. Other people may need oxygen therapy.

Preventing obstructive lung disease is similar to preventing other lung infections. There are some precautions a person can take, including:

  • quit smoking
  • avoiding secondhand smoke
  • exercising regularly
  • taking precautions around chemicals and vapors

The outlook for a person with obstructive pulmonary disease varies based on what type of obstructive pulmonary disease they have and, for some types of obstructive pulmonary disease, how severe it is.

A study paper that appeared in the International Journal of Chronic Obstructive Pulmonary Disease suggests that the more advanced a person’s COPD is, the lower their life expectancy may be.

A person with cystic fibrosis also has a reduced life expectancy, but this has increased with modern medicine.

For a person with obstructive pulmonary disease to live as long and healthily as possible, it is critical that they follow their doctor’s plan of care and follow a healthy lifestyle.

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