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Dr. Gott: Lung scarring has serious consequences

Peter H. Gott, M.D.

Dear Dr. Gott: I am an 82-year-old female. I don’t smoke but was diagnosed with pulmonary fibrosis in 2006 and used oxygen occasionally for the first four months following the diagnosis. Since then, I have had to use it 24/7. I started out with two liters and am now on 10 liters. I take 40 milligrams of prednisone daily.

My doctor had told me that this is normally a slow-moving disease, but for some reason, it is accelerating in my case. Everything I have read is terribly frightening. Can you provide any information or suggestions about treatment?

Dear Reader: Pulmonary fibrosis is a respiratory disorder in which lung tissue becomes thickened and stiff or scarred. Over time, the lungs’ ability to move oxygen into the bloodstream becomes compromised. It is a serious condition with no cure.

There is no known cause, but certain risk factors can increase the chance of developing pulmonary fibrosis. Cigarette smoking, certain viral infections, exposure to environmental pollutants and certain medications increase this risk. Genetics may play a role, but the extent is unclear at this time.

Another finding is that nine out of 10 sufferers also have gastroesophageal reflux disease. Researchers speculate that some GERD patients inadvertently breathe in tiny drops of stomach acid on a regular basis. This acid may, over time, damage lung tissue, leading to pulmonary fibrosis. This is only a theory and needs more research for confirmation.

Treatment is aimed at preventing more scarring, improving symptoms and maintaining the ability to get around and stay healthy.

Medications to reduce inflammation, such as prednisone, are commonly administered. Your doctor may also want to suppress your immune system with medication in an attempt to reduce further damage. It is also beneficial for most sufferers to receive yearly flu and pneumonia vaccines, take antireflux medications and include supplemental calcium and vitamin D to prevent bone loss due to corticosteroid treatment.

Oxygen therapy is used to increase blood oxygen levels and reduce shortness of breath. Pulmonary rehabilitation may be of help by conditioning the lungs and body to stay as healthy as possible for as long as possible.

Lung transplant is a final option. It is primarily reserved for those younger than 65 that are not helped by medication and have no other medical issues.

I suspect you are already under the care of a pulmonologist (lung specialist). This specialist is most familiar with diagnosis and treatment of this disorder and will be your best resource for the newest updates in treatment. He or she should also be able to help you with referrals to specialized rehabilitation programs, which may increase your existing lung capacity and keep the rest of your body as physically fit as possible.

To give you related information, I am sending you a copy of my Health Report “Pulmonary Disease.” Other readers who would like a copy should send a self-addressed, stamped No. 10 envelope and a check or money order for $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dr. Gott is a retired physician. He writes for United Media and can be contacted c/o United Media, 200 Madison Ave., Fourth floor, New York, NY 10016.
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