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Respiratory Medicine (Pulmonology) Specialist Doctor

Pulmonary (Respiratory Medicine) Specialist Doctor

When you are advised to see a pulmonologist, it is likely that you are dealing with health problems in your lungs or respiratory tract. Some people may not be familiar with the term pulmonologist, but the term is often used interchangeably with the term: lung specialist doctor. 

The lungs are one of the most vital organs in the human body. Without lungs, humans will not be able to breathe properly. In adults, the left lung is estimated to weigh about 325-550 grams and has two parts called lobes. Meanwhile, the right lung is estimated to weigh about 375-600 grams and consists of three lobes. In the lungs, there are various tissues that maximise their function as respiratory organs. The tissues that make up the lungs are the pleura, bronchi, bronchioles, and alveoli.

What is Pulmonology then? In medical science, pulmonology is a branch of medicine that focuses on studying health problems and diseases in the respiratory system which includes both organs and tissues such as the lungs, bronchi, bronchioles, and alveoli. In general, doctors who specialise in pulmonology are called pulmonologists and they treat cases of mild to severe respiratory problems.

Sub-specialties in Pulmonology (Respiratory Medicine)

There are several types of sub-specialties in pulmonary medicine that focus on dealing with various problems related to the respiratory system, such as:

  • Interstitial pulmonology, a sub-specialty that focuses on treating lung health problems that arise due to scarring and inflammation of the lungs.
  • Interventional pulmonology, a sub-specialty that focuses on treating respiratory problems, lung cancer, and pleural membrane disorders.
  • Neuromuscular, a sub-specialty focusing on treating lung problems due to disorders of the respiratory muscles.
  • Obstructive lung, a sub-specialty that focuses on treating lung disorders caused by blocked or narrowed airways.
  • Lung transplant sub-specialty
  • Paediatric pulmonology, a sub-specialty focusing on treating respiratory problems in children.

Division of Pulmonary

Apart from having several types of sub-specialties, pulmonology can also be broken down into Divisions that simplify the process of handling and administering medical treatment to respiratory patients:

  • Division of Interventional Pulmonology and Respiratory Emergency, a division that specialises in providing non-surgical medical treatment and diagnoses related to respiratory problems. Health problems commonly handled by this division include coughing up blood, breathing frequency issues, pleural effusion, and lower airway obstruction
  • Division of Asthma and COPD (Chronic Obstructive Pulmonary Disease), a division that specifically provides medical treatment for patients with airway disorders such as asthma and chronic obstructive pulmonary disease (COPD).
  • Division of Occupational and Environmental Pulmonology, a division that deals with lung disorders due to harmful substances or particles that enter the respiratory tract when working outdoors. Cases handled include asbestosis caused by asbestos fibers and silicosis caused by silica dust.
  • Division of Lung transplantation, a division that focuses on handling cases of respiratory system disorders that require medical treatment through a lung transplant. This division will supervise and monitor the patient from before to after the transplant. Monitoring needs to be done to determine the presence or absence of other organ rejection/reactions due to the lung transplantation.
  • Division of Infection, a division that focuses on dealing with lower respiratory tract disorders which arise due to infections caused by bacteria, viruses, parasites, or fungi. Generally, this division handles pulmonary tuberculosis, pneumonia, and bronchitis.
  • Division of Thoracic Oncology, a division that specifically deals with respiratory tract disorders like cancer or tumors through surgical and chemotherapy methods

Diseases and Conditions Treated by Pulmonologists

There are numerous disorders that may affect the respiratory system, both acutely and chronically. Pulmonologists generally treat severe lung diseases that require intensive treatment. A pulmonologist can also work with an internist (internal medicine specialist) to provide appropriate medical treatment.

Below are several diseases that can be treated by a pulmonologist:

  • Asthma, a disease that affects the respiratory tract and is chronic. This disease has several levels ranging from mild to severe. There is no cure for asthma as of yet, but a pulmonologist can provide treatments which makes asthma a highly treatable disease. 
  • Tuberculosis (TB), a respiratory disease that is both dangerous and contagious. This disease occurs because the patient is exposed to the bacteria Mycobacterium tuberculosis which may lead to death. This disease is easily transmitted through coughing or sneezing and requires treatment from a pulmonologist to cure and prevent the transmission.
  • Chronic Obstructive Pulmonary Disease, a progressive disease that can cause air from entering or leaving the lungs. This disease can appear via the conditions of reduced air sacs and airways, reduced and enlarged air pockets due to loss of walls between air pockets, swollen airway walls, and mucus obstruction of the airways. The two types of COPD are emphysema and bronchitis.
  • Interstitial disease, a condition that makes it difficult for a person to breathe due to scarring of the lungs. Usually characterised by shortness of breath and dry cough.
  • Pneumonia, a condition of inflamed and swollen lungs caused by infection. In the case of pneumonia, the lungs are filled with mucus or water – hence they are often referred to as ‘wet lungs’. This disease is characterised by nausea, vomiting, shortness of breath, fever, increased heart rate, decreased appetite, chest pain, and coughing up blood.
  • Pulmonary embolism
  • Pleural effusion
  • Pulmonary edema
  • Sleep apnea
  • Lung abscess
  • Lung cancer
  • Respiratory failure
  • Pneumothorax

Medical Procedures Performed by Pulmonologists

A pulmonologist will be able to do the following for patients:

  • Tracing the patient’s and family medical history through medical interviews. At this stage, pulmonologists perform a general physical test with methods such as chest inspection, chest percussion, chest palpation, and chest auscultation.
  • Performing additional tests to get a valid diagnosis, such as measuring the rate of blowing air (spirometry) and taking pleural fluid.
  • Providing interpretation of the results of additional test: lab tests and lung scans (CT-Scan, MRI of the chest cavity, and X-rays).
  • Providing medication and medical procedures through artificial respiration, inhalation and nebulization therapy, needle decompression, or oxygen therapy.

A pulmonologist can also perform medical procedures to examine the lungs and respiratory system:

  • Pulmonary function tests, tests performed to assess the performance of the lungs in the respiratory system.
  • Bronchoscopy, a test to look at your trachea, larynx, or throat.
  • Thoracocentesis, a procedure to remove fluid or air from the lungs.
  • Pleural and lung biopsy (taking tissue).
  • Pulse oximetry test.
  • Sleep study.
  • Lobectomy.
  • Tracheostomy.
  • Chest ultrasound.
  • Airway management.

When to See a Pulmonologist?

When experiencing respiratory-related disorders, it is advisable to see a pulmonologist immediately. Symptoms may come in the form of  shortness of breath, chest pain especially when inhaling and exhaling, chronic coughing, coughing up blood, to drastic weight loss.

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