Symptoms of Pulmonary Fibrosis
The inflammation and scarring that occur with an ILD can lead to symptoms such as:
- Dry cough
- Fatigue and weakness
- Muscle and joint pain
- Rapid, shallow breathing
- Shortness of breath, especially during exercise
- Unexplained weight loss
- Widening and rounding of fingertips (clubbing)
Diagnosis of Pulmonary Fibrosis
Our team, which includes pulmonologists, an ILD-trained nurse practitioner, a thoracic radiologist, and a pulmonary pathologist, is skilled at evaluating and diagnosing PF. We begin with a thorough evaluation that includes a:
- Physical exam
- Review of personal and family medical history
- Discussion of symptoms
To help confirm a diagnosis, our ILD specialists might recommend one or more of these tests:
- Blood tests to check for autoimmune diseases and to monitor patients taking medications that can affect liver function or blood counts
- Bronchoscopy to view inside the lungs and airways using a thin, flexible tube with a tiny light and camera (bronchoscope), and to take mucus or tissue samples for testing (biopsy)
- Chest X-ray to produce images of the lungs to rule out other causes for symptoms
- High-resolution computed tomography (CT) scan to produce more detailed images of the chest that can show the pattern of scar tissue and other lung damage, using specialized X-ray technology that takes cross-sectional images
- Echocardiogram to produce video images of the heart using ultrasound (sound waves) in a noninvasive procedure
- Endobronchial ultrasound (EBUS) to evaluate and diagnose lung disorders using a bronchoscope with an ultrasound probe to create images of the inside of the lungs
- Exercise stress test, typically a 6-minute walk to measure how well the lungs and heart function during exercise
- Pulmonary function tests to evaluate lung function, such as the volume of air flow in and out of the lungs, how well the lungs move oxygen into the bloodstream, and lung size
- Surgical biopsy to obtain a larger tissue sample, which is sometimes needed to confirm a diagnosis and is performed by our thoracic surgeons
Treatment for Pulmonary Fibrosis
The care team works to develop an individualized treatment plan based on each patient’s overall health, specific symptoms, and other health conditions. Treatment plans can include one or more options, such as:
Medications
Medications to treat ILD and its symptoms include:
- Pirfenidone (Esbriet) and nintedanib (Ofev) to slow progression of the disease
- Prednisone and other immunosuppressant medications to reduce the amount of inflammation in the lungs
- Anti-acid medications to treat gastroesophageal reflux disease (GERD), which frequently occurs in people with PF
- Nose sprays and inhalers to help treat cough
Nonsurgical Treatments
Our nonsurgical therapies include oxygen therapy, which can ease breathing, reduce the risk of complications from low blood oxygen levels, and prevent high blood pressure in the lungs (pulmonary hypertension).
At UT Southwestern, we also offer pulmonary rehabilitation, a long-term, outpatient program with specialized therapists. Pulmonary rehab can improve lung function and overall health, and we always recommend it after a lung transplant. Our services include:
- Breathing and coughing techniques
- Counseling and support
- Nutritional counseling
- Physical exercise
Lung Transplant
For people with advanced PF and severe lung damage, a single or double lung transplant can improve the ability to breathe and exercise. Over a recent 30-month period, the lung transplant program at UT Southwestern had the highest survival rate in the nation for one-year post-transplant patients. Since our lung transplant program began in 1990, it has consistently ranked among the top 10 in the United States.