Respiratory Symptoms

What is a respiratory illness?

Respiratory illness is a medical term that includes disorders affecting the parts of the body that are responsible for passing oxygen from the air into our blood stream and expelling waste products (carbon dioxide) from the body.

These include a variety of conditions including those of the upper respiratory tract (i.e. from the nose to our vocal cords), the airways (including the trachea, or wind pipe, bronchi and bronchioles) the lung tissue (alveoli), the covering of the lung (pleura) and the muscles and ribs that make up the chest wall. Finally, there are also important nerves and blood vessels that are vital for a well functioning system.

A persistent cough is one of the commonest Respiratory symptoms. It can range from a mild symptom to one that is very significant, affecting your quality of life. A cough usually originates from the Respiratory tract but can also be associated with diseases of other systems.

Some common causes of a cough include a post nasal drip (common in people with hay fever), heartburn and Asthma. Some medications and infections such as pertussis (whooping cough) can also lead to a persistent cough. Less common causes include chronic lung conditions such as Chronic Obstructive Pulmonary Disease (COPD – also known as Emphysema or Chronic Bronchitis) , Bronchiectasis (damaged infected airways), heart failure, lung cancer or even an inhaled piece of food!

When to see your doctor?

It is important to make an appointment to see your doctor if you have a cough that persists, even if you believe there is a reason to explain your cough, such as continued smoking or allergies. You should call your doctor immediately if you experience chest pain, shortness of breath or light-headedness, or are coughing up blood or discolored phlegm.

Coughing up of blood (hemoptysis) can be a frightening experience. Most people associate it with sinister disease such as lung cancer, but in reality there are a number of causes. 

Firstly, It is important to make make sure that the blood is not coming from the upper airway ( nose, mouth) or stomach (ie vomiting blood).

Even if the bleeding is definitely from the lungs, there are various causes, including:

• Inflammation and irritation in the airways from repeated coughing

• Bronchitis- inflammation of our larger airways

• Bronchiectasis- A condition in which there is damage and infection in the smaller airways

• Lung Cancer

• Pneumonia (ie lung infection)

• Blood clots in the lungs (pulmonary embolus)

• Inhalation of a foreign body (eg food)

   

When to see your doctor?

Even if you have coughed up blood only once it is important to see your doctor. As there are a variety of conditions which can cause this condition it requires thorough assessment. If you continue to cough up blood, cough up more than ½ a cup or are coughing up blood and also experiencing chest pain or breathing discomfort you need to see a doctor immediately. Coughing up more than a cup of blood in a day is considered a medical emergency.

There is no universally accepted clear definition of “shortness of breath”, but most people describe this symptom as a sensation of difficulty with breathing. You may have a feeling of being unable to get enough air in, or that it takes more effort to breathe than usual. Some people also describe a sensation of chest tightness. Shortness of breath can come on suddenly (in a matter of minutes or hours); or more slowly (over days, weeks, months or even years).

As with other respiratory conditions this symptom has many causes . Whilst there are a variety of lung diseases that cause breathlessness, it is commonly associated with other conditions not related to the lungs.

Some of the more common causes include:

• Asthma

• COPD (Emphysema)

• Heart attack/ Heart failure

• Pulmonary embolism, (a blood clot in the lung vessels)

• Infection (such as bronchitis and pneumonia)

• Pneumothorax, (a collapsed lung)

• Lack of regular exercise

• Large weight gain

• Anxiety

• Anaemia (low blood count)

• Thyroid conditions

Less common causes of shortness of breath may include:

• Lung Cancer

• Objects inhaled accidentally into the lungs

• Heart valve problems

• Allergic reactions (anaphylaxis)

• Neurological diseases

• Rarer lung diseases such as sarcoidosis and bronchiectasis

Chest pain is a very common presenting symptom. As the lung itself does not have pain receptors the majority of causes are from pain receptors from outside the lung.

These can include conditions affecting the

• heart muscle (such as a heart attack),

• inflammation of the covering of the heart (Pericarditis),

• inflammation of the covering of the lung (pleurisy) from infection (such as pneumonia, lung abscess), clot in the lung (pulmonary embolus), pleural effusion (fluid in between the lung and the chest wall) or lung collapse ( pneumothorax).

• cancer

• Costochondritis – inflammation in the rib joints

• Acid reflux, 

• and esophageal spasm

Unexplained weight loss is defined as the unintentional loss of 5% of body weight over a period of 6 to 12 months. Loss of weight is not a symptom that suggests disease in any particular part of the body, and so the cause can be in many body systems. 

 Of course it may occur simply because you are eating less, or perhaps your body is using nutrients differently due to a change in your metabolism. On the other hand, occasionally the cause can be sinister such as very severe lung disease, or the growth of a cancer.

When to see your doctor?

If you are losing weight but are not on a diet, then it is advisable to see your local GP.

A hoarse voice can be caused by anything that interferes with the normal movement of the vocal cords.

Hoarseness is a common symptom that most people have experienced from time to time while fighting a cold or the flu. But it can also be a symptom of something more serious.

Some possible causes include:

• Laryngitis - (or inflammation of the vocal cords) is the most common cause of hoarseness and can be caused by several things, ranging from the common cold to voice strain from activities such as singing

• Vocal cord cysts or polyps - Vocal cord cysts are essentially "lumps" on your vocal cords that interfere with their normal closing while speaking. They usually result from overuse of your voice.

• Allergies 

• Acid reflux/Heartburn 

• Thyroid conditions Smoking 

• Exposure to irritants

• Use of inhaled corticosteroids -  (a puffer medication used for asthma or COPD) 

• Cancer 

• Neurological conditions 

• Trauma 

• Spasmodic dysphonia - This is a local problem of the muscles of the larynx

• Laryngeal nerve paralysis - The nerves leading to the voice box may be damaged by surgery in the region where a nerve travels, such as thyroid surgery, heart surgery or head and neck surgery.

• Inhalation of a foreign body or caustic substance.

When to see your doctor?

If your hoarse voice has lasted more than a few days or if it is associated with other symptoms such as breathlessness, weight loss, hemoptysis or a new cough a review is advised.