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Lung and Bronchial Tract

The respiratory organ is dependant on the environment to transport oxygen into the entire body. This makes it susceptible to infections and pollutants. The immune system is therefore particularly active on the bronchial wall to ward off harmful influences. If the immune system is disturbed, allergies, asthma and autoimmune disorders are the result. An overload of pollutants such as cigarette smoke or fine dust lead to chronic obstructive pulmonary disease, also called COPD (chronic obstructive lung disease). Lung cancer develops mainly through smoking, but can also occur spontaneously.   

If the tone of the pharyngeal muscles is weakened by heavy snoring, it can lead to partial closure of the upper respiratory tract during sleep. The oxygen supply is repeatedly interrupted. This is called sleep apnoea. Since this is a disturbed regulation of breathing, sleep medicine examinations and therapies are mainly performed at a pulmonary specialist clinic.  

Breathing is associated with all brain functions through the involuntary and voluntary nervous system network. Breathing is therefore highly influenced by thoughts, emotions and vegetative conditions such as sweating, cold and pain.

Asian exercises to improve health such as Qigong, Taiji or Yoga use this network to harmonise the respiratory function.

  The lung is a sensitive environmental organ and with its bronchial tree needs to be nurtured with fresh air, exercise and restful sleep.

  In the context of lung and bronchial medicine as well as allergology we examine and treat not only adults in our clinic but also children from the second year of life.

Symptoms

Coughing is a natural defense reflex. In pathological conditions, a cough may have complex origins, which should be investigated by a specialist such as a pneumologist if the cough has lasted longer than six weeks.  

Shortness of breath often occurs only with physical exertion at the initial stages. It is often not perceived when individuals are not used to doing a lot of physical activity. Some people even avoid physical efforts in order not to feel the discomfort of breathlessness. Since the causes may be lung and/or heart disease, it is recommended to undergo diagnostics at the appearance of first signs. Shortness of breath at rest is usually an emergency case and must be treated immediately.  

 

Acute infections of the respiratory tract are usually caused by a virus. People without chronic diseases usually recover within three weeks when hit by an infection. In case of strong discomfort a doctor should be consulted. For patients with chronic asthma or COPD a viral infection may lead to severe complications. Thus it is recommended to ask for medical advice at the beginning when an infection occurs in order to prevent hospital admissions.  

Chest pain can be due to heart, pleura/lung or musculoskeletal problems. One should not hesitate to seek a medical diagnosis in order to exclude severe disease.   Dry mucous membranes of the throat and the bronchial tract are often caused by disturbed nasal breathing and can cause coughing. Inhalations of saline solutions via electrical or membrane nebulizers may be helpful in these cases. Instruction for appropriate inhalation therapy is offered in our practice.

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Diagnostics

The scope of the investigations is relative to each individual case and depends on the severity and complexity of the disease. In the pulmonary practice the diagnostic procedure includes an extensive interview, a physical examination and then tests on lung function.  Additional tests may be allergy tests, laboratory tests or lung function at exertion. If X-ray is necessary it can be obtained in the nearby practice of a radiologist.

If a valuable diagnostic is not achieved by the mentioned methods an endoscopy of the bronchi may be obtained. The procedure is then carried out by a cooperating colleague in the clinic. The investigation is also used to obtain tissue and secretion samples to detect inflammations or tumors.  

Lung function tests (body plethysmography, spirometry, diffusion measurement, p01-

Measurement) measure the volume of the lungs, the flow-properties of the respiratory air in the bronchi, the strength of the respiratory muscles and the capacity of the lung membranes for oxygen. This happens in a chamber, commonly called a bodyplethymograph. In order to obtain usable results, the sincere cooperation of the patient is required.  

Spiroergometry is an exercise test performed on a bicycle ergometer. It demonstrates and measures the performance of the lungs, cardiovascular and musculoskeletal systems under physical exertion. This examination is helpful in clarifying and differentiating the cause of dyspnea which may be the lung, the heart or the musculoskeletal function. It is also useful for the assessmentof athletic performance and as part of a medical checkup for early detection of diseases.

The arterial blood gases are determined from fresh blood samples and give information about the oxygen supply and the acid-base balance in the blood. Under exertion, a latent oxygen deficiency may be revealed. Before a patient receives oxygen and whhile he applies it an examination of the arterial blood gases is a pre-requisite.  

Pulse oximetry gives an indirect estimate of the oxygen saturation of the blood via a finger clip that uses light reflexes of the blood.

Using a pulse oximeter over a period of 24 hours allows us to observe and record the oxygen supply in the blood during periods of everyday life and sleep.  

The measurement of nitrogen oxide (FeNO) in exhaled air is a direct laboratory analysis, which tells us to what extent an asthmatic inflammation of the respiratory tract is present and to what extent this is already under control through medication.    

Therapy

In pulmonary and bronchial medicine, inhalation therapy via nebulizers, metered-dose inhalers and dry-powder inhalers play a large role. The correct dosage and application will be precisely administered in our practice and will continue to be monitored repeatedly throughout therapy. A positive response to inhaled medication is only to be expected if the medication is inhaled correctly. The German respiratory league has uploaded videos on their website that demonstrate the correct usage of all common devices. Take a look! Do you know exactly what your device is called and which drug it contains? You can find out this information by reading the two product-names on your medication plan: the first is the drug administered, then the type of inhaler. You should also find both names on the packaging and in any supplements.  

Oxygen inhalation is only required if lung function is severely impaired by serious loss (of oxygen). In this case an oxygen home therapy is prescribed, and also if necessary mobile oxygen therapy as well, if it is only with exertion that oxygen loss occurs. The indication for oxygen therapy is carefully checked in our practice. Anyone who is released from the clinic after an acute illness with the prescription of an oxygen therapy may possibly refrain from oxygen therapy after stabilization of the illness. In general, an optimization of the medicinal, including inhalative therapy must be carried out before a long-term oxygen therapy.  

In the case of exhaustion of the respiratory muscles due to chronic respiratory distress, i.e. by overworking the lungs via breathing, a nocturnal home ventilation can be prescribed, thereby relieving the respiratory musculature. This should be done in a suitable specialist area. Our practice has the relevant competent partners we cooperate with, and can advise on the necessity for home ventilation with the help of blood gas measurement and a pulmonary function test.

 

Respiratory physiotherapy makes an important contribution to improving breathing function. Medical training is medically instructed training taking into account individual performance. For these therapies we cooperate with physiotherapists and physical education instructors of the Physiokoop. A three-month training programme is provided subject to prior agreement on provision of costs by a private health insurance scheme. Based on an initial examination, an individual training programme is created.  

Drawing on many years of experience, developed complementary-therapy treatment programmes are available in our practice, when conventional therapies do not provide satisfying results, when certain problems can be resolved more elegantly through less-invasive methods and when the patient is open to these procedures.  

Lung cancer is a serious illness and requires the cooperation of various disciplines. In our practice, we can take the lead in diagnostics and therapy coordination and are also available with complementary methods in support. We have good partners whom we cooperate with. For difficult decisions we recommend obtaining a second opinion, which incidentally is the legal right of every patient.  

Support for quitting smoking is available via a medical consultation, and is supported with acupuncture and other complementary therapies.