All about restrictive lung diseases

Written in association with: Dr Shalin Diwanji
Published: | Updated: 09/08/2024
Edited by: Conor Lynch

Restrictive lung diseases are a category of respiratory disorders characterised by a reduction in lung volume, making it difficult for the lungs to fully expand during inhalation. Unlike obstructive lung diseases, which are marked by airflow obstruction, restrictive lung diseases primarily involve a decrease in the lungs' capacity to hold air. Here to explain more is distinguished consultant in respiratory and general medicine, Dr Shalin Diwanji

Types and causes

Restrictive lung diseases can be classified into two main types: intrinsic and extrinsic. Intrinsic restrictive lung diseases are those that originate within the lungs themselves. Common examples include interstitial lung disease (ILD), idiopathic pulmonary fibrosis (IPF), and sarcoidosis. These conditions typically involve scarring or inflammation of the lung tissue, leading to stiffness and reduced elasticity.

 

Extrinsic restrictive lung diseases, on the other hand, are caused by factors outside the lungs. These can include neuromuscular diseases (such as amyotrophic lateral sclerosis or muscular dystrophy), obesity, and abnormalities in the chest wall or spine (like scoliosis or kyphosis). These conditions restrict lung expansion by limiting the movement of the chest wall or diaphragm.

 

Symptoms and diagnosis

Common symptoms of restrictive lung diseases include shortness of breath, particularly during exertion, a persistent dry cough, fatigue, and discomfort in the chest. In severe cases, patients may experience cyanosis (a bluish tint to the skin due to low oxygen levels) and clubbing of the fingers.

 

Diagnosis typically involves a combination of medical history, physical examination, and diagnostic tests. Pulmonary function tests (PFTs) are crucial, as they measure the volume of air the lungs can hold and the flow of air in and out of the lungs. Imaging studies, such as chest X-rays and high-resolution CT scans, can reveal structural abnormalities, while blood tests and biopsies might be necessary to identify underlying causes.

 

Treatment and management

Treatment for restrictive lung diseases focuses on managing symptoms and addressing the underlying cause. For intrinsic restrictive diseases like IPF, antifibrotic medications may slow disease progression. Corticosteroids and immunosuppressants can reduce inflammation in conditions like sarcoidosis.

 

In cases of extrinsic restrictive diseases, treatment may involve weight loss programs for obesity-related restrictions or physical therapy and supportive devices for neuromuscular disorders. Oxygen therapy and pulmonary rehabilitation can improve quality of life by enhancing breathing efficiency and overall physical endurance.

 

Living with restrictive lung diseases requires ongoing medical care and lifestyle adjustments. While these conditions can significantly impact daily life, early diagnosis and appropriate treatment can help manage symptoms and improve patients' quality of life.

By Dr Shalin Diwanji
Pulmonology & respiratory medicine

Dr Shalin Diwanji is a distinguished consultant in respiratory medicine, renowned for his personalised approach to patient care. He emphasises understanding the unique differences between patients with the same disease, moving away from the traditional “one size fits all” approach. By working in close partnership with his patients, Dr Diwanji develops individualised treatment plans tailored to meet each patient’s specific needs, ensuring their optimal health and well-being.

Dr Shalin Diwanji is a consultant in respiratory medicine working at London North West University Healthcare NHS Trust. He sees private patients at The Clementine Churchill Hospital, HCA UK at Devonshire Street, London Digestive Centre, The Harley Street Clinic, Syon Clinic, and St John & St Elizabeth Hospital. 

Dr Diwanji graduated in 2006 and completed his foundation training in India. After which he moved to the UK to pursue research in respiratory medicine. He was granted Doctor of Medicine (MD) in 2010 for research into non-CF bronchiectasis. He completed higher training in respiratory and general medicine, rotating through London Chest Hospital, The Royal London Hospital and St Barts Hospital.

Dr Diwanji was awarded Fellowship of The Royal College of Physicians, London in 2019.

Dr Diwanji has set up an Enhanced Respiratory Care Unit at London North West University Healthcare NHS Trust to provide specialist care for acute and chronic respiratory failure patients. He also co-chairs the lung cancer multidisciplinary team.

Recently, Dr Diwanji has been appointed as Clinical Director for respiratory medicine at London North West University Healthcare NHS Trust.

Dr Diwanji provides lung cancer screening services, often limited in availability through the NHS. He collaborates with colleagues in a multidisciplinary approach to deliver comprehensive lung cancer care.

Dr Diwanji’s practice involves treating common respiratory conditions like chronic obstructive lung disease, asthma, respiratory infections, sleep disorders and respiratory failure.

Dr Diwanji’s clinical practice encompasses a broad range of respiratory conditions including, but not limited to:

  • Chronic cough
  • Breathlessness
  • Wheeze
  • Asthma
  • Chronic bronchitis
  • Chronic obstructive pulmonary disease (COPD)
  • Emphysema
  • Pneumonia and lung infections
  • Tuberculosis
  • Allergy testing
  • Lung fibrosis
  • Sarcoidosis
  • Bronchiectasis
  • Lung cancer screening and care
  • Pulmonary embolism
  • Pneumothorax
  • Fitness to fly assessments
  • COVID-19
  • Pulmonary nodules
  • Smoking cessation
  • Endobronchial ultrasound
  • Sleep disorders

Dr Diwanji is currently Principle Investigator for London North West University Healthcare NHS Trust for the PHOSP-COVID trail and sub-investigator for the TRIBE study for London North West University Healthcare NHS Trust.

Dr Diwanji is an active member of the British Thoracic Society (BTS), the European Respiratory Society (ERS) and the Royal College of Physicians, London.

Dr Diwanji’s dedication to personalised patient care, combined with his extensive experience and research involvement, makes him a highly respected figure in the field of respiratory medicine. His commitment to individualised treatment plans ensures that his patients receive the best possible care tailored to their unique needs.

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