Chest diseases (pulmonology) is a branch of internal medicine that covers the diagnosis, treatment, and follow-up of respiratory system diseases. All diseases of respiratory organs such as the lungs, bronchi, trachea, and pleura fall under this specialty. The Koru Hospital Department of Chest Diseases provides comprehensive healthcare services for respiratory system disorders with advanced diagnostic technologies and an expert physician staff.
The Importance of the Respiratory System and the Scope of Chest Diseases
The respiratory system is a critical organ system that provides the oxygen exchange essential for life. Our lungs, which breathe approximately 20,000 times a day, are constantly exposed to various disease-causing factors. Factors such as air pollution, cigarette smoke, occupational exposures, infections, and genetic predisposition pave the way for respiratory system diseases.
Chest disease specialists provide diagnostic and treatment services for a wide range of conditions, including asthma, COPD, pneumonia, tuberculosis, lung cancer, interstitial lung diseases, sleep apnea, and pleural diseases. A comprehensive approach is adopted, ranging from preventive medicine to advanced diagnostic methods.
Asthma
Asthma is a disease characterized by chronic inflammation of the airways, manifesting with recurrent attacks of shortness of breath, wheezing, chest tightness, and coughing. Affecting approximately 300 million people worldwide, asthma can occur in any age group, although it frequently begins in childhood.
Asthma triggers include allergens (dust mites, pollen, animal dander, mold), air pollution, cigarette smoke, cold air, exercise, stress, and respiratory infections. Pulmonary function tests (PFT), bronchial provocation tests, and allergy tests are used in diagnosis.
A stepwise approach is applied in asthma treatment:
- Controller medications: Inhaled corticosteroids, long-acting beta-2 agonists, leukotriene receptor antagonists, and biological agents
- Rescue medications: Short-acting beta-2 agonists, used during acute attacks
- Allergen immunotherapy: Desensitization treatment for allergic asthma
- Lifestyle adjustments: Avoiding triggers, smoking cessation, regular exercise
Chronic Obstructive Pulmonary Disease (COPD)
COPD is a progressive and preventable disease characterized by permanent narrowing of the airways and destruction of lung tissue. As the third leading cause of death worldwide, COPD constitutes a major public health problem. Smoking is the most significant risk factor; more than 80 percent of patients have a history of smoking.
The main symptoms of COPD are:
- Chronic and progressive shortness of breath
- Chronic cough and sputum production
- Reduced exercise capacity
- Wheezing
- Frequent respiratory infections
- Weight loss and muscle weakness in advanced stages
Smoking cessation is the most effective approach in COPD treatment. Inhaled bronchodilators, inhaled corticosteroids, pulmonary rehabilitation programs, oxygen therapy, and vaccination (influenza and pneumococcal vaccines) form the core components of treatment. Surgical treatment options are also evaluated in severe cases.
Pneumonia
Pneumonia is an infection of the lung tissue. Bacteria, viruses, fungi, and rarely parasites can cause pneumonia. Fever, cough, sputum, shortness of breath, chest pain, and fatigue are the primary symptoms. Community-acquired pneumonia, hospital-acquired pneumonia, and pneumonia developing in immunocompromised individuals require different approaches.
Diagnosis involves chest X-rays, computed tomography (CT), blood tests, sputum culture, and bronchoscopy when necessary. Treatment involves antibiotics, antivirals, or antifungal drugs targeting the infectious agent. Hospitalization and intensive care follow-up may be required in severe cases.
Tuberculosis
Tuberculosis (TB) is a contagious infectious disease caused by the Mycobacterium tuberculosis bacillus. Tuberculosis, which remains a significant health problem in our country, most commonly affects the lungs but can affect any organ in the body. Chronic cough, bloody sputum, night sweats, fever, and weight loss are the main symptoms.
Diagnosis utilizes sputum smear and culture, tuberculin skin test, interferon-gamma release assays (IGRA), chest X-ray, and computed tomography. Treatment is carried out with a combination of multiple antibiotics lasting at least six months. Adherence to treatment is critical for preventing drug-resistant tuberculosis.
Interstitial Lung Diseases
Interstitial lung diseases (ILD) are a broad group of diseases characterized by inflammation and fibrosis in the interstitium (supporting tissue) of the lungs. Idiopathic pulmonary fibrosis, sarcoidosis, hypersensitivity pneumonitis, and lung involvement due to connective tissue diseases are the primary members of this group.
Progressive shortness of breath and dry cough are the most common symptoms. Diagnosis involves high-resolution computed tomography (HRCT), pulmonary function tests, bronchoalveolar lavage, and lung biopsy when necessary. While treatment varies depending on the type of disease, antifibrotic drugs, immunosuppressive therapies, and supportive care are applied.
Lung Cancer Screening and Diagnosis
Lung cancer is the most common cause of cancer-related deaths. Because it often does not show symptoms in the early stages, diagnosis at advanced stages reduces the chances of treatment. Regular low-dose computed tomography screening in high-risk individuals (long-term smokers, over 50 years old) can be life-saving for early diagnosis.
Chest disease specialists play a critical role in the lung cancer diagnostic process:
- Bronchoscopy: Endoscopic evaluation of the airways and biopsy
- Endobronchial ultrasound (EBUS): Biopsy of mediastinal lymph nodes
- Transthoracic needle biopsy: Tissue sampling from peripheral lung lesions
- Pleural fluid cytology: Evaluation of pleural fluid for cancer cells
Sleep Apnea and Sleep Disorders
Obstructive sleep apnea syndrome (OSAS) is a common respiratory disorder characterized by recurrent obstruction of the upper airway during sleep. Snoring, pauses in breathing during sleep, excessive daytime sleepiness, morning headaches, and difficulty concentrating are the main symptoms.
If left untreated, it increases the risk of hypertension, heart disease, stroke, diabetes, and traffic accidents. Polysomnography (sleep study) is the gold standard method for diagnosis. Treatment involves CPAP (continuous positive airway pressure) devices, oral appliances, lifestyle changes, and surgical intervention in appropriate cases.
Pleural Diseases
Pleural effusion (fluid accumulation between the lung membranes) can develop due to many different diseases. Heart failure, infections, cancers, and liver and kidney diseases are among the most common causes. Shortness of breath and chest pain are the primary symptoms. Analysis of the fluid obtained via diagnostic thoracentesis is important in determining the underlying cause.
Occupational Lung Diseases
Exposure to various dusts, gases, fumes, and chemicals in the workplace can lead to respiratory system diseases. Asbestosis, silicosis, coal worker's pneumoconiosis, and occupational asthma are the primary occupational lung diseases. Improving the working environment, using protective equipment, and regular health check-ups are of great importance in preventing these diseases.
Diagnostic Methods
The main diagnostic methods used in chest disease practice are:
- Pulmonary function tests (PFT): Measurement of lung capacity and airflow rates
- Chest X-ray and computed tomography: Imaging of lung diseases
- Bronchoscopy: Endoscopic evaluation of the airways
- EBUS: Ultrasound-guided mediastinal biopsy
- Polysomnography: Diagnosis of sleep disorders
- Allergy tests: Diagnosis of allergic respiratory diseases
- Arterial blood gas analysis: Measurement of blood oxygen and carbon dioxide levels
- Diffusion capacity test: Evaluation of the gas exchange efficiency of the lungs
Pulmonary Rehabilitation
Pulmonary rehabilitation is an important component in the treatment of chronic respiratory diseases. It is a comprehensive program that includes exercise training, respiratory physiotherapy, nutritional counseling, psychological support, and patient education. It aims to increase functional capacity and improve the quality of life, especially for patients with COPD, interstitial lung diseases, and those recovering from lung surgery.
Smoking Cessation Support
Smoking is the most important preventable risk factor for respiratory system diseases. Chest disease specialists provide comprehensive support to their patients during the smoking cessation process. Patients are supported through nicotine replacement therapy, pharmacological treatment, behavioral therapy, and motivational interviewing techniques.
In the Koru Hospital Chest Diseases (Pulmonology) department, our expert physicians provide comprehensive and individualized healthcare services to our patients by applying the most current scientific approaches in the diagnosis and treatment of respiratory system diseases.
