Category: COPD

What is Honeycombing in the Lungs? (Pulmonary Fibrosis)-Causes and Treatment

ABSTRACT

The human respiratory system consists of a network of tissues or organs, lungs are the primary organs of the respiratory system. Lungs are the paired organ located on either side of the heart of human beings. The prime function of the lungs involves the gaseous exchange between the atmosphere and the bloodstream, basically, oxygen is extracted and transferred into the bloodstream and in turn releasing the carbon dioxide from the blood to the external environment. But due to increased air pollution and some other factors can lead to the degradation of the normal function of the lungs. One of such diseases is pulmonary fibrosis. In this article, we’ll discuss in brief the disease and its best Ayurvedic management.

INTRODUCTION

Pulmonary fibrosis also known as honeycombing in lungs due to the radiological appearance of this disease and is defined as the condition which is characterised by presence of small cystic spaces with irregularly thickened walls composed of fibrous tissue in the lungs. Basically in pulmonary fibrosis, the tissue of lungs gets scarred, and lungs are unable to perform the normal functions efficiently. With increase in time, this condition gradually becomes worse and may ultimately lead to complete loss of function of lungs. Honeycomb cysts often predominate in the pleural/ sub pleural and peripheral regions of the lungs regardless of their cause.

SIGN AND SYMPTOMS

The common clinical features of lung fibrosis include shortness of breath especially on exertion, chronic dry cough, weakness and fatigue, chest discomfort and pain in chest and back regions, loss of appetite is followed by rapid loss of weight On auscultation, sometimes the fine cracked during inspiration can be heard on the base of lungs.

CAUSES

The causes of pulmonary fibrosis include environmental pollution, some medications, infections such as SARS infections, idiopathic pulmonary fibrosis, interstitial lung disease etc., and connective tissue diseases. Endogenous stimuli- dust, fumes, cigarette smoke, autoimmune conditions.
Exogenous stimuli- drug interactions, radiations and other diseases.

PATHOPHYSIOLOGY OF PULMONARY FIBROSIS (Cause of honeycombing)

Due to the overexposure of endogenous and exogenous stimuli, leading to microscopic lung injury, separated spatially and temporally and if these injuries remain intact lead to lung haemostasis, and when healed up it leads to gradual change in lung parenchyma with fibrotic tissue leading pulmonary fibrosis, which appear as honeycombs on radiological imaging. This progressive changes in the normal lung tissue with scarred one, resulting in the reduced oxygen diffusion capacity and increase in stiffness of chest and back region.

Pulmonary Fibrosis

DIAGNOSIS

  • The diagnosis of this condition may be based on symptoms, lung function tests, medical imaging and lung biopsy
  • Honeycomb lung is the classical radiological appearance with widespread fibrosis.
  • The terminal and respiratory bronchioles are dilated and thickened to produce cystic airspaces, giving this characteristic honeycomb appearance on chest x-ray.
  • High resolution CT may be required for proper visualisation of the abnormalities.

COMPLICATIONS

If proper management of this condition is not done it may lead to many several lifethreatining complications. These include pneumothorax, lung cancer, pulmonary hypertension and respiratory failure.

AYURVEDIC VIEW

In Ayurveda, the best correlation of this disease can be made with Kshatksheen janya shwas rog, (respiratory disorder as a result of healed pulmonary abscess).

The person who is regularly on inappropriate diet and unwholesome diet, excessive dry and following the trauma to the lungs or due to any infective cause, the vitiated tridosha got entered in the chest region causing severe pain in the chest, back and also passes blood in sputum (hemoptysis), leading to abscess formation in the lungs and also causing depletion of shukra and oaj (the supreme body tissue that can be correlated with hormones responsible for growth and reproduction and immunity) and leading to the condition called kshatksheen. This kshat ksheen, itself when healed, makes the progressive changing of normal to fibrosed tissues in the lungs leading to pulmonary fibrosis condition.

The common symptoms of kshatksheen include

Uroruk- Pain in chest, Shonitchardi- haematemesis, Kaaso-cough, due to the pulmonary abscess (urahkasht), and also the generalised symptoms such as Sraktmutratvum– Haemeturia, parshavprishtkatigreh- stiffness in chest, back and lumbar region and weight loss.

The bleeding when the tissue becomes fibrosed decreases but it leads to the gradual increase in breathing difficulty, exertional dyspnea and other such symptoms.

TREATMENT of Pulmonary Fibrosis

Planet Ayurveda Is The Best Emerging Manufacturing Hub Which Is Gradually Becoming The Global Distributor Of Herbal Formulations That Are Being Made On Ancient Ayurvedic Principles. The Products That Are Manufactured Here Are Under The Strict Supervision Of Our Expert Team Of Ayurvedic Doctors And Are Made With Ancient Time Tested Formulas.

Best Herbal Remedies as suggested by our experts for pulmonary fibrosis

  1. Praanrakshak Churna
  2. Vasaka Capsule
  3. Tulsi Capsule
  4. Shwas kuthar ras

Herbal Supplements for Pulmonary Fibrosis

Herbal Supplements for Pulmonary Fibrosis

PRODUCT DESCRIPTION

1. Praanrakshak Churna

This is a poly herbal prepration made by Planet Ayurveda’s team on the ancient Ayurvedic principles. The shwas roga have prodominaece of kapha and vata dosha. This churna is very much efficient in screeching out the collected kapha dosha along with the soothing effects on the vata dosha. The product is having expectorant and properties to enhance the lung functions. The ingredients of this formulation include Sirisha (Albizia lebbeck), mulheti (Glycyrrhiza glabra) and kantakari (Solanum xanthocarpum) etc.

Dosage– 1 teaspoon twice daily with equal amount of honey, after meals

2. Vasaka Capsules

These are the standardized extract of the vasa (Adhatoda vasica). Vasa is an amazing rejuvenating herb that helps in the prevention of infections of lungs and promoting the health of the lungs, it helps in getting rid of the excess congestion in the chest and also improves digestion. This herb enhances the blood purifying ability, and boosts up the immunity. These all factors make them both suitable and one of the best medicines for pulmonary fibrosis.

Dosage- 1 capsule two times daily with water after meals

3. Tulsi Capsules

Tulsi Capsules are made from the standardized extract of Ocimum sanctum. Tulsi is the best remedy to treat the respiratory difficulties used since ages. Moreover, tulsi is the abundant source of antioxidants such as eugenol that protects the lungs from free radicals. Due to its kapha shamak property, it aids in relieving the symptoms of pulmonary fibrosis.

Dosage- 1 capsule twice daily with water after meals

4. Shwas kuthar ras

The classical Ayurvedic formulation used for the shwas roga (respiratory ailments). This medicine is useful in chronic breathing difficulties and dyspnea on exertion along with the stiffness issues in the lungs. Shwas kuthar ras is the best herbomineral preparation for dissolving the fibrosed tissue (due to kapha) and helps in promoting the normal lung functions.

Dosage– 2 tablets twice daily after meals, for better results crush the tablets in half teaspoon of ginger juice, and consume it with 1 teaspoon of honey.

CONCLUSION

There is no treatment method available with the Allopathic medicine for this condition, they mostly focus on symptomatic treatment (pulmonary rehabilitation or oxygen therapy), whereas Ayurveda with an integrated approach of lifestyle and dietary modification along with the herbal formulations is the best way to manage the condition of  Pulmonary fibrosis.

Chronic Obstructive Pulmonary Disease (COPD) Treatment in Ayurveda

introduction

COPD is a chronic inflammatory disease that can cause obstructed airflow from the lungs.Chronic Obstructive Pulmonary Disease is commonly referred to as a group of lung diseases. The most common are emphysema and bronchitis. It is a progressive disease which means the disease gets worse over time. COPD is generally characterized by increased breathlessness. It is caused by prolonged exposure to certain gases and particles. The main symptoms include breathing difficulty, cough and wheezing (whistling sound).Emphysema is a condition in which the alveoli at the end of air passages are damaged due to continuous exposure to cigarette smoking or certain gases. Bronchitis is the inflammation of bronchioles. Bronchioles are the airways that carry oxygen to the lungs. It causes breathlessness, cough and chest tightness.

COPD is more common in females (56%) than in males (44%). (REF. COPD NATIONAL ACTION PLAN)

Chronic Obstructive Pulmonary Disease (COPD)

COPD is lung disease which is characterized by chronic inflammation of airflow that interferes with normal breathing and is not fully reversible. Emphysema and bronchitis are included under COPD.

AYURVEDA ASPECT OF COPD

(Reference: Charak Chiktsa Sathan)

In Ayurveda, COPD is considered under shwaas rog (श्वास रोग).COPD is a disease of pranavaha srotas. When there is an increase in kapha (mainly kapha) and vata in the body, it spreads throughout the body and causes COPD.

In Ayurveda there are five types of shwaas:

  1. Mahashwaas (Vata dosh)
  2. Urdhvashwaas (Vata)
  3. Tamak Shwaas(Kapha Vata)
  4. Partamak Shwaas (Kapha)
  5. Shudra shwaas (Vata)

TYPES- Following diseases are included under COPD

  1. Emphysema
  2. Bronchitis

It is a chronic disease that is not communicable and affects the lungs.
Males who smoke are more prone to this disease. It can occur to any age group.

SPIROMETRY AND STAGES OF COPD-

FVC (FORCED VITAL CAPACITY)-This is the largest amount of air you can breathe out after breathing in as deeply as you can.

FVC (FORCED VITAL CAPACITY)-This is the largest amount of air you can breathe out after breathing in as deeply as you can.

STAGES OF COPD

COPD is categorized under following categories

  1. Mild
  2. Moderate
  3. Severe
  4. Very Severe

1. Mild (STAGE 1)—There may be no symptoms or shortness of breath during brisk walking or climbing a hill or climbing stairs. .

2. MODERATE (STAGE2)-In this stage if you are walking on level ground, you have to stop every few minutes to catch your breath.

3. SEVERE (STAGE-3)-In this stage there is shortness of breath even doing little things like dressing and undressing.

4. VERY SEVERE (STAGE 4)-There is difficulty in breathing even during rest along with chest tightness.

MAIN CAUSES OF COPD

  1. Tobacco smoking- The main cause of COPD is tobacco smoking.
  2. Secondhand smoke-Even if you are not a smoker you can get COPD if you are living with a smoker.
  3. Asthma- If you have asthma and you are not taking any treatment, it can lead to COPD..
  4. Pollution-You can get COPD if you have continued exposure to harmful gases and toxic substances.

SYMPTOMS OF THE DISEASE

  1. Shortness of breath especially during physical activity
  2. Wheezing
  3. Chest tightness
  4. A chronic cough can lead to mucus which may be white, yellow, or greenish
  5. Frequent respiratory infections

SEVERE SYMPTOMS

  1. Swelling at extremities
  2. Bluish discoloration of the skin (cyanosis)
  3. Rapid breathing
  4. Acute chest discomfort
  5. Diffuse breath sounds

MAIN RISK FACTORS

People who smoke tobacco are at the highest risk of COPD. Other risk factors include secondhand smoke (you are not a smoker but you are living with a smoker), exposure to toxic substances and gases. There is a genetic factor called alpha-1 antitrypsin that places a small percentage(1%) of people at higher risk for COPD because a protective factor ( alpha 1 antitrypsin)for lung elasticity is decreased or almost absent.

Other factors which may lead to COPD are mentioned

  1. Connective tissue disorders
  2. Immune deficiencies disorders
  3. Vasculitis syndromes

DIAGNOSIS OF THE DISEASE

The preliminary criteria to diagnose COPD in an affected person is given below

  1. By brief history
  2. By breathing history
  3. By history of tobacco smoking
  4. By history of exposure to chemicals and toxic gases

LAB INVESTIGATIONS TO DIAGNOSE COPD

Pulmonary function test

PFT tests can detect the problem even before appearing the symptoms. This includes the spirometry test and lung volume tests.

Sputum examination

A sputum sample is taken to check the disease. The presence of bacteria in the sample confirms the COPD.

  1. Pulse oximetry- the amount of oxygen in the blood is measured with the help of a small device that is attached to your fingertips.
  2. Chest x-rays
  3. CT scan of lungs (computerized tomography)
  4. Arterial blood gas (abgs) or pulse oximeter to look for oxygen saturation rate in the patient’s blood.

COPD TREATMENT IN AYURVEDA

COPD Treatment in Ayurveda

COPD Treatment in Ayurveda

AYURVEDA ASPECT OF COPD

COPD Treatment in Ayurveda

(Reference: Charak Chikitsa Sathan)

According to Ayurveda COPD treatment includes:

1. Nidan Parivarjan

  • Nidan Parivarjan is to avoid the known disease-causing factors in the diet and lifestyle of the patient.
  • Avoid tobacco smoking
  • Avoid exposure to pollution, chemical substances, and toxic gases.
  • Avoid second-hand smoke (living with people who smokes)

2. Shodhan Chikitsa

  • Shodhan Chikitsa means the elimination of toxins from the body by performing panchakarma. According to Ayurveda COPD occurs due to an increase of Vata and Kapha in the body (as there are three doshas in the body which include Vata, pitta, and Kapha and imbalance in these three doshas lead to diseases).
  • Sweden (Steaming)-Rock salt and sesame oil steam are used to pacify Kapha dosha.
  • Snehan-after snehan, medicated ghee is given to the patient. Snehan is given to initiate Vamana karma (emesis) in patients. Virechana is given in Tamak shwas.
  • Doompan (Ayurveda herbal smoking)-to To completely remove excess Kapha dosha in body herbal smoking is given to the patient.

3. Shaman Chikitsa

Shaman Chikitsa includes the removal of toxins by consuming oral medicines.

BEST HERBS USED IN COPD

  • Curcumin (Curcuma longa) – Curcumin has anti-inflammatory and antioxidant properties
  • Tulsi (Ocimum sanctum)-It is anti-inflammatory.
  • Shunthi (Zingiber officinale)-It breaks down mucus, increases circulation in the lungs. It is anti-inflammatory.

PRODUCTS OF PLANET AYURVEDA

  1. Curcumin capsules– 2 capsules daily twice with water after meals.
  2. Tulsi capsules-1 capsules daily twice with water after meals.
  3. Praanrakshak churna– 1 teaspoon twice daily with water or honey after meals.
  4. Kaas-har churna-1 teaspoon twice daily with water or honey after meals.
  5. Vasaka capsules-2 capsules daily twice with water after meals.

DIET AND LIFESTYLE

Dietary habits play a huge role in the treatment of COPD. It is very important in COPD to follow a healthy diet.

FOOD TO AVOID

  1. Curd
  2. Cheese
  3. Buttermilk
  4. Ice cream
  5. All fried foods
  6. Carbonated soft drinks
  7. Citrus fruits

FOOD TO TAKE

  1. Potassium-rich foods like avocado, dark leafy vegetables, potato, tomato, banana, oranges.
  2. Peas, beans, oats.

Yoga–Yoga is very beneficial for COPD patients. Following yoga, asanas can help in the improvement of COPD.

  1. Standing mountain pose
  2. Standing backbend
  3. Pranayama

References

https://www.nhlbi.nih.gov/sites/default/files/media/docs/COPD%20national%20action%20plan%20508_0.pdf