What is fibrosing alveolitis?

20 February 2019

Could a persistent cough be a sign of fibrosing alveolitis?

While it may have an unfamiliar name, fibrosing alveolitis is a condition that affects approximately five million people worldwide, with around 5,000 new cases being diagnosed in the UK every year (1).

One of the reasons you may not have come across the term before now is that the condition is sometimes also known by these alternative names:

• Pulmonary fibrosis 

Idiopathic pulmonary fibrosis 

• Cryptogenic fibrosing alveolitis 

• Usual interstitial pneumonitis

Fibrosing alveolitis is an interstitial lung disease (or ILD for short). This is a group of conditions affecting the tissues that support the air sacs within the lungs, making it harder for them to take in the amount of oxygen the body needs.

When someone has fibrosing alveolitis, their lungs become thickened and scarred, which means that over time they have less elasticity – and this makes breathing difficult.

What are the symptoms and causes?

Fibrosing alveolitis symptoms include the following:

• Dry cough 

• Shortness of breath 

• Chest pains

Some of these symptoms – such as feeling short of breath – may not appear serious at first. In many cases people may put breathlessness down to being unfit from a lack of exercise, or assume that it’s just a part of growing older. If you have these symptoms, though, it’s really important to get them checked out – since they can progress over the course of time, making even simple activities more difficult.

The causes of fibrosing alveolitis may sometimes be associated with autoimmune conditions such as rheumatoid arthritis and lupus (2). In some cases it may be associated with certain drug treatments used to treat cancer and heart disease (3), as well as some other conditions. However, in most cases the illness is not associated with another condition and its cause is unknown (4) – although medical experts believe that genetic and environmental factors may play a part.

Diagnosing fibrosing alveolitis

Because there are a number of lung conditions that display similar symptoms, your GP will usually need to rule these out before they can make a firm diagnosis. Typically they will listen to your chest, take into account your medical and work history and arrange for blood tests in the first instance.

Further tests may include:
Chest x-ray/CT scan to provide a detailed image of your lungs
Breathing tests to measure how well you can breathe in and out
Bronchoscopy – whereby a narrow tube with a camera is passed down into your lungs, allowing the doctor to see what’s going on and collect tissue samples for analysis.

Who is at risk of fibrosing alveolitis?

While the cause of the condition is unknown in the majority of cases (5), medical experts believe that a number of factors may increase someone’s risk of contracting fibrosing alveolitis. These include smoking, and long-term exposure to dust, for instance through working with wood or metal, or as a miner.

One striking characteristic of fibrosing alveolitis is that men are almost twice as likely as women to contract it (6). However, men are less likely than women to go for regular health check-ups. 

So, if you’re experiencing any of the symptoms of fibrosing alveolitis mentioned above, then it really is important to get them checked out. A dry cough or shortness of breath may seem trivial – but don’t leave them unchecked. They could be a sign of something more serious.

Treating the condition

As yet, there’s no cure for fibrosing alveolitis. But the condition can be treated depending on how it affects the individual. This may involve medication as well as oxygen therapy, which can help people with severe symptoms take in more oxygen than they would get normally. Treatment may also include lung rehabilitation, which includes physical and breathing exercises that help people to cope with their symptoms.

For more on lung conditions and their treatment plus support for people affected, the UK charities British Lung Foundation, Action for Pulmonary Fibrosis and Breathing Matters UK all offer a wide range of information.

Looking after your health – stopping smoking

It goes without saying that stopping smoking is a big step towards a healthier lifestyle.

Not only is smoking thought to increase the risk of fibrosing alveolitis, it is also associated with a long list of health risks that includes various forms of cancer as well as coronary heart disease and strokes.

And if the health risks associated with smoking have got you thinking about quitting, then why not sign up for a smoking cessation programme – and see how easy it can be to quit for good.

Sources

(1) Stark facts about pulmonary fibrosis, Breathing Matters

(2) Idiopathic Pulmonary Fibrosis, National Organization for Rare Diseases 

(3) Schwaiblmair, Martin et al. “Drug induced interstitial lung disease” open respiratory medicine journal vol. 6 (2012): 63-74 

(4) Ideopathic pulmonary fibrosis – NHS factsheet

(5) Types, Causes and Risk Factors of Pulmonary Fibrosis, American Lung Foundation

(6) Stark facts about pulmonary fibrosis, Breathing Matters

Sources and further reading

What is a full health check or medical MOT – AXA PPP healthcare

Where can I get a full health check – AXA PPP healthcare

Idiopathic pulmonary fibrosis – NHS factsheet

Useful resources

British Lung Foundation
Action for Pulmonary Fibrosis
Breathing Matters UK
NHS Smokefree – support to help you quit smoking