Lung Disease & Respiratory Health Center

Obstructive and Restrictive Lung Disease

Symptoms of Obstructive and Restrictive Lung Disease

Obstructive lung disease and restrictive lung disease cause shortness of breath. In early stages of obstructive or restrictive lung disease, shortness of breath occurs only with exertion. If the underlying lung condition progresses, breathlessness may occur with minimal activity, or even at rest.

Cough is a common symptom in restrictive and obstructive lung diseases. Usually, the cough is dry or productive of white sputum. People with chronic bronchitis, a form of obstructive lung disease, may cough up larger amounts of colored sputum.

Symptoms of depression and anxiety are also common among people with obstructive lung disease and restrictive lung disease. These symptoms occur more often when lung disease causes significant limitations in activity and lifestyle.

Treatments for Obstructive Lung Disease

Obstructive lung disease treatments work by helping to open narrowed airways. Airways may be narrowed by constriction of involuntary muscles that surround the airways (bronchospasm).

Medicines that relax these smooth muscles and improve airflow are called bronchodilators, and are inhaled. These include:

• Albuterol (Proventil HFA, Ventolin HFA, AccuNeb)
• Ipratropium (Atrovent)
• Formoterol (Foradil)
• Salmeterol (Serevent)
• Tiotropium (Spiriva)
• Combined medications like Combivent, DuoNeb, and Advair, which include a bronchodilator

Theophylline (Theo-Dur and other brand names) is a rarely used bronchodilator taken as an oral tablet.

Inflammation also contributes to airway narrowing in obstructive lung disease. Inflamed airway walls may be swollen and filled with mucus, obstructing airflow. Various medicines help reduce inflammation in obstructive lung disease, including:

• inhaled corticosteroids (Aerobid, Azmacort, Flovent, Pulmicort, Advair, QVAR, and others)
• oral corticosteroids (prednisone and others)
• montelukast (Singulair)

A program of regular exercise will improve symptoms of breathlessness in virtually all people with obstructive lung disease. Oxygen therapy may be necessary for some people.

In severe cases of end-stage, life-threatening obstructive lung disease, lung transplantation can be considered as a treatment option.

Treatments for Restrictive Lung Disease

Few medicines are available to treat most causes of restrictive lung disease. In cases of restrictive lung disease caused by ongoing inflammation, medicines that suppress the immune system may be used, including:

• Corticosteroids (such as prednisone)
• Azathioprine (Imuran)
• Cyclophosphamide
• Methotrexate

Supplemental oxygen therapy may be necessary. Mechanical breathing assistance may be helpful to some people with breathing difficulty from restrictive lung disease. Non-invasive positive pressure ventilation (BiPAP) uses a tight-fitting mask and a pressure generator to assist breathing. BiPAP is helpful for people with obesity hypoventilation syndrome and some nerve or muscle conditions causing restrictive lung disease.

In cases of obesity-related lung disease, weight loss and exercise can help reduce the resistance to breathing caused by excess fat.

Severe, end-stage restrictive lung disease (such as idiopathic pulmonary fibrosis) may be treated with lung transplantation.

Regular exercise improves shortness of breath and quality of life in almost everyone with restrictive lung disease.