A pulmonary doctor, also known as a pulmonologist, is a physician who specializes in the diagnosis and treatment of diseases affecting the respiratory system. This field of medicine, called pulmonology, is a subspecialty of internal medicine.
Specialty Focus
A pulmonologist’s expertise centers on the lungs and the entire respiratory system, which includes all structures involved in breathing. This encompasses the mouth, nose, sinuses, throat (pharynx), voice box (larynx), and windpipe (trachea). Their focus extends to the bronchial tubes, the lungs themselves, including tiny air sacs called alveoli, and the diaphragm, a muscle that assists in breathing.
The respiratory system is divided into an upper and lower tract, both falling under the pulmonologist’s purview. The upper tract involves structures like the nasal cavity and pharynx, while the lower tract includes the trachea, bronchi, and lungs. Pulmonologists also address conditions that might involve the chest wall and respiratory muscles, managing infectious, inflammatory, structural, or tumor-related disorders.
Conditions Diagnosed and Managed
One common condition is asthma, characterized by inflamed and narrowed airways, leading to difficulty breathing. Chronic Obstructive Pulmonary Disease (COPD) also includes emphysema, which damages air sacs, and chronic bronchitis, involving inflammation of the airways.
They also treat infections such as pneumonia, which inflames the air sacs in the lungs, and bronchitis, where airways become inflamed and produce excess mucus. Sleep apnea, a condition causing repeated pauses in breathing during sleep, is frequently managed by pulmonologists. Genetic disorders like cystic fibrosis, which leads to thick mucus buildup in the lungs, are also managed. They also address interstitial lung diseases, which scar and stiffen lung tissue, and lung cancer originating in the lungs.
Diagnostic Tools and Therapeutic Interventions
Spirometry, a pulmonary function test, measures how much air a person can inhale and exhale, and how quickly they can do so. Imaging studies like chest X-rays and CT scans provide detailed images of the lungs and chest structures to identify abnormalities.
To gain direct views of the airways, bronchoscopy may be performed, involving a thin tube with a camera inserted into the lungs. Sleep studies are conducted to diagnose sleep-related breathing disorders such as sleep apnea. Beyond diagnosis, pulmonologists provide therapeutic interventions, including medication management with inhalers and oral medications.
Oxygen therapy may be prescribed for individuals who require supplemental oxygen to maintain adequate levels. Pulmonary rehabilitation programs are often recommended, which combine exercise, education, and support to improve lung function and quality of life. Pulmonologists are also involved in ventilator management for patients who need mechanical breathing support, particularly in hospital settings.
When to Consult a Pulmonologist
Consulting a pulmonologist becomes appropriate when symptoms related to the respiratory system are persistent or severe. A chronic cough lasting more than eight weeks is a common reason for referral. Persistent shortness of breath, especially if it interferes with daily activities, also warrants evaluation.
Other concerning symptoms include wheezing, a high-pitched whistling sound during breathing, and unexplained chest pain that may be related to the lungs. Unexplained fatigue, particularly when accompanied by other respiratory symptoms, can indicate an underlying lung issue. If routine chest X-rays or other imaging reveal abnormal findings, a pulmonologist can provide further diagnosis and management.