Bronchiolitis Obliterans

Bronchiolitis obliterans is a disease that causes destruction and scarring of the small airways of the lungs. As the scarring and hardening of the lungs gets worse, it becomes harder to breathe.

This disease is similar to emphysema, which can be caused by smoking. However, bronchiolitis obliterans patients usually have normal oxygen exchange in their lungs. Emphysema patients do not.

This condition is essentially irreversible and treatment is mainly supportive. The lungs can never return to normal. There are measures you can take which will improve them and make you feel better.

CAUSES

  • Irritant fume exposure, such as exposure to chlorine, ammonia, nitrogen oxides, or sulfur dioxide.

  • Respiratory infections.

  • Connective tissue disorders, such as rheumatoid arthritis or lupus.

  • Hormone producing lung diseases, such as neuroendrocrine cell hyperplasia.

  • Medication reaction.

  • Bone marrow, lung, or heart-lung transplants.

  • Unknown.

SYMPTOMS

  • Shortness of breath.

  • Chronic bronchitis.

  • Exercise intolerance, worsens with exertion.

  • Long lasting cough.

  • Asthma.

DIAGNOSIS

  • Breathing (pulmonary function) tests can show difficulty moving air in and out of the lungs. This is called lung obstruction. In the case of bronchiolitis obliterans, that obstruction is "fixed." This means it does not respond to normal asthma medications.

  • A biopsy of lung tissue can be done to prove the diagnosis. This is taking out a small piece of lung tissue. It can then be looked at under a microscope by a specialist. 

HOME CARE INSTRUCTIONS

  • If you smoke, stop smoking. The carbon monoxide buildup in the blood robs you of your already short oxygen supply.

  • Take your antibiotics as directed. Finish them even if you start to feel better.

  • Avoid antihistamines and cough syrups. They dry your system up and slow down the elimination of secretions. This decreases respiratory capacity and may lead to infections.

  • Drink enough fluids to keep your urine clear or pale yellow. This loosens secretions.

  • Use humidifiers in your home and at bedside if they do not make breathing difficult.

  • Receive all protective vaccines your caregiver suggests, especially pneumococcal and influenza.

  • Use home oxygen as suggested. 

SEEK IMMEDIATE MEDICAL CARE IF:

  • Sputum becomes pus-like (purulent).

  • An oral temperature above 102° F (38.9° C) lasts 2 days or more, and is not controlled by medication.

  • Breathing is more labored or it becomes difficult to exercise.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.