Pleuritis: symptoms, causes, complications, to treatment

Definition

What is pleurisy?

Pleuritis is inflammation that occurs in the pleura. Pleura is two layers of thin tissue that surrounds the inside of the chest cavity and lungs.

Between the two tissues, there is pleural fluid which functions to lubricate the lining when there is friction. When pleural tissue becomes inflamed, the two layers of pleura cannot rub together smoothly.

Inflammation is generally caused by infection. This condition can cause excruciating pain, especially when you inhale. The pain can also be felt when the sufferer coughs, sneezes, or makes certain movements.

This disease can be transmitted to other people if the cause is a contagious infection. Treatment of this disease usually focuses on treating the infection or other causes of inflammation.

How common is this condition?

Pleuritis is a fairly common condition. However, the incidence continues to decline along with developments in the medical world, especially after antibiotic treatment was discovered.

This disease is more common in elderly patients, especially those aged 65 years and over. The incidence of this disease does not show a significant difference in patients with male and female sex.

This disease has a great chance to be cured and can be overcome by controlling the existing risk factors. To find out more information about this disease, you can discuss with your doctor.

Signs & symptoms

What are the signs and symptoms of pleurisy?

The main symptom of pleurisy is sharp, stabbing, and persistent pain in the chest. Pain can be felt in one or both parts of the chest, shoulders and back.

When you inhale, the pain usually gets worse. Although the lungs do not have pain nerves, the pleura contains numerous nerve endings.

In addition, you may also experience symptoms of shortness of breath if this condition is related to the buildup of fluid in the pleura (pleural effusion).

Quoted from the Mayo Clinic, here are the most common signs and symptoms:

• Shortness of breath that gets worse when you breathe, cough, or sneeze
• Shortness of breath or shortness of breath
• Cough — only in a few cases
• Fever — only in a few cases
• The chest feels tight and tender
• The pain is often in the front or back of the cavity, and sometimes you may experience back or shoulder pain

Some of the other symptoms or signs may not be listed above. If you feel anxious about these symptoms, consult your doctor immediately.

When to go to the doctor

Call your doctor if you experience:

• Cough, chills, and high fever that produces yellow or green phlegm. It is possible that you have pneumonia.
• Swollen arms or legs. You may have pulmonary embolism and deep vein thrombosis.

Each sufferer's body shows signs and symptoms that vary. To get the most appropriate treatment and according to your health condition, check any symptoms you feel at the doctor or the nearest health service center.

Cause

What causes pleurisy?

There are two layers of membranes that separate your lungs and the walls of the chest cavity. The membrane that lines the lungs is called the deep pleura, while the one in the chest wall is the parietal pleura.

Between the deep and parietal pleura, there is a small amount of fluid which acts as a lubricant. When you breathe and your lungs contract, the two layers of pleura rub against each other normally in the presence of this lubricant.

However, if there is irritation and inflammation of the pleural lining, the friction between the two layers can cause pain, especially when breathing.

Inflammation can be caused by pleural infection, medications, or medical conditions. Some of the conditions or diseases that commonly cause pleurisy are:

• Viral infections, such as flu (influenza)
• Bacterial infections, such as pneumonia and tuberculosis
• Yeast infection
• Autoimmune diseases, such as rheumatoid arthritis and lupus
• Certain drugs
• Lung cancer near the surface of the pleura

Smoking does not directly affect pleural inflammation. However, people who suffer from this disease should avoid smoking. This is because smoking often causes coughing, so that the pain gets worse.

Avoiding and stopping smoking not only protects you from this disease, it can also help maintain overall lung health.

Risk factors

What factors increase my risk of developing pleurisy?

Pleuritis is an inflammatory disease that can occur in almost anyone, regardless of age and racial group. However, there are several factors that can increase a person's risk of developing this disease.

Several factors can increase your risk of developing pleurisy, including:

1. Age

The incidence of this disease is more common in people aged 65 years and over. Your risk for suffering from this disease increases with age.

2. Have had an injury or trauma to the chest

If you've had an accident that resulted in injury or trauma to the chest, your risk of developing this condition is much higher.

In addition, surgical or surgical procedures on the chest, such as heart surgery, also have the potential to cause trauma to the chest, so that the risk of suffering from this disease also increases.

3. Suffering from respiratory and lung problems

If you have problems or diseases related to the lungs, such as pulmonary embolism, bronchitis, or lung cancer, your chances of developing inflammation of the pleura are greater.

4. Suffering from other diseases

Certain types of diseases, such as lymphoma, rheumatoid arthritis, mesothelioma, or heart disease, can increase your risk of developing pleurisy.

Complications

What are the health complications that can occur due to pleurisy?

Pleuritis is a disease that can be cured. However, there are chances that complications will occur if the disease is not treated promptly.

1. Pleural effusion

The buildup of fluid in the pleural cavity has the potential to cause infection. In addition, this fluid may push up against the lungs, so that the sufferer's breathing can be disturbed.

2. Pneumothorax

If pleurisy is related to injury or trauma to the chest cavity, it is possible that this can cause the lungs to shift and air can enter the pleura. This condition is called a pneumothorax.

3. Hemothorax

Trauma to the chest cavity can cause pain and a build-up of blood in the pleural cavity. If too much blood has accumulated in that area, the patient may go into shock from losing a lot of blood.

Hemothorax also has the potential to cause hypoxia or oxygen deficiency in the body's cells.

Diagnosis & treatment

The information described is not a substitute for medical advice. ALWAYS consult your doctor.

How to diagnose this condition?

The main focus in diagnosing pleurisy is determining the location and cause of inflammation and swelling. First of all, the doctor will perform a physical examination and ask about your history of the disease.

After that, to get a more accurate diagnosis, your doctor will ask you to undergo one or more of the following tests:

1. Chest X-ray

A chest x-ray can help your doctor detect inflammation in your lungs. The type of x-ray that is done is decubitus, which is an x-ray that is taken when you lie on your side.

With this position, the buildup of fluid in your pleura can be seen more clearly.

2. Blood test

Through a blood test, you can find out if there is an infection and what causes it.

In addition, blood tests can also detect any abnormalities or problems with your immune system.

3. Toracentesis

During a thoracentesis procedure, the doctor will insert a needle into part of your chest. After that, the doctor will suck the fluid in the lungs through the needle. The fluid will be checked in a laboratory for infection.

However, this test is quite risky, so it is rarely performed in most cases of pleurisy.

4. Computerized tomography scan (CT scan)

Sometimes, the doctor will also ask you to undergo a CT scan to find out the structure of the internal organs in your chest.

A CT scan can produce clearer and more detailed images, so your doctor can see even the most delicate tissues inside your chest.

5. Ultrasonography (USG)

An ultrasound test uses sound waves to produce an image of the inside of your chest cavity. Through this test, the doctor can detect fluid buildup or inflammation.

6. Biopsy

Pleural biopsy is useful for determining the cause of pleurisy. During this procedure, the doctor will insert a small needle in your chest. Then, a small sample of tissue from your pleura will be taken with the needle.

The tissue will then be examined in the laboratory to check for infection, cancer, or tuberculosis (TB).

7. Thoracoscopy

During an ongoing thoracoscopy procedure, your doctor will insert a tube with a camera through an incision in your chest. The camera aims to find out the infected chest area.

How to treat pleurisy?

Treatment given to pleurisy patients focuses on the main cause. If the main cause is a bacterial infection, such as pneumonia or tuberculosis, antibiotics will be given to fight the bacterial infection.

If the cause is a viral infection, the inflammation will go away on its own. Shortness of breath associated with inflammation can be treated with painkillers, such as nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen is also often used to treat pain.

If NSAIDs are ineffective or unsuitable, you may be given other painkillers, such as paracetamol or codeine.

Lying on your side on the side of the chest that hurts you may help reduce the pain.

The results of treatment depend on the severity of the disease. When conditions causing inflammation are diagnosed and treated quickly, complete recovery is common.

Home remedies

What are some lifestyle changes or home remedies that can treat pleurisy?

Lifestyle and home remedies below may help treat pleurisy:

• Take the medicine according to the doctor's direction. Take medications such as ibuprofen (Advil, Motrin IB, etc.) as needed to relieve pain and inflammation.
• Get plenty of rest. Find a position that you feel most comfortable with and try to stay in that position. Even if you start to improve, don't try to work too hard.

If you have any questions, consult your doctor to better understand the best solution for you.