Medically, an indication is a valid reason to use a certain test, medication, procedure or surgery. Spirometry is a common office test used to assess how well a person’s lungs work by measuring how much air the person inhales, how much they exhale and how quickly they exhale. Spirometry measurements include;
Forced Vital Capacity (FVC): This is the largest amount of air that a person can forcefully exhale after breathing in as deeply as they can. A lower than normal FVC reading indicates restricted breathing.
Forced Expiratory Volume (FEV): This is how much air the person can force from their lungs in 1 second. This reading helps the doctor assess the severity of a person’s breathing problems.
Below is a list of ten indications for Spirometry:
1. Chronic bronchitis: This is a more severe condition. It is a constant irritation or inflammation of the lining of the bronchial tubes, often due to smoking. Signs and symptoms may include cough, fatigue, shortness of breath, slight fever and chills, chest discomfort, production of mucus/sputum which can be clear, white, yellowish-grey or green in colour. In rare occasions, it may be streaked with blood. The most common cause of chronic bronchitis is smoking. Other contributory factors include air pollution and dust or toxic gases in the environment or work place.
2. Pulmonary Fibrosis: This is a lung disease that occurs when lung tissue becomes damaged or scarred. The thickened, stiff tissue makes it more difficult for the lungs to work properly. Lung damage caused by pulmonary fibrosis can’t be repaired but medications and therapies can sometimes help ease symptoms or improve quality of life. For some people, a lung transplant might be appropriate. Signs and symptoms may include shortness of breath, a dry cough, fatigue, unexplained weight loss, aching muscles and joints, widening and rounding of the tips of the fingers or toes (clubbing).
3. Chronic Obstructive Pulmonary Disease (COPD): This is a group of lung diseases that block airflow and make it difficult to breathe. This condition can’t be cured but treatment can help. In Nigeria, there are over 1.5 million cases of COPD reported. The main cause of COPD is smoking but non-smokers can get COPD too due to long term exposure to air pollution, second-hand smoke and dust, fumes and chemicals (which are often work-related).Emphysema and Chronic bronchitis are the most common conditions that make up COPD.
4. Cystic Fibrosis: This is an inherited life-threatening disorder that damages the lungs and digestive system. People with this condition must have inherited 2 copies of the defective cystic fibrosis gene—one copy from each parent. Both parents must have at least one copy of the defective gene. Cystic fibrosis affects the cells that produce mucus, sweat and digestive juices, causing them to become thick and sticky. They then plug up tubes, ducts and passageways. It can’t be cured but treatment can help. Symptoms may include cough, repeated lung infections, inability to gain weight and fatty stools.
5. Persistent/Chronic Cough: A cough is chronic when it lasts longer than 8 weeks in adults or 4 weeks in children. It can either be wet and produce phlegm, or dry and tickle the throat. Common causes include asthma, allergies, gastroesophageal reflux disease (GERD), postnasal drip (where mucus drips down the back of the throat, irritating the throat and thereby triggering a cough reflex)or bronchitis. In rare occasions, it can be a sign of a more severe condition such as heart cough and lung disease.
6. Dyspnea: This is shortness of breath. The main symptom is laboured breathing. The person may have the sensation of just not getting quite enough air into their lungs all the time. In serious cases the person may feel as though they are suffocating. Dyspnea that occurs after strenuous exercise is understandable. However, there is dyspnea caused by medical conditions such as heart failure, low blood pressure, pneumonia, stress or anxiety, pulmonary embolism. When shortness of breath isn’t a sudden emergency but instead lingers for at least 4 weeks, it is considered chronic. Some of the causes of chronic dyspnea include COPD, interstitial lung disease (scarring of the lung tissue), poor physical conditioning, heart disease and obesity.
7. Chronic wheezing: The most common causes of recurrent wheezing are asthma and COPD. Inflammation and narrowing of the airway in any location from the throat out into the lungs, can result in wheezing. Other conditions that can lead to wheezing include allergies, anaphylaxis (severe allergic reaction such as to an insect bite or medication), bronchitis, childhood asthma, emphysema, lung cancer, heart failure, medications like aspirin, pneumonia, obstructive sleep apnea (a condition in which breathing stops and starts during sleep), epiglottitis (swelling of the “lid” of the windpipe), bronchiectasis (chronic lung condition in which abnormal widening of bronchial tubes inhibits mucus clearing).
8. Emphysema: This is a lung condition that causes shortness of breath. In people with this condition, the air sacs in the lungs (alveoli) are damaged. Overtime, the inner walls of the air sacs weaken and rupture—creating larger air spaces instead of many small ones. This reduces the surface area of the lungs and in turn, the amount of oxygen that reaches the bloodstream. When the person exhales, the damaged alveoli don’t work properly and old air becomes trapped, leaving no room for fresh, oxygen-rich air to enter.A person can have emphysema for many years without noticing any signs or symptoms. The main symptom is shortness of breath which usually begins gradually. It eventually causes shortness of breath even while the person is at rest. Main cause is long term exposure to airborne irritants including tobacco smoke, marijuana smoke, chemical fumes and dust. Rarely, it is caused by an inherited deficiency of a protein that protects the elastic structures in the lungs. It is called alpha-1-antitrypsin deficiency emphysema.
9. Asthma: A condition in which a person’s airways become inflamed, narrow and swell and produce extra mucus, which makes it difficult to breathe. It may also cause chest pain, cough and wheezing. The symptoms may sometimes flare up and the person may experience coughing at night or during exercise (this may be chronic, dry, with phlegm, mild or severe), fast breathing, breathing through the mouth, frequent respiratory infections, rapid breathing or shortness of breath at night, chest pressure, fast heart rate, anxiety, early awakening or throat irritation.
10. Assessment of asthma control at least every 1 to 2 years and to evaluate changes in asthma therapy: Spirometry may be used periodically to check how well a person’s medications are working and whether their breathing problems are under control.
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