Bronchiolitis obliterans is a potentially fatal airway disease where the bronchioles, the small branches of the airway, become dysfunctional as a result of inflammation and scarring. The patient will have difficulty breathing and cannot get enough oxygen to meet the needs of his body. If the disease is allowed to progress, the lungs may stop functioning altogether, and the only treatment is a lung transplant to replace the damaged small airways with donor tissue.
This disease can be caused by infections as well as exposure to chemicals and particulates. Inhaling hazardous substances can trigger airway inflammation, causing the bronchioles to narrow. Chronic inflammation will lead to scarring, making it impossible for the airways to open back up again. Symptoms may onset suddenly in some cases. Patients usually report shortness of breath, wheezing, fatigue, and confusion caused by oxygen deprivation.
A doctor can listen to the lungs, request medical imaging studies to evaluate the airways, and order spirometry testing to learn more about the patient's lung function. All of this information, along with a patient interview to check for potential exposure to toxins or infectious organisms, will help the doctor arrive at a diagnosis. One problem with bronchiolitis obliterans is the tendency to confuse it with other lung diseases, delaying appropriate treatment until the damage has progressed to a dangerous stage.
Damage to the lungs caused by bronchiolitis obliterans is irreversible. The focus of treatment is on preventing more damage and providing the patient with supportive care. Patients may receive medications to kill infectious organisms and steroids to keep the airways open. If exposure to toxins is occupational, the doctor might recommend a new profession or advise an employer to use tighter controls to limit airway damage among personnel at a company. These can include simple measures like wearing respirators to prevent inhalation of hazardous substances.
A patient with bronchiolitis obliterans may need supplemental oxygen to boost the oxygen saturation levels in the blood. The doctor will recommend regular appointments to check on lung health and determine if the patient needs more aggressive interventions. A lung transplant may be an option in a patient who meets transplant criteria and experiences severe declines in lung function. Patients waiting for transplants will need to be close to a transplant facility and ready to rush to the hospital when a lung becomes available.
This condition should not be confused with bronchiolitis obliterans organizing pneumonia, a different type of lung disease. Patients with this condition develop scarring around the alveoli, the small air sacs in the lungs.