Pleurisy, also known as pleuritis, is an inflammation of the pleura (the lining of the pleural cavity surrounding the lungs) that can cause painful respiration, also called pleuritic chest pain, and other symptoms. Pleurisy can be generated by a variety of infectious and non-infectious causes. It's important to understand that pleurisy is not a disease, but may come about as a result of a number of different conditions. The typical symptoms consist of chest pain that worsens with breathing in and upon coughing. The intensity of the pain is variable and is usually localized to the area of inflammation, but may also occur in the lower chest or abdomen.
The commonest cause is a chest infection. Pleurisy may also arise as a result of injury or localized non-infectious disease. Treatment is dependent on the cause. In the case of a chest infection, this would normally comprise a course of antibiotic therapy. Whether or not one should continue to work is a matter for you to discuss with your doctor and workplace. Physicians will employ various means to treat pleurisy that, depending on its severity, can range from a simple aspirin to surgery. Natural remedies can help ease various symptoms, making patients more comfortable, but the effects of pleurisy can often be felt long after the condition has gone away.
Treatment of Pleurisy
There is no particular treatment for pleurisy because it's usually the result of an infection or a number of conditions. However, ibuprofen or aspirin can ease the inflammation around the chest area and relieve pain and discomfort.
The body's immune system will usually fight off any infections. Nonetheless, antibiotics can be prescribed for the infection if required. It'll normally clear up within seven to ten days once the infection that has caused it is under control. Other treatments may be required if the pleurisy is the result of a more serious condition such pneumonia or rheumatoid arthritis.
Basically, to treat pleurisy, you need to:
- Take antibiotics exactly as prescribed. If you feel they're not helping, call your doctor. Don't quit taking them on your own. Simply continue taking them until they're all gone, even if you feel well. If you're taking medicine that makes you drowsy, don't drive or use heavy equipment.
- Prepare yourself if a steroidal anti-inflammatory is prescribed because some people find they make them jittery. Hopefully your doctor will want you to take non-steroidal drugs. They can help relieve some of the more uncomfortable symptoms of pleurisy without making you feel like you are on speed.
Over-the-counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs) may help relieve some of the signs and symptoms of pleurisy. Prescription codeine may also help control coughing as well as the pain. If you have a large buildup of fluid, you may need to stay in the hospital to have the fluid drained over a period of several days through a tube inserted into your chest.
- Get rid of the painful cough that usually accompanies pleurisy with a good, codeine-based cough syrup prescribed by your physician.
- Follow medical advice to avoid getting hospitalized. Without proper care, complications can occur and excessive fluid can build up and cause pus to form. If that happens, you'ill need to have the fluid drained through a tube inserted into your chest.
- Try supplementing your prescribed treatment with vitamins if sanctioned by your physician. Some studies have shown high doses of Vitamin C and A can help fight infection.
- Brew some pleurisy root tea—with your doctor's approval, of course—for a natural way of keeping your chest and lungs cleared out. The tea will help you cough up mucus so you can get rid of it.
- Find out what's the disease that's causing your pleurisy. The most important goal in relieving pleurisy or pleural effusion is treatment of the underlying condition that's causing your signs and symptoms.For example, if the cause of pleurisy is a bacterial infection of your lung (pneumonia), an antibiotic may control the infection. But, for pleurisy due to a viral infection, antibiotics won't be effective. Most viral infections run their course without treatment.
- Quit smoking. It harms the lungs. If you're having trouble quitting, ask your doctor for help.
- Hold a pillow tightly against your chest to ease your pain. Additionally, lie on the side that hurts. You may also need to loosely wrap a 6-inch elastic ace bandage around your chest. You should unwrap it several times a day.
- Take two or three deep breaths and then cough to help keep your lungs free of infection. Do this often during the day.
- Don't eat or drink foods that contain milk if you're coughing up sputum; milk seems to make the sputum thicker.
- Drink eight to ten (soda-can size) glasses of water each day. This helps thin the sputum so it can be coughed up more easily.
- Use a humidifier to help keep the air moist and your sputum thin. This makes it easier to cough up your phlegm. You must keep the humidifier free of fungus by cleaning it everyday.
- Rest until you feel better. You may return to work or school when your temperature is around 98.6 degrees F (37 degrees Celsius).Once you decide to go to the hospital, you may encounter the following procedures and equipment during your stay:
- Activity: At first, you'll need to rest in bed, with a few pillows to keep you sitting up a little. This will help your breathing. Don't just lie flat on your back. Once you're breathing more easily, you'll be allowed to increase your amount of exercise.
- Oxygen: Your body may need extra oxygen at this time. It's given either by a mask or nasal prongs. Tell your doctor if the oxygen is drying out your nose or if the nasal prongs bother you.
- Pulse Oximeter: While you're getting oxygen, you may be hooked up to a pulse oximeter. It's placed on your ear, finger or toe and is connected to a machine. It tells how much oxygen is in your blood.
- ECG: Also called a heart monitor, an electrocardiograph or EKG. The patches on your chest are hooked up to a TV-type screen or a small portable box (telemetry unit). This screen shows a tracing of each heartbeat. Your heart will be watched for signs of injury or damage that could be related to your illness.
- 12 Lead ECG: This test makes tracings from different parts of your heart. It can help your doctor decide whether you have a heart problem or not.
- Chest X-ray: This picture of your lungs and heart shows how they're handling the illness.
- Blood: Usually taken from a vein in your hand or from the bend in your elbow. Tests will be done on the blood.
- IV: A tube placed in your vein for giving medicine or liquids. It'll be capped or have tubing connected to it.
- Medicines: You will be given medicine to ease the pain. This will help you breathe more easily also. You may also need antibiotics to fight infection.
- Cold/Heat: A cool towel or heating pad (set on low) placed on the area that hurts may help ease the pain.
- Sputum Sample: If you are coughing up sputum, your doctor may need to send a sample to the lab. This sample may show what's causing your illness. It will also help the doctor choose the medicine you need.
Causes of Pleurisy
The causes of pleuritic pain range from benign, self-limited conditions to life-threatening diseases such as pulmonary embolism, which is found in 5% to 20% of patients presenting to the emergency department with pleuritic pain. Other clinically significant diagnoses associated with pleuritic pain include pericarditis, pneumonia, myocardial infarction and pneumothorax. These maladies must be ruled out with appropriate evaluations.
The hallmark of pleurisy is severe chest pain that starts suddenly. The pain is often strong or stabbing when you take a deep breath. It usually subsides or disappears between breaths. It's usually felt on one side of the stomach area or lower chest. Deep breathing and coughing often make it worse. You may also have a fever, pain when moving or fast, shallow breathing. Typically, you should be able to point to the exact location of the pain. In some people, the pain spreads to the neck, shoulder or abdomen.
All patients with pleuritic chest pain should be evaluated with history, physical examination and chest radiography. Electrocardiography is helpful, particularly when myocardial infarction, pulmonary embolism or pericarditis is suspected. When these significant diagnoses associated with pleuritic pain have been excluded, the diagnosis of pleurisy remains as a diagnosis of exclusion.
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