The term obstructive lung disease includes conditions that hinder a person’s ability to exhale all the air from their lungs.
Obstructive vs Restrictive Lung Disease
Doctors classify lung disease as either obstructive or restrictive.
The term obstructive lung disease includes conditions that hinder a person’s ability to exhale all the air from their lungs.
Those with restrictive lung disease experience difficulty fully expanding their lungs.
Obstructive and restrictive lung disease share one main symptom–shortness of breath with any sort of physical exertion.
Here’s what you need to know about the difference between obstructive and restrictive lung disease.
Obstructive Lung Diseases
Obstructive lung disease and its characteristic narrowing of pulmonary airways hinder a person’s ability to expel air from the lungs completely.
The practical result is that by the end of every breath, quite a bit of air remains in the lungs.
Some common conditions related to obstructive lung disease include:
- Chronic obstructive pulmonary disease (COPD), which encompasses emphysema and chronic bronchitis
- Asthma
- Bronchiectasis
- Cystic Fibrosis
Obstructive lung disease makes breathing significantly harder during increased activity or exertion.
Exhalations take longer with obstructive lung disease so that as the rate of breathing increases and the lungs work harder, the amount of fresh air circulated into the lungs and spent air circulated out decreases.
Restrictive Lung Diseases
People suffering from restrictive lung disease have difficulty fully expanding their lungs when inhaling.
That is, it’s more challenging to fill lungs with air. This is a result of the lungs being restricted from fully expanding.
This can occur when tissue in the chest wall becomes stiffened or due to weakened muscles or damaged nerves. Any of these factors can restrict the expansion of the lungs.
Some of the conditions classified as restrictive lung disease include:
- Interstitial lung disease
- Sarcoidosis
- Neuromuscular diseases, such as amyotrophic lateral sclerosis (ALS)
- Pulmonary fibrosis
- Asbestosis
- Silicosis
The severity of most lung diseases is tested by using a pulmonary function test.
Obstructive and restrictive lung diseases can cause shortness of breath, severe coughing and chest pain.
Treatments are different for each condition and will require a special treatment plan provided by your doctor.
If you have been diagnosed or suspect that you might have lung disease, you should immediately talk to your doctor about your condition.
Do some research on your own to be sure to ask the right questions.
We hope that you have found our article about the difference between obstructive and restrictive lung disease helpful.
While having a chronic lung disease presents many challenges, you can improve your quality of life by gaining more knowledge about your condition, learning about healthy lifestyles, and researching alternative treatments.
Christine Kingsley, APRN is the Health and Wellness Director at the Lung Institute where she focuses on providing helpful online resources for people looking for information on various lung diseases, breathing exercises, and healthy lifestyle choices. She advocates for holistic care that involves working with your doctor to explore all options including traditional and alternative care while focusing on diet and exercise as proactive measures.
Related Posts:
- Our Guide To Obstructive And Restrictive Lung Disease
- Restrictive Lung Disease: Here’s What You Need To Know
- What Does It Mean When You Have End-Stage Lung Disease?
- 13 Pulmonary Fibrosis Stage 4 Symptoms (and Finding Relief)
- COPD Exacerbation (Education and Action Plan)
- COPD Life Expectancy (Understanding, Prognosis, and…
- Interstitial Lung Disease Life Expectancy
- Lung Function Tests: Your Complete Guide
- FEV1 And FVC: What Do They Mean For You?
Obstructive and Restrictive Lung Disease
Doctors may classify lung conditions as obstructive lung disease or restrictive lung disease. Obstructive lung diseases include conditions that make it hard to exhale all the air in the lungs. People with restrictive lung disease have difficulty fully expanding their lungs with air.
Obstructive and restrictive lung disease share the same main symptom: shortness of breath with exertion.
What Is Obstructive Lung Disease?
People with obstructive lung disease have shortness of breath due to difficulty exhaling all the air from the lungs. Because of damage to the lungs or narrowing of the airways inside the lungs, exhaled air comes out more slowly than normal. At the end of a full exhalation, an abnormally high amount of air may still linger in the lungs.
The most common causes of obstructive lung disease are:
- Chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis
- Asthma
- Bronchiectasis
- Cystic fibrosis
Obstructive lung disease makes it harder to breathe, especially during increased activity or exertion. As the rate of breathing increases, there is less time to breathe all the air out before the next inhalation.
What Is Restrictive Lung Disease?
People with restrictive lung disease cannot fully fill their lungs with air. Their lungs are restricted from fully expanding.
Restrictive lung disease most often results from a condition causing stiffness in the lungs themselves. In other cases, stiffness of the chest wall, weak muscles, or damaged nerves may cause the restriction in lung expansion.
Some conditions causing restrictive lung disease are:
- Interstitial lung disease, such as idiopathic pulmonary fibrosis
- Sarcoidosis, an autoimmune disease
- Obesity, including obesity hypoventilation syndrome
- Scoliosis
- Neuromuscular disease, such as muscular dystrophy or amyotrophic lateral sclerosis (ALS)
Diagnosis of Obstructive Lung Disease and Restrictive Lung Disease
Most commonly, people with obstructive or restrictive lung disease seek a doctor because they feel short of breath.
Restrictive and obstructive lung diseases are identified using pulmonary function tests. In pulmonary function testing, a person blows air forcefully through a mouthpiece. As the person performs various breathing maneuvers, a machine records the volume and flow of air through the lungs. Pulmonary function testing can identify the presence of obstructive lung disease or restrictive lung disease, as well as their severity.
A doctor’s interview (including smoking history), physical exam, and lab tests may provide additional clues to the cause of obstructive lung disease or restrictive lung disease.
Imaging tests are almost always part of the diagnosis of restrictive and obstructive lung disease. These may include:
- Chest X-ray film
- Computed tomography (CT scan) of the chest
In some people, a bronchoscopy may be recommended to diagnose the lung condition causing obstructive or restrictive lung disease. In a bronchoscopy, a doctor uses an endoscope (a flexible tube with a camera and tools on its tip) to look inside the airways and take samples of lung tissue (biopsies).
Symptoms of Obstructive and Restrictive Lung Disease
Obstructive lung disease and restrictive lung disease cause shortness of breath. In early stages of obstructive or restrictive lung disease, shortness of breath occurs only with exertion. If the underlying lung condition progresses, breathlessness may occur with minimal activity, or even at rest.
Cough is a common symptom in restrictive and obstructive lung diseases. Usually, the cough is dry or productive of white sputum. People with chronic bronchitis, a form of obstructive lung disease, may cough up larger amounts of colored sputum.
Symptoms of depression and anxiety are also common among people with obstructive lung disease and restrictive lung disease. These symptoms occur more often when lung disease causes significant limitations in activity and lifestyle.
Treatments for Obstructive Lung Disease
Obstructive lung disease treatments work by helping to open narrowed airways. Airways may be narrowed by spasms in the smooth muscles that are in the wall of the airways (bronchospasm).
Medicines that relax these smooth muscles and improve airflow are called bronchodilators, and are inhaled. These include:
- Albuterol (ProventilHFA, Ventolin HFA, AccuNeb, ProAir HFA)
- Ipratropium (Atrovent)
- Formoterol (Foradil)
- Salmeterol (Serevent)
- Tiotropium (Spiriva)
- Combined medications like Combivent Respimat, DuoNeb, Anoro Ellipta, and Advair, which include a bronchodilator
Theophylline (Theo-Dur and other brand names) is a rarely used bronchodilator taken as an oral tablet.
Inflammation also contributes to airway narrowing in obstructive lung disease. Inflamed airway walls may be swollen and filled with mucus, obstructing airflow. Various medicines help reduce inflammation in obstructive lung disease, including:
- inhaled corticosteroids (Flovent, Pulmicort, Advair, QVAR, Alvesco, and others)
- oral corticosteroids (prednisone and others)
- montelukast (Singulair)
A program of regular exercise will improve symptoms of breathlessness in virtually all people with obstructive lung disease. Oxygen therapy may be necessary for some people.
In severe cases of end-stage, life-threatening obstructive lung disease, lung transplantation can be considered as a treatment option.
Treatments for Restrictive Lung Disease
Few medicines are available to treat most causes of restrictive lung disease.
Two drugs, Esbriet (pirfenidone) and Ofev (nintedanib), are FDA-approved to treat idiopathic pulmonary fibrosis. They act on multiple pathways that may be involved in the scarring of lung tissue. Studies show both medications slow decline in patients when measured by pulmonary function tests.
In cases of restrictive lung disease caused by ongoing inflammation, medicines that suppress the immune system may be used, including:
- Corticosteroids (such as prednisone)
- Azathioprine (Imuran)
- Cyclophosphamide
- Methotrexate
Supplemental oxygen therapy may be necessary. Mechanical breathing assistance may be helpful to some people with breathing difficulty from restrictive lung disease. Non-invasive positive pressure ventilation (BiPAP) uses a tight-fitting mask and a pressure generator to assist breathing. BiPAP is helpful for people with obesity hypoventilation syndrome and some nerve or muscle conditions causing restrictive lung disease.
In cases of obesity-related lung disease, weight loss and exercise can help reduce the resistance to breathing caused by excess fat.
Severe, end-stage restrictive lung disease (such as idiopathic pulmonary fibrosis) may be treated with lung transplantation.
Regular exercise improves shortness of breath and quality of life in almost everyone with restrictive lung disease.
Show Sources
SOURCES:
Mason, R. Murray and Nadel’s Textbook of Respiratory Medicine, 5th Edition, Saunders, 2010.
News release, FDA.
National Institutes of Health.
Vainshelboim, B et al. Respiration 2014; 88(5):378-88
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