Understanding the Relationship Between Asthma and Pulmonary Fibrosis

Charlene Marshall avatar

by Charlene Marshall |

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According to the Canadian Lung Association, idiopathic pulmonary fibrosis (IPF) is difficult to diagnose because its symptoms mimic other common respiratory conditions. I have spoken with many IPF patients who can attest to this. They describe their diagnostic journey as long, complicated, and frustrating.

The process of being diagnosed with IPF includes eliminating many other common respiratory ailments such as bronchitis, chronic obstructive pulmonary disease, and asthma. For months before my diagnosis, I was told I had adult-onset asthma, and because I knew nothing about interstitial lung diseases (ILDs), I never questioned the doctors.

Since my diagnosis of IPF in 2016, I’ve been trying to learn everything I can about ILDs, but they’re complicated. The causes of pulmonary fibrosis can vary widely, as can the disease’s progression. Before my lungs worsened, at times I actually would forget that I had IPF. When that happened, I wasn’t short of breath, I wasn’t coughing frequently, and I was able to manage the fatigue. But that has changed in the past few years.

Last week, I wrote about being prescribed new medications after my IPF symptoms worsened. I wondered about what to do when the new inhalers proved less than effective in managing my symptoms. I believed that the newly prescribed inhaled steroids were making my lungs worse. So, I spent much of last week documenting when I took the medications and how I felt both before and after, to discuss the results later with my doctor.

My doctor isn’t convinced the new therapies are causing more damage, but he did agree to keep trying to better manage my symptoms. After listening to my lungs and manually evaluating my breathing, rather than using pulmonary function tests, he added Ventolin (albuterol) back into my medication regimen.

I have used Ventolin before, and picking up that light blue inhaler brought me back to the days of being wrongfully diagnosed with asthma. When I asked my doctor about the inhaler’s use for asthmatics, he said it also can be used to open up airways for anyone struggling with breathlessness.

What he told me next shocked me: He believes I have asthma in addition to IPF.

Perplexed, I asked how that is possible, and he noted that many of his patients with ILDs have been struggling this year with asthmatic symptoms due to the environmental triggers of pollen. He also said that many of his patients with IPF are being diagnosed with asthma, and while inhalers aren’t typically used to treat IPF, they can be effective in managing symptoms for anyone with a lung disease.

I am now on a quest to better understand the relationship between asthma and IPF. Both conditions lead to damage in the lungs, although according to the nonprofit group Pulmonary Fibrosis Now, there is no direct link between the two. I am desperate to ensure my lungs aren’t further damaged, so I’m curious to hear from other patients with IPF who have also been diagnosed with asthma.

I’m interested in hearing about other experiences with Ventolin, particularly if it has helped to manage breathlessness, cough, and wheezing. There is nothing worse than being unable to catch your breath!

If you’d like to contribute to the discussion, please share your thoughts in the comments below. 

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Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.

Comments

Sandi L Philson avatar

Sandi L Philson

hello, is Ofev recommended for IPF?

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Charlene Marshall avatar

Charlene Marshall

Hi Sandi,

Thanks reading my columns and reaching out via the comments. Yes, IPF is one of the two anti-fibrotic medications used to manage IPF. Whether or not it is recommended can only come from a medical doctor though, so it would be good to discuss it with your physician.
Char.

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Tammy Bell avatar

Tammy Bell

I have never been diagnosed I have SOB and heart palpitations since September. I've seen 3 cardiologist and a pulmonary specialist. It often feels like I cant take a deep breath, not really breathless. Feels more like I breath harder. The HR goes up upon standing and walking and back down during standing and sitting. When you say csnt catch your breath is it so bad you jave to stop?? Like I can walk and clean and everything I just feel like a deep breath is sometimes hard.

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Charlene Marshall avatar

Charlene Marshall

Hi Tammy,

Thanks so much for reading my columns and reaching out via the comments. Being SOB and experiencing heart palpitations is awful, I'm sorry to hear you don't have any explanation for those symptoms. Explaining SOB is so hard because it is so widely varied among people. My recommendation is to get a second opinion if you can, including pulmonary function tests to better understand what your lungs are doing, along with all the cardiac tests. Sometimes IPF is a process of elimination. I hope that helps?
Take care,
Char.

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Christine avatar

Christine

I was diagnosed with COPD, emphysema, IPF and asthma. However I don't cough a lot or have phlegm, often I don't feel like I have any respiratory problems but, then I do, I take Esbriet and am convinced it helps. There are times when I feel my lungs won't take in the oxygen and I get very panicky because I know that when the end comes that is how it will be and I can't stand that feeling.

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Charlene Marshall avatar

Charlene Marshall

Hi Christine,

Thanks so much for reading my columns and reaching out via the comments. Sorry to hear of your diagnoses' and that you can relate to the respiratory problems. Glad to hear that the Esbriet is helping, that's great news. Not being able to breathe is so scary and I also feel very panicked when I'm short of breath. Hang in there and feel free to reach out anytime.
Char.

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Susan Godfrey avatar

Susan Godfrey

I had asthma as a young adult. It seemed to have started in my mid thirties and was managed with albuterol. I felt as though it was due to my working with chemicals as a chemist. Now in my sixties, I have been diagnosed with IPF. Could there be a correlation between these two lung ailments?

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Charlene Marshall avatar

Charlene Marshall

Hi Susan,

Thanks so much for reading my columns and reaching out via the comments. Regarding your question about the correlation between these two lung diseases, I'm seeking those answers as well. It's not something I thoroughly understand as I'm not a physician and lung diseases are so complex, but I'm trying to do some credible research to better understand the two. If you find any, or if you hear of any answers from your doctors, please let me know. I'm very curious as my story is similar to yours!
Char.

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Merrilly Nicolazzi avatar

Merrilly Nicolazzi

I was diagnosed with asthma about 7 years ago. Tried many different inhalers. I would get sinus infections which triggered what we thought became asthma attacks: horrible coughing, multiple nebulizer treatments and shortness of breath etc. I know now that was causing the fibrosis scaring in my lungs. Fast forward to 18 months ago when when a new pulmonologist at a ILD Center diagnosed all of this as IPF from HCT scans and PFT and I'm on 02 24/7. I am a new person! Getting ready to start OFEV this month. However, he said I also have a reactive air way (asthma portion of this disease for me)and I continue to use Brio Elipta. No more cough or breathlessness. I feel great although I know I am in the early stages of IPF.

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Charlene Marshall avatar

Charlene Marshall

Hi Merrilly,

Thank you so much for reading my column and reaching out via the comments. It's always nice to hear from others, and I appreciate you sharing your experience. I'm glad having the 02 helps, as difficult as it can be to accept, it really does make us feel better when we're struggling. Goodluck with OFEV, I hope that starting it goes well and I'm glad to hear you're feeling great and now have some answers.
Be well,
Char.

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Richard Doan avatar

Richard Doan

Hello everyone. Just got diagnosed with PF. Don't know yet if it is IPF. I have many extended coughing attacks (1-4 hours long). Not dry, but wet. Albuterol does not help. On my 3rd pulmonologist. Just miserable.

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Charlene Marshall avatar

Charlene Marshall

Hi Richard,

Thanks so much for reading my column and reaching out via the comments, though I'm so sorry to hear of your new PF diagnosis. I hope you're being gentle with yourself during this time; I remember it well and it was a hard few weeks. Usually a diagnosis of IPF is a process of elimination as I understand it, looking at what other things might cause the PF so I hope your pulmonologist is able to look into all the options. Sorry to hear you're having extended coughing attacks! Goodluck on this journey and please feel free to join the PF News forums: https://pulmonaryfibrosisnews.com/forums/ if you want to chat with other patients. There are a lot of amazing people on there who can help too!
Char.

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Kathleen O’Heron Desramaux avatar

Kathleen O’Heron Desramaux

Hello I was diagnosed with IPF about 8 years ago previously various diagnoses guessed heart related Shortness of breath blamed on heart and, perhaps, lack of exercise I kept searching until the biopsy proved IPF I have been on Espriet yet find it makes me nauseous, and painful with burping IPF is now causing SOB doing any physical activity There is another drug suggested So you know the name of drug other than Espriet? K Desramaux

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Charlene Marshall avatar

Charlene Marshall

Hi Kathleen,

Thanks so much for reading my columns and reaching out via the comments. Getting a diagnosis of IPF can be a really frustrating process, I'm so sorry it took 8 years and various misdiagnoses! Both of the two anti-fibrotic medications used to manage IPF and slow the progression can have really difficult side effects. The other drug is called Ofev, and it can have some GI side effects as well for some patients, but others tolerate it well. It might be worth talking to your doctor about to see if you can switch from Esbriet?
Char.

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Bernard Zeitler avatar

Bernard Zeitler

As a Young adult in Early Highschool I was diagnosed with an allergy to house Dust. Then 30 years later with Asthma as a result of an emergency room visit. Being born about 2 months early much of my breathing issue has been thought to be from that But I was just diagnosed with possible Pulmonary Fibrosis. Since being diagnosed with Asthma I knew I had some scarring but have found this latest probability curious as it seems to have been a progression. I also have been diagnosed with sleep Apnea. Has anyone else seen this kind of progression?

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Charlene Marshall avatar

Charlene Marshall

Hi Bernard,
Thanks so much for reading my column and reaching out via the comments. Your question is a really good one, as I know many asthmatics who seem to develop PF. This could (of course) be due to a misdiagnosis originally or maybe there is a relationship we're still not sure about. In either case, I'd be curious to hear from others about this progression too. It may make more sense to pose this question on our forums though: https://pulmonaryfibrosisnews.com/forums/ ... you're much more likely to get a response :)
Take care,
Char.

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