Understanding the Relationship Between Asthma and Pulmonary Fibrosis
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.
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Comments
Sandi L Philson
hello, is Ofev recommended for IPF?
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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: http://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.
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
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.
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?
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: http://pulmonaryfibrosisnews.com/forums/ ... you're much more likely to get a response :)
Take care,
Char.
JEROME ALTERADO SERRANO
i had covid last oct. 2021 and thought that i was on my way to full recovery after my quarantine period. in dec. of 2021 (about 1.5 mos. after my release in the quarantine facility), i had cough and was given antibiotics. after the medication, i felt that my breathing was not 100% (or not the same as before). i was given inhaler by my doctor but the condition has not been eliminated up to now. i wonder whether this is asthma-related or fibrosis-related. i am however due to undergo a CT scan for chest, hoping that eventually my doctor will be able to determine the exact cause of my current breathing pattern.
Charlene Marshall
Hi Jerome,
Thanks for reading my columns and reaching out via the comments. So sorry to hear of your experience with COVID, and the subsequent breathing challenging. Not feeling like your breathing is 100% is both scary and frustrating, and I hope the inhaler helps a little bit. Getting a CT scan is the best thing you can do for your lungs, as this scan reveals a lot more than an xray, etc. Hopefully the doctor will know what the next steps are after having that imaging done.
Take care,
Char.
Larry Hill
My father, his brother (my uncle) and that uncle’s son all developed IPF, a disease once called farmer’s lung, and have all died in the past twenty-five years. I worry that I, now 66, have symptoms of the same ailment. I’ve read that there is a genetic predisposition to IPF and it can be inherited.
Paul Schroeder
I am 65 years old and was diagnosed with IPF in November 2021. I have also had Asthma for the past 15 years or so. In January 2021 repeated visits to the GP for coughing would result in trying a different Asthma inhaler. Finally a chest X-ray revealed Fibrosis and then on to a Respiratory Specialist. This year I have found that my Asthma sensitivity has become considerably worse. My thoughts are, that the Asthma is aggravated by the IPF and the IPF is aggravated by the Asthma. I now never leave the house without my little blue inhaler (Ventolin)
Tammy Smith
Hi I have been having shortness of breath and fatigue for a few years now at first it would come and go but over time it stays I have been to many Doctors over the years had tests and was told once I had COP then they said no it was asthma. My husband has had asthma since he was a kid we have been married for 42 years and I have watched him and taken him to the hospital many a times for asthma related issues and my breathing problems are nothing like I have seen his. I was just recently and the Doctor because of shortness of breath and wheezing. They told me it was my asthma but they treated me with antibiotics and prednisone which helped me some but still have the cough and shortness of breath when I talk walk or just get active. Even though my doctor has never diagnosed me with pulmonary fibrosis should I have them check me for it. Is it possible that that is what I have?