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by Rosenblum LB

Idiopathic Pulmonary Fibrosis

Definition

Idiopathic pulmonary fibrosis (IPF) is a chronic disease. It causes inflammation and fibrosis (scarring) of tissue in the lungs.

Causes

Idiopathic means the cause is not known.
Researchers think that IPF is an exaggerated and uncontrolled inflammatory response. This produces the scar tissue. What starts the cycle is not known. Over time, scarring surrounds the thin walled air sacs in the lungs. This makes the tissue thicker and stiffer. As a result, breathing becomes difficult. The lungs gradually lose their ability to pass oxygen to the rest of the body.
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Risk Factors

IPF occurs most often in males and people aged 50 years and older. Other factors that may increase your chance of IPF include:
  • Cigarette smoking
  • Viral infection
  • Occupational exposures to dusts containing wood, metal, silica, bacteria, and animal proteins or to aerosol sprays, gases, and fumes
  • Certain medications
  • Gastroesophageal reflux disease (GERD)
  • Other family members with IPF

Symptoms

Over time, the symptoms get worse. This makes daily activities difficult. People with IPF gradually start to have some or all of these symptoms:
  • Shortness of breath, at first only during or after physical activity, but later also when resting
  • Dry cough
  • Gradual weight loss
  • Fatigue
  • Enlargement of the fingertips or sometimes the toes

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids and tissues may be tested. This can be done with:
Images may be taken of your lungs. This can be done with:
Your lung function may be tested. This can be done with:

Treatment

There is no known cure. The goal of treatment is to improve symptoms and slow the disease process. This is done by reducing inflammation and scarring. The tissue that is already scarred cannot be healed.

Medication

Medication is the main form of treatment. It does not work for everyone. Medications are used to:
  • Reduce inflammation
  • Inhibit immune response
  • Slow the progression of the fibrosis

Gastroesophageal Reflux Disease

If present, GERD will need to be treated. This most often involves the use of medication and lifestyle changes.

Supportive Care

  • Some people may need to receive oxygen. This will help them breathe.
  • A pulmonary rehabilitation program may be needed to improve lung function.
  • Get appropriate vaccinations to prevent lung infection, including a flu shot every year and the pneumonia vaccine.
  • A healthy lifestyle may also help slow the disease. This includes:
    • Not smoking
    • Eating a healthy diet
    • Exercising regularly
    • Resting when needed
  • Lung transplantation may be considered for people with advanced IPF who do not respond to other treatments.

Prevention

There is no proven way to prevent IPF. However, avoiding smoking and wearing masks for work in some occupations may help.

RESOURCES

American Lung Association
http://www.lung.org
Coalition for Pulmonary Fibrosis
http://www.coalitionforpf.org

CANADIAN RESOURCES

Health Canada
http://www.hc-sc.gc.ca
The Lung Association
http://www.lung.ca

RESOURCES

Explore idiopathic pulmonary fibrosis. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/ipf. Updated September 20, 2011. Accessed May 9, 2016.
Idiopathic pulmonary fibrosis. American Thoracic Society. Available at: https://www.thoracic.org/patients/patient-resources/resources/idiopathic-pulmonary-fibrosis.pdf. Updated March 2015. Accessed May 9, 2016.
Idiopathic pulmonary fibrosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 11, 2016. Accessed May 9, 2016.
Pulmonary fibrosis. American Lung Association website. Available at: http://www.lung.org/lung-disease/pulmonary-fibrosis. Accessed May 9, 2016.

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