Doctors & therapists

Pulmonologist – Diagnosis, treatment & choice of doctor

Pneumologe

Whoever first thinks of tires when it comes to “pneumatics” is not far off the mark: Just like tires, the human lungs are primarily filled with air. The pulmonologist is the specialist for lung diseases. In principle, everything is covered, from asthma to lung cancer .

What is a pulmonologist?

Pneumology is a branch of medicine known as pulmonary medicine and is sometimes also referred to as pulmonology or pulmonology. It is a specialist specialization from the large field of internal medicine .

The pulmonologist not only deals with diseases of the lungs themselves, but also with problems that affect the surrounding tissues such as the lung and pleura (pleura) or the mediastinum (middle layer).

Treatments

The treatment spectrum of the pulmonologist thus includes a wide range of common civilization diseases, the age structure of the patient population is very mixed for the pulmonologist.He takes over young asthmatics from the pediatrician as soon as they are over the age limit, treats acute and chronic bronchitis of all age groups and has a lot to do with middle-aged and older patients with chronic obstructive pulmonary disease ( COPD ) and pulmonary emphysema ], the overinflation of the lungs to do.

In the field of occupational diseases, there are various pulmonary fibrosis and work-specific diagnoses such as farmer’s lung, winegrower’s lung or woodworker’s lung, all of which are caused by short-term or long-term inhalation of organic dust.

Another major area of ​​his specialty is bronchial carcinoma , i.e. the classic “lung cancer”, and all other tumor diseases of the lungs and pleura, such as asbestos-related pleural mesothelioma.

Other diseases associated with the lungs, such as pulmonary embolism , which can form as a result of thrombosis as an acute vascular occlusion, or pleural effusion as a sign of heart failure , also belong strictly to the field of pneumology, but are often treated by other general internists or cardiologists . The same applies to acute infections such as acute bronchitis , tuberculosis or pneumonia – if there is a pneumology ward in larger hospitals, you will always end up there with pneumonia.

In turn, younger patients suffer from chronic diseases such as mucoviscidosis , also known as cystic fibrosis, which requires permanent care first by a pediatrician and then by a pneumologist and unfortunately often leads to death in young adulthood. Another fairly common and serious condition that is clearly within the purview of the pulmonologist is chronic high blood pressure in the pulmonary circulation, known in technical jargon as pulmonary hypertension .

Diagnostic & examination methods

Since many patients owe their chronic lung diseases to smoking , the lung specialist must attach great importance to education and prophylactic measures such as smoking cessation.

Measures that are frequently used in diagnostics are first of all the usual general medical methods such as taking anamnesis, auscultation with a stethoscope or percussion, in which the doctor taps the patient’s chest with his finger and looks for sound attenuation or amplification as an indication of compression or collapse the lungs. Technically, it then becomes the classic “thoracic X-ray”, i.e. the X-ray image of the lungs, and the radiological imaging measures based on this, such as the chest CT or the lung scintigraphy.

With a flexible, thin tube, the bronchial system can also be viewed optically (analogous to gastroscopy) ( bronchoscopy ) – the patient can remain awake if necessary – the same principle also works for the mediastinum and the chest (mediastinoscopy and thoracoscopy), whereby it However, these are major interventions in the operating room and under general anesthesia.

Another large area of ​​pneumological diagnostics is functional diagnostics, which requires the active cooperation of the patient: With spirometry and body plethysmography, you breathe into a bag or a mask and a device records the physical air movement, which allows parameters such as and derive expiratory volume and lung flow rate.

Special diseases such as infections or allergies must be determined accordingly via swab and pathogen diagnostics or allergy tests. In addition to physical measures such as breathing training or special training for chronic patients, a lot can be achieved therapeutically, especially with medication. Medicines that are often prescribed in pneumology are bronchodilators or cortisone preparations that suppress the immune system . In the best case, both can be used as a spray, but in more serious cases also as a tablet or as an injection into the vein.

If the air quality becomes permanently worse, a pulmonologist can also prescribe home oxygen devices for permanent ventilation after exhausting the other options. If an operation is required, for example in the case of bronchial carcinoma, the pneumologist refers the patient to his surgical colleague in thoracic surgery.

What should the patient pay attention to?

When choosing a suitable pneumologist , one should of course take into account the experience of the doctor, i.e. how long he worked in the clinic, whether he was senior physician there, which diseases he was primarily involved with there and whether he might also have special scientific interests as researcher has or had.

Of course, all of this is difficult to find out overnight. If in doubt, you should ask your family doctor to recommend a suitable specialist. Of course, strategic things like the distance between the practice and the place of residence also play an important role. In the end you have to rely on your feelings anyway, whether you feel in good hands after the first consultation with a doctor, or whether you prefer to look for alternatives again.

You should be careful with online reviews. As a rough estimate, they can sometimes be very interesting and helpful, but they are not really credible: if you really want it, you can write or have your own recommendations written at any time. At the same time, with almost every doctor in the Google search, there is always a frustrated negative criticism from a patient for whom the expected miracle healing did not materialize after the first doctor’s appointment – this only spoils the mood of the person searching and the doctor who needs trust right from the start -patient relationship.

It is always better to rely on your own assessment or the well-founded experiences of friends or other doctors.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.