Respiratory disease types

First, they are divided into upper respiratory tract and lower respiratory tract diseases according to the location of onset, and second, they are divided into infectious and non-infectious diseases according to the cause of the disease. There is no absolutely unified subdivision standard, and different departments will adjust the classification logic according to the direction of diagnosis and treatment.

Last week, we just received a 12-year-old girl from the clinic. After using the air conditioner all night, she woke up in the morning with a hoarse voice, runny nose, and a body temperature of 37.8°C. Her parents gave her a cephalosporin at home for two days, but it didn't work. The blood test was completely normal. She just had a common upper respiratory tract viral cold. Just drink more water and take some medicine to relieve symptoms. I wasted two days of antibiotics. Many people can't tell the difference between the upper and lower respiratory tracts and take anti-inflammatory drugs blindly when they have a cold or fever. In fact, the problem lies in which part and how to deal with it are very different.

The upper respiratory tract is the collective name for the nose, pharynx, and larynx. In addition to the common cold, common diseases include acute and chronic pharyngitis, tonsillitis, acute laryngitis, and allergic rhinitis, which is said to affect at least two or three out of ten people. There is also an interesting difference here. Allergists often classify allergic rhinitis into immune diseases, but our respiratory department generally still counts it as an upper respiratory tract disease - after all, the location of the disease is in the nasal mucosa. Many patients only discover it after they go to the respiratory department because of a persistent cough. Essentially, the logic of the disease and the direction of diagnosis and treatment are different. No one is right or wrong.

If the discomfort moves downward to the back of the sternum, causing chest pain when coughing, or even making it difficult to breathe, then there is a high probability that the problem has reached the lower respiratory tract - the trachea, bronchi, and lungs. Two years ago, there was an old patient named Uncle Zhang. He was 58 years old and had smoked for 30 years. He would cough for two or three months every winter. He always said that he was an "old chronic bronchitis" and it didn't matter. Last winter, he coughed so much that he couldn't even go downstairs. When he came to check his lung function, he showed that he had moderate COPD. Now he has quit smoking completely and takes medicine on time every day to control it. Common diseases of the lower respiratory tract include acute bronchitis, various types of bacterial/viral pneumonia, bronchiectasis, and asthma, which is becoming more and more common. A while ago, I encountered a 7-year-old child who couldn't stop coughing every time he took two steps. The parents always thought that the child had poor physical fitness, but after investigation, they found out that it was cough variant asthma. With early intervention and control, it basically does not affect normal life.

Oh, by the way, don’t think that respiratory diseases are all caused by viruses and bacteria. In fact, non-infectious diseases account for almost half of them. The asthma and chronic obstructive pulmonary disease mentioned just now are included, as well as pneumoconiosis and silicosis caused by long-term exposure to dust environment, lung cancer caused by air pollution, long-term smoking, and oil fume stimulation. These all belong to the category of respiratory diseases. I once had a patient who worked in stone processing. He had never worn a dust mask in 10 years of work. He had a cough that was treated as bronchitis for more than half a year. Later, a CT scan found that both lungs were diffuse small nodules. When he was diagnosed with pneumoconiosis, he regretted it. Therefore, friends who work in dust-related jobs should really wear protective clothing firmly and don't carry it with their bodies.

In fact, I rarely bother to classify when explaining to patients. After all, the respiratory tract is a whole connected passage. How can there be any clear boundaries? Just like many people with allergic rhinitis, a common cold may trigger asthma. It is not only an allergy problem in the upper respiratory tract, but also affects the airway function of the lower respiratory tract. What kind of asthma do you think it is? These classifications are essentially for doctors to use as a reference for diagnosis and treatment, not for ordinary people to make their own diagnoses.

Finally, I would like to mention that if you have a sore throat or cough that has not gone away for more than a week, or even have difficulty breathing, chest pain, or coughing up blood, don’t search online and blindly take medicine according to the categories. It is safer to come to the hospital to register and let the doctor judge in person.