Pleurisy

What is Pleurisy?

Pleurisy is a condition in which the pleura, a thin membrane in the chest cavity, becomes irritated and inflamed. The pleura lines the chest cavity and is the layer of tissue that borders the lungs. These layers of tissue that make up the pleura rub together when a person breathes in and out. This causes no discomfort when the pleural layers are healthy, but if they develop an infection or become inflamed, the condition can be quite miserable.

Pleurisy is also called pleuritis and can develop for a variety of reasons. Oftentimes, pleurisy occurs as the result of an infection. This can be a viral infection like influenza or a bacterial infection like pneumonia. Bronchitis can also cause pleurisy as can tuberculosis and certain immune disorders. Pleurisy can also develop when a person suffers from a chest wound, blunt trauma to the chest, or fractured ribs. Tumors and cancer in the chest cavity or lungs could also potentially cause pleurisy.

What are the Symptoms of Pleurisy?

The most common symptom of pleurisy is chest pain. This chest pain can vary in type and in severity. Sometimes, a person may experience severe and sharp chest pain that worsens when a person breathes. Coughing and sneezing can also elicit sharp pain when a person is suffering from pleurisy. Some people may also experience shortness of breath. Most of the time, the shortness of breath is caused by the person either consciously or unconsciously trying to minimize the size of their breaths to avoid the pain that it causes.

Pleurisy Causes

Pleurisy, or pleuritis, is the result of inflammation of the tissue surrounding the lungs, known as the pleura. This is commonly caused by pleural effusion, or the buildup of fluid around the lungs; however, there are also other drivers that can cause inflammation of this tissue as well.

Both acute and chronic conditions can lead to pleurisy. Chronic conditions include cancer, especially lung cancer, congestive heart failure and collagen vascular diseases, which are disorders or conditions which impact connective tissue. Acute conditions that can lead to pleurisy include tuberculosis, pneumonia, pulmonary embolism, and rheumatic fever.

Trauma can also be a risk factor in developing pleurisy. There are also gastrointestinal conditions that can lead to pleurisy, including pancreatitis, cirrhosis of the liver, splenic injury and gallbladder processes.

How is Pleurisy Treated?

Treating pleurisy depends on what condition is causing it. For example, if bacterial pneumonia is a cause of pleurisy, antibiotics may be prescribed to help. In addition to this treatment of the root cause of pleurisy, anti-inflammatory medications may also be administered to reduce the inflammation causing friction between the layers of the pleura. Prescription cough medicine may also help with the coughing and associated pain, especially cough medication with codeine.

Pleurisy Prevention

While pleurisy cannot be prevented in all cases, given the multiple risk factors, there are many things that can be done to help prevent this condition.

Lifestyle changes that prevent the development of some of the chronic conditions that lead to pleural effusion and pleurisy are essential. These include smoking cessation and proper diet and exercise. This helps to prevent some cancers, diabetes, hypertension, hypercholesterolemia, and coronary artery disease, which are risk factors for congestive heart failure, which leads to pleural effusion, and subsequently pleurisy. If some or all of these conditions are already present, proper management is essential in reducing risk.

Evaluation and management of the gastrointestinal conditions that influence pleurisy risk is also imperative. Additionally, vaccination against some of the infections, such as some types of pneumonia, which are risk factors for pleurisy, is significantly beneficial.

For those with an increased susceptibility to pulmonary embolism, proper monitoring is very important to limit complications, including pleural effusion. Preventative measures for acute conditions are also important, such as antibiotic use for bacterial infections like strep throat to prevent rheumatic fever.

In addition, proper evaluation and treatment of any traumatic injury to the thorax, ribs, and abdomen is effective in preventing complications leading to pleurisy, including pneumothorax.