Pleurisy: Symptoms, Causes, Diagnosis, Treatment, Cost, and Side Effects

Pleura are two large, thin and delicate tissue layers that are responsible for separating our lungs from our chest wall. Pleurisy, or pleuritis, is a condition when a person’s pleura gets inflamed. In a person suffering from this condition, the lining gets inflamed and causes the membranes to rub against each other causing friction.

This reaction can be compared to two sandpapers being rubbed against each other. This reaction causing the friction gives rise to a sharp pain inside the chest called pleuritic pain. This pain is extremely bothersome as it can worsen with breathing.

People experiencing any or all symptoms of pleurisy should get tests done immediately.

Some of the notable signs and symptoms of pleurisy are as follows:

• Stuffed pain in the chest area while breathing, coughing or sneezing
• Shortness of breath and taking a while to gasp for breath
• Cough and fever in some cases
• Extreme tiredness or fatigue

Pleurisy pain can also spread to the back and shoulder of the patient. This pain can also worsen with rigorous movement of the upper body and can be considered pleurisy symptoms.

Patients suffering from pleurisy may also develop conditions like pleural effusion, atelectasis or empyema:

• Pleural effusion: In some patients with pleurisy, there may be fluid build-up in the space between the two tissues. This condition is called pleural effusion. When the fluid build-up reaches a certain point, the pain associated with pleurisy lessens or disappears. This is because the fluid build-up does not allow the two tissues to rub against each other, thus no friction causes the pain.
• Atelectasis: With pleural effusion going unchecked, a sufficiently large amount of fluid can be retained in between the tissue layers. This can create pressure which in turn compresses your lungs and it can partially or completely collapse them. This condition is called atelectasis. Atelectasis can cause difficulty in breathing along with constant cough.
• Empyema: This extra fluid build-up in between the two tissues can become infected when stored for a prolonged time, converting into pus later. This condition is called empyema, often associated with fever, chills and coughing.

There can be several causes of pleurisy. Some of them are as follows:

• Viral infections, like the Flu caused by the influenza virus, can cause pleurisy
• Pneumonia or other bacterial infections
• Any kind of fungal infection can also be major pleurisy causes
• Several autoimmune diseases like arthritis or lupus
• Lung cancer may have cropped in the pleural canal
• Trauma near the rib area like a rib fracture as a result of shock or accident
• Sickle sick disease or any other inherited diseases
• The use of recreational drugs or any other medication that may have been used by the person for a prolonged time.

Any kind of injury or illness listed above can lead to pleurisy. But it cannot be said for sure that having any of these diseases will also lead to pleurisy additionally. The risk of developing pleurisy can be reduced by:

• Controlling the need or want of smoking as much as possible.
• Treating underlying conditions at their earlier stage as soon as it gets diagnosed, such as autoimmune or lung diseases.
• Maintaining proper oral hygiene by washing hands frequently to rule out any viral or bacterial infection.
• Getting an early diagnosis will ensure that treatment of any infection will start on time. Early treatment will prevent fluid from building up in the pleural cavity further and will cause a minimum level of inflammation in the area.

Dos of Pleurisy

• Routine checkups with the doctor
• Take your daily dose of medication as prescribed by the doctor
• Staying at home, getting enough rest
• Eating home-cooked food loaded with vitamins and antioxidants
• Keeping your bedrooms and living environment clean and fresh
• Take a short, brisk walk in the garden or terrace to get fresh air
• Keeping your room well-ventilated and well-lit.

Don’ts of Pleurisy

• Avoid smoking or anything that has a burning end to avoid strained coughing
• Avoid crowded and congested places
• Eating too much spicy food will also do no good. The patient should steer clear of too sour or too spicy food materials.
• Avoid drinking cold water, even though it may be a harsh summer afternoon. Cold water may aggravate cough and cold symptoms, thus making your healing process become longer.
• While staying at home resting is advisable, once you feel better, avoid staying in bed all day. This may also be a problem.

Diagnosis for pleurisy will likely start with your healthcare practitioner asking you about your medical history. It is important to share all prior illnesses or health conditions that you may have suffered from to help him chart your course of diagnosis. nThis will be followed by a physical exam that involves listening to your heartbeat and rate with the help of a stethoscope.

In some cases, your doctor may remove buildup fluid from the pleural space for testing. To remove the fluid, certain procedures have to be followed. Procedures might include:

• Thoracentesis: In this procedure, a numbing factor (preferably local anaesthetic) is injected between the patient’s ribs to the area where fluid was seen in your imaging studies like an X-ray or CT scan. This is followed by a needle being inserted through the patient’s chest wall between his/her ribs to remove fluid for lab analysis. The patient’s breathing will also be normalized and will be comfortable. With the help of guidance by ultrasound, the needle is inserted.
• Thoracoscopy: While pleurisy is diagnosed, if cancer or tuberculosis is suspected, the doctor may suggest a thoracoscopy. In this procedure, popularly known as pleuroscopy, a small camera device called a thoracoscope is inserted through a small cut in the patient’s chest wall. This enables the lab technician to get a direct view of the inside of the patient’s chest to check for any problems or to get a tissue sample for biopsy.

To understand if your condition is in fact pleurisy, your doctor may recommend the following tests:

Blood tests: Blood tests are a wide variety of tests, some of which determine if you have an infection. The others help in determining autoimmune disorders, such as rheumatoid arthritis or lupus. Pleurisy can be one of the first signs of these disorders.

Chest X-ray. A chest X-ray can help to determine if your lungs inflate fully upon breathing in, or if there is air or any kind of fluid in between your lungs and ribs.

Computerized tomography (CT) scan: This test is done in the form of a scan where a series of X-ray images are taken from different angles of the patient’s body. The computer then processes these scans as cross-sectional images that are created that look like slices of your chest. The series of images are quite detailed, which helps to see the condition of your pleurisy. For example, if you have blood clots in your chest, a CT scan will show you the details.

Ultrasound: An ultrasound test is again a test involving images that use high-frequency sound waves. This enables the test to produce detailed structures within your body. A pleural effusion can be detected with the help of ultrasound tests.

Electrocardiogram (ECG or EKG): This test is done to monitor the heart and its condition. Usually, ECGs are recommended to rule out certain heart problems as the cause of your chest pain.

If you have been experiencing pain in the chest, along with coughing, it can be a sign of pleurisy. Fever and cold along with constant coughing and difficulty breathing

If you are facing an issue with breathing, if breathing in and out simply is causing a shooting pain inside your chest, you can get it diagnosed with professional help to be sure that it is indeed pleurisy.

Pleurisy is a very painful condition that affects everyday life. The following list has some of the home remedies that have been proven to be effective to reduce the pain caused by pleurisy:

Apply hot bags to the painful area
Applying heat with hot bags or some other way for at least 30 minutes can show a reduction in pain. The heat applied will help reduce the pain and congestion in your chest, and therefore, will provide you with some comfort and relief from the sharp pain. While showering, spend at least 20 minutes under the shower of lukewarm water. This also helps in reducing chest congestion. If you have a fever alongside, avoid water baths and use cold packs for chest pain.

Drink more and eat less
Keeping yourself hydrated is key, with at least 3 litres of water, which comes to around 8-10 glasses daily. Drinking water not only keeps the body hydrated but also helps get rid of toxins from the body, and will also liquify your mucus so that your lungs can easily cough them out. By eating less, your digestive tract will have to work less and there will be lower pressure in your chest. Home-cooked food is suggested during the recovery process for pleurisy treatment at home.

Steam inhalation
Take a bowl of boiling water and inhale the steam to relieve yourself of cough congestion. To inhale the steam, cover your head completely with a towel and bring your face lower to the bowl and inhale the steam. You can add vapour action medicines like Karvol Plus inside the water. Keep inhaling until the water cools down. Do it thrice a day to relieve cough and blocked nose, thus less coughing and chest pain.

Use the home specialities - garlic, onion, and honey
Take 4 to 5 cloves of garlic with half an onion. To this, add about 10 to 12 tablespoons of water and 3 tablespoons of honey. Blend this well and consume it about 40 minutes before your meal. This will liquify the mcus and clear apath for releasing congesting and cleaning your bronchial passages. This remedy especially helps when you do it when your lungs feels congested, but not more than three or four times a day.

Immersion baths
Take a tub and heat water up to 40 degrees. Use this water and put it inside the tub to create an immersion bath. Use cold packs on the shoulders and chest. This will help your body cool as well as reduce the inflammation and congestion in your chest.

If the reason for your pleurisy is caused by a viral infection, it will usually get better on its own after a few days, a week at most. If it is caused by a bacterial infection, you will require antibiotics as prescribed by your doctor. Depending on the severity of your symptoms, this may be either tablets, capsules or injections.

Add the following foods to your diet if suffering from pleurisy:

• Whole grains: Whole grains like barley, oats, wheat and rice are high in carb content. Carbohydrates provide energy to the body. They also have selenium, a mineral also found in organ meats and seafood present in these grains strengthens the immune system as well.
• Protein-rich food items: A diet rich in protein is beneficial for people suffering from pleurisy. Protein content is quite high in dairy products like milk, eggs, curd and paneer; along with nuts, white meat; fishes like salmon and cod. They help to increase the body strength and also have antiimmflamoty properties.
• Leafy greens: Leafy vegetables like kale, cabbage, lettuce and spinach are packed with healthy vitamins and other nutrients that help in the healing of any kind of respiratory infection. Green vegetables are a good source of vitamins and minerals, along with antioxidants to protect the body from viral infections.
• Citrus fruits: Vitamin C present in citrus fruits like oranges, lemons, lime and kiwi have antioxidants that protect the body from free radicals. They also help build up the immune system and strengthens it to protect one from foreign agents.
• Honey: Honey, with its antibacterial and antimicrobial properties, has been known for healing cough and cold for centuries. Honey can be consumed with warm water and lemon, or with milk, on bread. It is a versatile food item that can easily be incorporated into many dishes.

Highly salted foods: A minimum amount of salt consumption is advised to people with lung and heart diseases. This is because sodium in common salt causes water retention and makes one feel bloated. This is why usually after eating salty foods, one may feel the need to reach out for water.

Dairy products: A breakdown of milk solids when the milk is being digested is produced by the body called casomorphin. This particular compound is responsible for increasing mucus, that further causes coughing and wheezing to patients with lung infections. They can increase the chances of more fluid build up in the pleural cavity.

Processed cuts and meats: Cured cold cut meats, like dried pork, sausages or salami have an added amount of nitrate which help giving a nice colour to the meat. This makes the meat look better and also increases their shelf life. Meats consumed fresh instead of being dried or processed are based on lung patients.

Fried foods and snacks: Fried foods are not only good for overall health, it is extremely harmful for people with pleurisy. Chicken fingers, french fries, burgers and pizza all fall under this category. An enormous amount of these food items in the system causes one to bloat and suffer from discomfort, pushing the diaphram below. They are hugely responsible for worsening the symptoms of pleurisy.

Pleurisy treatment can vary from person to person, as it is entirely dependent on its underlying cause. If bacterial pneumonia is the cause of pleurisy, then an antibiotic can be prescribed to reduce the effect of the infection. Pleurisy caused by a viral infection can go on its own in a few weeks.

Nonsteroidal anti-inflammatory medications called NSAIDs, examples of which include ibuprofen (drugs like Advil and Motrin IB) are generally used to treat the pain and inflammation associated with pleurisy. Steroid medications may be provided by your doctor if is is required.

If you have already been diagnosed and your course of treatment is ongoing, there is no need to go to an urgent care hospital unless the doctor advises so. However, if you experience sudden chest pain with coughing or breathing that is not going away even with treatment after a few weeks, then you must go into urgent care.

There are several doctors available for the diagnosis and treatment of Pleurisy in India. To find the best doctor in your city, visit the Pristyn Care website and find a list of doctors available in your city along with other information like fees, days of visit, etc.

Antibiotics and painkillers for chest pain like medications with ibuprofen like Advil are usually prescribed for patients with pleurisy.

Anti-inflammatory drugs, NSAIDs and home remedies are the only way to go about pleurisy treatment.

Pleurodesis: The excess fluid build-up in the cavity poses an enormous risk to increase the pressure in the lungs. In this surgical procedure, the excess fluid in the pleural cavity of pleurisy or lung cancer patients is effectively drained out. Pleurodesis surgery can be done in several ways, but the most common method is with thoroscopy, where a small and thin instrument called a thoracoscope is used to drain out the excess fluid. The device is fitted with a small lens and a white light to help navigate the device towards the pleural cavity. The pressure created by excess fluid build-up in the lungs, and pleurodesis helps to remove the pressure and helps in better breathing.

Bullectomy: When there are air pockets or air bubbles inside the lung cavity, bullectomy is the procedure used to remove them. These pockets or bubbles get created due to any lung disease which in turn puts pressure on the lungs and difficulty in breathing.

Minimally invasive tumour removal: This procedure involves thoracoscopic surgery that is video-assisted that helps remove tumours from the lungs.

The cost of pleurisy treatment can range from Rs. 15,000 to Rs. 20 lakh depending upon the underlying cause of the condition and the complexity of the disease or infection of the patient. For more information on doctors, surgeries and costs, head to the Pristyn Care website for a wide range of options to choose from.

Although there is no single cause of pleurisy, the condition is majorly caused due to a bacterial infection of excess fluid buildup, which can be reduced with antibiotics. Antibiotics or other medicines should be taken as prescribed. Within a week, symptoms of pleurisy will start to reduce. It may take two to four weeks for symptoms to fully disappear.

Finding and treating the cause of pleurisy, such as an infection from bacteria, is important for recovery. The patient may likely fully recover from her pleurisy if the root cause is eradicated. Unfortunately, if the root cause of pleurisy is seriously caused by a prolonged infection or something similar, it will be difficult to treat and the condition will take longer to heal, sometimes even for months. In most cases, if you maintain a proper lifestyle after treatment, the condition does not come back unless you have another series of infections that affects the lungs.

• Taking slow, brisk walks after a few days of surgery
• Avoiding smoking, alcohol or any other additives
• Eating healthy and home-cooked food.
• Steer clear of spicy or too sour food items
• Take care of daily doses of medications and have them regularly
• Visit the doctor for weekly check-ups and post-op follow-ups

If you are diagnosed with a build-up of excess fluid in the lungs or you have developed a single or multiple air pockets in the lungs, you most likely have pleurisy and you are eligible to go forward with its treatment. However, if you are above 60 years and have other heart or lung diseases, surgery may prove to take a toll on your body. Under such cases, the patient should get pleurisy diagnosed as early as possible so that the treatment involves only medications and home remedies.

Pleurisy treatment is safe when carried out by experienced doctors such as the ones at Pristyn Care.

Pleurisy is not a life-threatening disease and can be easily cured if treatment starts earlier. With any delay, the condition remains treatable, but the cost of surgery, medications and complications go higher. So if you are dealing with any symptoms of pleurisy, get a routine diagnosis and once found out about the condition, begin with your treatment.