Lung disease: Q My dad has just been diagnosed with silicosis as a result of working in tunnels for 10-15 years.

He experiences shortness of breath, lack of energy and sleeplessness. His lungs recently filled with nearly two litres of fluid that had to be drained off in hospital. He can’t walk far or do any normal activities like walking around the garden or the shops.

The doctor says there is no cure. Instead, he has prescribed antibiotics, an inhaler and a thick medicine to reduce the catarrh in his chest. Do you know of any alternative treatments? – Bernadette Moyle, via e-mail

A Silicosis is the oldest recognised occupational lung disease. Pottery and ceramic workers, sandblasters, miners, quarrymen and tunnel workers, like your dad, are particularly vulnerable to developing the condition because of their long-term exposure to silica, mainly from the quartz in rocks and sand. When inhaled, these tiny particles of silica dust become trapped in the tiny air sacs (alveoli) of the lungs, causing an inflammatory reaction. This, in turn, triggers the laying down of fibrous scar tissue (fibrosis) to seal off the inflamed areas, resulting in damage to the lungs.

As your doctor has already told you, there is no conventional cure for silicosis. The best that can be done is to slow the progression of the disease, and to manage the symptoms by reducing inflammation and, thus, improving lung function.

Managing silicosis is similar to dealing with any other chronic lung disorder such as COPD (chronic obstructive pulmonary disease), emphysema or chronic bronchitis. First and foremost, if your father is a smoker, he should quit – and if any of your family and/or his friends smoke, they should not do so in his presence to avoid passive smoking. Make sure he steers clear of particularly smoky atmospheres.

Smoking weakens the natural antioxidant defence system of the lung, enabling free radicals to cause damage to tissues. Toxic substances in tobacco smoke prevent the tiny hairs (cilia) in the airways from doing their job – expelling foreign matter and mucus from the lung – thereby increasing the risk of bacterial infections such as pneumonia. More worrying, a recent study found a strong link between smoking and the development of lung cancer in workers who had silicosis (Ind Health, 2004; 42: 303-14).

An air purifier can help by removing other pollutants in the atmosphere (from, for example, aerosol sprays and car-exhaust fumes) which can irritate the lungs. Regular maintenance and cleaning of air-conditioning and heating-system ducts and filters can also help to reduce the volume of dust circulating in the air.

Good nutrition is crucial in managing chronic lung disorders. If possible, eliminate dairy and gluten (wheat) from your dad’s diet, as they stimulate mucus secretion. Increase his intake of unprocessed foods and antioxidants, in particular, vitamin A (suggested dose: 25,000-50,000 IU/day). Scientists in Brazil found that supplementing the diet of COPD patients with vitamin A improved lung function. They concluded that a low intake of the vitamin was linked to the severity of the disease (Am J Clin Nutr, 1996; 64: 928-34).

Other nutritional supplements that your dad may wish to include in his diet are:

* coenzyme Q10, an antioxidant which also contributes to efficient breathing. Take at least 90 mg/day

* alpha-lipoic acid, a free-radical scavenger that can boost other antioxidants and may help to restore energy production in damaged lung tissue. The recommended dosage for smoking-related disease is 100 mg/day

* taurine, a non-essential amino acid that improves circulation and, thus, may help breathlessness by bringing more oxygen to the lungs. The recommended dosage is 150 mg/day

* magnesium, important for nerve function, could benefit COPD patients by relaxing bronchial muscles. Taking 400 mg/day eased symptoms in adult asthmatics (Eur Respir J, 1997; 10: 2225-9).

To loosen catarrh in his chest, just inhaling steam has stood the test of time. You could try adding a few drops of essential oils such as cedarwood, eucalyptus and ginger. Drinking lots of water will help thin mucus, making it easier to shift from the lungs. Experts also recommend taking 600 mg of N-acetyl cysteine three times a day together with 2 g of vitamin C to help break up thick mucus.

Regular exercise builds up lung and heart capacity, thus, improving breathing. As your father isn’t up to walking, yoga may be a good place to start as it emphasises gentle breathing techniques that would be particularly beneficial.

Traditional Chinese medicine can also help in lung disorders. Researchers in Taiwan found that, when patients with chronic obstructive asthma added acupuncture to their standard care, their quality of life was markedly improved (J Altern Complement Med, 2003; 9: 659-70).

As for Chinese herbal preparations, one study found that the herbal compound Xifukang alleviated symptoms in silicosis patients. According to the researchers, the herbal remedy promotes blood circulation, thus enhancing the lung’s capacity to clear itself, and regulates immune function to prevent further progression of the condition (Zhong Xi Yi Jie He Za Zhi, 1990; 10: 420-1, 389).

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Written by What Doctors Don't Tell You

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