Spirometry results

[Whin1963]

Sorry I am very new to this not even sure if I should be on here not been told if i have asthma waiting test results. I'll give you a bit of a background after several chest infection and loads of antibiotics and inhalers. I had a chest xray which show atelectasis which i believe is pneumonia this is me guessing here i had to waiting 6 week before i could have spirometry test due to taking antibiotics. I finally had a spirometry test which showed restrictive patterns what does this mean. I was sent for another chest x-ray waiting to receive my results on Wednesday. Can anyone tell what restrictive patterns are please?

[Homely2 Administrator]

With lung conditions, they call some conditions like asthma, obstructive. They call a bunch of other conditions, restrictive.

So once they categorise you between obstructive and restrictive, they then will do the further tests necessary to narrow it down further.

As well as the asthma Forum under health unlocked, there is a good general lung forum, if they decide it is not asthma.

[Whin1963 in reply to Homely2]

Thank you for your reply maybe I need to hold tight and wait for my results.

[peege in reply to Homely2]

I thought it was the other way round 🤔 that asthma is restrictive and copd is obstructive as in Chronic Obstructive Pulmonary Disease/COPD ??

[Homely2 Administrator in reply to peege]

I think I am right, restrictive is stuff like pneumonia, things that restrict you expanding your lungs properly.

While asthma and copd are obstructive, where the lungs cannot exhale properly.

However I am sure lysistrata will put us right later.

[eleanordigby in reply to Homely2]

I think you’re right too 😊 COPD, asthma, CF & bronchiectasis are all restrictive ie something - inflammation or swelling - is blocking the airways, making it difficult to breathe out. Whereas pneumonia, sarcoidosis, pulmonary fibrosis are restrictive in that the lungs have less capacity so it’s harder to breathe in. I think so anyway!

[Lysistrata Administrator Community Ambassador in reply to Homely2]

Asthma and COPD are both considered obstructive yes - Troilus and eleanordigby have helpful explanations below!

[ForestFreda]

Sadly being very overweight can produce a restrictive spirometry as can issues with a curved spine and quite a few other conditions but not asthma/COPD. Atelectasis may be result of pneumonia ( collapsed alveoli or the little air sacs where oxygen/carbon dioxide is exchanged-but that should improve over time and that's why they are checking again with another chest Xray. Maybe you should be asking about chest physiotherapy and breathing exercises when you go back for you results...

[Lysistrata Administrator Community Ambassador in reply to ForestFreda]

You can get a 'pseudorestrictive' pattern in obstructive lung diseases like asthma though, and not *just* if you're very overweight/have spinal issues (I have neither and I get this pattern as an asthmatic, so I looked into it).

It's basically obstruction in disguise, but it looks like restriction on 'basic' spirometry or just looking at FVC and FEV1. With pseudorestriction FVC and FEV1 are both reduced, so the ratio is 'normal' and it looks like it's restrictive with no obstruction, but a full set of lung function values will show the difference - from memory I think the lung volumes are normal in pseudorestriction but not normal in real restriction, and there are almost certainly other changes that someone in the know can spot.

I've not found even my specialist doctors very helpful on this though as they tend to just look at two numbers and ignore the rest. Eg I get air trapping, I know enough to know it's there but it gets no attention as they just look at the two 'main' numbers and compare with average values (problematic in itself if they don't acknowledge that people's actual best can vary from the population average).

[Troilus]

Hi. Just to clarify. Asthma and copd are obstructive. In a nutshell, obstructive lung diseases are conditions that hinder a persons ability to exhale all the air from their lungs. On the other hand, individuals with restrictive lung diseases have a difficult time fully expanding their lungs fully.

[Whin1963 in reply to Troilus]

Thank you everyone it sounds like maybe I do not have asthma or copd. I do not want to google anything. I have never smoked I am very active but over the last few months getting out of breathe more easily but just thought it was another chest infection, not overweight. Hopefully all will become clear on Wednesday. If it is lung disease is there another forum I could join please.

[Troilus in reply to Whin1963]

Hi Whin, There is another forum - I think it is called Lung conditions community forum - used to be British Lung Foundation. There are people on there with all kinds of conditions including asthma.

[Patk1]

I think its best to wait for dr to diagnose any problem.u can go on forever looking at what if... all the best

[Whin1963]

It is the waiting game that makes it more scary. I have been ok till now but the more closer it gets the scary it gets I keep telling myself it will be nothing. Then I saw the restrictive patterns on the report and thought oh what can this be.

[Lysistrata Administrator Community Ambassador]

I did another reply on this but not sure how much you already know so will break it down.

Simply put, restrictive patterns on spirometry are when the forced vital capacity (FVC, the most you can exhale in one go after a deep breath) and the forced expiratory volume in one second (FEV1, the largest amount you can breathe out in one second) are both reduced. Obstructive is when the FVC is higher than the FEV1 by a certain amount or more, shown as a percentage so for example if your FVC is 4 and your FEV1 is 2.5 then the ratio would be 63%.

They're supposed to calculate a cutoff for how much higher the FVC should be than the FEV1 before it counts as obstruction. based on your age, sex, and height. However, they don't always and will often just use 70% ie any time the FEV1 number is less than 70% of the FVC number. Even though say a tall young man would be obstructed when the values are closer together so eg when the FEV1 number is perhaps 87% of the FVC number, whereas his short granny wouldn't actually be obstructed until her FEV1 is say 65% of her FVC.

BUT as I said in my other reply, it can often be more complex than that, because if they just look at those two numbers and you haven't had a full set of tests, or they didn't look at everything, then it might be that you have an obstructive disease like asthma, pretending at first look to be a restrictive disease - they really need to look at everything in context. If you haven't had the full set of lung function tests at the hospital where they measure a lot of things, that may be worth asking for when you get your results.

Atelectasis as someone else has said could be from pneumonia but can also happen sometimes with asthma, especially in certain parts of the lungs - and it definitely can get better.

You might find it helpful to talk to the nurses: 0300 2225800 or WhatsApp [phone] Monday-Friday 0915-5pm

[Birthday60]

probably best to ask your GP for a full explanation

[Whin1963]

Thank you I think I will wait and see what GP has to say.