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Acid Reflux causes and Treatment

Respiratory disorders research in Thames Valley

Respiratory disorders research in Thames Valley

We cover everything that runs
from the mouth out to the edge of the lung and then the encasement of the lung
as well. So that includes problems with the upper airway, things like sleep apnea,
problems inside the lung that can include famous diseases like emphysema
or COPD, asthma, problems in the lung itself, infections, cancer and then
problems in the lining of the lung like pleural disease. So it’s a very broad
speciality. So respiratory is famously associated with smoking and of course
that’s very true many respiratory diseases are caused by smoking, but
actually, unfortunately as time goes on we’re seeing an increasing number of
cancer patients for example who have never smoked. Around 20% of patients who
get lung cancer have never touched a cigarette.
So it’s pleasing to see nationally that people are smoking less and less, but
respiratory disease still continues to increase, so smoking is a definite risk
factor for some but not all respiratory diseases. In my own area,
exposure to inhaled chemicals and inhaled fibers is a big problem and
asbestos exposure is the most famous. Sadly the exposures occurred 30 – 40 years
ago and we see the disease is occurring now so people who’ve worked with
asbestos in the 1960s, 1970s often get very serious respiratory diseases in the
2010s and 2020s. So there’s lots of areas of research that are becoming very
interesting in respiratory if I take COPD as an example, in the past we
treated this with a certain set of inhaled medication to try to open up the
lungs and help people breathe. We’re now understanding that the problem is to do
with the inflammation that occurs within the lining of the inside of the lung or
the trachea, the main airways and there are lots of exciting research
areas now looking at specific medications that can calm down that
inflammation rather than just operating on the mechanical properties of the lung.
So it’s a very interesting area in both asthma and COPD. In my own area, which is
research into pleural disease, we’re looking at specific treatments for how
to drain fluid from the lining of the lung much more effectively and also to
start giving treatments back inside into the chest cavity, including some exciting
areas of mesothelioma which is a cancer based in
the lining of the lung, some areas of research there. I think in respiratory
the advances have been very significant. We’ve probably lagged behind some of the
other larger areas like oncology and cardiovascular, but respiratory disease
is one of the commonest causes of a chronic problem in this country. It’s one
of the few disease areas that’s increasing unlike other areas that are
decreasing and the research that’s been done in the last twenty years especially
has transformed some areas of respiratory medicine.
I think our understanding of the commonest respiratory diseases like
asthma and COPD is completely different to what it was 20 years ago and I
imagine in the next five or ten years there’ll be a revolution in how we treat
people with these very common wheezing illnesses. So rather than treating
everybody with the same set of inhalers as if they’re the same, we will be able
to do much better assessments to tell us which medication works for which person
and aim at preventing the disease manifesting at all, rather than treating
the patient who’s got very damaged lungs later down the line. In terms of other
areas such as cancer or infection again our understanding of how those develop
how best to treat them early is becoming revolutionary and again in 15 years or
so I imagine our approach to these diseases will be completely different.
Life expectancy in respiratory diseases improving all the time. The obvious
example is something like cystic fibrosis where, in the past – this is a
genetic disease causing recurrent infections in the lungs – in the past 30 –
40 years ago the life expectancy was very short and I’m afraid many of these
children didn’t get to adulthood. Now with good research, good quality care,
good quality nutrition, good infection control, the average life expectancy is
into the 40s and 50s now. So there’s been a transformation in life expectancy. In
terms of quality of life there’s no doubt that respiratory disease has an
enormous impact on people’s quality of life.
You can imagine that having breathing difficulty is a daily problem it affects
every part of your life and therefore the interventions that we have there
improve people’s breathing is again transformational for quality of life.
I would always promote research but not just because I’m an academic. As a
clinician, which is the other part of my job, we only know how to treat people
properly when we do good quality research that
tells us what the best way of engaging with their diagnosis and engaging with
their treatment is. So it’s to benefit both the way that you’re treated
currently but also future generations will be treated. It enables us as physicians
to understand the diseases better and how to treat them and enables us as
scientists to understand what’s underlying the diseases. In terms of the
patient experience of being part of research, in research patients get looked
after extremely well, so your clinical care is very well looked after, you have
access to potentially new exciting drugs or medications or treatment options that
you may not have if you don’t take part in research and I’m hopeful that our
research teams are very engaging, very understanding and very accessible.

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