Pleural effusion is often referred to as "water on the lungs." Not in the lungs, but on the lungs. This medical condition is where excess fluid builds up in the space between the layers of the pleura surrounding the lungs. The pleura is a thin membrane that lines the surface of your lungs and the inside of your chest cavity. Normally, there is a small amount of fluid in this space to help your lungs move smoothly as you breathe. However, pleural effusion occurs when there's too much fluid. This in turn makes it hard for your lungs to expand properly.
There are two types of pleural effusion:
- Exudative pleural effusion
- Transudative pleural effusion
An exudative effusion is caused by inflammatory conditions like lung infections or cancerous tumors. A transudative effusion is when fluid leaks into the pleural space, usually because of a condition like heart failure or liver cirrhosis. An exudative effusion is harder to treat and more serious. Here, PatientsLikeMe will explore common symptoms and management strategies for both types.
Symptoms
Pleural effusion can cause a variety of symptoms.
- Shortness of breath
- Chest pain
- Cough
- Fever
- Anxiety
- Malaise
Sometimes, people with pleural effusion have no symptoms and discover the condition during a chest X-ray for another issue. Issues with shortness of breath can get worse when lying down. This makes sleep a challenge.
Causes
Pleural effusion can come about as a result of a few different factors. There are two buckets we are going to explore here. The first is a group of diseases or medical conditions that can cause fluid to build up. They include:
- Heart failure
- A blood clot in the lung (called a pulmonary embolism)
- Liver disease
- A lung infection (pneumonia)
- Kidney disease
You can also have a malignant pleural effusion. This is caused by cancer cells, which can spread to the space between pleural layers. These cells then cause the body to make excess pleural fluid and stop the cavity from draining properly. The potential causes include:
- Lung cancer
- Breast cancer
- Mesothelioma
- Non-Hodgkin lymphoma
- Stomach cancer
- Kidney cancer
- Ovarian cancer
- Colon cancer
Treating an Effusion
How will your care team approach treating pleural effusion? There are a few standard steps. The goal of treatment is to drain the extra fluid from the pleural space and prevent it from building up again. This will help relieve symptoms. One further step is to treat any underlying conditions that caused the effusion.
Draining Fluid
A thoracentesis is a procedure done to remove fluid. Doctors will use an ultrasound to find the location of fluid, and then insert a hollow needle to drain it from the pleural space. This can help with breathing, reduce coughing, and improve oxygen levels. This measure can reduce fluid levels, but does not stop if from building up again.
Medication
Depending on the reason behind the effusion, doctors may prescribe certain medications.
- Antibiotics if there is an infection
- Steroids and nonsteroidal anti-inflammatory drugs to relieve pain and reduce inflammation or swelling
- Diuretics to help the body get rid of extra fluid by increasing the amount of urine it makes
- Bronchodilators to widen the airways in the lungs and allow for more air flow
Surgery
A pleurodesis helps with future build up. In a pleural effusion, doctors remove the space between your lungs and your chest wall. This prevents it from filling with fluid or air in the future. A narrow tube is then inserted for 3-5 days to help it drain. A pleurectomy is when the inner or outer pleura are removed completely.
Preventing Pleural Effusion
A healthy lifestyle is key to preventing your first pleural effusion, or to reduce the risk of it happening again. Healthy foods like fruit, vegetables, beans, lean meat and fish keep your body functioning properly without overdoing it on potentially harmful substances like sugar, alcohol and fat. While smoking does not directly cause pleural effusion, it should be avoided. Nicotine and other chemicals increases your risk for heart, lung and liver disease. They also increase your risk or cancer. These conditions can lead to pleural effusion. Staying hydrated will help keep your air passages moist. This can help your body get rid of germs and irritants. Exercising reduces blood pressure and stress! Be sure to talk to your doctor before starting any exercise routine.
If you have pleural effusion, it's important to stay on top of your care! Be sure to go to any follow-up appointments and monitor your health closely. If your doctor has given you instructions for care, stick to your treatment plan closely. If you experience any breathing difficulties or symptoms, get medical attention immediately.
While pleural effusion can be a recurring issue, especially in cases related to cancer, effective treatment and ongoing care can help improve your quality of life and manage symptoms. Be sure to work closely with your doctor! They can help with this condition and get you back to health.