The airways are the tubes that take air from the atmosphere into our lungs. The upper airways include the nose and throat. The lower airways are airways in the chest. They consist of the large airways such as the trachea (also known as the windpipe) and bronchi, as well as smaller airways like the bronchioles and alveolar ducts.
Tracheobronchomalacia is a condition where the walls of the windpipe (trachea) or airways (bronchi) become weak and collapse during breathing. This can restrict airflow and cause symptoms such as noisy breathing (stridor), wheeze, persistent cough, and recurrent chest infections.
Some people are born with this condition, while others develop it due to infections, airway inflammation, irritant exposure (such as smoking), acid reflux, or conditions like relapsing polychondritis.
Treatment focuses on managing the underlying cause and improving airway stability. This may include treating infection or inflammation, using CPAP (continuous positive airway pressure) to keep the airways open, and in more severe cases, airway stenting or surgery.
Tracheitis is inflammation of the trachea. It is more often seen in children but can occur in adults.
The cause is usually a bacterial infection (e.g. Staphylococcus aureus, Mycoplasma pneumoniae, Chlamydia pneumoniae) but fungal infections (e.g. Aspergillus fumigatus) are also a known cause that is often overlooked, particularly if there is a history of potential exposure to mould spores or a lack of improvement to antibiotics.
Acute bronchitis is caused by infection of the lower respiratory tract without evidence of pneumonia. Viral bronchitis is more common and doesn’t require specific treatment as it resolves on its own over time. The cough can be protracted and home remedies may help. Bacterial bronchitis can be caused by bacteria such as Bordetella pertussis with the condition known as Whooping cough. Bacterial bronchitis may also occur following viral bronchitis where retained mucus gets infected with bacteria. This can also lead to bronchopneumonia. In acute bronchitis there may be airway hyper-responsiveness which is transient and inhaler therapy may help releif symptoms but this should not be confused with asthma.
Chronic bronchitis is a type of irritative bronchitis, where the airways have been irritated by noxious environmental stimuli. Most commonly this is due to the longterm exposure to tobacco smoke. The airways become inflammed and secrete mucus. This results in COPD, lung function decline and shortness of breath.
Bronchiectasis is a heterogenous condition of the airways caused by several other diseases. Most often it is due to previous infections and in some cases a cause is never identified. The airways are dilated and don’t taper normally in the lung. This results in reduced mucus clearance, inflammation, infections and the production of excess mucus. If you have symptoms such as a chronic cough that is productive of phlegm or frequent chest infections that require courses of antibiotics to get better it is important that you see a specialist with expertise in bronchiectasis so that you receive the correct diagnosis and best treatment. Although there is no cure for bronchiectasis, specialist management reduces the symptom burden, frequency of chest infections and improves quality of life. For more information on bronchiectasis click here
Chronic obstructive pulmonary disease results in obstructive airway disease that is irreversible and causes lung function to decline over time. The inflammation of the airways causes narrowing of the airways and obstruction with mucus.
Frequently people with COPD may have exacerbations of the airway disease that in some cases is triggered by viral or bacterial infections.
The cause in most cases is due to smoking but in some it is due to the inhalation of fumes form biomass fuel.
A similar condition is seen in people that were born premature and have bronchopulmonary dysplasia.
It is important to see a specialist for the correct diagnosis and treatment. Smoking cessation is highly encouraged and is the best intervention to impact on survival. Treatment includes the use of inhalers, pulmonary rehabilitation, keeping up to date with vaccinations, oxygen therapy, non-invasive ventilation and lung volume reduction.
Asthma is a common condition affecting the chest of children and adults.
The airways of people with asthma are inflammed, narrow and blocked with mucus.
Common symptoms are shortness of breath, wheeze and cough. The symptoms may be more pronounced during exercise or at night.
As many chest conditions may appear to be asthma it is important to get an evaluation and diagnosis by a specialist so that correct treatment can be prescribed.
Dr Ricardo José uses a structured, patient-centred approach to diagnose airway disease. He combines a detailed clinical assessment with targeted investigations to identify the cause, assess severity, and guide treatment.
Dr José begins with a thorough medical history and examination. He asks about key symptoms such as cough, wheeze, breathlessness, and mucus production, as well as triggers, duration, and impact on daily life. He also reviews smoking history, environmental exposures, infections, and co-existing conditions.
During the examination, he assesses breathing patterns, listens to the chest for wheeze or abnormal sounds, and looks for signs of underlying lung or systemic disease.
Blood tests assess markers of inflammation and help identify underlying causes or contributing conditions.
Dr José requests further tests when needed to evaluate co-existing conditions that may contribute to airway disease.
