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Before making a diagnosis of lung fibrosis, your medical team will ask you questions about your breathing problems, examine you and order some tests. The tests and other information taken together will help them narrow down your diagnosis and recommend the most appropriate treatment.

Questions about your breathing

  • Your symptoms, including coughing and breathlessness
  • Jobs you have had, particularly where you may have been exposed to asbestos, dust from wood or stone, metals, birds or animals
  • Your hobbies and pets
  • Smoking
  • Family history of lung disease
  • Your general health

Tests to diagnose pulmonary fibrosis

Pulmonary fibrosis diagnosis involves a number of tests, including lung function tests, blood tests, scans and X-ray, and sometimes a biopsy.

Lung function tests

You will breathe into a tube so that your medical team can see how well your lungs work. The tests will identify your lung capacity and how well your lungs transfer oxygen to and from your blood. This will help the inform your treatment plan.

Scans and x-rays

  • A chest x-ray can indicate whether you have scarring in your lungs and where. Pulmonary fibrosis often starts in the lower part of your lungs.
  • A high-resolution CT scan will give a more detailed picture of the inside of your lungs. Typical features of pulmonary fibrosis include fine lines, ‘ground glass’ opacities and honeycombing patterns.
  • An echocardiogram looks at how well your heart is working. Increased pressure on the right side of the heart is a sign of pulmonary hypertension – which is a complication of pulmonary fibrosis.

Looking inside your lungs

Your medical team may have to look inside your lungs to be clear whether you have PF.

  • A bronchoscopy involves a small camera that looks at the cells inside your upper lungs and takes samples. The camera is passed either through the nose or mouth into your lungs. You will have a local anaesthetic and will not usually have to spend the night at hospital.
  • You may also have a bronchial lavage as part of the bronchoscopy, in which small amounts of salty water are passed into the lungs and sucked back out, sampling cells from the lungs that can be analysed to inform your diagnosis.
  • A surgical lung biopsy is sometimes necessary when other tests haven’t provided enough information for a certain diagnosis. You will have a general anaesthetic and have to spend a few days in hospital.
I always ask for a copy of my results from tests so I know what is going on and I can take the information to other appointments. I have my appointment folder and it has been useful as communication can sometimes be disjointed!

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