Respiratory medicine

Many respiratory problems can be quite frightening to experience. Whether you are struggling with frequent bouts of breathlessness or a long-term cough, you will appreciate rapid access to comprehensive assessment and treatment from an expert in respiratory health.

Respiratory medicine is involved with the diagnosis and management of diseases in the lower respiratory tract (trachea, bronchi and lungs). This includes the airways (bronchi), the substance of the lung (known as lung parenchyma which include air sacs (alveoli), and the blood vessels.

A Consultant in Respiratory Medicine also manages diseases of the lining (pleura) of the lung and chest wall, and those affecting some structures in the centre of the chest (known as mediastinal structures), such as lymph glands.

Whether your symptoms are completely new or caused by a flare-up of an existing respiratory condition, when you visit Bath Clinic you will receive consultant-delivered care, tailored to your particular requirements and condition, so that you can return to better respiratory health without delay.

Your respiratory system plays a crucial role in your health. Every time you breathe in and out, oxygen is moved into your body and dispersed through it, while waste gases such as carbon dioxide are removed.

A problem in any part of the respiratory system has the potential to have a significant, potentially life-threatening, impact on your health.

Respiratory conditions tend to cause certain symptoms. Some of the common reasons people come to see us for help include:

• Breathlessness
• Persistent coughing
• Coughing up blood or sputum
• Shallow or rapid breathing
• Chest pain
• Wheezing

The global pandemic caused by COVID-19 raised awareness of the danger of having a severe, untreated respiratory condition. While many people with this illness experienced relatively mild flu-like symptoms, a great many others became very seriously ill, requiring hospitalisation to receive critical care including artificial ventilation.

COVID-19 and long COVID (a term used to describe a wide range of symptoms believed to be caused by COVID-19) has made many people much more aware of the importance of a healthy respiratory system. However please note, patients with symptoms or diagnosis of long COVID are best treated by specialist clinics established in Primary Care, and not a Respiratory Consultant.

Bath Clinic is based a couple of miles outside the historic city of Bath in the South West of England. Our Consultant in Respiratory Medicine provides private respiratory care for people in Bath and the surrounding areas with a wide range of symptoms and conditions.

If you are experiencing any of the symptoms listed above, it can be a sensible course of action to seek expert help. Why not book an appointment with our consultant to access the support you need sooner?

Diseases and conditions that affect the respiratory system can be categorised as:

• Allergic
• Vascular
• Autoimmune
• Inflammatory
• Infective
• Cancer
• Idiopathic (unknown cause)

Within these six categories, more common respiratory conditions include:

• Asthma – a common condition, causing wheezing and shortness of breath. These symptoms may be mild or more severe
• Pneumonia – inflammation of the lungs
• Chronic Obstructive Pulmonary Disease (COPD)
• Interstitial lung diseases - such as Pulmonary Fibrosis (scar tissue in the lungs)
• Lung cancer – one of the most common types of cancer, around 47,000 people in the UK alone are diagnosed with it every year.
• Bronchitis - inflammation of the airways - bronchi - in the lungs
• Bronchiectasis – the airways of the lungs become abnormally enlarged, leading to a build-up of mucus. This can increase the risk of developing an infection
• Sarcoidosis - an inflammatory condition that may cause shortness of breath and/or a persistent cough

Although many respiratory conditions cannot be cured, symptoms can often be very well managed and controlled with the right treatment.

There are a wide range of treatments available, including inhalers, antibiotics, steroids, or immune modulators.

There is no ‘one size fits all’ treatment for respiratory conditions and treatment is always tailored to the individual.

For various respiratory symptoms or conditions, your consultant may work closely with consultants in another speciality to ensure you receive the best possible treatment. For example, if you are experiencing pains in your chest and a respiratory cause has been ruled out, you may well be referred to Cardiology (Heart specialists) to investigate other causes.

Radiologists (X-ray specialists) will report all imaging carried out at Bath Clinic.

Correct treatment for any respiratory condition depends on an accurate diagnosis. With so many problems causing similar symptoms, your first consultation at Bath Clinic will be focussed on getting clarity about the cause of your symptoms.

Most people are referred to us by their GP or another healthcare professional. A medical referral is helpful, as it means your consultant has access to your previous medical history and any recent or relevant test results, such as blood tests or a chest X-ray.

When you meet with your consultant, they will take a medical history and talk with you in detail about the symptoms you have been experiencing. They will also carry out a physical examination of your chest and any other relevant systems, using a stethoscope to listen to your lungs as you breathe in and out.

There are a number of tests which can be helpful in coming to a diagnosis, including:

• Chest X-ray – many people who visit us have had a recent X-ray arranged by their GP. If not, this will be done at Bath Clinic on the same day as your consultation.
• Lung Function Tests – measurements of airway and lung function
• Blood tests
• Analysis of available tests which may have been done previously

Depending on what these tests show, you may need additional investigations such as:

• Computed Tomography (CT) of the chest to give detailed cross-sectional images through the chest
• Bronchoscopy - a telescopic view of the airways under sedation, allowing capture of samples for analysis
• Ultrasound (U/S) of the chest +/- guided drainage of fluid between the lung and chest wall

Some of these tests and investigations can be done at Bath Clinic while others will be arranged for you off-site (at the RUH) if required. Where appropriate, Positron Emission Tomography (PET) scans and other advanced investigations can also be requested outside the hospital.

Once any results are back and a diagnosis has been made, your consultant will meet with you again to talk about treatment options to best manage your condition. If you have any questions or concerns, they will of course be very happy to discuss these with you.

Treatment for respiratory conditions is very much a collaboration between you and your consultant. They will monitor the effects of any treatment, and if adjustments are needed at any time (for example, changing the dose of medication) this is easily arranged.

If you live in or around Bath, South West England, and are experiencing respiratory symptoms, we believe you will not find a better place to come for comprehensive investigation, diagnosis, treatment and ongoing support than Bath Clinic. Here is why:

• Assessments ASAP – Certain chest and lung conditions respond best when diagnosed at an early stage. We can usually arrange a Respiratory appointment for you within a week. Earlier assessment and diagnosis means you will be able to benefit from starting any treatment needed sooner.
• Consultant-led care, always – You will see the same consultant for each visit, so you will never have to worry about seeing a more junior doctor. Your consultant will oversee every aspect of your care, from initial consultation and diagnosis through to treatment planning, treatment and ongoing monitoring. If you have any questions or concerns at any time (for example, if your symptoms flare up without warning) it is very easy to arrange another appointment with your consultant.
• Experience - Respiratory Physicians have accredited training and experience in Respiratory and General Medicine and are able to manage many other medical problems. They can also recognise and direct your care to another specialist where appropriate.
• Personalised care – For respiratory health, there is no ‘one size fits all’ treatment. The best treatment for your condition will be one that is tailored to your specific requirements in order to successfully manage and treat your condition.
• Face to Face consultations – Although we can offer remote consultations by telephone if required, the vast majority of our consultations are carried out in person in the hospital. While technology can be very helpful, it is not a substitute for meeting in person with your consultant, where they can carry out a physical examination if needed.
• Safety – All consultations and activity within the Bath Clinic adhere to the latest guidance aiming to reduce risks associated with COVID infection.
• Recommended by patients – In an independent survey, 97.9% of the people we treated said they were likely or extremely likely to recommend Bath Clinic to their family and friends. We do not take this for granted and continue to work hard to deliver the highest level of care for everyone who visits us for help with any respiratory concern.
• A multidisciplinary team – Your consultant is supported in their role by a wide variety of other healthcare professionals including radiologists, physiotherapists, nurses and oncologists who work on-site at Bath Clinic. Fast, easy access to any member of this multidisciplinary team means you will always see the most appropriate person for your specific needs. Particularly complex respiratory cases can be discussed with other specialists within a multidisciplinary team meeting in order to formulate the very best treatment plan for you.
• Location – Bath Clinic is based around two miles from the centre of historic Bath and very easy to travel to by private or public transport. Our 100-space private car park is free for patients and visitors.
• Facilities - Formerly a private home, the hospital is situated within a beautifully landscaped setting right next to a National Trust property. While many modern hospital buildings can often come across as quite industrial, cold and impersonal, the historic exterior of Bath Clinic offers a refreshingly personal welcome. Step through the door and you will find yourself in a modern hospital with state-of-the-art equipment and facilities.

If you would appreciate expert guidance and support for a respiratory condition, whether new or pre-existing, why not book your respiratory appointment now? We look forward to welcoming you to Bath Clinic and helping to improve your respiratory health sooner.