Treatments to Manage Symptoms of IPF: Breathing Difficulty, Cough, and More

About 80 percent of people with IPF develop a chronic cough at some point. Coughing can affect your life in many ways. You may avoid social events or errands because talking or walking can trigger the cough and make you breathless. It may also be painful.

There may be an underlying condition prompting the cough, such as:

• obstructive sleep apnea
• gastroesophageal reflux disease (GERD)
• allergies
• postnasal drip

You may also take medications for IPF that make the cough worse.

Chronic coughing from IPF is unlikely to respond to typical over-the-counter (OTC) medications for relieving cough. But there are other ways you can ease coughing:

• Drink water or hot tea.
• Take medications for conditions that may trigger the cough, such as GERD, allergies, or postnasal drip.
• Speak with your doctor about using medications like steroids, opioids, thalidomide, or sodium cromoglicate. The side effects can be severe.

GERD is a common complication of IPF. It occurs when the acid in your stomach comes back up your esophagus.

GERD can cause symptoms like cough and gastrointestinal problems. You may also have chest pain, a burning sensation in your throat and chest, and difficulty swallowing.

Your doctor can prescribe medications or recommend OTC treatments to help manage GERD.

You may also want to avoid foods that trigger your symptoms, such as highly acidic foods. This includes:

• tomatoes
• fried foods
• chocolate
• onions

Beverages that contain alcohol or caffeine may also exacerbate your GERD symptoms.

Over time, it may become more difficult to breathe with IPF. This can be due to shortness of breath, a lack of oxygen in your blood, or both.

Breathlessness can be both physically and emotionally demanding. You may experience limited mobility and find it harder to exercise or complete everyday activities.

You may also feel vulnerable and choose to limit physical activities altogether, which can lead to anxiety and depression.

Talk to your doctor if you’re finding it increasingly difficult to breathe. Your doctor will examine you and rule out any other conditions that could also cause this symptom.

IPF can occur with other health conditions, including pulmonary hypertension, heart diseases, and sleep disorders.

Your doctor can advise you on several options for managing your shortness of breath. These include:

• taking medications like inhalers, steroids, or opioids
• using oxygen therapy
• practicing breathing techniques
• going to pulmonary rehabilitation
• using a handheld fan
• measuring your oxygen level with a pulse oximeter

You may feel more tired as your condition progresses. Fatigue can occur for many reasons, including shortness of breath, a cough, or weakness.

This symptom can be difficult to overcome. The factors that contribute to fatigue are also difficult to counteract when you’re exhausted.

Other conditions that you may have along with IPF can contribute to fatigue. Examples include depression, a heart condition, or obstructive sleep apnea. Your doctor may test you for one or more of these conditions to help treat your fatigue.

To improve your energy levels and combat fatigue, you can:

• Use oxygen therapy.
• Remain active. Talk to your doctor about what exercises are best for you.
• Participate in a pulmonary rehabilitation program.
• Rest when you need it.
• Eat healthy foods like whole grains, fruits and vegetables, and lean proteins.
• Seek help for tasks inside and outside your home.

You may experience gastrointestinal (GI) problems from medications you take to manage your IPF. Common GI symptoms include nausea, a lack of appetite, and diarrhea.

You can calm your digestive system in various ways to ease these symptoms:

• Ask your doctor when you should take your medications to avoid GI distress.
• Try eating small meals throughout the day. If you’re not often hungry, bulk up the calories in your food when you do eat.
• Go for a walk before you eat to stimulate your appetite.
• Keep your diet bland. Avoid fibrous foods if you have nausea or diarrhea.

Your doctor may recommend a new medication or lowering your dosage to help your digestive system function normally.

A diagnosis of IPF can have an immediate or delayed effect on your mental health. Because the condition doesn’t have a current cure and symptoms get worse over time, it can be emotionally challenging.

Two mental health conditions that commonly occur in people with IPF include depression and anxiety. Depression and anxiety can also worsen symptoms like shortness of breath and coughing.

Your doctor should screen you for depression and anxiety soon after your IPF diagnosis. If you begin to feel anxious or depressed, get help as soon as possible. Your doctor can refer you to a mental health professional who can diagnose and treat these conditions.

Here are some ways you can relieve stress and reduce depression or anxiety in IPF:

• Talk to your healthcare team about medications that can treat depression or anxiety.
• See specialists at a pulmonary rehabilitation clinic.
• Make regular appointments with a mental health professional for cognitive behavioral therapy.
• Attend support groups for people with IPF.
• Discuss your condition and feelings with family and friends.
• Practice relaxation methods, such as meditation and mindfulness.

IPF can lead to several symptoms that don’t just affect your lungs. Always talk to your doctor about any new or worsening symptoms you experience.

They can help you find medications or lifestyle modifications that can ease coughing and breathing difficulties, and help you better manage your IPF.