Table of ContentsView AllTable of ContentsObstructiveRestrictiveSymptomsDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Obstructive
Restrictive
Symptoms
Diagnosis
Treatment
There are two types oflung diseases: obstructive lung disease and restrictive lung disease. Both types can cause symptoms like shortness of breath, but a key difference is when you feel like you’re having trouble breathing.Obstructive lung diseases like asthma and chronic obstructive pulmonary disorder (COPD) cause more trouble when you’reexhalingair. Restrictive lung diseases such as pulmonary fibrosis make it harder toinhaleair.
The diagnosis and treatment for obstructive vs. restrictive lung diseases depend on the cause but can include chest imaging and medications that help open up or clear the airways.
This article will go over obstructive and restrictive lung disease causes and symptoms, how each condition is diagnosed, and the treatments for obstructive and restrictive lung disease.
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2:00Click Play to Learn the Difference Between Obstructive vs. Restrictive Lung Disease
2:00
Click Play to Learn the Difference Between Obstructive vs. Restrictive Lung Disease
Obstructive Lung Disease
Obstructive lung diseases happen when there is an obstruction in the air passages that causes slow and shallow exhalation. Obstruction can occur when inflammation and swelling cause the airways to become narrowed or blocked, making it harder to expel air from the lungs.
The block means that there’s an abnormally high volume of air being left in the lungs (i.e., increased residual volume). The trapped air and lung hyperinflation are changes that contribute to worsening respiratory symptoms.
The following lung diseases are categorized as obstructive:
Restrictive Lung Disease
Restrictive conditions cause difficulty in filling the lungs with air during inhalation. Restrictive lung diseases cause a reduced total lung capacity.
Intrinsic Restrictive Lung Diseases
Intrinsic restrictive disorders occur due to restriction in the lungs (often a “stiffening”) and include:
Extrinsic Restrictive Lung Diseases
Neurological Restrictive Lung Diseases
Common causes of neurological restrictive lung diseases include:
A person can have symptoms and tests that suggest a combination of obstructive and restrictive disease—for example, when a person has both COPD and pneumonia. Some diseases, such as silicosis, cause an obstructive pattern in the early stages of the disease and a restrictive pattern later on when the condition is more advanced.
There can be a significant overlap in symptoms between obstructive and restrictive lung diseases, which is why pulmonary function tests are often needed to make a diagnosis.
Obstructive Symptoms
With obstructive lung disease, a person may have difficulty expelling all of the air from the lungs. This often worsens with activity. When theirrespiratory rateincreases, it gets harder to blow out all of the air in the lungs before taking the next breath. Narrowing of the airways can causewheezing, as well as increased mucus (sputum) production.
Restrictive Symptoms
With restrictive lung disease, a person may feel like it is hard to take a full breath. The feeling can even cause anxiety at times. With extrinsic lung disease, a person may change positions trying to find one that makes it easier to breathe.
Obstructive Disease SymptomsLungs may feel chronically full or part fullWheezingMucus productionRestrictive Disease SymptomsFeels hard to breathe enough airBreathing difficulties may cause panicMay change positions to attempt to make it easier to breathe (extrinsic cases)
Obstructive Disease SymptomsLungs may feel chronically full or part fullWheezingMucus production
Lungs may feel chronically full or part full
Wheezing
Mucus production
Restrictive Disease SymptomsFeels hard to breathe enough airBreathing difficulties may cause panicMay change positions to attempt to make it easier to breathe (extrinsic cases)
Feels hard to breathe enough air
Breathing difficulties may cause panic
May change positions to attempt to make it easier to breathe (extrinsic cases)
A provider can talk to you about your medical history and do an exam (like listening to your breathing) to try to diagnose the cause of obstructive or restrictive lung disease. Pulmonary function tests and imaging tests are also useful because they can help your provider figure out what condition (or conditions) you may have.
Pulmonary Function Tests
Spirometryis a common test used to see how well your lungs are functioning. It measures how much air you inhale and how much and how quickly you exhale. The test can be helpful in telling the difference between obstructive and restrictive lung diseases, as well as seeing how severe the disease is.
Here’s what pulmonary function tests look at:
There are other types ofpulmonary function teststhat providers can use:
Obstructive and Restrictive Lung Patterns
MeasurementObstructive PatternRestrictive PatternForced vital capacity (FVC)Decreased or normalDecreasedForced expiratory volumein one second (FEV1)DecreasedDecreased or normalFEV1/FVC ratioDecreasedNormal or increasedTotal lung capacity (TLC)Normal or increasedDecreasedLaboratory TestsLab tests can help your provider gauge how severe lung disease is but they are not helpful at showing whether it’s obstructive or restrictive.Here are a few examples of what tests might show:A measure of the oxygen content in the blood (oximetry) is often low in both restrictive and obstructive lung disease.Arterial blood gases may show a low oxygen level and, sometimes a high carbon dioxide level (hypercapnia). With chronic lung disease, hemoglobin levels are often high in an attempt to carry more oxygen to the cells of the body.Imaging StudiesIf the underlying condition is something like pneumonia or a rib fracture, imaging tests like achest X-rayor chestcomputed tomography (CT) scanmay help a provider see if the lung disease is obstructive or restrictive.ProceduresBronchoscopyis a test where a provider uses a lighted tube with a camera on it to look in your mouth and down into the large airways. Like imaging studies, it can sometimes help diagnose the underlying condition that’s causing obstructive or restrictive lung disease.Lung Disease TreatmentThe treatment options are different for obstructive and restrictive lung diseases and depend on what the underlying cause is.Obstructive Lung DiseaseObstructive lung diseases such as COPD and asthma are often treated with medications that dilate the airways (bronchodilators) and help with symptoms. Inhaled or oral steroids are also frequently used to reduce inflammation.Here are some specific obstructive lung disease treatments based on the underlying condition:Chronic obstructive pulmonary disease (COPD)usually needs to be treated with medications and lifestyle changes.Chronic bronchitisis treated with medications to relax the airways, lifestyle changes, and pulmonary rehab.Asthma can be treated with medications like inhaled steroids.Bronchiectasisusually needs to be treated with lifestyle approaches, medications, and preventing infections.Bronchiolitiscan’t be cured but the symptoms can be managed with therapy and medication. Sometimes, a lung transplant is considered.Cystic fibrosiscan’t be cured but there are treatments that can help manage symptoms and prevent complications.Restrictive Lung DiseaseTreatment options forrestrictive lung diseasesare more limited.Depending on the type and cause, restrictive lung disease may need to be treated with antibiotics, inhalers, chemotherapy,expectorants(type of cough medicine), lung transplantation, andoxygen therapy.Here are some specific restrictive lung disease treatments based on the underlying condition:Pneumoniacan be treated with medications like antibiotics or antifungals depending on the cause.Pneumoconiosis usually needs to be treated with lifestyle changes, especially avoiding substances that harm the lungs (like smoke).Acute respiratory distress syndrome is life-threatening and needs medical treatment like oxygen therapy, usually in the hospital.Eosinophilic pneumoniaoften requires steroids as part of treatment. If an underlying trigger is known, that cause must be addressed.Tuberculosisneeds to be treated with medication, including antibiotics.Sarcoidosisneeds to be treated with medications like steroids, immunosuppressants, and anti-inflammatories.Pulmonary fibrosisusually needs to be treated with special medications calledantifibrotics, and in some cases, a lung transplant.With extrinsic restrictive lung disease, treatment of the underlying cause (e.g., pleural effusion or ascites) can help with symptoms. This is also true for intrinsic restrictive lung diseases like pneumonia.Other conditions can be harder to treat. For example, until recently, there was little that could be done totreat idiopathic pulmonary fibrosis. Today, there are drugs available that can reduce the progression.Supportive treatment for restrictive and obstructive lung diseases can include supplemental oxygen,noninvasive ventilation(such as CPAP or BiPAP), or mechanical ventilation.Pulmonary rehabilitation can be helpful for some people—for example, those living with COPD and those who have had lung cancer surgery. When the condition causing restrictive or obstructive lung disease is severe and there is too much damage to the lungs, a lung transplant might be the recommended treatment.PrognosisThe prognoses of obstructive vs. restrictive lung diseases depend more on the specific condition than the category of lung disease. With obstructive lung diseases, the conditions that are reversible often have a better prognosis than the ones that are permanent or progressive.SummaryObstructive and restrictive lung diseases have some similar symptoms but different causes and treatments. It’s possible that a lung condition can go from being obstructive to being restrictive. If you have lung disease symptoms, your provider will figure out what the underlying cause is and recommend the appropriate treatment to help improve your quality of life and prevent complications.
Measurement
Obstructive Pattern
Restrictive Pattern
Forced vital capacity (FVC)
Decreased or normal
Decreased
Forced expiratory volumein one second (FEV1)
FEV1/FVC ratio
Normal or increased
Total lung capacity (TLC)
Laboratory Tests
Lab tests can help your provider gauge how severe lung disease is but they are not helpful at showing whether it’s obstructive or restrictive.
Here are a few examples of what tests might show:
Imaging Studies
If the underlying condition is something like pneumonia or a rib fracture, imaging tests like achest X-rayor chestcomputed tomography (CT) scanmay help a provider see if the lung disease is obstructive or restrictive.
Procedures
Bronchoscopyis a test where a provider uses a lighted tube with a camera on it to look in your mouth and down into the large airways. Like imaging studies, it can sometimes help diagnose the underlying condition that’s causing obstructive or restrictive lung disease.
Lung Disease Treatment
The treatment options are different for obstructive and restrictive lung diseases and depend on what the underlying cause is.
Obstructive lung diseases such as COPD and asthma are often treated with medications that dilate the airways (bronchodilators) and help with symptoms. Inhaled or oral steroids are also frequently used to reduce inflammation.
Here are some specific obstructive lung disease treatments based on the underlying condition:
Treatment options forrestrictive lung diseasesare more limited.
Depending on the type and cause, restrictive lung disease may need to be treated with antibiotics, inhalers, chemotherapy,expectorants(type of cough medicine), lung transplantation, andoxygen therapy.
Here are some specific restrictive lung disease treatments based on the underlying condition:
With extrinsic restrictive lung disease, treatment of the underlying cause (e.g., pleural effusion or ascites) can help with symptoms. This is also true for intrinsic restrictive lung diseases like pneumonia.
Other conditions can be harder to treat. For example, until recently, there was little that could be done totreat idiopathic pulmonary fibrosis. Today, there are drugs available that can reduce the progression.
Supportive treatment for restrictive and obstructive lung diseases can include supplemental oxygen,noninvasive ventilation(such as CPAP or BiPAP), or mechanical ventilation.
Pulmonary rehabilitation can be helpful for some people—for example, those living with COPD and those who have had lung cancer surgery. When the condition causing restrictive or obstructive lung disease is severe and there is too much damage to the lungs, a lung transplant might be the recommended treatment.
PrognosisThe prognoses of obstructive vs. restrictive lung diseases depend more on the specific condition than the category of lung disease. With obstructive lung diseases, the conditions that are reversible often have a better prognosis than the ones that are permanent or progressive.
Prognosis
The prognoses of obstructive vs. restrictive lung diseases depend more on the specific condition than the category of lung disease. With obstructive lung diseases, the conditions that are reversible often have a better prognosis than the ones that are permanent or progressive.
Summary
Obstructive and restrictive lung diseases have some similar symptoms but different causes and treatments. It’s possible that a lung condition can go from being obstructive to being restrictive. If you have lung disease symptoms, your provider will figure out what the underlying cause is and recommend the appropriate treatment to help improve your quality of life and prevent complications.
27 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Lung disease.The Ohio State University.Types of lung disease.Office on Women’s Health.Lung disease.American Lung Association.COPD.American Lung Association.Chronic bronchitis.American Lung Association.Asthma.American Lung Association.Bronchiectasis.American Lung Association.Bronchiolitis.Øymar K, Skjerven HO, Mikalsen IB.Acute bronchiolitis in infants, a review.Scand J Trauma Resusc Emerg Med. 2014;22:23. doi:10.1186/1757-7241-22-23American Lung Association.Cystic fibrosis.American Lung Association.Pneumonia.Centers for Disease Control and Prevention.Pneumoconioses.National Heart, Lung, and Blood Institute.Acute Respiratory Distress Syndrome.National Organization for Rare Diseases.Eosinophilic pneumonia.American Lung Association.Tuberculosis.American Lung Association.Pulmonary fibrosis.American Lung Association.Sarcoidosis.American Lung Association.Lobectomy.Mangera Z, Panesar G, Makker H.Practical approach to management of respiratory complications in neurological disorders.Int J Gen Med. 2012;5:255-63. doi:10.2147/IJGM.S26333American Lung Association.Silicosis.Johnson JD, Theurer WM.A stepwise approach to the interpretation of pulmonary function tests.Am Fam Physician. 2014;89(5):359-66.The University of Chicago: Asthma & COPD Center.How Asthma Works.Scelfo C, Caminati A, Harari S.Recent advances in managing idiopathic pulmonary fibrosis.F1000Res. 2017;6:2052. doi:10.12688/f1000research.10720.1Johns Hopkins Medicine.Restrictive Lung Disease.American Lung Association.Acute respiratory distress syndrome (ARDS).American Lung Association.Pulmonary fibrosis medications.UCSF.Lung transplant.Additional ReadingKasper DL, Fauci AS, Hauser SL.Harrison’s Principles of Internal Medicine. New York: McGraw Hill Education, 2015. Print.Kumar V, Abbas AK, Aster JC.Robbins and Cotran Pathologic Basis of Disease. Philadelphia: Elsevier-Saunders, 2015. Print.McCormack M.Overview of Pulmonary Function Testing in Adults.UpToDate.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Lung disease.The Ohio State University.Types of lung disease.Office on Women’s Health.Lung disease.American Lung Association.COPD.American Lung Association.Chronic bronchitis.American Lung Association.Asthma.American Lung Association.Bronchiectasis.American Lung Association.Bronchiolitis.Øymar K, Skjerven HO, Mikalsen IB.Acute bronchiolitis in infants, a review.Scand J Trauma Resusc Emerg Med. 2014;22:23. doi:10.1186/1757-7241-22-23American Lung Association.Cystic fibrosis.American Lung Association.Pneumonia.Centers for Disease Control and Prevention.Pneumoconioses.National Heart, Lung, and Blood Institute.Acute Respiratory Distress Syndrome.National Organization for Rare Diseases.Eosinophilic pneumonia.American Lung Association.Tuberculosis.American Lung Association.Pulmonary fibrosis.American Lung Association.Sarcoidosis.American Lung Association.Lobectomy.Mangera Z, Panesar G, Makker H.Practical approach to management of respiratory complications in neurological disorders.Int J Gen Med. 2012;5:255-63. doi:10.2147/IJGM.S26333American Lung Association.Silicosis.Johnson JD, Theurer WM.A stepwise approach to the interpretation of pulmonary function tests.Am Fam Physician. 2014;89(5):359-66.The University of Chicago: Asthma & COPD Center.How Asthma Works.Scelfo C, Caminati A, Harari S.Recent advances in managing idiopathic pulmonary fibrosis.F1000Res. 2017;6:2052. doi:10.12688/f1000research.10720.1Johns Hopkins Medicine.Restrictive Lung Disease.American Lung Association.Acute respiratory distress syndrome (ARDS).American Lung Association.Pulmonary fibrosis medications.UCSF.Lung transplant.Additional ReadingKasper DL, Fauci AS, Hauser SL.Harrison’s Principles of Internal Medicine. New York: McGraw Hill Education, 2015. Print.Kumar V, Abbas AK, Aster JC.Robbins and Cotran Pathologic Basis of Disease. Philadelphia: Elsevier-Saunders, 2015. Print.McCormack M.Overview of Pulmonary Function Testing in Adults.UpToDate.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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American Lung Association.Pulmonary fibrosis.
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Johnson JD, Theurer WM.A stepwise approach to the interpretation of pulmonary function tests.Am Fam Physician. 2014;89(5):359-66.
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American Lung Association.Acute respiratory distress syndrome (ARDS).
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UCSF.Lung transplant.
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Kumar V, Abbas AK, Aster JC.Robbins and Cotran Pathologic Basis of Disease. Philadelphia: Elsevier-Saunders, 2015. Print.
McCormack M.Overview of Pulmonary Function Testing in Adults.UpToDate.
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