Pleurisy (Pleuritis) - Treatments

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How is pleurisy treated?

External splinting of the chest wall and pain medication can reduce the pain of pleurisy. Treatment of the underlying disease, of course, ultimately relieves the pleurisy. For example, if a heart, lung, or kidney condition is present, it is treated. Removal of fluid from the chest cavity (thoracentesis) can relieve the pain and shortness of breath. Sometimes fluid removal can make the pleurisy temporarily worse because without the lubrication of the fluid, the two inflamed pleural surfaces can rub directly on each other with each breath.

If the pleural fluid shows signs of infection, appropriate treatment involves antibiotics and drainage of the fluid. If there is pus inside the pleural space, a chest drainage tube should be inserted. This procedure involves placing a tube inside the chest under anesthesia. The tube is then connected to a sealed chamber that is connected to a suction device in order to create a negative pressure environment. In severe cases, in which there are large amounts of pus and scar tissue (adhesions), there is a need for "decortication." This procedure involves examining the pleural space under general anesthesia with a special scope (thoracoscope). Through this pipelike instrument, the scar tissue, pus, and debris can be removed. Sometimes, an open surgical procedure (thoracotomy) is required for more complicated cases.

In cases of pleural effusion that result from cancer, the fluid often reaccumulates. In this setting, a procedure called pleurodesis is used. This procedure entails instilling an irritant, such as bleomycin, tetracycline, or talc powder, inside the space between the pleural layers in order to create inflammation. This inflammation, in turn, will adhere or tack the two layers of pleura together as scarring develops. This procedure thereby obliterates the space between the pleura and prevents the reaccumulation of fluid.

Return to Pleurisy (Pleuritis)

See what others are saying

Comment from: bunchaflowers, 55-64 Female (Patient) Published: November 17

I began having chest pain and after not having slept for 2 nights went to the emergency room. After much testing, I was diagnosed with pleurisy and sent home with steroid dose pack. Five years later, same pain, and ruled out heart and lung embolus. I suggested pleurisy since it felt so much like the incident 5 years prior so he started me on a steroid dose pack and voila! Fixed me right up!

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Comment from: Seapoint, 65-74 Male (Patient) Published: February 18

I recently underwent a quadruple bypass and have been slowly recovering. Five days ago I started getting a sharp pain in my right lung. It got worse and I couldn't breathe. I went immediately to my doctor who diagnosed pleurisy. He gave me a big bottle of ibuprofen 600 mg tablets. He prescribed that I take it three times a day with food. I felt an immediate cessation of pain by the end of the first day. By the second day I was able to breathe without any problem and by the third day I stopped taking Ibuprofen tablets because I was pain free and able to breathe normally. The only drawback was a stomach reaction, lots of gas and some dry heaves which stopped as soon as I ceased taking the pills. I hope that my experience will be of some help to those still looking for relief.

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