What They Do and Why You’d See One

If you are experiencing breathing problems, your primary healthcare provider may refer you to a pulmonologist. A pulmonologist is an internal medicine physician who specializes in respiratory health conditions. Your respiratory system manages airflow in and out of your lungs and contains organs such as your throat, trachea (windpipe), bronchial tubes, pleura, and lobes.

Pulmonologists are certified to treat respiratory health conditions, including asthma, pulmonary hypertension, and cystic fibrosis.

A pulmonologist has the same standard internal medical training as an internist. After completing a three-year internal medicine residency, they enroll in a two-year fellowship focusing on pulmonology. Some pulmonologists also do an additional year studying critical care. After passing several exams, they become certified in pulmonology through the American Board of Internal Medicine.

A pulmonologist is a healthcare provider who has studied the anatomy of the respiratory system in detail. They can identify infections, inflammation, and health conditions in every part of your respiratory system.

A pulmonologist examines the following parts of the respiratory system:

• Trachea: Also known as the windpipe, your trachea connects your throat to your lungs
• Bronchial tubes: Your trachea splits into these two branches of sponge-like tissue, which lead into the right and left sides of your lungs to help you take in oxygen and remove carbon dioxide
• Bronchioles: The smaller branches of your bronchial tubes that deliver air to the alveoli
• Lobes: Your right lung is divided into three lobes, while your left lung is divided into two lobes that bring in oxygen and remove carbon dioxide from your lungs
• Pleura: A membrane covering your lungs and separating them from your chest wall
• Alveoli: The tiny air sacs at the end of your bronchioles where oxygen and carbon dioxide exchange takes place
• Capillaries: The blood vessels surrounding your alveoli
• Diaphragm: The muscle that separates your chest from your abdominal cavity and helps your lungs expand

What Conditions Does a Pulmonologist Diagnose and Treat?

Your primary healthcare provider can diagnose and treat common respiratory problems related to a cold or flu (influenza) infection. They will refer you to a pulmonologist to manage any severe respiratory symptoms that go beyond the occasional cough or congestion.

Pulmonologists treat a wide array of respiratory health conditions, including:

• Asthma: A chronic lung condition that causes inflammation and narrowing in your airways
• Chronic obstructive pulmonary disease (COPD): Also known as emphysema, a disease that causes lung damage and restricted airflow in your lungs
• Cystic fibrosis: A rare genetic health condition that can cause breathing difficulties
• Lung cancer: An overgrowth of cancer cells in the tissue of your lungs
• Pulmonary hypertension: A health condition that makes it more difficult for your heart to pump blood into your lungs and causes shortness of breath, dry cough, and nausea
• Tuberculosis (TB): An infection in your lungs caused by the bacteria Mycobacterium tuberculosis
• Sleep apnea: A sleep condition where your breathing starts and stops while you sleep

Procedures

A pulmonologist may order or perform several tests for diagnosis. These tests include:

• Lung function tests: Measures how much air your lungs can hold, how well you move air in and out of your lungs, and how well your lungs absorb oxygen
• Arterial blood gas test (ABG): A blood oxygen level test measuring carbon dioxide and oxygen in your blood
• Chest X-ray: An exam that gives a detailed image of your chest cavity
• Bronchoscopy: A camera attached to the end of a tube looks at your air passages
• Computed tomography (CT): A detailed imaging exam of your organs that a healthcare provider can use to focus on the chest cavity

If your primary healthcare provider determines that your breathing problems are more than cold, flu, or allergy symptoms, they will most likely refer you to a pulmonologist.

Common symptoms of a severe respiratory complication may include:

• Uncontrollable asthma
• Chest tightness
• Dizziness
• Lightheadedness or fainting
• Difficulty breathing during physical activity
• Persistent fatigue
• Chronic bronchitis
• Recurring colds
• Wheezing

Talk with your regular healthcare provider for a referral or recommendation to see a pulmonologist. Your pulmonologist may run several tests to get an accurate diagnosis before developing a treatment plan.

How To Prepare

Have your healthcare provider send the results of previous tests, such as chest X-rays or lung function tests, to your pulmonologist or bring the results with you to your first appointment. Your pulmonologist can also perform these tests during your visit.

One of the first questions they will ask is about your past and family medical history. It may be helpful to write a list of the medications and supplements you take for them. Mention the dosage and how frequently you take each medication as well.

What To Expect During Your Visit

When you arrive at your appointment, your pulmonologist will ask what symptoms you have been experiencing. They will also measure your height, weight, blood pressure, temperature, and oxygen level.

Your pulmonologist may ask follow-up questions like:

• How often do you cough?
• Is your cough so bad that you can’t catch your breath?
• Do you wheeze when you cough?
• Does physical activity affect your breathing or coughing?
• Does your coughing ever wake you up or prevent you from falling asleep?
• Do you notice anything in particular that affects your breathing or coughing?
• Does your cough produce sputum? If so, how much and how often? What color is your sputum?
• Do you have gastric reflux?
• Do you ever wake up with a headache?

If you are experiencing serious breathing problems, contact your healthcare provider to check whether a cold, flu, or other common infection is the cause. If not, your healthcare provider can refer you to a pulmonologist. A pulmonologist can diagnose and treat conditions like pulmonary disease, cystic fibrosis, and asthma.