What should you know about obliterative bronchiolitis?

The smallest airways can become narrowed after certain infections, inhaled irritants, immune conditions, medication exposures, or medical treatments. Airflow limitation may cause dry cough, wheezing, chest tightness, and breathlessness, especially with activity. Symptoms can resemble other respiratory illnesses, so a history of exposure and previous illness matters.

Assessment may include listening to the chest, measuring breathing with lung-function tests, checking oxygen levels, and reviewing imaging. In children, symptoms may follow a significant respiratory infection; a Child Health Consultation can help coordinate age-appropriate assessment.

Arrange medical review for ongoing cough, wheezing, or reduced exercise tolerance. Avoid tobacco smoke, vaping aerosol, dust, fumes, and other known irritants. Use prescribed inhalers exactly as directed, keep follow-up appointments, and record changes in breathing or activity. A nebuliser may be recommended in selected situations, but it does not replace diagnosis or follow-up.

Get emergency help for severe or rapidly worsening breathlessness, blue or grey lips, confusion, exhaustion, inability to speak in full sentences, or pauses in a child's breathing. Seek same-day advice if wheezing or breathing effort is increasing, drinking is difficult, or fever accompanies a worsening cough. Do not wait for a routine appointment when breathing is visibly laboured.

What other conditions could explain these symptoms? Which lung-function or imaging tests are appropriate? How can we reduce exposure triggers, and what signs mean the current breathing plan is not enough?