Chronic Obstructive Pulmonary Disease (COPD)

What Is COPD?

COPD or Chronic Obstructive Pulmonary Disease is a term which encompasses progressive lung disease from emphysema and chronic bronchitis. The disease has increasing breathlessness as its main characteristic.

COPD is a gradually progressive disease no cure. But with proper diagnosis and treatment there are many helpful ways by which COPD can be kept under control and the patients can have better exercise tolerance and quality of life.

People can live for many years in spite of having COPD. Let us have a look into the conditions, which come under COPD, in detail:

 

  • Chronic Bronchitis: When there is damage caused to the bronchial airways due to any irritant like cigarette smoke or other industrial and environmental toxins, they can get swollen and irritable; something in medical terms is called inflammation.The bronchial tubes of the lungs have hair-like fibres, known as cilia, which help the mucus in moving up the tubes. Irritation and damage to the bronchial wall causes loss of ciliary structures.The loss of cilia makes it hard to cough up the mucus, which in turn, causes more coughing. More coughing results in the tubes getting irritated further, creating more mucus.The tubes also get swollen further, making it difficult to breathe. Shortness of breath and cough persisting over 3 months are clinical signs pathognomonic of Chronic bronchitis.

 

  • Emphysema: Any kind of damage caused to the alveoli or the air sacs are responsible for causing emphysema. The walls inside the alveoli will disappear, making the small sacs become large and single sacs. The larger sacs are not able to absorb Oxygen and release carbon dioxide back to blood as efficiently as the undamaged alveoli. Hence in this condition often the blood levels of Oxygen are low and Carbon dioxide is high. Clinically shortness of breath is the major sign of emphysema.

Signs & Symptoms Of COPD

Coughing and shortness of breath becomes a part and parcel of life, as we proceed towards the wrong side of age. We might ignore them, but they can be signs of COPD. Thus, it is very important for us to talk to the doctor if any of the following symptoms start bugging our or our near and dear ones lives:

  • Frequent coughing with or without mucus.
  • Increased breathlessness
  • Wheezing
  • Tightness in the chest

 

What Are The Causes Of COPD?

COPD mostly occurs, due to inhalation of pollutants, including smoking, both active and passive form. Presently we are surrounded by fumes, dust and chemicals, which play a great role in developing COPD. Often, genetics can also lead to a person developing COPD, even if he has never smoked or has no exposure to various kinds of lung irritants

 

COPD and Other Health Conditions

Comorbid conditions are often more common in people with COPD than in people with other medical conditions. These conditions are:

  • High Cholesterol
  • Heart Disease
  • High Blood Pressure
  • Depression
  • Arthritis
  • Cancer
  • Sleep Apnoea

Diagnosis & Treatment Of COPD

What Is The Diagnosis For COPD?

A general practitioner will help in diagnosing COPD, by doing the following:

  • Asking about the symptoms.
  • Calculating the body mass index or BMI with the help of the weight and height.
  • Asking whether the patient is addicted to smoking.
  • Examining the chest.
  • Asking whether there is a family history of lung problems.

A breathing test, known as the spirometry can also be arranged for. Spirometry helps in finding out, how well the lungs are functioning. The vulnerable patients are asked to breathe into a machine, known as a spirometer, after taking in a medicine called a bronchodilator. This helps in widening the airways.

 

Treatment

If someone incurs COPD, it may be in milder forms, and there is no need to worry at all. There are therapies, even for advanced stages of the condition. They can control the symptoms, reduce the risks and improve the abilities to lead a normal life. Ceasing smoking is the first and foremost need, for treating all forms of COPD. Nicotine replacements will help. Doctors can help in dealing with relapses. Second-hand smoking is also a great danger and should be avoided at any cost.

Some medications are of immense help:

 

  • Bronchodilators: These medicines are usually available in the form of an inhaler. They are capable of relaxing the muscles around the airways and relieve shortness of breath and coughing.

 

  • Inhaled steroids: The inhaled corticosteroid medications are helpful in reducing the inflammation of the airways and preventing exacerbations.

 

  • Combination inhalers: These medications are a combination of inhaled steroids and bronchodilators.

 

  • Oral steroids: These are for people who have a severe or moderate exacerbation.

 

Lung therapies

The doctors often use lung therapies for people who suffer from severe or moderate conditions of COPD.

  • Oxygen therapy: Often the victims of COPD suffer from lack of oxygen in the blood. They may need supplemental oxygen. The supply can be guaranteed with devices that can deliver oxygen to the blood.

 

  • Pulmonary Rehabilitation program: These programs combine exercise training, nutrition advice, education and counselling. A variety of specialists help in preparing a customised rehabilitation program.

 

  • Flu Vaccine: COPD patients are at high risk of developing intercurrent infection and the infection is also likely to be more serious in them. Providing the Flu vaccine every winter should be routine practise to reduce the number of intercurrent infections.

 

Written By Dr. Dwaipayan Sen


FRCP(Glasgow) MRCP Geriatrics, Clinical Lead Comprehensive Stroke Services, Manchester Centre for Clinical Neurosciences

Dr. Dwaipayan Sen is a Consultant Stroke Physician and Clinical Lead for Comprehensive Stroke Services (Salford Hope Hospital, UK)

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