Chronic Obstructive Pulmonary Disease (COPD)
COPD (chronic obstructive pulmonary disease) is the name of a group of chronic lung conditions that reduce air flow to the lungs, making difficult to breathe. The disease develops slowly over a number of years.
As COPD progresses, breathing difficulties make it increasingly more difficult to carry out everyday activities. The lung damage that causes symptoms does not heal, and it cannot be repaired. Cigarette smoking is undoubtedly the most important factor contributing to the development of COPD.
The two conditions commonly falling under COPD are chronic bronchitis and emphysema.
- Chronic bronchitis is caused by inflammation of the smaller airways, which gradually progresses to the larger airways. The process causes damage to the tiny hairs that normally clear mucus from the airways increases and they are obstructed.
- Emphysema involves damage and destruction of the walls surrounding the small air sacs in the lungs call alveoli. As a result, the elasticity of the lung tissue is lost, causing airways to collapse and obstruction of the airways to occur.
There are 4 types of emphysema:
- Panacinar / panlobular: enlargement of all air spaces (from bronchioles to terminal blind alveoli). This type is associated with alpha-1-antitrypsin deficiency
- Centriacinar / centrilobular: proximal to central parts of acini (air spaces closer to bronchioles) are affected
- Distal acinar / paraseptal: proximal acinus normal, distal acinus affected
- Irregular: various parts of acinus involved. Associated with fibrosis.
Some people suffering from COPD experience rapid, sudden, and prolonged worsening of symptoms. This is called COPD exacerbation.
What causes COPD?
The risk of COPD increases with the total number of particles inhaled overtime. These particles can come from:
- Occupational exposure to chemicals and dusts – intense of prolonged expose to fumes vapours, or irritants in the workplace.
- Tobacco smoke - smoking cigarettes, pipes and cigars as well as being exposed to second-hand smoke.
- Air pollution - while air pollution itself isn’t a major cause of COPD. It can significantly increase the number or particles inhaled into the lungs over the course of a lifetime.
- Lung Infection - having repeated lung infections as a child
- A rare condition - called Alpha-1 antitrypsin deficiency
What are the symptoms of COPD?
- Shortness of breathe
- Chronic cough or heavy sputum (Phlegm) – cough may fell like it is shallower, as though something is stuck inside the chest
- Unexplained weight loss
- Colds that last for weeks
- Many bouts of asthma or bronchitis
As the condition progresses, the lungs become increasingly less able to function properly. Shortness of breath and difficulty sleeping are common, and some people find that they get out of breath with little or no activity, severely limiting the things they can do.
A person with COPD may have both emphysema and chronic bronchitis symptoms at the same time.
How is it diagnosed?
The first step in reaching a diagnosis is a physical exam. Depending on the results, the doctor may also order chest x-rays and other tests such as lung function tests to help identity COPD and to rule out conditions with similar symptoms. The sooner COPD detected, the better the chances of slowing the damage to the airways and lungs. People who belong to one of the following high-risk groups, should speak to their doctor about being screened for COPD, especially if they have any breathing difficulties:
- Those with a strong history of emphysema
- Smokers and ex-smokers
- Anyone with Asthma
- People whose work environments expose them to lung irritants, like chemicals
Screening is often done using a test called spirometry (meaning the measuring of breath) is the most common of the pulmonary function tests (PFTs), measuring lung function, specifically the measurement of the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled. Spirometry is an important tool used for generating pneumotachographs which are helpful in assessing conditions such as asthma, pulmonary fibrosis, cystic fibrosis, and COPD. that measures how quickly a person can move air in and out of his lungs and how much air is moved.
Although there is no cure for COPD, the condition can be managed. Treatment focuses on slowing the progress of the disease and relieving symptoms. A lung rehabilitation program that includes counseling, education, physical exercise, breathing exercises, and nutritional guidance may help reduce symptoms.
The main treatments for COPD include:
- Avoiding pollution: It is important to take all possible steps to make breathing easier, such as avoiding air pollution, smog, high altitudes, and air that either cold and dry or hot and humid.
- Avoiding illness: Staying healthy and avoiding respiratory illnesses, such as the flu and pneumonia, can help keep COPD from getting worse.
- Not smoking: Smokers must quit if they want to prevent or slow damage to their lungs. No matter how long a person has had COPD or how serious it is , quitting smoking will help slow the progression of the disease.
- Being active: Exercise strengthens the lungs.
- Eating nutritious diet: People with COPD often struggle with muscle weakness and weight loss. A healthy balanced diet can help prevent these problems.
- Medications: There are a number of medicines that can slow the progression of the disease and reduce the symptoms. After a diagnosis of COPD is made, the physician will determine which of the available medications is right for that particular patient.
Below is a brief summary of some of these medications:
- Bronchodilator medications – Inhaled anticholinergic bronchodilators such as ipratropium, and oral bronchodilators such as theophylline help to open up constricted airways. These medications are most often used on a regular basis for treatment of COPD.
- Inhaled Corticosteroids – These medications reduce inflammation, swelling and mucus production. Examples of inhaled corticosteroids include fluticasone, budesonide, flunisolide and beclomethasone. These medications must be used on a regular basis to be effective. They do not have any immediate effects. Anyone who has used a corticosteroid medication for an extended period of time should not stop taking it abruptly, but should wean off the medication slowly.
- Quick Relievers – Inhaled “bronchodilators” such as salbutamol, terbutaline and fenoterol relax the muscles around the airways, thereby helping them to open up. These medications act most quickly to relieve airway symptoms. It is important not to use these medications more than prescribed.
- Oral (pill form) Corticosteroids – are used when COPD symptoms are severe. They are usually used for a short time only due to side effects when used for longer periods.
- Antibiotics – are used at the first sign of respiratory infection as prescribed by a doctor to prevent further damage and infection in the diseased lungs. Examples of antibiotics include penicillin and erythromycin.
- Quitting Smoking will prevent further damage to your lungs.
- You should avoid inhaling any fumes that might be irritating in your lungs such as second-hand smoke, paint fumes, cleaning agents, smoke from woodstoves or fireplaces or air pollutants.
- If you are overweight, you should talk with your doctor about healthy strategies for reducing your weight.
- People with COPD are much more likely to get infections because the lung’s defense mechanisms are not working properly. It is important that infections be treated as soon as they are noticed.
Article By:- eHealthhut Webmaster