COPD-Chronic Obstructive Pulmonary Disease

Understanding COPD

COPD or Chronic Obstructive Pulmonary Disease refers to a group of non-contagious progressive lung diseases which are caused as a result of poor air-flow into the lungs. The disease is characterized by difficulty in breathing, coughing and wheezing which usually aggravate over time. Many confuse the symptoms of COPD with normal signs of aging. Since the symptoms appear mild at the onset, this disease often goes undiagnosed initially. But as the disease progresses, the symptoms tend to get more pronounced rendering the person susceptible to respiratory disorders and even cardiac complications

The two major types of COPD are chronic bronchitis and emphysema. Refractory (non-reversible) asthma is also included in this group.

Emphysema leads to gradual destruction of air-sacs within the lungs which restrict the outflow of air. Bronchitis occurs as a result of inflammation and narrowing of bronchial tubes and increases in mucus build-up.

As a result of such prolonged build-up of the condition, simple activities such as walking, running or climbing stairs turn difficult progressively.

The single most significant factor contributing to the widespread prevalence of COPD, especially in developed countries is tobacco smoking. Mostly affecting smokers who are in their 40s, COPD is also caused by other forms of smoking such as pipes, cigars and even second-hand (passive) smoking. Results show that 50% of life-long smokers contract this disease. Also, women smokers are much more susceptible to the harmful effects as compared to male smokers. Chances of acquiring COPD increase if you are already suffering from asthma but smoke.

• COPD also occur as a direct result of toxic air pollution. Inhalation of exhaust fumes or being exposed to poorly-ventilated cooking areas can trigger the symptoms of COPD.
• Long-term contact with harmful chemicals and pollutants in the workplace could be a major cause for the onset of COPD. Within occupations such as coal-mining, cotton textile industries, welding etc, the workers have high exposure to dust and fumes which increase the risk of acquiring COPD.
• Genetics also play a role in the development of COPD symptoms in many cases. AATD (Alpha-1 Antitrypsin Deficiency) is a genetic defect resulting in emphysema 2, where lung deterioration occurs where the white blood cells start attacking the lung cells. Up to 5% of all COPD cases are caused due to this genetic flaw.
• COPD also exists along with other conditions such as high blood pressure, diabetes mellitus, lung cancer, anxiety disorder etc

COPD symptoms – Mild to severe

The early onset of COPD causes the development of mild symptoms in the patient, much similar to the common cold. These include difficulty in breathing (following physical activities), persistent coughing, and increased phlegm production. The symptoms start aggravating with time and manifest themselves as listed below:

• Shortness of breath, even after simple exercises.
• Noisy breathing (wheezing) indicating some form of lung congestion.
• A chronic cough which can last for months, with or without sputum.
• Chest tightness.
• Frequent catching of cold, flu, and other respiratory diseases.

In exacerbated conditions, COPD could also lead to swelling of the legs or bulging of neck veins. These happen because there is a high pressure on the lung arteries, which strain the right ventricle of the heart. It may also cause unexplained weight loss and fatigue due to restrained breathing.

How is COPD detected?

Since COPD is an umbrella term used to describe progressive lung diseases, there is no single test for diagnosing it. There is a range of tests and physical examinations which confirm the presence of COPD.  You should get checked for COPD if you are experiencing continued difficulty in breathing and/or are exposed to smoke, fumes, and chemicals.  The doctor will ask you about:

• History of smoking.
• Exposure to lung-irritants in the workplace.
• Exposure to passive smoking
• Family history of COPD and other respiratory diseases
• If the patient is currently suffering from asthma

The physical exam will include the doctor listening to your breathing through a stethoscope. The following tests will be then prescribed depending on the severity of the condition:

• Spirometry Test – This measures the volume of airflow in and out of the lungs, usually conducted after the use of a bronchodilator. This non-invasive test provides data about Forced Expiratory Volume and Forced Vital Capacity of the lungs.
• Chest X-ray and CT Scan – These shed light on the level of lung congestion if any, and a detailed study of the lungs, heart, and the blood vessels. They also help in ruling out other medical conditions pneumonia or pulmonary edema.
• Arterial Blood Gas Test – In this test, the blood sample from an artery is collected to check for the oxygen levels. This is usually conducted on patients who have Forced Expiratory Volume less than 35% predicted.

How is COPD treated?

There are no complete cures for COPD, but there are treatment methods which can aid in delaying the progression of the symptoms. These also help in preventing further medical complications which can occur along with COPD and acute exacerbations of the condition. These mainly include:

• Bronchodilators – These comprise of inhalers and nebulizers which open up air pathways within the lungs and relax the lung muscles, facilitating easy breathing.
• Glucocorticosteroids which help in reducing lung inflammation.
• Yearly flu shots, pneumococcal vaccines and tetanus booster for protection from Whooping Cough.
• Portable oxygen units, oxygen masks, and prongs also relieve the patient from difficulty in breathing.
• Pulmonary Rehabilitation which is a program comprising of exercise, disease management and counseling, usually for people suffering from the acute symptoms.
• Long-term antibiotics such as erythromycin reduce the occurrence of exacerbated symptoms in patients for as long as two years.
• For severe COPD cases, surgeries such as lung transplant and bullectomy would remain as the only viable options, mostly in the case of emphysema.

Preventing the progression of COPD

• To lead a healthy life, free from COPD, one should stay away from smoking. Quitting this habit helps the slowing down of lung damage. This result is even more pronounced in the case of people who have lower levels of the protein alpha-1 antitrypsin.
• One should also steer clear away from the bad air (pollution, lung irritants, chemicals, and second-hand smoking). Care must be taken when working in hazardous conditions which worsen air quality. Protective gears, masks, and covers should be used to cover nose and mouth.
• Controlled coughing, drinking plenty of water, and using humidifier also help prevent COPD.
• Regular exercise which improves overall strength and endurance along with controlling body weight facilitate easy breathing.

TL;DR?

References