Chronic Obstructive Pulmonary Disease
What is COPD?
Chronic Obstructive Pulmonary Disease (COPD) is a long term disease that affects the lungs. It is a common term used for two different diseases - emphysema and chronic bronchitis - because most people with COPD have a combination of these two diseases. In these conditions, air flow in the lungs is obstructed and a person with COPD thus experiences shortness of breath.
In chronic bronchitis, the breathing tubes (bronchi) become swollen and inflamed and produce large amounts of mucus. The swollen tissues and mucus narrow the air passages making breathing difficult. The airways often become easily infected.
In emphysema, the air sacs (alveoli) and small airways (bronchioles) are damaged and have lost their elasticity. When a person with emphysema breathes out, stale air becomes trapped inside the air sacs. This makes it harder for fresh air (oxygen) to come in and waste air (carbon dioxide) to go out. The blood vessels around the air sacs can be damaged too. This also prevents fresh air (oxygen) from reaching the bloodstream and waste air (carbon dioxide) from going out of the body.
What causes COPD?
Tobacco smoke – long-term smoking of cigarettes, cigars, pipes and other forms of tobacco products is the main cause
Occupational dusts and chemicals – when there is intense or prolonged exposure to these chemicals in the form of vapours, irritants and fumes
Air pollution – urban air pollution may be a contributing factor for COPD. In developing countries, indoor air pollution, usually due to biomass fuel, has been linked to COPD, especially in women
Genetic factor – very rarely, there may be a deficiency in a glycoprotein known as alpha1-antitrypsin
Are you at risk of developing COPD?
The main risk factor for COPD is smoking. Most people who have COPD smoke or used to smoke. People who have a family history of COPD are more likely to get the disease if they smoke.
Long-term exposure to other lung irritants also is a risk factor for COPD. Examples of other lung irritants include air pollution and chemical fumes and dust from the environment or workplace. Most people who have COPD are at least 40 years old when symptoms begin. Although it isn't common, people younger than 40 can have COPD. For example, this may happen if a person has alpha-1 antitrypsin deficiency, a genetic condition.
How can you tell if you have COPD?
Cough, excessive mucus and breathlessness that will not go away are all common symptoms of COPD. A person who has been smoking for a long period of time and has any of the above symptoms is highly likely to have COPD. The diagnosis is confirmed after chest X-rays are done to exclude other lung diseases and the results of the lung function tests show that it is COPD.
Spirometry is the most commonly ordered lung function test and is the test usually performed to find out if a person has COPD. A spirometer is used to measure the amount (volume) and/or speed (flow) of air that is inhaled (breathed in) and exhaled (breathed out) by the person. This test can detect COPD in early stages when the person does not have any symptoms yet.
How is COPD treated?
As COPD is an illness that can eventually affect your bodily functions and not just your lungs, proper treatment should be aimed at improving general well-being and health status, rather than just for using on preserving lung function. Hence, besides medication that can help you breathe better, other aspects such as proper nutrition, relaxation, regular exercise and maintaining a positive outlook towards the illness are equally important. The goals of an effective treatment are to:
- Prevent worsening of the disease
- Relieve symptoms such as breathlessness and cough
- Improve ability to perform daily tasks and exercise
- Improve health status
- Prevent and treat complications resulting from the illness
- Prevent and treat periods of worsening of your condition
- Improve longevity
- Quit Smoking - The most important treatment if you are a smoker is to stop smoking. Quitting smoking will make a huge difference to the rate at which your disease progresses. While the damage already done to your airways cannot be reversed, stopping smoking helps to prevent the progression of the condition. It is never too late to stop smoking at any stage of the disease. Even if you have fairly advanced COPD, you are likely to benefit and prevent further progression of the disease. However, do bear in mind that the earlier you quit, the smaller the degree of permanent damage to your lungs.
Medications help to relieve and prevent symptoms, reduce the frequency and severity of attacks and improve your exercise tolerance. They can be divided into bronchodilators (which open the airways in your lung), steroids (which help to reduce the swelling of the airways) and other medication that help to control symptoms or treat infections. Some of these medications may come in the form of inhalers, e.g. the bronchodilators and steroids while the others come in tablet or syrup form.
Long-Term Oxygen Therapy - Using oxygen continuously (for at least 15 hours a day) can improve longevity and quality of life in patients with low or inadequate levels of oxygen in the body. However, this should be discussed with the doctor.
How can COPD be prevented?
The best way to keep chronic obstructive pulmonary disease (COPD) from starting or from getting worse is to not smoke. Other airway irritants (such as air pollution, chemical fumes, and dust) also can make COPD worse, but they are far less important than smoking in causing the disease.
Useful Links:
COPD Association: http://www.copdas.com/