Chronic Obstructive Pulmonary Disease (COPD) is a group of progressive irreversible inflammatory lung diseases that impair airflow and make breathing difficult. It is usually caused due to smoking or exposure to chemical irritants. After heart disease and cancer, it is the third leading cause of death in United States and typically occurs in people who are at least 40 years of age or who have some history of smoking.
Which lung diseases can be caused by COPD?
It is a group of irreversible lung diseases including:
Emphysema: It is caused by damage to fragile air sacs (alveoli) and elastic fibres which help to expand the lungs during inhalation. This damage causes difficulty in inhaling oxygen and exhaling carbon dioxide, thereby impairing airflow through the lungs.
Chronic bronchitis: It is inflammation and narrowing of bronchial tubes that leads to mucus accumulation, thereby blocking the tubes and causing chronic cough and impairing breathing.
Refractory asthma: It is chronic inflammatory disease characterized by airway obstruction that causes breathlessness.
What are the early signs and symptoms of COPD?
COPD is often asymptomatic and may not be noticed until it is in later stages or until there is significant lung damage that gets worse with time. People over 65 years of age are more likely to develop COPD and are at increased risk of having heart diseases, lung cancer. The most common warning signs and symptoms include:
Dyspnea (difficult breathing), cough, wheezing, retaining fluid, tightness in the chest, frequent cold, lack of energy, mucus (sputum) production. It can be prevented with short-acting bronchodilators and discontinuance of smoking
Chronic cough, swelling of the feet, ankles, or legs weight loss, increased sputum production, noisy breathing, breathlessness. Long-acting inhalers and pulmonary rehabilitation can help ease the symptoms
Lack of energy, weight loss, anorexia, disturbed sleep pattern, tiredness, anxiety, fatigue, depression, flu or other respiratory infections. It can be prevented by inhaling corticosteroids, short-acting bronchodilator or long-acting inhalers
Respiratory failure, cyanosis, dizziness, episodes of exacerbations, breathing difficulties, rapid heartbeat, deficiency of alpha -1 protein that affects the liver and lungs and can become life threatening. It requires immediate medical care, oxygen therapy or surgery.
As per the research by American Lung Association, COPD cases are caused by cigarette smoking in 85 to 90% of people who are at least 40 years of age but in some cases can occur even in those who have no history of smoking.
Symptoms are likely to worsen if the patient continues smoking or is exposed to smoke and other hazardous chemicals. It is not curable, but symptoms can be prevented by medications, therapies and lifestyle modifications.
What are the risk factors that cause COPD?
People with Chronic obstructive pulmonary disease often experience limitation of airflow which makes breathing difficult. The main causes of the disease include:
- Exposer to smoke or chemical irritants
- Indoor or outdoor air pollution
- Inhaling airborne irritants
- Exposure to dust or chemical fumes
- People suffering from Asthma or respiratory infections
- Inhaling fumes in poorly ventilated homes
- Deficiency of alpha-1- antitrypsin
What are the complications of COPD?
COPD reduces life expectancy with the severity of the condition depending on patients’ BMI (body mass index), the degree of blocked airflow to the lungs, dyspnea levels and exercise tolerance. The main complications of COPD include:
COPD can damage lung tissue, making breathing difficult and people may suffer from pneumonia, cold and flu which can be prevented by regular vaccinations against these conditions.
People with COPD are more likely to have heart diseases that may be mitigated with cessation of smoking.
It is caused by high blood pressure in the arteries that move from heart to the lungs which increase risk of exacerbations, dyspnea, syncope (temporary loss of consciousness due to insufficient blood flow to the brain) and edema (swelling caused by excess fluid accumulation). Eisenmenger syndrome which is congenital heart disease is the main cause of pulmonary hypertension.
It is not curable but can be improved with treatment and liver health monitoring.
People with COPD are at higher risk of developing lung cancer. The most common type is adenocarcinoma which causes dyspnea (shortness of breath). Surgery or radiation therapy may be required immediately for survival.
Depressive symptoms are common in people suffering from COPD depending on the social, biological and behavioral factors. They may experience anxiety, irritability, fatigue, disturbed sleep pattern and appetite. Physical activity and treatment may help to live a quality life.
How can we diagnose COPD?
To diagnose COPD several tests may be required including:
Spirometry: To check how well the lungs function. It can also detect the disease before symptoms develop.
Blood tests: To check if the patient is suffering from anemia, polycythaemia or deficiency of alpha-1-antitrypsin.
Chest X-ray: To check for chest infections and lung cancer.
CT scan: To identify problems occurring in the lungs
Phlegm test: To check for sputum accumulation due to chest infections
Arterial blood gas analysis: To measure oxygen levels in the blood
Peak flow test: It is a breathing test to check the speed and force of exhalation
How is COPD treated?
COPD is not curable and one cannot reverse the damage to the lungs but treatment can control the symptoms and slow down progression of the disease. Treatment options include the following:
Some medications can be taken on a continuous basis (maintenance medications) with rescue medications being required in the case of an exacerbation of symptoms.
They are used for delivering medication directly into the lungs to make breathing easier. Inhalers can be short-acting bronchodilators or long-acting bronchodilators depending on the condition of the lungs.
It makes breathing easier by mechanically delivering air into the lungs.
It can be given through nasal tubes or masks when symptoms are severe to compensate for oxygen desaturation as a result of inadequate airflow to the lungs.
This is a holistic disease management program that includes physical exercise, a dietary plan, education on management of symptoms and emotional and psychological support.
Pneumonia, flu or whooping cough vaccines can be given annually or periodically if there is a history of contracting these infections.
Surgery is recommended when symptoms are severe and are not controlled with medications. This can include Lung volume reduction surgery to remove the damaged portion of the lungs, Bullectomy surgery to remove enlarged bullae of lungs and Lung transplant to replace damaged lung with a healthy lung.
Airway clearance techniques:
These are techniques to clear mucus from your airway. Chest physiotherapy using expectorants can be used to control cough.
COPD effects physical, emotional, social, and practical aspects of life. It is not fully reversible but treatment and management can significantly improve the quality of life and prevent complications especially if treatment is commenced at an early stage in the progression of the disease.