COPD

COPD stands for chronic obstructive pulmonary disease. It’s a chronic inflammatory disease of lungs and results in obstruction of airflow.

COPD includes:

-       Chronic bronchitis

-       Emphysema

It’s a common disease, however it’s preventable and manageable.

Symptoms of COPD

Symptoms of COPD may not appear until there’s significant damage to the lungs. Once developed, the disease worsens usually, especially if smoking or exposure to smoke continues.

Symptoms of chronic bronchitis usually include daily cough and sputum for at least 3 months per year, consecutively for 2 years.

Common symptoms of COPD include:

-       Dyspnea on exertion

-       Wheezing

-       Chest tightness

-       Productive cough (cough with sputum), the sputum may be clear, yellow, greenish or white

-       Urge to clear your throat when you wake up in the morning, due to the accumulation of excess mucous in lungs over night

-       Cyanosis – bluish discoloration of lips, fingernail beds, etc.

-       Increased frequency of respiratory tract infections

-       Tiredness and lack of energy

-       Weight loss (unintended), occurs in later stages of COPD

There can be episodes of exacerbation of COPD in some patients. During these episodes, the symptoms are more marked as compared to usual days and may persist for several days.

Causes of COPD

COPD occurs when lungs are exposed to damaging irritants for a longer period of time.

Common causes and irritants include:

-       Tobacco smoking

o   Cigarette

o   Pipe

o   Cigar

o   Other types of tobacco

-       Breathing in second hand smoke (from other people smoking)

-       Pollution

-       Dust

-       Chemical fumes

-       Genetic disorder:

o   Alpha-1 antitrypsin deficiency

-       Asthma can lead to COPD

Rarely, in the patients suffering with genetic disorder: AAT (alpha-1 antitrypsin) deficiency results in COPD too. AAT is a protein made by liver. Low levels of this protein can result in damage to the lung and thus development of COPD if the patient is exposed to lung irritants including smoke. The condition can worsen quickly in the patients with this genetic disorder if they’re exposed to smoke.

Asthma is treatable, however if not treated, it can result in COPD.

Diagnosis of COPD

COPD is diagnosed on the basis of:

-       Medical history

-       Family history

-       Physical examination

-       Test results

History would include if you’re a smoker or not or if you have been in contact with lung irritant, like:

-       Secondhand smoke

-       Chemical fumes

-       Air pollution

-       Dust

Tell your doctor if you’re having a long-term cough. Tell him how much you cough and does it have mucus associated with it or not, if it has then which color, etc.

 Your doctor will examine you using a stethoscope and listen for chest sounds.

One or more tests might also be advised for you in order to confirm the diagnosis. Tests performed include:

-       Lung function tests

-       Spirometry

-       Other tests

o   Chest x-ray

o   Chest CT-scan

o   ABGs (arterial blood gases)

Treatment of COPD

There is no complete cure to COPD yet, however various treatment and life style modifications can reduce the symptoms of the disease, make the patient feel better and active and slow down the progress of disease.

COPD treatment is aimed towards:

-       Relieving the symptoms of the patients

-       Slowing down the progression of disease

-       Improving exercise tolerance of the patient

-       Prevent complications

-       Manage complications if they had occurred already

-       Improving overall health of the patient

Consult a pulmonologist if you’re having the symptoms of COPD to get the best possible treatment in your specific case.

Treatment options for COPD include:

-       Life style modification

o   Quit smoking

o   Avoid any lung irritants

o   Have healthy diet to avoid worsening of the symptoms

o   Talk to your doctor in detail about possible life style changes that can help you

-       Medicines

o   Bronchodilators

o   Inhaled medicines

§  Steroids (glococorticosteroids) combined with bronchodilators

-       Vaccines

o   Flu shots

o   Pneumococcal vaccine

-       Pulmonary rehabilitation, it’s a broad program for well being of patients with chronic COPD, includes:

o   Exercise program

o   Disease management training

o   Nutritional counseling

o   Psychological counseling

-       Oxygen therapy

o   May be needed all the time or only on occasions

o   Helps the patients in:

§  Performing tasks with less symptoms

§  Prevent damage to heart and other organs

§  Improves sleep

§  Improves activity levels when awake

-       Surgery

o   Bullectomy

§  Bullae are large air spaces in lungs, created when the air sacs walls are destroyed, they interfere with normal breathing

§  In this procedure, the large bullae are removed from the lungs

o   Lung volume reduction surgery

§  Removal of damaged tissue of the lung

§  Improves the breathing capability of the patients and enhances the quality of life in selected patients

o   Lung transplant

§  Can improve lung function

§  Infections or rejection can be fatal