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Overview
Chronic Obstructive Pulmonary Disease (COPD) is a disease that would cause damage to the lung that is permanent and the airways of the lungs (bronchi) to narrow down. This creates trouble breathing at the advanced stage of the disease. Activities that are performed daily like climbing stairs, gardening, and walking can cause trouble breathing. COPD takes a while to develop or it can be said that it develops gradually, Persistent cough is a normal symptom of COPD which can be easily mistaken for asthma or a normal smoker’s cough. Hence COPD is often diagnosed when the symptoms get worse and it is often diagnosed at an age of over 60 years old. The goal of the treatment is to slow down the progression of the disease or to completely stop it. It is very important to quit smoking in order to avoid COPD. There are also medicines that are available that can provide relief from the symptoms and would prevent shortness of breath. There are several educational programs designed for COPD patients that can to cope with the disease.
Consulting Doctor
Pulmonologist or lung specialist.
Symptoms
Pulmonologist or lung specialist.
Causes
Inflammation of the bronchi.
-Overinflated ait sac or alveoli of the lung which is called pulmonary emphysema.
-Long-term cough called chronic bronchitis in case of exposure to tobacco, smoke, dust, or gases.
-Destruction of cilia due to inflammation (tiny hairs that line inside of nasal hair like carpet)
-Trapping of dust and germs from outside to inside the mucus layer that can prevent them from reaching the lungs. Musus is transported out of the bronchi.
-Clogged bronchi due to damaged cilia since mucus cannot move out of the lungs.
-Damaged wall of air sac and formation of the large air sac that decreases the surface area of the lungs and thus less oxygen enters the bloodstream.
Diagnosis:
- Pulmonary (Lung) function test: This test measures the quantity of air one can inhale or exhale and if your lung can deliver enough oxygen to your lungs. A common test called spirometry is performed where the air is blown into a large tube that is connected to a small machine to measure how much air your lung can hold and how long it takes to blow the air out of the lungs. Measuring lung volume and diffusion capacity are also measured along with a six-minute walk test and pulse oximetry.
- X-ray of the chest: Emphysema can clearly be seen in chest x-ray which is one of the main causes of COPD. Other lung problems or heart failure can also be ruled out from chest x-ray.
- CT scan: Emphysema can be detected from a CT scan and is used to determine if surgery for COPD is beneficial. It is also used for screening for lung cancer.
- Analysis of arterial blood gas: A blood test is performed that measures the binding capacity of oxygen to the lungs and the removal of carbon dioxide.
- Lab test: Test are not used to diagnose COPD but it is used to determine the source of symptoms or rule out other conditions. Genetic disorders of alpha 1 antitrypsin deficiency can also be determined through lab tests since this can also cause COPD. In case of a family history of COPD and its development at a young age, this test is performed.
Prevention
- Do not smoke or quit smoking if you are a current smoker. Try combining a support program and nicotine replacement therapy.
- Avoid harmful substances from the environment and workplace. Protective measures should be taken to avoid exposure to harmful substances at the workplace.
- Avoid flares that are often triggered by infections.
- One should stay away from sore throat, sweats, and fever that can weaken the body.
- One should take enough care to avoid infection during cold and flu.
- One should avoid contact with people during cold and large crowds.
- One should have administered flu and pneumococcal vaccines.
Treatment
One of the ways to treat this disease is the manage symptoms for their relief in order to improve quality of life. Furthermore, the purpose is to slow down the progression of this disease so that exacerbation can be prevented.
Taking prescribed medication is essential as a step to treat this disease. Medicines can either be inhaled or can be taken orally. A combination of various drugs is used which depends on to what extent the disease has progressed.
The following are the drugs that are available:
1, Drugs that dilate or open the airway or bronchodilators: Bronchodilators are the drugs that are inhaled in powder form that makes it easier to breathe. Some the examples of bronchodilators include beta 2 agonists, anticholinergics, and methylxanthines.
2. Medication containing steroids: Steroid medication in the form of spray and tablets can be used to reduce inflammation of the airways.
3. PDE4 inhibitors: These are the medications available that have anti-inflammatory effects.
At times. Oxygen therapy is also provided depending on the disease severity. After exhausting all the treatment options for COPD, surgery is also performed. In a process called bullectomy, overinflated parts of the lungs are reduced in size. It is also known as lung volume reduction surgery. At times, a lung transplant is also needed.
-Physical exercise, breathing, changes in diet, and inhalation can also be used as supportive measures along with the treatment.
-Rehabilitation: Pulmonary rehabilitation is also performed to cope up with the disease and live a normal life as soon as possible. A treatment plan based on an individual’s needs is outlined that includes a combination of physical exercise, an educational program on dealing with the disease, and support groups to provide emotional and social support.
-Pulmonary rehabilitation is an important part of COPD management which can be performed either on an inpatient or an outpatient basis.
Useful information:
-The impact of this disease on a day to day’s life depends upon the severity of this condition and the extent to which the disease has progressed. Symptoms worsen as the time passes and it has been found to cause only minor problems. During severe conditions, it is hard to lead a normal life and people often end up in nursing homes and extensive support care homes.
-People often adjust their lifestyle and daily routine according to their body’s needs. Specialized breathing and relaxation exercises are often helpful.
-One should allow themselves to have lot of rest and should only engage in low-impact sports activities.
-Emotional and social support from friends and family is also helpful.
Tests Required for Diagnosis
- Pulmonary (Lung) function test: This test measures the quantity of air one can inhale or exhale and if your lung can deliver enough oxygen to your lungs. A common test called spirometry is performed where the air is blown into a large tube that is connected to a small machine to measure how much air your lung can hold and how long it takes to blow the air out of the lungs. Measuring lung volume and diffusion capacity are also measured along with a six-minute walk test and pulse oximetry.
- X-ray of the chest: Emphysema can clearly be seen in chest x-ray which is one of the main causes of COPD. Other lung problems or heart failure can also be ruled out from chest x-ray.
- CT scan: Emphysema can be detected from a CT scan and is used to determine if surgery for COPD is beneficial. It is also used for screening for lung cancer.
- Analysis of arterial blood gas: A blood test is performed that measures the binding capacity of oxygen to the lungs and the removal of carbon dioxide.
- Lab test: Test are not used to diagnose COPD but it is used to determine the source of symptoms or rule out other conditions. Genetic disorders of alpha 1 antitrypsin deficiency can also be determined through lab tests since this can also cause COPD. In case of a family history of COPD and its development at a young age, this test is performed.
Useful info
The impact of this disease on a day to day’s life depends upon the severity of this condition and the extent to which the disease has progressed. Symptoms worsen as the time passes and it has been found to cause only minor problems. During severe conditions, it is hard to lead a normal life and people often end up in nursing homes and extensive support care homes.
-People often adjust their lifestyle and daily routine according to their body’s needs. Specialized breathing and relaxation exercises are often helpful.
-One should allow themselves to have lot of rest and should only engage in low-impact sports activities.
-Emotional and social support from friends and family is also helpful.
References
- Institute of Quality and Efficiency In healthcare (2017). Chronic obstructive pulmonary disease (COPD): Overview. National Library of Medicine. https://doi.org/https://www.ncbi.nlm.nih.gov/books/NBK315789/
Mayo Clinic (2023, January 1). COPD- Diagnosis. Mayoclinic. Retrieved May 22, 23, from https://www.mayoclinic.org/diseases-conditions/copd/diagnosis-treatment/drc-20353685
