Chronic Health Diseases and ConditionsDisorders and Diseases

COPD: Symptoms, Causes, Treatment

What is COPD? Definition, Causes, Symptoms, Stages, Diagnosis, Complications and Treatment of COPD...

What is COPD?

COPD (Chronic Obstructive Pulmonary Disease) is an umbrella term, used to refer a group of progressive lung diseases, including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some other forms of bronchiectasis.

Most people with Chronic Obstructive Pulmonary Disease usually have both emphysema and chronic bronchitis.

COPD (Chronic Obstructive Pulmonary Disease) causes obstructed airflow from the lungs and results in symptoms like shortness of breath, chronic cough, and wheezing.

Symptoms of COPD may be mild at first, beginning with coughing and shortness of breath. As the COPD progresses, it can become increasingly difficult to breathe.

COPD

The top cause of Chronic Obstructive Pulmonary Disease is tobacco smoking. Prolong exposure to chemical irritants can also lead to this condition. It’s a disease that typically takes a very long time to develop.

It’s estimated that about 3 Crore people in the USA alone suffering from COPD.


How does COPD occur?

COPD is typically caused by cigarette smoking. The longer one smokes the higher the risk of contracting Chronic Obstructive Pulmonary Disease.

Regular inhaling of second-hand smoke can also cause this disease. Prolonged exposure to air pollutants, dust, workplace fumes, biomass smoke like wood smoke too are causes of Chronic Obstructive Pulmonary Disease.

When we breathe in, oxygen-rich air passes down the windpipe and into small bronchial tubes or airways situated in the lungs.

These bronchial tubes divided into numerous tinier tubes which are known as bronchioles. At the end of the bronchioles are some small, round air sacs known as alveoli, which have tiny blood vessels called capillaries.

When the air enters the alveoli, oxygen passes through the capillaries and then into the bloodstream and carbon dioxide moves into the alveoli so we can breathe it out.

Smoking and air pollutants damage the walls between the air sacs so that they become weak over the time period, and their walls break open.

This creates single large air sac, instead of the many tiny ones making it more difficult for the capillaries to absorb enough oxygen and for the body to expel the carbon dioxide. This will lead to, the affected person struggles to breathe.


Causes of COPD

The main causes of COPD include:

  • Smoking cigarettes or cigar
  • Exposure to fumes such as burning fuel for cooking and heating in poorly ventilated homes
  • Long time exposure to air pollutants, dust, and workplace fumes
  • Second hand or passive smoke
  • Infectious diseases which destroy lung tissue in patients

In developed countries such as the USA, the single biggest cause of Chronic Obstructive Pulmonary Disease is cigarette smoking. Around 90% of people who have this disease are smokers or former smokers.

Among long-time smokers, about 20 to 30% develop Chronic Obstructive Pulmonary Disease while many others develop chronic lung conditions or have reduced lung function.

Most people with Chronic Obstructive Pulmonary Disease are at least 40 years old and have at least some history of smoking.

Your risk of Chronic Obstructive Pulmonary Disease is even greater if you have asthma and smoke.


Symptoms of COPD

Symptoms of COPD

Early symptoms of COPD:

  • Shortness of breath, typically after exercising
  • A recurrent cough with the mucus
  • Needing to clear your throat often, typically first thing in the morning
  • Fatigue

As lungs get more damages the symptoms are more severe such as:

  • Shortness of breath, after even mild exercise like walking up a flight of stairs
  • Wheezing, whistling or squeaky sound when breathing
  • Chest discomfort or chest tightness
  • A chronic cough, with or without the mucus
  • Need to clear mucus from your lungs each day
  • Frequent colds, flu, and other respiratory infections
  • Lack of energy

Advanced stage symptoms of COPD:

  • Swelling of the feet, ankles, and legs
  • Weight loss

Symptoms which needs immediate medical care:

  • Bluish or grey fingernails or lips, as this indicates low oxygen levels in the blood
  • Trouble catching a breath or cannot talk
  • Feeling confused, muddled, and faint
  • Heart is racing

Who is at higher risk to COPD?

People who are prone to Chronic Obstructive Pulmonary Disease include:

  • Those who smoke daily
  • People who are exposed to secondhand smoke from tobacco
  • Injection drug addicts
  • A person who have immune deficiency syndromes
  • People who have connective tissue disorders
  • People who suffer from genetic problems like Salla disease

Risk factors of COPD

  • Exposure to tobacco smoke
  • A person with asthma who smoke
  • Occupational exposure to dust particles and chemicals
  • Exposure to the fumes from burning fuel
  • Age, i.e above 40 years
  • Genetic disorder alpha-1-antitrypsin deficiency

Diagnosis of COPD

A general practitioner can easily diagnose COPD, however, if your condition is much severe then he may refer patient to a pulmonologist.

The doctor will start the diagnosis by asking the patient about his habits such as smoking, lifestyle, i.e., if he is exposed to secondhand smoke, air pollution, dust, and chemicals on a daily basis, and his past medical history.

He can suggest the patient undergo some tests such as:

  • Spirometry: To check how well the lungs work.
  • Chest x-ray: This can show emphysema, one of the main causes of this disease and also rule out other lung conditions or heart failure.
  • Arterial blood gas test: This can measure the oxygen level in the blood.
  • CT scan of lungs: It can help detect emphysema and determine if a patient might benefit from surgery for COPD.
  • Laboratory tests: to determine if a patient has the genetic disorder alpha-1-antitrypsin (AAt) deficiency, this can be the cause of some cases of COPD.

Complications of COPD

The complications of COPD (Chronic Obstructive Pulmonary Disease) include:

  • Arrhythmia
  • Depression 
  • Coronary Artery Disease
  • Pneumonia
  • Heart failure
  • Lung cancer
  • Right-Sided Heart Failure
  • Trouble sleeping
  • Dementia
  • Death

Treatment of COPD

There’s no exact cure for COPD (Chronic obstructive pulmonary disease), however, treatment can ease symptoms, prevent complications, and typically slow disease progression.

If smoking is the only cause of this disease, the doctor will ask you to stop smoking immediately else he will go with other types of treatments.

Medication

Bronchodilators are medications which help relax the muscles of the airways, widening the airways so the patient can breathe easier.

They’re typically taken through an inhaler or a nebulizer. Glucocorticosteroids can be used to reduce inflammation in the airways.

To lower risk of related respiratory infections, ask your doctor if you should get a yearly flu shot, pneumococcal vaccine, and a tetanus booster which includes protection from pertussis (whooping cough).

Some medications used for the treatment of COPD include:

  • Inhaled bronchodilators
  • Corticosteroids
  • Phosphodiesterase-4 inhibitors
  • Theophylline
  • Antibiotics and antiviral
  • Vaccines

Oxygen therapy

If the patient’s blood oxygen level is very low, he can receive supplemental oxygen through a mask or nasal cannula to help him breathe better.

Surgery

Surgery is reserved for severe Chronic obstructive pulmonary disease or when other treatments have failed, which is more likely when you have a form of severe emphysema.

Another type of surgery is called a bullectomy. During this procedure, surgeons remove large, abnormal air spaces (bullae) from the patient’s lungs.

Another treatment is lung volume reduction surgery, which removes damaged upper lung tissue. Lung transplantation is also an option in a few cases.

Lifestyle changes

Certain lifestyle changes can also help alleviate patient’s symptoms or provide relief.

  • Quit Smoking
  • Avoid secondhand smoke and chemical fumes.
  • Get rich nutrition and create a healthy eating plan.
  • Discuss to your doctor regarding how much exercise is safe for you.

Exercise

It may seem difficult to exercise as patient trouble breathing due to COPD, but exercising regularly can improve the overall strength and endurance and also strengthen the respiratory muscles.

It is highly advisable to discuss with the doctor regarding which exercises will be appropriate for you.

Exercises which are usually recommended for chronic obstructive pulmonary disease patients include:

  • Walking
  • Cycling
  • Tai Chi

For people having mild COPD:

  • Jogging
  • Rowing
  • Skating
  • Water aerobics

Diet recommendations for a patient with COPD

There’s no specific diet for this disease, however, a healthy diet is very important for maintaining overall health. The stronger you are, the abler you’ll be to fight or avoid complications and other health problems.

Choose a variety of nutritious foods from below groups:

  • Vegetables
  • Fruits
  • Grains
  • Protein
  • Dairy

Drinking at least 6 to 8-ounce glasses of noncaffeinated liquids a day can help keep mucus thinner which may make the mucus easier to cough out. Avoid caffeinated beverages as they can interfere with medications.

A full stomach makes it harder for the lungs to expand, leaving you short of breath. If that happens, try below remedies:

  • Clear your airways about 60 minutes before a meal.
  • Take smaller bites of food which you can chew slowly before swallowing.
  • Swap 3 meals a day for 5 or 6 smaller meals.

Stages of COPD

One measure of Chronic Obstructive Pulmonary Disease is achieved by spirometry grading. There are different grading systems of this condition, and one grading system is part of the GOLD classification.

The GOLD classification is used for determining the severity of Chronic Obstructive Pulmonary Disease and helping to form a prognosis and treatment plan.

There are 4 GOLD grades based on Spirometry testing:

GRADETYPE
1Mild
2Moderate
3Severe
4Very Severe

This is based on the Spirometry test result of a patient’s FEV1. This is the amount of air patient can breathe out of the lungs in the first one second of a forced expiration. The severity increases as a patient’s FEV1 decreases.


A connection between COPD and lung cancer

Chronic Obstructive Pulmonary Disease and lung cancer are major health problems worldwide. These 2 diseases are linked with each other in a number of ways. Both have several common risk factors like smoking.

It was estimated in 2009 that between 40 to 70 % of people with lung cancer also have COPD.

A 2015 study suggests they may actually be different aspects of the same disease, and that Chronic Obstructive Pulmonary Disease could be a driving factor in lung cancer.

However, having COPD doesn’t necessarily mean that you’ll get lung cancer.


COPD facts and statistics

  • Worldwide, it’s estimated that about 6.5 Crore people have moderate to severe COPD.
  • About 1.2 Crore adults in the USA have a diagnosis of COPD.
  • Most people with this disease are 40 years of age or older.
  • The majority of patient with COPD are smokers or former smokers.
  • Between 20 to 30% of chronic smokers develop this disease that shows symptoms and signs.
  • Between 10 to 20% of people with Chronic Obstructive Pulmonary Disease have never smoked.
  • In up to 5% of people with Chronic Obstructive Pulmonary Disease, the cause is a genetic disorder involving a deficiency of a protein called alpha-1-antitrypsin.
  • This disease is a leading cause of hospitalizations in industrialized countries.
  • In the United States, COPD is responsible for a higher amount of emergency department visits and hospital admissions.
  • In the year 2000, it was noted that there were over 7 million hospital admissions and approximately 1.5 million emergency department visits for this disease.
  • Among people with lung cancer, between 40 to 70 % also have COPD.
  • About 1.2 million people die from this disease each year in the United States alone. It’s the third leading cause of death in the USA.
  • More women than men die from Chronic Obstructive Pulmonary Disease each year.
  • It’s estimated that the number of patients diagnosed with COPD (Chronic Obstructive Pulmonary Disease) will increase by more than 150 % from 2010 to 2030.

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