CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
Q 1. What is COPD?
Answer: CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis. This disease is characterized by increasing breathlessness.
Emphysema occurs when the tiny air sacs in your lungs — the alveoli — break down and become larger. With the destruction of the alveoli, your lungs are less able to get oxygen out of the air and less effective at getting rid of carbon dioxide. The walls of the damaged air sacs are stretched and less flexible, so that air is trapped inside the lungs. When this happens the airways can become "flabby," and don't push out air as well. And because so much air is trapped in the lungs, your diaphragm (the muscle at the bottom of the lungs that acts like an accordion) can become shortened and unable to assist in breathing. Damaged air sacs trap air inside your lungs. You might feel that it's hard to take a deep breath. Like old balloons, the tiny air sacs get stretched out of shape and break down. Old air gets trapped inside the air sacs so there is no room for new air to get in.
Chronic bronchitis is an inflammation of the airways. It results in coughing (with phlegm) that you have every day, and that occurs often. The inflammation occurs when the tiny hair-like projections — called cilia — that line your bronchial tubes are damaged. Normal cilia help propel mucus up the bronchial tubes. But when cilia are damaged, it becomes harder to cough up mucus, which in turn causes more coughing, more irritation, and more mucus production. And that means your airways become swollen and clogged. The result is obstruction and increased shortness of breath. You might say you have a "smoker's cough" or a cold that won't go away. But it could be due to damaged airways that have gotten tight, swollen, and filled with mucus. These changes limit airflow in and out of your lungs. And, this makes it hard to breathe.
Q 2. What is the signs and symtomps of COPD?
Answer: Symptoms of COPD can be different for each person, but the common symptoms are:
- Shortness of breath*
- Frequent coughing (with and without sputum or phlegm)
- Increased breathlessness
- Feeling tired, especially when exercising or doing daily activities
- Wheezing
- Tightness in the chest.
Q 3. What are the causes of COPD?
Answer:
The causes are:
1. Long-term exposure to lung irritants that damage the lungs and the airways usually is the cause of COPD.
2. Cigarette smoking
3. Breathing in secondhand smoke, air pollution; or chemical fumes or dusts from the environment or workplace also can contribute to COPD.
4. Rarely, a genetic condition called alpha-1 antitrypsin deficiency may play a role in causing COPD
Q 4. What are the diagnosis process?
Answer:
- Pulmonary Function Tests
Pulmonary function tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood.
The main test for COPD is spirometry. Other lung function tests, such as a lung diffusion capacity test, also might be used. .
SPIROMETRY
During this painless test, a technician will ask you to take a deep breath in. Then, you'll blow as hard as you can into a tube connected to a small machine. The machine is called a spirometer.
The machine measures how much air you breathe out. It also measures how fast you can blow air out.
| The image shows how spirometry is done. The patient takes a deep breath and blows as hard as possible into a tube connected to a spirometer. The spirometer measures the amount of air breathed out. It also measures how fast the air was blown out. |
The test results also may help find out whether another condition, such as asthma or heart failure, is causing your symptoms.
- Other Tests
- A chest x ray or chest CT scan.
- An arterial blood gas test.
Treatment
COPD has no cure yet. However, lifestyle changes and treatments can help you feel better, stay more active, and slow the progress of the disease.
The goals of COPD treatment include:
- Relieving your symptoms
- Slowing the progress of the disease
- Improving your exercise tolerance or your ability to stay active
- Preventing and treating complications
- Improving your overall health
Types of medicines often prescribed for COPD:
- Bronchodilator
Bronchodilators relax the muscles around the airways which helps to keep them open and makes breathing easier. Most bronchodilators are often delivered through an inhaler or can be nebulized.
Bronchodilators can be short-acting or long-acting. Short-acting bronchodilators work quickly so that you get relief from symptoms fast, but they wear off in a few hours. Long-acting bronchodilators provide relief for many hours, but the effect may be slower. Short- and long-acting bronchodilators include beta2-agonists and anticholinergics.
- Beta2-Agonists are very potent at relaxing tightened muscles around your airways. This opens the airway and makes breathing easier. Short-acting beta-agonists work within minutes but last only 4-6 hours. Long-acting beta-agonists may be slow to start working but can last up to 12 to 24 hours so are used to maintain open airways throughout the day or the night.
- Anticholinergics prevent the muscles around your airways from tightening so keep the airways open and help clear mucus from your lungs. This combination allows your cough to expel mucus more easily. There are short-acting and long-acting anticholinergics.
Beta-agonists and anticholinergics can be delivered through an inhaler or a nebulizer.
- Anti-Inflammatory
Decreasing inflammation leads to less swelling and mucus production in the airways and that makes it easier to breathe. These medicines are known as corticosteroids or steroids. They are usually inhaled with an inhaler device.
Corticosteroids can also be swallowed as a pill and are usually delivered for short periods of time in special circumstances when your symptoms are getting more severe. Steroids have serious side effects, such as weight gain, diabetes, osteoporosis, cataracts and increased risk of infection so they must be monitored carefully. Your doctor will talk with you about these side effects.
- Combination Medicines
A corticosteroid, an anticholinergic and a beta-agonist can be combined into one inhaler or nebulizer solution. The most common combinations contain two or three of these medicines as a:
- Short-acting beta-agonist and short-acting anticholinergic
- Long-acting beta-agonist and corticosteroid
- Long-acting anticholinergic and corticosteroid
- Long-acting beta-agonist and long-acting anticholinergic
- Long-acting beta-agonist, long-acting anticholinergic and corticosteroid
- Antibiotics
People with COPD do experience flare-ups with more coughing, more mucus and more shortness of breath. This is often caused by bacterial or viral infections. Your doctor may give you an antibiotic to keep on hand and fill for when you have an infection.
Make sure you take all of the antibiotic exactly as prescribed.
- Vaccinations
COPD increases your risk for infection with influenza (flu) and pneumonia. Vaccines are available to protect you against the flu and you should get immunized every year. You need a yearly flu shot because the influenza virus changes slightly every year and you must get the latest and newest vaccine.
Pneumococcal pneumonia is a bacterial infection of the lung that often follows an influenza infection. There are two vaccines to protect against this infection. You only need to get vaccinated once but you need to get each one. Your doctor can provide these to you.
Vaccinations are very important for people living with COPD to prevent COPD flare-ups so you can be healthy.
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