Know about COPD (Chronic obstructive pulmonary disease)

1. What is COPD?

Chronic obstructive pulmonary disease, or COPD, is a group of progressive lung diseases. The most common are emphysema and chronic bronchitis. Many people with COPD have both of these conditions.

Emphysema slowly destroys air sacs in your lungs, which interferes with outward air flow. Bronchitis causes inflammation and narrowing of the bronchial tubes, which allows mucus to build up.

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

You may experience wheezing and tightness in the chest. Some people with COPD have exacerbations, or flare-ups of severe symptoms.

COPD

The top cause of COPD is smoking. Long-term exposure to chemical irritants can also lead to COPD. It’s a disease that takes a long time to develop.

Diagnosis usually involves imaging tests, blood tests, and lung function tests.

There’s no cure for COPD, but treatment can help ease symptoms, lower the chance of complications, and generally improve quality of life. Medications, oxygen therapy, and surgery are some forms of treatment.

Untreated, COPD can lead to heart problems and worsening respiratory infections.

COPD

About 24 million people in the United States have COPD. As many as half are unaware that they have it.

2. What are the symptoms of COPD?

At first, symptoms of COPD can be quite mild. You might be inclined to dismiss them as a cold.

Early symptoms include:

• occasional shortness of breath, especially after exercise
• mild but recurrent cough
• needing to clear your throat often, especially first thing in the morning
• You might start making subtle changes, such as avoiding stairs and skipping physical activities.

COPD

Symptoms can get progressively worse and harder to ignore. As the lungs become more damaged, you may experience:

• shortness of breath, after even mild exercise such as walking up a flight of stairs
• wheezing, or noisy breathing
• chest tightness
• chronic cough, with or without mucus
• need to clear mucus from your lungs every day
• frequent colds, flu, or other respiratory infections
• lack of energy

In later stages of COPD, symptoms may also include:

• fatigue
• swelling of the feet, ankles, or legs
• weight loss

Immediate medical care is needed if:

• you have bluish or gray fingernails or lips, as this indicates low oxygen levels in your blood
• you have trouble catching your breath or cannot talk
• you feel confused, muddled, or faint
• your heart is racing
• Symptoms are likely to be much worse if you currently smoke or are regularly exposed to smoke.

  COPD

3. What causes COPD?

In developed countries like the United States, the single biggest cause of COPD is cigarette smoking. About 90 percent of people who have COPD are smokers or former smokers. Among smokers, 20 to 30 percent develop COPD. Many others develop lung conditions or have reduced lung function.

Most people with COPD are over 40 years old and have at least some history of smoking. The longer you smoke, the greater your risk of COPD is. In addition to cigarette smoke, cigar smoke, pipe smoke, and secondhand smoke can cause COPD.

Your risk of COPD is even greater if you have asthma and smoke.

You can also develop COPD if you’re exposed to chemicals and fumes in the workplace. Long-term exposure to air pollution and inhaling dust can also cause COPD.

In developing countries, along with tobacco smoke, homes are often poorly ventilated, forcing families to breathe fumes from cooking and heating fuel.

There may be a genetic predisposition to developing COPD. Up to 5 percent of people with COPD have a deficiency in a protein called alpha-1-antitrypsin. This deficiency causes the lungs to deteriorate and also can affect the liver. There may be other genetic factors at play as well.

COPD isn’t contagious.

COPD

4. Treatment for COPD

Treatment can ease symptoms, prevent complications, and generally slow disease progression. Your healthcare team may include a lung specialist (pulmonologist) and physical and respiratory therapists.

Medication

Bronchodilators are medications that help relax the muscles of the airways so you can breathe easier. They’re usually taken through an inhaler. Glucocorticosteroids can be added to reduce inflammation in the airways.

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

Oxygen therapy

If your blood oxygen levels are low, you can receive oxygen through a mask or nasal prongs to help you breathe better. A portable unit can make it easier to get around.

Surgery

Surgery is reserved for severe COPD or when other treatments have failed, which is more likely when you have emphysema. One type of surgery is called bullectomy. That’s when surgeons remove large air sacs (bullae) from the lungs. Another is lung volume reduction surgery, which removes damaged lung tissue.

Lung transplant is an option in some cases.

Lifestyle changes

Certain lifestyle changes may also help alleviate your symptoms or provide relief.

These include:

• If you smoke, quit. Your doctor can recommend appropriate products or support services.
• Whenever possible, avoid secondhand smoke and chemical fumes.
• Get the nutrition your body needs. Work with your doctor or dietician to create a healthy eating plan.
• Talk to your doctor about how much exercise is safe for you.

COPD

Medications can reduce symptoms and cut down on flare-ups. It may take a bit of trial and error to find the medication and dosage that works best for you. These are some of your options:

Bronchodilators

Medicines called bronchodilators help loosen tight muscles around your airways. They are typically taken through an inhaler or nebulizer.

Short-acting bronchodilators last from four to six hours. You only use them when you need them. For ongoing symptoms, there are long-acting versions you can use every day. They last about 12 hours.

Some bronchodilators are beta-agonists. They work by relaxing tightened muscles around the airways. Some are anticholinergics. They prevent muscle tightening and clear mucus from the lungs. Anticholinergics can also be taken with a nebulizer.

Corticosteroids

Sometimes bronchodilators are combined with inhaled glucocorticosteroids. Using the two together can reduce inflammation in the airways and lower mucus production. Corticosteroids are also available in pill form.

COPD

Phosphodiesterase-4 inhibitors

This newer medication in pill form reduces inflammation and changes mucus production. It’s generally prescribed for severe COPD.

Theophylline

This medicine eases chest tightness and shortness of breath. It may help prevent flare-ups. It’s available in pill form.

Antibiotics and antivirals

Antibiotics or antivirals may be prescribed when you develop respiratory infections.

Vaccines

COPD increases your risk of other respiratory problems. For that reason, your doctor might recommend that you get a yearly flu shot, the pneumococcal vaccine, or the whooping cough vaccine.