Chronic Obstructive Pulmonary Disease (COPD)

What is a chronic obstructive pulmonary disease (COPD)? 

The chronic obstructive pulmonary disease also called COPD, is a group of progressive lung diseases that can interfere with normal breathing and it obstructs airflow from the lungs. It can lead to a faster progression of heart problems and worsening respiratory infections but timely treatment for COPD will help to ease the symptoms, lower the chance of complications, and improve the quality of life. A person suffering from COPD is at increased risk of developing heart disease and lung cancer. Emphysema and chronic bronchitis are the most common conditions contributing to COPD.

  • Emphysema is a chronic lung condition destroying the fragile walls and elastic fibres of the alveoli. This will reduce respiratory function and can cause breathlessness. The damage to the air sacs is irreversible and it could result in permanent “holes” in the lung tissue.
  • Chronic bronchitis is a condition where your bronchial tubes become inflamed and narrowed and your lungs produce more mucus, which can further block the narrowed tubes.

How does COPD affect your lungs?

To understand how COPD affects the lung you need to understand how the lung generally works. Oxygen travels down your windpipe (trachea) into your lungs through two large tubes (bronchi). Inside your lungs, these tubes divide like the branches of a tree into many smaller tubes (bronchioles) ending in clusters of tiny air sacs (alveoli).

The air sacs have thin walls full of tiny blood vessels (capillaries). The oxygen in the air you inhale passes into these blood vessels and thus enters your bloodstream. At the same time, carbon dioxide is exhaled.

Your lungs depend on the natural elasticity of the bronchial tubes and the air sacs force the air out of your body. COPD will cause them to lose their elasticity and over-expand, leaving some air trapped in your lungs when you exhale.

What are the symptoms of the chronic obstructive pulmonary disease?

The symptoms of COPD do not appear until significant lung damage has occurred, and they will worsen over time. The signs and symptoms of COPD include the following:

  • Shortness of breath, especially during physical activities
  • Wheezing
  • Chest tightness
  • A chronic cough that produces mucus (sputum) may be clear, white, yellow or greenish
  • Frequent respiratory infections
  • Lack of energy
  • Unintended weight loss (in later stages)
  • Swelling in ankles, feet or legs

Are there any complications of COPD?

COPD can cause many complications which include:

  • Respiratory infections – People with COPD usually get flu and pneumonia. Respiratory infections will make it more difficult to breathe and cause further damage to the lung tissue.
  • Heart problems – COPD increases your risk of a heart attack.
  • Lung cancer People with COPD have a risk of developing lung cancer.
  • Pulmonary Hypertension (High blood pressure in lung arteries) – COPD may cause high blood pressure in the arteries that bring blood to your lungs.

What are the causes of COPD? 

COPD is not contagious and the causes are as follows:

  • Exposure to tobacco smoke – The major cause of chronic bronchitis and emphysema is cigarette smoking.
  • Occupational exposure to dust and chemicals – Long-term exposure to air pollution and inhaling dust can also cause COPD.
  • Exposure to fumes from burning fuel – When people cook in poorly ventilated homes or who work in factories where there is high exposure to fumes/smoke.
  • Genetics –  Heredity may also be a factor.
  • Asthama – A person with asthma is at risk of diagnosing with COPD.

How can you prevent complications associated with COPD?

These are some steps you can take to help prevent complications associated with COPD:

  • Quit smoking to help you reduce the risk of heart disease and lung cancer.
  • Annual flu vaccination and regular vaccination against pneumococcal pneumonia are required to prevent some infections.

What are the treatment options for COPD?

Treatment will ease symptoms, prevent complications, and slow the progression of the disease. The treatment options for COPD are as follows:

  • Medication – Bronchodilators are medications that help to relax the muscles of the airways, widening the airways so that you can breathe easier. They are taken through an inhaler or a nebulizer. Glucocorticosteroids are added to reduce inflammation in the airways.
  • Oxygen therapy – If your blood oxygen level is too low, you can receive supplemental oxygen through a mask or nasal cannula to help you to breathe better. A portable unit can make it easier to move around.
  • Surgery – There are in total three surgical options used for the treatment of severe chronic obstructive pulmonary disease, these are:
    • Bullectomy – Bullectomy is reserved for severe cases of COPD or when other treatments have failed. In this procedure, surgeons will remove large, abnormal air spaces (bullae) from the lungs.
    • Lung volume reduction surgery – In this surgery, the damaged upper lung tissue is removed.
    • Lung Transplantation – In some cases, a lung transplant is the best option for the treatment of COPD.
  • Lifestyle changes – Quit smoking and avoid secondhand smoke and chemical fumes.

    The COPD rehabilitation programs include the following:

    • Medication management
    • Exercises to reduce respiratory symptoms and improve muscle strength
    • Respiratory treatments to improve breathing ability
    • Assistance in obtaining respiratory equipment and portable oxygen
    • Methods to increase independence for activities of daily living (ADLs)
    • Exercises for physical conditioning and improved endurance
    • Stress management, relaxation exercises, and emotional support
    • Smoking cessation programs
    • Nutritional counselling
    • Patient and family education and counselling
    • Vocational counselling

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