Chronic Obstructive Pulmonary - Symptoms, Risk factors and Treatment

Chronic obstructive pulmonary disease, or COPD, is an umbrella term used for a combination of diseases that affect the lungs and cause airflow obstruction.


COPD includes emphysema and chronic bronchitis. These two conditions usually co-exist and cause airflow obstruction. Unlike some diseases in which there is trouble getting air into the lungs, in COPD air can’t be properly expelled out of the lungs. This causes air trapping inside the lungs, which affects normal gas exchange.


Emphysema:

In this condition, the small airways of the lungs (alveoli) become dilated which prevents air from being exhaled properly out of the lungs.


Chronic bronchitis:

In chronic bronchitis, the large and medium-sized airways- the bronchi get inflamed. Inflammation causes loss of cilia- tiny structures that help get rid of the mucus from the bronchi. The mucus buildup causes chronic cough. A cough with mucus that lasts for 3 months or more in a year for at least 2 years 


Causes of COPD:

Tobacco smoking: Tobacco is one of the most common causes of COPD in developed countries. The risk of getting COPD increases with increasing cigarettes. Passive smoking can also play a role in COPD.


Exposure to other irritant gases: Other than tobacco smoke, exposure to other irritants such as cooking fires fueled by wood remains a big cause of COPD in developing countries. Occupational exposure to different irritants can also play a role in COPD such as:


  • Exhaust gas

  • Cadmium 

  • Silica dust

  • Coal dust

  • Gold dust

  • Cotton dust


Genetic causes: Not everyone with exposure to the above-mentioned smokes and gases develops COPD, meaning there are some other factors too that play a role in COPD. One such genetic condition identified is alpha-1 antitrypsin deficiency. Alpha-1 antitrypsin is a protein that protects the lungs from an enzyme that can damage the lung tissue. When alpha-1 antitrypsin is low, the lungs are unprotected from damage, and as a result, COPD can develop.


Asthma: The risk of COPD is increased in people with asthma. Smoking along with asthma increases the risk of COPD even further.


Symptoms of COPD:


The symptoms of COPD include:


  • Chronic cough

  • Cough with lots of mucus

  • Breathlessness, particularly on exertion

  • Wheezing 

  • Chest tightness

  • Frequent respiratory tract infections

  • Fatigue

  • Swollen ankles, feet, or legs

  • Unintentional weight loss


Diagnosis of COPD:


COPD can be diagnosed by history, physical exam, and investigative tests. Your doctor may ask questions related to smoking history or any exposure to irritant smoke etc. During a physical exam, your doctor will listen to your chest using a stethoscope. To confirm the diagnosis, your doctor may suggest different tests such as:


  • Spirometry to assess lung function

  • X-ray 

  • CT scan


Treatment of COPD:


There is no cure for COPD. However, with proper treatment, the condition can be managed well. The treatment of COPD usually includes:


Bronchodilators: These are drugs given in the inhaled form. They decrease airway resistance and increase airflow to the lungs.


Corticosteroids: They are responsible for controlling inflammation and are usually administered in inhaled form. During COPD exacerbations, they may be given as tablets.


Antibiotics: COPD increases the risk of different respiratory tract infections. Long-term antibiotics may be given to control infections and exacerbations of COPD.


Oxygen supplementation: In severe COPD, supplemental oxygen may be given to increase oxygen supply to the lungs.


Surgery: Surgery may be suggested to treat very severe COPD. Lung volume-reduction surgery involves the resection of parts of the lungs affected by emphysema. A lung transplant may also be suggested in very severe diseases.


Conclusion:


COPD is a serious condition that requires lifelong management. With appropriate treatment, the disease progression can be slowed and the quality of life can be restored to normal. It is highly advisable to follow your treatment properly to avoid serious complications. Quit smoking if you smoke. Smoking is a major cause of COPD, and to prevent it, you must stop smoking. 

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