Definition and Overview

COPD, short for Chronic Obstructive Pulmonary Disease, is a general term used to describe a number of progressive lung diseases such as refractory asthma, chronic bronchitis, and emphysema. This disease is characterized by difficulty in breathing and unexplained, excessive feeling of tiredness. COPD can become a debilitating disease and is currently the fourth leading cause of death in the United States. It currently affects over 24 million patients in America alone, with at least half of them yet to be diagnosed. Men are more likely to contact COPD than women.

Causes of COPD

Chronic obstructive pulmonary disease is primarily characterized by shortness of breath. This is because of the decreased airflow in and out of the bronchial tubes in the lungs. The bronchial tubes are thinner, smaller tubes commonly referred to as bronchioles. These contain air sacs (alveoli), through which gas (oxygen and waste carbon dioxide) exchange occurs in the bloodstream. When a person has COPD, the air sac is unable to accommodate enough air flowing in and out of the lungs, depriving the body of much-needed oxygen. This occurrence can be caused by any of the following underlying reasons:

  • The air sacs and airways (bronchioles) lose their elasticity to accommodate air
  • The walls between air sacs are damaged or destroyed
  • The walls of the airways have become inflamed
  • Too much mucus buildup in the airways, causing clogging

Development of COPD can be attributed to several factors. Although smoking continues to be its usual cause, even non-smokers are inclined to contract this disease. The top three risk factors for the development of COPD are as follows:

  • Smoking: COPD most often occurs in people who are aged 40 and above, and who have a history of smoking, either as a current or past habit. About 90% of COPD cases are linked to smoking.

  • Environmental Factors: COPD can also develop in those who have long-term contact with cigarette smoke (second-hand smoke) or harmful pollutants including chemicals, fuel, fumes or dust.

  • Genetic Factors: Studies have found that a deficiency in the protein called Antitrypsin (a condition called Alpha-1 Antitrypsin Deficiency, AATD) increases one’s chances of developing COPD. Without this protein, the body’s natural immune system attacks the lungs, leading to lung deterioration. Recent research has established other genetic factors and predispositions that are linked to COPD.

Symptoms of COPD

The main symptom of COPD is chronic and long-lasting cough that comes with mucus and phlegm. This is often accompanied by shortness of breath that gets worse with physical activity. As COPD progresses, you may experience difficulty in breathing while performing the simplest activities like getting dressed or fixing the bed. It will become harder to exercise and move, with breathing taking more toll on your energy level.

Symptoms of COPD may suddenly appear and get much worse, leading to a stage called COPD exacerbation. Symptoms of this advanced stage of COPD can include excessive mucus, changes in color or thickness of the mucus, and greater tightness in the chest, often caused by infections such as pneumonia or aggravated by air pollution. COPD exacerbation is often life threatening and requires immediate medical care.

Types of COPD

COPD is often a combination of different lung diseases. The two main types of this condition are the following:

  • Chronic bronchitis: A lung disorder characterized by inflamed bronchial tubes that overproduce mucus, which results to blockage of the airways.

  • Emphysema: A condition that occurs when the air sacs become brittle and damaged, resulting to less elasticity to accommodate air that gets in and out of the lungs.

When to See a Doctor

If you have been experiencing breathlessness and mucus-laden cough that worsens or persists over a long period, it is imperative to see your doctor as soon as possible. Although these symptoms may not always be indicative of COPD, a doctor consultation is necessary to rule out possibilities. During your appointment, you will be asked about your medical history, including history of smoking, asthma or exposure to pollutants. If COPD is suspected, your general practitioner will refer you to a pulmonologist or pulmonary specialist for treatment.

Diagnosing COPD

In order to conclusively diagnose COPD, certain tests have to be performed. A breathing test called the spirometry or FEV1 test measures the amount of air that flows in and out of your lungs and the speed in which the air moves. A chest x-ray can also be performed to rule out other conditions that have similar symptoms, such as lung cancer or tuberculosis. Arterial blood gas or oximetry test to measure oxygen and carbon dioxide levels or electrocardiogram to rule out heart disease may also be performed.

The sooner the COPD is diagnosed, the better the chances for proper management of this condition. Screening tests, especially for those who smoke (or are ex-smokers) and those who have higher risk of developing COPD, is highly recommended.

Treatment Methods for COPD

Currently, there is no definitive cure for COPD. Treatment for this condition is aimed only at slowing down the progression of the disease, managing symptoms, preventing attacks or flare-ups and promoting overall health. Treatment can come in the form of medications such as bronchodilators to manage cough and breathing problems, corticosteroids to treat flare-ups, PDE4 inhibitors to prevent exacerbation, and methylxanthines for serious COPD cases.

Aside from medications, doctors usually recommend a pulmonary rehabilitation program to train the heart, muscles and mind to maximize the function of the damaged lungs. This program involves breathing therapy, exercise, nutrition advice, and constant education. Quitting smoking and avoidance of air pollutants are very important to slow down the progress of this disease.

For severe COPD cases, oxygen treatment and surgery may be recommended.

References:

  • British Lung Foundation (2014). What is COPD? Available: http://www.blf.org.uk/Page/what-is-COPD
  • Center for Disease Control and Prevention (2012). Chronic Obstructive Pulmonary Disease (COPD) Available: http://www.cdc.gov/Features/COPD/
  • Global Initiative for Chronic Obstructive Lung Disease (2013). Global Strategy for the Diagnosis, Management, and Prevention of COPD. Available: http://www.goldcopd.org/guidelines-global-strategy-for-diagnosis-management.html.
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