Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) represents an inflammatory condition that negatively and progressively affects the lungs by obstructing the airflow, thus making it difficult to breath. Usually, it includes two diseases, namely chronic bronchitis and emphysema. The first disease causes the inflammation of the bronchial tubes, which have the mission to carry the air to and from the lungs, and the production of mucus, a blockage for the airways that leads to difficulties in normal breathing. The second disease refers to the major damage of the air sacs in the lungs. In those people who do not have emphysema, the tiny air sacs are stretchy meaning that during breathing, they change size in order to permit the air move through the lungs. However, people with this condition feel short of breath because the respective air sacs lose the necessary elasticity so the lungs do not receive enough air. Unfortunately, nobody can restore the health of the lungs entirely but there are efficient ways to avoid more damage and decrease the risk of associated conditions.


Causes of Chronic Obstructive Pulmonary Disease (COPD)

In developed countries, the primary cause of COPD is smoking and breathing tobacco as well as the exposure to fumes coming from burning fuel and heating resulting from homes with poor ventilation. With the passage of time, cigarette smoke proves to be extremely harmful for the lungs because it destroys the elastic fibers in the lungs and irritates the bronchial tubes. Taking into account that the lung damage needs many years to start manifesting and showing the characteristic symptoms, elders are more prone to chronic obstructive pulmonary disease. In addition, only a certain percentage of the smokers develop this condition, which means that other factors like genetic susceptibility and severe lung infections during childhood contribute to its development. Risk factors for COPD involve:

  • Long-term exposure to tobacco smoke, which represents the most significant cause for developing this disease; practically, the risk increases after smoking many packs of cigarettes for many years.
  • People with airway hyper-responsiveness, which is a feature of chronic asthma, and smoking habits, face a greater risk of chronic obstructive pulmonary disease.
  • Exposure to dusts, vapors and chemicals in the work environment can lead to irritation and inflammation of the lungs.
  • Alpha-1 antitrypsin deficiency represents a genetic factor that, even though is very rare, places a certain percentage of individuals at higher risk for this condition due to the absence of a protective factor necessary for lung tissue elasticity.
  • Immune deficiency syndromes, connective tissue disorders, intravenous drug use and other genetic problems also represent harmful factors that could damage the lungs.


Signs and Symptoms of Chronic Obstructive Pulmonary Disease (COPD)

Because chronic obstructive pulmonary disease shows a slow progress, the initial signs and symptoms are quite mild and because of this, sometimes people mistake them for a cold. They include shortness of breath after tiring activities, mainly after exercise, mild but lingering cough, also known as smoker’s cough, production of a lot of mucus, which explains the need of people with COPD of clearing their throat often. Nevertheless, if the tobacco exposure continues, the symptoms will become worse gradually and people usually start eliminating certain activities from their daily schedule as well as avoiding stairs. With the passage of time, the lungs suffer more damage and they simply cannot overlook the serious and specific symptoms of COPD that refer to chest tightness, lack of energy, shortness of breath caused by simple actions like normally walking up stairs, frequent colds and respiratory infections, chronic cough, daily necessity of clearing mucus from the lungs and noisy breathing. Ultimately, in later stages, chronic obstructive pulmonary disease provokes weight loss, fatigue and swelling of the feet.

People with COPD must seek immediate medical attention or care if they experience heart palpitations and confusing or fainting episodes, trouble catching their breath or inability to speak or if they have low oxygen levels in the blood, which they can recognize by the color of their lips and fingernails, usually bluish or grey.


Signs and Symptoms of Chronic Obstructive Pulmonary Disease (COPD)


Complications of Chronic Obstructive Pulmonary Disease (COPD)

In the lack of a proper diagnosis and treatment for COPD, people can experience several complications.

Heart problems: In people with chronic obstructive pulmonary disease, the body does not benefit from the needed oxygen. Furthermore, eliminating the carbon dioxide waste produced in the body becomes significantly more difficult. In serious cases, people experience hypoxia, meaning that a low level of oxygen flow through the blood and hypercapnia, which refers to high levels of carbon dioxide. On the long term, these two can provoke acute respiratory failure leading to arrhythmia. Practically, the heart starts to beat irregularly. Besides arrhythmia, coronary artery disease can result from lung inflammation and narrow the blood vessels that have the purpose to bring oxygen, nutrients and blood to the heart.

Pneumonia: This represents a very dangerous infection caused by the presence of bacteria or viruses in the lungs, which can lead to death in certain cases. The risk becomes even greater for those with chronic obstructive pulmonary disease, due to their weakened pulmonary system. Thus, in order to prevent lung infections, maintaining an overall good health is essential. Prevention methods include quitting the harmful habit of smoking, washing their hands consistently, drinking plenty of water, getting flu and pneumonia vaccines.

Lung cancer: It should not be surprising that smokers develop lung cancer, taking into consideration the warnings on the cigarettes packs. Nevertheless, researchers have discovered a connection between chronic obstructive pulmonary disease and lung cancer, even in people who do not smoke. The cause lies in the chronic inflammation of the lungs. Another possible cause is genetics.

Diabetes:  Even though COPD does not lead to diabetes, it becomes an obstacle in battling the symptoms of diabetes. Dealing with chronic obstructive pulmonary disease and diabetes at the same time could cause complications due to the combination of medications for both conditions. These types of people may experience an aggravation of symptoms because diabetes restricts the cardiovascular system. Failing to monitor the blood sugar levels can reduce lung function. The implication of a doctor becomes imperative for prescribing medications that work together as a treatment for both conditions.

Psychiatric complications of COPD

Older COPD patients are most likely to experience a gradual mental decline, usually dementia because of the irreversible damage in the blood vessels of the brain, high carbon dioxide and low oxygen. Several actions and methods have the power to prevent dementia development, such as controlling diabetes and cholesterol, maintaining a normal and healthy body weight as well as engaging in stimulating activities to sharpen the mind. Furthermore, people in late stages of the condition, encounter difficulties when it comes to performing everyday activities including walking up stairs or lifting and carrying heavier objects. A good percentage of those people suffer from insomnia, which increases the risk for psychiatric conditions including anxiety, depression and agoraphobia, a fear of situations and places that might cause negative feelings like embarrassment, helplessness and even panic.


Prevention of Chronic Obstructive Pulmonary Disease (COPD)

Unlike other conditions, chronic obstructive pulmonary disease has a specific cause, which allows a sure path of prevention. Considering that most cases appear as a direct result of tobacco smoking, putting an end to this habit represents the most certain way of preventing COPD development. For tobacco fiends, this efficient solution is quite challenging, almost impossible. However, working with a specialist and creating a beneficial tobacco cession program is critical. After all, this represents the only chance of preventing lung damage. The exposure to dust and fumes at the workplace is another risk for COPD because these chemicals provoke lung irritation so for those people with harmful work environments talking with a supervisor and agreeing on certain protection methods like respiratory protective equipment is very important.

In order to slow the progression and prevent the appearance of complications following chronic obstructive pulmonary disorder, apart from the prevention methods mentioned above, observing the doctor’s treatment and instructions sacredly will help the patients live actively, breathe easier and manage severe symptoms. Moreover, discussing with the doctor concerning flu, pneumonia or influenza vaccines is imperative because it can significantly lower the chances of dealing with these types of illnesses in the near future.


Diagnosis of Chronic Obstructive Pulmonary Disease (COPD)

Taking into account that doctors commonly misdiagnose people with chronic obstructive pulmonary disease, they prefer to wait for the condition to advance and assess attentively and carefully the characteristic signs and symptoms of COPD before reaching a conclusion. After reviewing the symptoms, they proceed to ask about the family and medical history as well as performing a physical exam and various tests. The patient has the duty to be very honest and inform the doctor if he is or he was a smoker, if he works in a harmful environment for the lungs, if he suffers from respiratory conditions like asthma or if he takes over the counter medications. The physical exam consists of using a stethoscope to listen closely the patient’s lungs during breathing. After receiving the necessary information from the medical history, the conversation with the patient and the physical exam, the doctor may choose to perform further tests in order to complete the diagnosis for COPD. These tests include:

  • Spirometry: This represents the most common procedure for evaluating the lung function. After taking a deep breath, the patient must blow into a tube connected to a small apparatus known as spirometer, hence the name of the test. This is very useful for the doctor because it helps him determine the amount of air the lungs can support and the amount of time before blowing the air out. Spirometry can detect COPD before the manifestation or the appearance of symptoms. In addition, doctors use it for tracking the progression of the condition and monitoring the efficiency of the treatment.
  • Imaging tests, namely CT scan and chest X-ray, allow the doctor to examine in detail the patient’s lung, heart and blood vessels. They easily detect emphysema, which represents a main cause of chronic obstructive pulmonary disease.
  • Arterial blood gas analysis: Doctors use this test when looking for clear signs of COPD because it helps them measure the capacity of the lungs when it comes to bringing oxygen into the blood and eliminating carbon dioxide.
  • Laboratory tests: Even though doctors do not use these tests for establishing a proper diagnosis, it does help them discover the exact cause of the patient’s symptoms and exclude the possibility of other diseases. For instance, it gives them the ability to determine the presence of the genetic factor alpha-1 antitrypsin deficiency, which can lead to COPD in certain cases. Usually, they choose laboratory tests for patients with a family history of chronic obstructive pulmonary disease or patient under 45 who develop this condition.


Healthy vs. COPD


Treatment for Chronic Obstructive Pulmonary Disease (COPD)

Receiving a diagnosis leads to a proper treatment for COPD that has the power to ease upsetting symptoms, avoid complications, control the progression of the condition and increase the overall health of the patient. Generally, different specialists intervene including a pulmonologist as well as physical and respiratory therapists.

  • Medication: Doctors prescribe multiple medications for patients with chronic obstructive pulmonary disease, according to their needs. Bronchodilators have the purpose to help the patient breathe easier by relaxing the muscles of the bronchial tubes. In addition, they can add other medications to the treatment for reducing the inflammation in the airways.
  • Oxygen therapy: This method is helpful for those patients with low oxygen levels in the blood because it allows them to receive extra oxygen through a mask or a small tube placed inside the nose. They do not have to remain in the hospital for this therapy because they have the possibility to carry a portable unit with them.
  • Treatment for weight loss and muscle weakness: Patients with COPD encounter difficulties maintaining a healthy weight and a strong body. For this reason, lifestyle changes that focus especially on the diet are necessary.
  • Surgery: Even though surgery represents the last resort in severe cases of chronic obstructive pulmonary disease, doctors are most likely to consider it for patients with emphysema. Bullectomy is a common type of surgery that consists in removing large air sacs from the patient’s lungs.

Last updated on March 2nd, 2018

Chris Riley

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