CONDITIONS
Chronic Obstructive Pulmonary Disease (COPD)
What is COPD?
COPD, or chronic obstructive pulmonary disease, is a progressive lung disease that causes restricted airflow and breathing difficulties.
COPD refers to two main lung conditions including:
- Emphysema: Emphysema develops when there is damage to the lung’s tiny alveoli (air sacs). Normally, these sacs are elastic and usually stretched like ballons during breathing. When an individual breathes in, each air sac fills up with air, and when an individual breathes out, the air sacs deflate, and the air goes out. In emphysema, these sacs become stiff; they cannot stretch, making it harder for the lungs to move air out of the body, causing breathing difficulties and fatigue.
- Chronic bronchitis: It inflames and irritates the airways, resulting in redness and swelling. Excess mucus production by airway glands makes extra mucus (phlegm), which blocks some air from passing through, leading to coughing, mucus expulsion, and breathlessness.
COPD can lead to coughing that produces significant amounts of slimy mucus. It also results in breathing difficulties, shortness of breath, chest tightness, and other symptoms. As COPD is a progressive condition, its symptoms typically develop gradually but worsen over time, potentially restricting the ability to perform routine activities. Advanced COPD may hinder basic tasks like walking, cooking, or self-care.
What happens to the lungs in COPD?
Over time, COPD reduces the airflow in and out of the airways due to:
- Loss of elasticity in air sacs and airways.
- Damage to the walls between air sacs.
- Inflammation of airway walls.
- Accumulation of mucus leads to airway blockage.
What causes COPD?
- Smoking: The number one cause of COPD is tobacco smoke. 75% of COPD patients have a history of smoking.
- Air Pollution: Long term exposure to lung irritants can also cause COPD. This includes secondhand smoke, and chemicals or fumes from workplace environments, and other sources of air pollution.
- Genetics: Alpha-1 Antitrypsin deficiency is a genetic condition that causes COPD.
- Repeated lung infections during childhood
- Severe asthma
What are the common signs and symptoms of COPD?
COPD may begin with experiencing breathlessness or persistent coughing when walking up or down stairs. Individuals often confuse these symptoms with signs of aging, reduced fitness, or asthma. Symptoms may include morning coughing and increased breathlessness. In the early stages, symptoms may not be constant, but as COPD advances, performing everyday activities becomes increasingly difficult due to shortness of breath.
Common symptoms of COPD include:
- Shortness of breath (breathlessness), especially with physical activity
- A cough that lasts longer than three months
- Increased phlegm or mucus production, which is often thick and white or brownish in colour
- Feeling tired
- More frequent chest infections
- Taking longer to recover from a cold or chest infection
How is COPD diagnosed?
- Listening to lungs and heart.
- Measuring blood pressure and pulse.
- Examining nose and throat.
- Assessing feet and ankles for swelling.
Spirometry: Spirometry is the most common breathing test used to confirm a diagnosis of COPD. It is a simple breathing test that measures the speed and the amount of air an individual can blow out of the lungs.
Other tests may include:- Chest X-ray: An imaging test is performed to look for any lung changes due to COPD.
- CT scan: CT scan provides more detailed pictures than an X-ray to examine the lungs and surrounding organs.
- Arterial blood gas analysis: A blood test that measures the lungs’ ability to oxygenate the blood and remove carbon dioxide
- Electrocardiogram (ECG): ECG checks heart function and rules out heart disease as the cause of shortness of breath.
Pulse oximetry: Measures oxygen in the blood.
How is COPD managed?
The primary treatment for COPD in smokers is quitting smoking. Medications and therapies can aid in nicotine addiction treatment. Medications can help manage COPD symptoms and prevent exacerbations. COPD treatment aims to alleviate symptoms like coughing and breathing difficulties, and to avoid respiratory infections. Treatment options include:
- Bronchodilators: Inhaled medications that relax airways.
- Anti-inflammatory medications: Inhaled steroids or oral pills to reduce lung inflammation.
- Supplemental oxygen: Oxygen is used for people who have had COPD for a long time or have severe COPD. Portable tanks to boost low blood oxygen levels.
- Antibiotics: To treat lung infections.
- Vaccinations: Important for preventing flu and pneumonia.
- Rehabilitation: Pulmonary rehabilitation programs to teach exercises to improve breathing.
- Anticholinergics: Drugs that relax airway muscles and clear mucus.
- Leukotriene modifiers: Medications to reduce airway muscle tightening and mucus production.
- Surgery: Surgery may be considered in severe advanced cases of COPD where other treatments have not been effective.
- Lung volume reduction surgery (LVRS): This procedure involves removing damaged tissue from the lungs to improve lung function and reduce breathlessness. It is typically considered for patients with severe emphysema.
- Lung transplant: In very severe cases of COPD where other treatments have failed, a lung transplant may be considered. This involves replacing one or both diseased lungs with healthy lungs from a donor.
- Bullectomy: This procedure involves removing large, damaged air sacs called bullae that can form inside the lungs.
Lifestyle changes can help improve symptoms of COPD, and management includes:
- Quitting smoking
- Avoid secondhand smoke and indoor cooking fumes.
- Maintain regular physical activity and stay active
- Protect against lung infections by:
- Getting an annual flu vaccine.
- Receiving the pneumonia vaccine.
- Maintain proper nutrition
In summary, chronic obstructive pulmonary disease (COPD) is a common lung condition characterized by airflow restriction and breathing difficulties. Often referred to as emphysema or chronic bronchitis, COPD can lead to lung damage or mucus buildup, resulting in symptoms such as coughing (sometimes with phlegm), shortness of breath, wheezing, and fatigue. Smoking and exposure to air pollution are primary causes of COPD, placing individuals at higher risk for other health issues. While COPD is not curable, symptom management is possible through lifestyle changes like quitting smoking and minimizing exposure to air pollutants, along with receiving vaccinations to prevent infections. Treatment options include medications, supplemental oxygen, and pulmonary rehabilitation programs aimed at improving lung function and overall well-being.
References
- Respiratory Health Association. Living better with COPD: A guide for you. Available from: https://resphealth.org/wp-content/uploads/2021/11/RHA-COPD-Guide-2021.pdf Accessed on 23rd April 2024
- National Heart, Lung, and Blood Institute (NIH). COPD. Available from: https://www.nhlbi.nih.gov/health/copd Accessed on 23rd April 2024
- American Thoracic Society. Chronic obstructive pulmonary disease (COPD). Available from: https://www.thoracic.org/patients/patient-resources/resources/copd-intro.pdf . Accessed on 23rd April 2024
- Cleveland Clinic. Chronic obstructive pulmonary disease (COPD). Available from: https://my.clevelandclinic.org/health/diseases/8709-chronic-obstructive-pulmonary-disease-copd . Accessed on 23rd April 2024
- Breathe the lung association. A COPD Handbook. Available from: https://www.lung.ca/sites/default/files/LungAssociation_COPDHandbook_ENFINAL_0.pdf Accessed on 23rd April 2024
- Chronic obstructive pulmonary disease (COPD). Available from: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd) Accessed on 23rd April 2024
- When to consider surgery for COPD. Available from: https://www.webmd.com/lung/copd/copd-surgery Accessed on 23rd April 2024
