Chronic Obstructive Pulmonary Disease
It is a long-term lung disease that characterized by difficulty breathing. It includes emphysema and chronic bronchitis. It causes restricted airflow and breathing problems. Damage caused to lungs by this condition is irreversible. The primary cause of COPD is smoking. However, it should be noted that not every smoker ends with the condition.
Symptoms can be managed by changes in lifestyle and proper prescription medications.
Stages of COPD rare;
- Mild COPD
- Moderate to severe COPD
- Very severe COPD
COPD increases chances for development of other health conditions. COPD increases risk for;
Typically, patients present with symptoms of chronic bronchitis, emphysema and sometimes asthma.
Emphysema is an abnormal, permanent enlargement of air spaces that are distal to the terminal bronchioles. It is accompanied by destruction of their walls and with no fibrosis.
Chronic bronchitis refers to presence of a chronic productive cough for 3 months during each of consecutive 2 years.
Key Facts
- Globally, COPD is the third leading cause of death and the seventh leading cause of poor health.
- It was responsible for more than 3 million deaths in 2019. These facts are presented in accordance with the World Health Organization.
- In developed nations(high income countries), smoking tobacco products accounts for 7 out of 10 cases of COPD.
- In LMIC(low and medium income countries), 30% of COPD cases are due to smoking.
- 9 out of 10 COPD-related deaths of individuals under 70 years happen in LMICs.
- In 2020, around 15 million American nationals were diagnose with COPD.
- Smoking tobacco is responsible for up to 90% of COPD cases.
Risk Factors
- Exposure to household air pollution.
- History of childhood respiratory conditions.
- Working in environments with chemicals and dust without proper protective clothing.
- Old age. Being over 65 years old.
- Sex. Individuals that were assigned female at birth.
- Genetics. Having AAT(alpha-1 antitrypsin) is a genetic risk factor.
Causes
- The main cause of COPD is smoking. However, it should be noted that not every smoker ends up developing the condition. Smoking causes irritation of the airways and subsequent inflammation. This makes airways to become narrower. Apart from this, smoke also causes damage to cilia, making them unable to trap unwanted particles in air.
- Passive(second-hand) smoke.
- Air pollution.
- Alpha-1 antitrypsin deficiency, which is a genetic disorder. This is a rare inherited condition that can predispose to emphysema. the enzyme alpha-1 antitrypsin protects lungs from damages caused by inflammation. Deficiency leads to decreased production. In such people, their lungs are likely to be damaged by irritating substances like smoke.
Signs & Symptoms
- Typically, patients present with symptoms of chronic bronchitis, emphysema and sometimes asthma.
- Wheezing
- Persistent cough with mucus
- Difficulty breathing in deeply
- Dyspnea/ shortness of breath even with mild exercises such as climbing up a staircase.
In severe disease;
- Peripheral edema
- Tachypnea
- Cyanosis
- Elevated jugular venous pulse(JVP)
Diagnosis
- Proper history-taking(anamnesis). Social, medical and recreational drug use history is captured.
- Clinical examination.
- Spirometry test to check how well the lungs are functioning.
- Arterial blood gas analysis.
- Pulse oximetry. A pulse oximeter measures the percentage of oxygen saturation in blood.
- Chest X-ray test or chest CT scan.
Note that pulse oximetry and spirometry are part of lung function tests.
Treatment & Management
- Bronchodilators. These are administered by inhalation through devices such as inhalers. Short-acting bronchodilators include albuterol and ipratropium while long-acting bronchodilators include salmeterol, formoterol and tiotropium.
- Anti-inflammatory medications. Steroid inhalation helps to reduce inflammation in the lungs. Inhaled steroids include fluticasone and budesonide.
- Supplemental oxygen for hypoxemic patients(low levels of oxygen in blood).
- Antibiotics. These are prescribed to stop progression of bacterial infections, as COPD makes an individual prone to lung infections
- Anticholinergic that relax muscles around airways.
- Rehab to teach effective techniques of breathing.
- Expectorants. The thin mucus along the airways so that it can be coughed out more easily.
- Antihistamines to relieve sneezing and watery eyes.
- Surgery. This includes lung transplant and lung volume reduction surgery.
Prevention
- Do not smoke. Avoid smoking at all cost.
- Avoid staying in environments that have dust, smoke, gases, fumes and generally poor quality air.