Chronic Obstructive Pulmonary Disease - Causes, Symptoms, Diagnosis and Prevention
Health Education

Chronic Obstructive Pulmonary Disease

Dr.Sai Praveen Haranath profile Authored by Dr.Sai Praveen Haranath on 18 Jul 2014 - 13:32.

Chronic Obstructive Pulmonary Disease (COPD) is characterized by obstruction of the airflow into and out of the lungs leading to shortness of breath, cough and sputum production. It is a progressive disease which often leads to continued decrease in lung function over time .

When you breathe in, the air goes down the windpipe into tubes in your lungs called bronchial tubes or airways. These bronchial tubes branch into thousands of smaller, thinner tubes called bronchioles which end into bunches of tiny round air sacs called alveoli.

When you breathe in, each air sac fills up with air like a small balloon as they are elastic in nature. Similarly when you breathe out, the air sacs deflate as the air goes out. The air sacs if stretched out are almost the size of a tennis court.

In a person suffering from COPD, less air flows in and out of the airways because of any of the following reasons:

  • The airways and air sacs lose its elasticity.
  • The walls between the air sacs are destroyed.
  • The walls of the airways become thick and inflamed.
  • The airways make abnormally more mucus thus clogging them.

Obstruction of air flow may result from either of the two types of COPD:

  • Emphysema: It is a condition characterized by damaged air sacs (alveoli).
  • Chronic Bronchitis: it is characterized by inflammation of the air way track.

COPD is also known as Chronic Obstructive Airway Disease (COAD)

  • Cigarette smoking: it is one of the major causes of COPD.
  • Environment: Heavy exposure to environmental pollution and poor ventilation at home may cause COPD. Use of wood and other fuel to burn for cooking is often a cause especially among wornen.
  • Occupational exposure: Certain occupations like coal mining, welding, etc may gradually lead to development of COPD.
  • Genetics: Genetic makeup of an individual may also play a role in developing COPD.

Symptoms include the following:

  • Shortness of breath
  • Cough
  • Sputum production
  • Chest pain
  • Wheezing
  • Fatigue 
  • Bluish discoloration of skin

COPD diagnosis can be confirmed by performing one or more of the following:

  • Evaluation by a physician such as an internist or pulmonologist
  • Pulmonary function test
  • X-ray
  • CT-scan

    Severity:

    ​According to Global Initiative for Chronic Obstructive Lung Disease (GOLD), COPD can be differentiated into four grades based on the severity of the disease. The measure below is an index of how much airflow is lost from the disease. The normal values depend on age, race ,gender and height.

    Severity

    FEV1 % (Forced Expiratory Volume)

    Mild

    ≥80

    Moderate

    50-79

    Severe

    30-49

    Very severe

    <30

     

 

Although COPD cannot be treated completely, it can be controlled and prevented from worsening. The key to control COPD is to reduce the risk factors and treat the symptoms. Smoking cessation is the first line treatment of COPD. Medicines which are used in COPD are:

Bronchodilators: these are the agents responsible for dilating the airway resulting in free airflow. Short acting bronchodilator such as Salbutamol is used in mild COPD, whereas long acting agents like Salmeterol and Formoterol are used in severe disease.

Anti-cholinergic agents: These agents relax and enlarge the airways in the lungs and also reduce mucus production. Ex: Ipratropium Bromide.

Corticosteroids: These medications may help in reducing the number of exacerbations in a COPD patient. (Exacerbation is a sudden worsening or a flare-up of COPD). Corticosteroids are used in inhaled as well as oral forms. Budesonide is commonly used as inhaled corticosteroid and Methyl Prednisolone or Hydrocortisone are used orally.

Antibiotics: Macrolide antibiotics such as azithromycin are commonly used for reducing exacerbations.

Methylxanthines: Theophylline is a mild bronchodilator, which is used in some cases as third line of therapy.

Mucolytics: These drugs help in breaking down the mucous into a less viscous substance, which can be easily coughed out. Ex: Ambroxol & Acetylcysteine.

Long-term Oxygen therapy: This can be helpful for hypoxemic( low oxygen) patients to ease their breathing.

Pulmonary rehabilitation is known to decrease overall sensation of shortness of breath and help in mobility training.

Some patients need machines like noninvasive ventilation to help with breathing especially when sleeping.

General measures to monitor nutrition and other diseases the patient may have like diabetes or heart disease is also important.

Surgical Options:

  • Lung Volume Reduction Surgery (LVRS) for Emphysema
  • Bronchoscopic Lung Volume Reduction (LVR)
  • Bullectomy
  • Lung transplantation

The following may help in preventing COPD:

  • Smoking should be avoided.
  • Influenza & Pneumococcal vaccination may also help in preventing worsening of the disease.
  • Respirators should be used during welding process and at work places like coal mines.
  • Good ventilation should be maintained at home.

 

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.