What is COPD?

Chronic Obstructive Pulmonary Disease, commonly known as COPD, is a group of progressive diseases of the lungs. Progressive means that this disease gets worse over time. These are chronic inflammatory diseases characterized by airflow obstruction. People suffering from COPD are at a higher risk to be diagnosed with other heart problems, lung cancer and various other conditions. It has no cure, but with proper management and appropriate treatment, a person can achieve control over the symptoms, reduce the risk of other associated diseases and also lead a quality life.

How Does COPD Affect The lungs?

When a person breathes, the air travels from the windpipe (trachea) and reaches down to the lungs through two tubes called bronchi. The bronchi divides into many smaller tubes like a branch of a tree, the smaller tubes are called bronchioles. At the end of the small tubes are small sacs (alveoli). Alveoli have fragile walls that consist of tiny blood vessels (capillaries). The air passes through these blood vessels and enters the body’s bloodstream, and carbon dioxide is exhaled at the same time. The lungs rely on the elasticity of the bronchial tubes and the air sacs push the air out of the body. COPD causes damage to these tubes and sacs and eventually they over-expand, leaving some air trapped in the lungs even after a person exhales.

With COPD, the airways of the lung become inflamed, and flow of air in and out decreases. This results in less oxygen being supplied to the body, and it gets difficult for carbon dioxide to leave the body, which leads to COPD symptoms. COPD can cause coughing along with mucus, wheezing, breathlessness, and chest tightening. Smoking cigarette is one of the leading causes of COPD. A person suffering from COPD can have other respiratory infections like influenza or flu. Also, it is well established that not all smokers are diagnosed with COPD. It is also caused due to long-term exposure to irritants.

What Causes COPD?

Though cigarette smoking is one of the major reasons for a person to be diagnosed with COPD, there are other factors as well, that contribute to the development of COPD. Most people with COPD are at least at the age of 40 or above and they mostly have a history of smoking. Genetic susceptibility and other irritants are also risk factors for COPD.

Here is a list of risk factors for COPD:

• Exposure to Tobacco smoke – cigarette smokers, cigar smokers, marijuana smokers and even pipe smokers are at a higher risk of developing COPD. People who are exposed to secondhand smoke too often can also develop COPD.
• People with Asthma – Asthma is a chronic lung disease, and it can be a risk factor for a person to develop COPD
• Genetics - Alpha-1-antitrypsin deficiency is a rare condition of a genetic disorder, and it can cause COPD.
• Exposure to Tobacco smoke – cigarette smokers, cigar smokers, marijuana smokers and even pipe smokers are at a higher risk of developing COPD. People who are exposed to secondhand smoke too often can also develop COPD.
• Workplace exposure to chemicals and dust – Long term exposure to irritants such as vapour, fumes, chemicals, dust can inflame the lungs and may contribute to the development of COPD.
• Household air pollution - Prolonged exposure to household smoke emitted from fuel burning such as wood, agricultural waste, and animal dung attribute in the development of COPD.

Symptoms of COPD

COPD makes it difficult for a person to breathe. Initially, symptoms can be mild but as the diseases progress, these symptoms can become severe and frequent or continuous. Often, it is not diagnosed until the condition reaches an advanced stage as people might not know how to recognize the early signs and symptoms of COPD. The primary symptoms of COPD are:

• Producing an excess amount of mucus (phlegm)
• Chest tightening
• Coughing
• Wheezing
• Shortness of breath (dyspnea) after exercising or even after climbing a few stairs
• Frequent respiratory infections such as cold and flu

In later stages of COPD, a person may experience fatigue, weight loss, blue or grey fingernails (a sign of a low oxygen level in your blood), inability to talk, feeling confused, etc. and these symptoms would require immediate medical attention.

Types of COPD Diseases

Emphysema and Chronic Bronchitis are the two main diseases that contribute to COPD. These conditions might also occur at the same time, but the symptoms and severity of these conditions vary from person to person. Refractory asthma is also part of COPD disease.

• Chronic bronchitis is caused due to the inflammation of the airway linings of the lungs. These airways carry air to and from the air sacs of the lungs. One of the significant signs of chronic bronchitis is a daily cough and mucus production. The symptoms include breathing problems, frequent infections, and disability.
• Emphysema is a condition where damage is caused to the fragile walls and elastic fibers of the alveoli. When a person exhales, small airways collapse out of the lungs. The damage to sacs is irreversible and it results in permanent holed in the lung tissue.
• Refractory Asthma does not react to standard medications used for asthmatics. It may also be called an irreversible asthma condition.

Diagnosis and Treatment of COPD

Along with the questions asked by the doctor about symptoms and family history, there can be few tests recommended for confirming the diagnosis of COPD. One of the most reliable ways to diagnose COPD is the spirometry test that measures the speed and amount of air a person can blow out of the lungs. Another test called oximetry can help to estimate how much oxygen is present in a person’s blood (oxygen saturation). Other tests that can help to diagnose COPD are blood tests, peak flow test, ECG, chest X-ray, CT scan, etc.

The first step towards managing COPD would be to stop smoking. At times if breathing is affected, the person might be asked to use an inhaler. Pulmonary rehabilitation is an exercise programme designed for people suffering from lung diseases, such as COPD. Other treatment for COPD includes long-term oxygen therapy, nebulized medicine, or even surgery for patients with severe COPD.

COPD in Women

The number of deaths caused due to COPD is higher in women as compared to men. It can be because women’s lungs are more vulnerable to lung diseases. Estrogen may play a role in the worsening of lung disease in women.

How is COPD Related with Asthma?

COPD is a collection of disease and refractory asthma is a part of it. Thus, it is possible for a person to suffer from both COPD and asthma. It is known as asthma-COPD overlap syndrome (ACOS). Symptoms of asthma and COPD are often similar. At times, asthmatics might not realize that they have COPD. Asthma is triggered by allergens, and these allergens can make COPD symptoms worse. If these symptoms are left untreated, an asthmatic has higher chances of developing COPD. COPD and asthma are not the same, but COPD can be caused by asthma. COPD can be developed due to long-term exposure to certain environmental risk factors, often at workplaces. This same risk factor can also be a cause of occupational asthma.

To diagnose COPD or asthma, spirometry is a common test, and the doctor will ask the patient’s family history too. Asthma can be managed but COPD is a progressive disease and its symptoms will only get worse. However, after medications, the progression of COPD can slow down. There is no cure for both asthma and COPD, but treatment aims to manage symptoms and have a better quality of life with these conditions. Early diagnosis can help to improve the overall function of the lungs.

Complications in Health

Many other health problems accompany COPD. People suffering from COPD are at a higher risk of being diagnosed with any of these conditions:

• Respiratory infections
• Lung cancer
• High blood pressure in lung arteries
• Heart problems
• Depression

COPD requires long-term disease management and it significantly impacts on a person’s lifestyle. Having an action plan for emergencies will help to be prepared. COPD reduces life expectancy but with treatment and management of symptoms, it is more comfortable to live a life with this chronic disease. The doctor will be in the best position to evaluate a person’s health and then give an idea of what to expect.