What is chronic obstructive pulmonary disease?

According to the World Heath Organization (WHO), chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, causing 3.3 million deaths in 2019. In 2020, 148,512 people died from COPD in the United States, while in the UK an estimated 30,000 people die from the disease each year. COPD is a common disease and, while there is currently no cure, treatment can help slow the progression of the condition and control the symptoms. But COPD is also a preventable disorder, with healthy lifestyle choices key factors in halting its onset. So, what exactly is COPD, and how do its symptoms manifest themselves?

COPD definition

Chronic obstructive pulmonary disease (COPD) is the name for a group of chronic inflammatory lung diseases that cause obstructed airflow from the lungs.

Emphysema

The two most common conditions of COPD are emphysema and chronic bronchitis. Emphysema, or pulmonary emphysema, is a chronic lower respiratory tract disease where the air sacs in the lungs (alveoli) are damaged.

Chronic bronchitis

Chronic bronchitis is inflammation (swelling) and irritation of the bronchial tubes, the airways leading to your lungs.

Symptoms of COPD

COPD symptoms vary, and often don’t appear until significant lung damage has occurred. An early sign that something is amiss is shortness of breath, especially during physical activities.

Wheezing

Wheezing, the shrill, coarse whistling or rattling sound your breath makes when your airway is partially blocked, is an obvious sign of difficulty with breathing.

Chesty cough

A persistent chesty cough or hack that produces sputum or thick phlegm is another main symptom of COPD.

Chest infections

Those suffering the onset of COPD experience chest infections—for example, lower respiratory tract infections, both acute and chronic— with increased frequency.

Lack of energy

Persistent coughing, wheezing, and a propensity to chest infection is debilitating and often results in fatigue and a lack of energy.

Swelling

Swelling in the ankles, feet, or legs can be a sign of COPD. Swelling happens due to complications of COPD called pulmonary hypertension. It’s another warning sign not to be ignored.

When to see a doctor

If symptoms persist over several days, it’s time to see a doctor. This is especially so if you’re over 35 and a habitual smoker, or used to smoke. And always seek immediate medical care if you can’t catch your breath.

Diagnosing COPD

In order to determine an accurate diagnosis of COPD your doctor will ask you about your symptoms. Analysis usually includes a number of tests.

Chest examination

Typically, a patient will undergo a simple chest examination. The doctor will need to listen to your breathing using a stethoscope.

Spirometry

Depending on signs and symptoms, they may also do, or arrange for you to have, a breathing test called spirometry. This is a common procedure undertaken to assess how well your lungs work by measuring how much air you inhale, how much you exhale, and how quickly you exhale.

Chest X-ray

COPD diagnostics usually extend to a chest X-ray. An X-ray can be used to look for problems in the lungs that can cause similar symptoms to COPD. It can also reveal emphysema, one of the main causes of the disease.

Blood tests

Your doctor may recommend an arterial blood gas analysis. This measures how well your lungs are bringing oxygen into your blood and removing carbon dioxide. A blood test can also determine conditions that can cause similar symptoms to COPD.

Genetic problem

A blood test can also identify whether or not you have alpha-1-antitrypsin deficiency. This is a rare genetic problem that increases your risk of COPD.

Additional tests

Further tests to confirm the diagnosis or to determine the severity of COPD may include an electrocardiogram, echocardiogram, CT scan, and peak flow test—a breathing test that measures how fast you can blow air out of your lungs.

Causes of COPD

Data published by WHO points to the lung damage caused by long-term smoking as the leading cause of COPD. In fact, smoking is thought to be responsible for around nine in every 10 cases. Note, however, that just because you smoke it doesn’t necessarily follow that you will develop the disease.

Dusts and chemicals

Other causes of COPD include long-term exposure to occupational dusts and chemicals, fumes and vapors for example that can irritate and inflame your lungs.

Fumes

Other important risk factors include welding fumes and those emitted from burning fuel. In the developing world, people exposed to fumes from burning fuel for cooking and heating in poorly ventilated homes are at higher risk of developing COPD. Likewise, childhood respiratory infections are other important risk factors for COPD in developing nations.

Grain and flour dust

Exposure to grain and flour dust is associated with the development of respiratory symptoms and varying degrees of reduction in lung function.

People with asthma

People with asthma and already suffering a chronic inflammatory airway disease are at high risk of developing COPD. The risk factor increases considerably if they are also exposed to tobacco smoke.

Air pollution

According to The Lancet, air pollution exposure is considered an important risk factor for COPD, though the link is not conclusive and research is ongoing.

Complications from COPD

The most common complication of COPD is what’s known as a  exacerbation, or flare-up, in which respiratory symptoms suddenly worsen.

Lung cancer

People with COPD have a higher risk of developing lung cancer.

Depression

Being stricken with any medical disorder that inhibits your ability to undertake daily activities can induce feelings of anxiety and a depressed state of mind. COPD is no different.

Heart problems

Patients with severe COPD are particularly vulnerable to cardiac disease, for example the aforementioned pulmonary hypertension. This happens when the pressure in the blood vessels leading from the heart to the lungs is too high.

Treatment and prevention

The best way to prevent COPD is to never smoke. Of course, many people do. So, quit smoking now. If this sounds like an insurmountable hurdle, it’s essential to find a tobacco cessation program that can help you stub out the habit for good.

Vaccinations

Keep up to date with your jabs. Get an annual flu vaccination and regular vaccination against pneumococcal pneumonia. This will help lessen the risks of some infections.

Use of inhaler

If COPD is affecting your breathing, you’ll usually be given an inhaler. Indeed, short-acting bronchodilator inhalers are often the first treatment recommended. An inhaler can help relieve coughing and shortness of breath and make breathing easier.

Lung therapies

Another option in the fight against COPD is pulmonary rehabilitation, or PR (pictured). PR is a program of exercise and education designed to assist those living with the condition. Treatments include breathing techniques and positions to help you when you’re out of breath, and tips on how to use your inhalers and other medicines.

Supplemental oxygen

Long-term sufferers of COPD may be advised to have oxygen at home through nasal tubes or a mask to maintain sufficient blood-oxygen levels.

Surgery

One of the last resorts in tackling COPD is surgery. This is an option for some with severe emphysema who aren’t helped sufficiently by medications alone. A lung transplant may be required in extreme cases.

Sources: (WHO) (The Guardian) (MedlinePlus) (Johns Hopkins Medicine) (European Respiratory Journal) (International Journal of Tuberculosis and Lung Disease) (The Lancet) (WebMD) (American Lung Association) (British Lung Foundation)

Source: What is chronic obstructive pulmonary disease? (msn.com)