COPD – symptoms, causes and treatment

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease of lungs. It causes the obstruction in the normal airflow to and from the lungs.

COPD includes:

  • Emphysema
  • Chronic bronchitis

COPD is a common disease and through proper management, it can be prevented and controlled.

The term chronic refers to long standing. Chronic obstructive pulmonary disease encloses the long term diseases that obstructive the airflow in lungs.

Symptoms of Chronic Obstructive Pulmonary Disease

Lungs have a huge capacity and therefore the symptoms of COPD may not appear until the lungs are damaged to a significant degree. However, once the disease has developed, it keeps on worsening, especially if the patient keeps on smoking or remains exposed to lung irritants and smoke.

A patient is suspected to have chronic bronchitis when:

  • Daily productive cough (cough with sputum) for at least 3 months per year
  • This 3 month session appears for 2 years consecutively

Common symptoms of chronic obstructive pulmonary disease include:

  • Wheezing – whistle sound when breathing
  • Chest tightness
  • Dyspnea on exertion – shortness of breath when doing some exertion or heavy task
  • Productive cough – cough with sputum
    • Sputum may be clear or of any color including:
      • White
      • Yellow
      • Green
    • Uneasiness in throat and the urge to clear the throat as first thing in the morning
      • It’s due to the accumulation of mucous overnight in your lungs
    • Cyanosis – bluish discoloration of skin due to lack of oxygenated blood
      • Usually on fingernail beds and lips
    • Respiratory tract infections frequency is increased
    • Feeling of tiredness and lacking energy
    • Unintended and unplanned weight loss – especially in the late stages

This is not the complete list of symptoms and it may include various other signs and symptoms too.

COPD is often accompanied with exacerbations in some patients. During these episodes, the patient suffers with more marked symptoms as compared to normal days, which may last for a few days.

chronic-obstructive-pulmonary-disease

Causes of COPD

When the lungs are exposed to various damaging irritants for a long duration, it can damage the lungs and ultimately develop COPD.

Common causes of COPD include:

  • Various forms of tobacco smoking
    • Cigarette
    • Cigar
    • Pipe
    • Others
  • Secondhand smoking – breathing in smoke from other people’s smoking
  • Dust
  • Pollution
  • Chemical fumes
  • Asthma – can lead to COPD if not treated
  • Genetic disorders – Alpha-1 antitrypsin deficiency

Alpha-1 antitrypsin (AAT) is a protein that’s made in our liver. Rarely, due to a genetic disorder, a patient may suffer with AAT deficiency and result in developing COPD. Low levels of AAT can result in damage to the lung especially in the patients who’re exposed to various lung irritants including cigarette smoke. The condition usually worsens quickly in those patients when they’re exposed to irritants and smoke.

Diagnosis of COPD

Your doctor will ask you various questions related to your past and current medical history and family history.

COPD diagnosis is normally based on:

  • Past and current Medical history of the patient
  • Family history related to COPD and related diseases
  • Physical examination of the patient
  • Various test results

Medical history would also include if the patient is a smoker or not or have been exposed to lung irritants like:

  • Chemical fumes
  • Dust
  • Secondhand smoke
  • Air pollution

If you’re having long term cough, tell that to your doctor, along with how much you cough and is it productive or not (has mucus in it or not). If it has mucus, then what color it is, etc.

Once the doctor has taken your detailed medical, family and systemic history, he will examine you for suspected diseases. He may also examine you using the stethoscope to listen to various sounds in your chest.

He may advice several tests to confirm the diagnosis too, including:

  • Spirometry
  • Lung function tests
  • Chest x-ray
  • CT-scan chest
  • Arterial blood gases (ABGs)

Not all of these tests are performed in all patients. Your doctor will choose the ones that he feels necessary for your diagnosis.

Treatment of COPD

COPD can’t be cured completely as such, however it can be controlled, symptoms reduced and progress of the disease slowed down through various life style modifications and treatment options.

The aim of COPD treatment include:

  • To relieve the symptoms of disease
  • To slow down the progression of disease in the patients
  • Enhance exercise tolerance and productivity in patients
  • Prevent any complications
  • Manage and treat complications once they have occurred
  • Improve overall health state of the patient

Visit a pulmonologist if you’re experiencing any of the symptoms of chronic obstructive pulmonary disease. Don’t self medicate and try to manage it on your own, instead consult an expert to get the best possible advice and treatment for your condition.

COPD treatment options include:

  • Life style modifications
    • Avoid getting in contact with any lung irritant
    • Stop smoking
    • Improve your diet and take sufficient calories and required nutrients
    • Discuss with your doctor regarding all possible life style changes that are helpful for you
  • Medicines – including:
    • Bronchodilators
    • Glucocorticosteroids (steroids) – often used in combination with bronchodilators as inhaled medicine
  • Vaccination
    • Flu shots
    • Pneumococcal vaccine
  • Pulmonary rehabilitation – it covers various aspects of rehabilitation for the patients suffering with chronic obstructive pulmonary disease, including:
    • Disease management training for the patients
    • Exercise program
    • Nutritional counseling
    • Psychological counseling sessions
  • Oxygen inhalation therapy
    • Oxygen therapy might be needed all the time for some patients while others may need it occasionally
    • Oxygen therapy helps patients in:
      • Reducing the symptoms while performing various tasks
      • Prevent any damage to body organs including heart
      • Improves their sleep
      • Improves their activity and alertness levels while they’re awake
    • Surgical treatments
      • Lung volume reduction surgery
        • Damaged tissue from the lung is removed
        • This improves the overall breathing capability of selected patient, hence improving their quality of life
      • Bullectomy
        • Bullae are large air filled spaces in the lungs
          • They’re created when the walls of air sacs are destroyed
          • They interfere in normal breathing function of lungs
        • In this procedure, large space occupying bullae are removed from the patients lungs
      • Lung transplant
        • Lung transplant can improve breathing and lung function in some patients
        • Transplanted lungs can get complicated if any infection develops or if there is tissue rejection, that can be fatal too

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Dr Khan

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