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  • Chronic obstructive pulmonary disease (COPD)

    Introduction

    Chronic obstructive pulmonary disease (COPD) is a group of lung conditions that cause breathing difficulties. The conditions that make up COPD include chronic bronchitis and emphysema. Both lead to the obstruction of air flow in and out of the lungs. The damage to the lungs from COPD is permanent but treatments are available to ease symptoms. COPD is a progressive disease caused primarily by smoking. It is the third leading cause of death in the United States.

    Smoking cessation is the single most important step in limiting the progression of COPD and for prevention. More than 80 percent of COPD cases are caused by long-term cigarette smoking. Other causes for COPD include exposure to irritants and pollutants and about one percent of COPD cases result from a genetic disorder, alpha-1-antitrypsin (AAt) deficiency. AAt is a protein made in the liver that protects the lungs. When COPD is caused by AAt deficiency, the treatments are generally the same as when COPD is smoking related. Further damage to the lungs may also be prevented by giving the patient AAt.

    Causes

    Bronchitis

    Chronic bronchitis is inflammation of the bronchial tubes that results in scarring of the lining of these tubes. Excessive mucous is produced in response to the inflammation and is accompanied by a mucous-producing cough. In addition to the increased mucus and cough, symptoms include shortness of breath and frequent throat clearing.

    Emphysema

    Emphysema causes permanent holes to form in the alveoli, or air sacs of the lungs. This destruction progressively reduces the amount of oxygen the lungs can transport to the blood stream and this causes shortness of breath. Other symptoms of emphysema include cough and reduced exercise capacity. The lungs begin to lose their elasticity and this makes exhaling very hard.
    COPD can also lead to other severe complications such as an increased risk of respiratory infections including pneumonia and the flu. It also can lead to pulmonary hypertension, an increased risk of heart disease, and higher rates of lung cancer due to chronic bronchitis. Patients with COPD are more likely to suffer from mood disorders like depression.

    Symptoms

    Managing symptoms is important when living with COPD. The most common symptoms of COPD include:

    • Productive cough
    • Shortness of breath
    • Activity intolerance
    • Wheezing
    • Chest tightness

    When symptoms worsen, it is necessary to seek additional treatment. Patients are also encouraged to eat healthy, exercise, avoid smoke and pollutants, and keep all regular medical appointments.

    Testing and diagnosis

    Tests can be performed to determine if COPD is the cause of breathing difficulties. Recommended tests may include pulmonary function tests. including spirometry which measures how much air the lungs can hold and how quickly the air can be pushed out of the body. Other tests may include chest X-rays, CT scans and arterial blood gas analysis.

    Treatment

    Early detection of COPD is vital to successful treatment. Patients are encouraged to seek help before symptoms are severe.

    Treatments include medications such as bronchodilators (medications to open the lungs and move more air), inhaled steroids, combination bronchodilators, oral steroids, antibiotics, and other drugs that relax the airways. In addition, oxygen therapy and pulmonary rehabilitation can be used to treat moderate to severe COPD. Surgery is also an option for patients when medicine alone fails to provide substantial help. Lung volume reduction surgery and lung transplantation are two surgeries that may be considered for patients with severe COPD.

    Prognosis

    Because there is no cure for COPD, there is no way to stop the progression of the disease. Doctors are able to identify COPD earlier than ever before, and may be able to provide patients with a better quality of life. Prognosis depends significantly on the stage of COPD when it is identified and lifestyle changes implemented by the patient including smoking cessation. COPD is a potentially life-threatening disease.



Page last updated: 1/6/2014 3:54:44 PM