COPD (Chronic Obstructive Pulmonary Disease): What people should Know about COPD

Definition, Epidemiology, causes and risk factors, symptoms, diagnosis and treatment.

• Definition

  COPD is a common chronic progressive lung disease which makes it difficult to breathe. COPD is divided into two major forms:
  1. Chronic bronchitis manifested in addition to difficulty in breathing, by a long-term cough with mucus.
     
  2. Emphysema manifested mainly by difficulty in breathing and involves progressive destruction of the lungs over time.
     
     • Most people with COPD have a combination of both condition, but nearly 80 -90% of COPD patients have predominant chronic bronchitis.
  
  
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  Epidemiology

  • The damage of the lungs is the result of chronic inflammation resulting of tobacco smoking and less likely other factors, particularly occupational exposures.
  • The rate of COPD in the population is between 2% and 4%, the majority of whom remains undiagnosed.
  • The prevalence increases with age: 10% in men older than 75.
  
  
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  Causes and risk factors

  1. Acquired causes
     1. Active Tobacco Smoking is the major cause of COPD:
        • The more a person smokes, the more likely that person will develop COPD.
          
        • However, some people smoke for years and never get COPD.
     2. Other risk factors:
        • Exposure to certain gases, chemicals, fumes or dust in the workplace (occupational COPD).
        • Exposure to heavy amounts of secondhand smoking (passive smoking).
        • Exposure to home cooking smokes and heating fuels.
          
  2. Inherited (genetic) cause:
     • Alpha-1Antitrypsin (A1AT)deficiency emphysema.
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  Symptoms

  1. Predominant chronic bronchitis: (Blue bloater)
     
     • Shortness of breath (dyspnea) at rest, which worsens with mild activity.
     • Cough + Sputum production, especially daily morning production of whitish mucus.
     • Wheezing: whistling sound when breathing.
     • Generalized fatigue.
     • Frequent respiratory infections.
     • Often obese.
  2. Predominant emphysema: (Pink puffer)
     
     • Shortness of breath.
     • Cough with or without sputum.
     • Generalized fatigue and weight loss.
     • Cachexia and muscle wasting.

  Diagnosis

  • Diagnosis is based on a combination of history, examination and confirmation of the presence of airflow limitation, using particularly spirometry and sometimes chest-XRay and chest CT-Scan.
    
    
    
    
    
    

    Chest-XRay:

    
    
    
    
    
    

    Chest CT-Scan:

    
    
    
    
  • In younger patients, or in those who are not exposed to cigarette smoke or other factors, consider a genetic cause such asalpha-1-antitrypsin (A1AT)deficiency.

  Treatment

  • You should know that there is no complete cure for COPD.
  • You should confirm the diagnosis of COPD by your doctor and you should assess its severity (Gold classification), by performing spirometry.
    
    
  Then, treatment may include:
  1. Smoking cessation: Best way to slow down the damage and progression of disease. This is a complex, difficult process which is made easy by consulting aTobacco cessation clinic and by using newly developed drugs and nicotine replacement therapy (see Event on Tobacco cessation).
     
  2. Medications:
     • Inhaled bronchodilators to open the airways, such as Salbutamol, Ipratropium, tlotropiurn, salmeterol, formeterol and indacaterol.
     • Antl-inflammatorv medication particularly the promising new drug Roflimulast, and inhaled corticosteroids (ICS) maybe used sometimes.
     • Theophvlline is indicated and may be used sometimes.
  3. Home Oxygen supplementation in special cases of low blood level of O₂
  4. Pulmonary rehabilitation: it teaches you to breathe in a different way so you can stay active and to maintain muscle strength in the legs with special types of exercices.
  5. Surgery: In selected cases. It includes:
     • Bullectomy, Or
     • Lung Reduction Surgery, Or even
     • Lung transplantation
     • However you should know that we are more Optimistic at the present time to slow down the rate of progression of COPD, to relieve symptoms, to improve activity performance and to improve quality of life, with the development of new drugs and ¬with the better implementation of new programs of tobacco cessation.

  Prevention

  • The best way is to avoid tobacco smoking.
  • If you smoke: follow a tobacco cessation program in a tobacco cessation clinic if you find difficulty to quit by yourself.