As per the studies conducted by WHO (World Health Organization), nearly 65 million people suffer from moderate to severe form of COPD. More than 3 million people have died due to COPD in 2005, which was 5% global deaths. It is estimated that COPD is going to be the 3rd leading cause of worldwide deaths.
What is Chronic Obstructive Pulmonary Disorder?
COPD is a relatively wider term used to describe progressive lung diseases including emphysema, chronic bronchitis, asthma. The most significant character of this condition is breathlessness.
- Emphysema - This is a condition in which the tiny air sacs of the lungs are damaged. The walls are stretched, increasing the size of the lungs and making it harder for air to move in and out. The inhaled air gets trapped inside the alveoli for a long time such that the next time you inhale more air cannot get into the alveolar sacs.
- Chronic bronchitis - This is caused by inflammation of the breathing tubes in the lungs. The cilia (the tiny hair-like structure that keep the airways clean) are damaged making the airways swollen and clogged. This limits the airflow in and out of the lungs.
- Refractory or non-reversible asthma - This kind of asthma do not respond well to the medications. The airways get permanently tighten and swollen up.
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What causes COPD and what are the risk factors?
- Inhaling pollutants - Most of the COPD cases happen due to tobacco smoking such as cigarettes, pipes, cigars etc. and second-hand smoking. Though everybody who smokes does not get COPD, most of the COPD cases have a smoking history.
- COPD most commonly occurs in people with 40 years of age or above.
- Environmental fumes - People with long term exposure to harmful pollutants in the workplace including lung irritants, chemicals, dust or fumes can cause COPD. Also, long term exposure and contact with secondhand smoke or other lung irritants at home like cooking fuel can also COPD.
- Genetic causes - The most common genetic risk factor for emphysema is Alpha-1 Antitrypsin Deficiency. The deficiency causes harm to the lungs with White Blood Cells.
Signs and Symptoms
Most common signs and symptoms of COPD include,
- Tightness in the chest
- Wheezing
- Short breath
- Chronic cough with mucus
- Cyanosis of lips or fingernail beds
- Frequent respiratory infections
- Post nasal drainage
- Unintended weight loss
- Fatigue
- Swelling in ankles, feet or legs
Diagnosis of COPD
When you approach a pulmonologist, he/she will take a detailed case history. It is important to tell your doctor about all your past illnesses, family history, and any other medical information. Following tests are also advised to diagnose COPD that include:
- Lung Function Test - This test measures the amount of air the lungs can inhale and exhale and if the lungs are delivering enough oxygen to the blood.
- Spirometry - This is a widely used test. The patient is asked to blow into a large tube connected to a small machine known as a spirometer. This measures the amount of air the lungs can hold and the speed with which the air can be blown out of the lungs. Spirometry is used to track the progression of the disease and it can also diagnose COPD even before it manifests the symptoms.
- Chest X-ray - This helps in diagnosing emphysema, one of the main causes of COPD. A chest x-ray also helps to rule out lung problems and heart failure.
- CT scan - This is used to detect emphysema and also check if surgery is required. Other than this, the CT scan is also used to diagnose lung cancer.
- Arterial blood gas analysis - This tests the ability of the lungs to bring oxygen in the blood and remove carbon dioxide.
- Laboratory tests - Certain lab tests are used to check if there is any deficiency of alpha-1-antitrypsin deficiency which may be a cause of COPD. This is usually done if a person has a family history of COPD.
How is COPD Treated?
Quit smoking - This is the most imperative step in treating COPD. The patient must take the help of a doctor regarding nicotine replacement products and medications.
Medications - Following type of medications are usually recommended to the patients by the doctors. These are listed below:
- Inhalation steroids - Sometimes, the doctors prescribe corticosteroids medications to reduce the inflammation in the airways. These medications help in frequent aggravation of the symptoms. A few examples are fluticasone and budesonide.
- Bronchodilators - The bronchodilators help in the relaxation of muscles of the respiratory airways. As a result, symptoms like shortness of breath and cough are relieved. Bronchodilators are either short-acting such as albuterol, levalbuterol, ipratropium etc or long-acting like salmeterol, formoterol, indacaterol etc.
- Antibiotics - Infectious diseases like bronchitis, pneumonia, and influenza are treated with the help of antibiotics. This is done to prevent the exacerbations of COPD.
Breathing Therapies
- These include oxygen therapy which includes providing supplemental oxygen to assist the patient in breathing. Depending upon the severity of the illness, the oxygen supplementation can be used all the time or while doing physical activity and while sleeping.
- The other therapy is known as the Pulmonary rehabilitation program which includes a combination of counseling, exercise, nutrition, and education done by a team of specialists as per your needs.
Surgical Options
- Bullectomy - There are large spaces formed in the lungs when the air sacs get destroyed. The spaces are very large and make breathing difficult. Bullectomy involves removal of these spaces to improve the airflow.
- Lung Volume Reduction Surgery - The damaged portion in the upper part of the lungs is removed to create extra space in the chest cavity for the rest of the lung to expand. The diaphragm also works more efficiently.
- Lung Transplant - This is the ultimate surgical option for cases where the entire lung has been damaged. However, according to some of the best lung doctors in India the surgery has high risks and complications such as immune organ rejection by the body.
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