What Is COPD (Chronic Obstructive Pulmonary Disease)?
The term chronic obstructive pulmonary disease (COPD) applies to both chronic bronchitis and emphysema. These are chronic conditions, usually attributed to smoking that cause shortness of breath and limit activities of daily living such as walking.
Chronic bronchitis causes inflammation and swelling of the airways (or bronchi) that connect the trachea to the lungs. This causes a narrowing of the bronchi which become blocked by thick mucus, called phlegm. Sometimes chronic bronchitis is accompanied by emphysema. In this case, the alveolar sacs of the lungs are damaged and reduce the area where the oxygen transfer takes place. These disorders make breathing difficult.
Smoking is responsible for COPD in 85% of cases. Tobacco is the cause of overproduction of mucus lining the walls of the airways and significantly reduces the caliber. This excess of secretions favors bronchial infections. An infection can cause more damage to the airways by further increasing mucus production. Tobacco also destroys the alveolar sacs from which oxygen travels from the lung to the blood, making the lungs less effective.
More common causes of COPD include:
- A rare genetic condition known as alpha-1 antitrypsin deficiency
- Air pollution
- Occupational exposure to dusts and chemicals
- Frequent lower respiratory tract infections during pregnancy
- Women who do cooking on suffocated place
- If there have been lung infections in childhood
- Extreme temperatures (very cold or very hot)
COPD occurs in people aged 45 and over. The progression of the disease is slow, but constant, and the symptoms are more and more marked over time. The damage to the bronchi is irreversible. COPD can also increase the risk of heart failure because the heart has to work harder to circulate the blood through the damaged lungs.
What Are The Symptoms Of COPD?
The first symptoms often go unnoticed. People tend to think that it is normal for a smoker to cough and have shortness of breath. They usually consult a doctor when the symptoms have become so severe that they interfere with their daily activities.
The symptoms experienced by people with COPD are:
- Difficulty breathing or shortness of breath (dyspnea)
- Persistent cough
- Excessive production of bronchial secretions
- Oppression in the chest
- Constant fatigue
- Weight loss (in the case of emphysema)
Periods of Aggravation
Throughout the illness, periods of sudden worsening, called “super-infections,” can occur because of a bacterium. It is important to recognize the symptoms of such an aggravation in order to know when to consult a doctor or take his “action plan”:
- Colored secretions (yellow, green or brown)
- More abundant secretions, thicker or more difficult to spit
- Unusual increase in coughing or shortness of breath
Some symptoms require a medical consultation without delay:
- Chest pain
- Blood in sputum
- Swollen ankles
- Difficulty sleeping in a supine position
- Headache, dizziness, confusion
- Sickness sensation (general malaise)
- Lips or blue fingers
Your doctor will determine how much air you can expel during a forced expiration. These functional examinations of the lungs are simple and painless. If the amount of air expelled is lower than normal, it could mean that the airways are inflamed, contracted or blocked by mucus. If this condition persists, you may have COPD.
The Evolution of COPD
The respiratory function capacity (the quantity of air and the rate at which it has expired from the lungs) makes it possible to categorize the severity of the disease in four stages: mild, moderate, severe and very severe. In the mild stage, the person feels shortness of breath only during an energetic exercise, while at the most severe stage, the patient is out of breath by performing simple tasks of daily life. With the progression of the disease, respiratory abilities are not the only ones to deteriorate. In fact, the symptoms associated with COPD (cognitive impairment, mood disorders, cardiovascular diseases) will progress simultaneously.
Despite the use of treatment, COPD worsens gradually as time passes. If medications are able to decrease symptoms and improve your quality of life, they cannot cure COPD. Pulmonary functions deteriorate with age even in healthy people, but faster for smokers. It is therefore very important to stop smoking.
Your doctor may prescribe medications called quick-acting bronchodilators, including salbutamol, ipatropium bromide, a combination of both, and terbutaline. These drugs relax and dilate the bronchi (airways) and help relieve shortness of breath.
If symptoms persist, long-acting bronchodilators such as tiotropium, glycopyrronium, salmeterol, formoterol or a combination of product may be added to the treatment. If you have difficulty breathing, your doctor may recommend that you add inhaled corticosteroids.
There are also medications that combine the prolonged action of bronchodilators with that of inhaled corticosteroids. Your doctor may prescribe antibiotics and oral corticosteroids for you to have on hand in case of pulmonary bacterial infection.
It is recommended that people with COPD receive the annual influenza vaccine because influenza can worsen the symptoms of COPD and cause respiratory failure and hospitalization. People with COPD may also benefit from a pneumococcal vaccine to reduce their risk of getting pneumonia (a lung infection) that can also cause complications. Talk to your doctor about whether these vaccines would be helpful.
Oxygen therapy via bottled oxygen or the use of an oxygen concentrator can be helpful for people with severe COPD who do not have enough oxygen in their blood when they breathe in the air. Consuming a large amount of fluid throughout the day helps reduce the buildup of phlegm.
Exercise, with or without physiotherapy treatments, can improve a person’s quality of life and facilitate their activities.
Healthy eating is important as weight loss due to breathing efforts is a sign of the evolution of COPD. In extreme cases, lung volume reduction or transplantation is sometimes considered.