Overview:
COPD (Chronic Obstructive Pulmonary Disease) is a chronic and progressive respiratory condition. It primarily affects the airflow with no cure and is assumed to affect 16 million people in the U.S. The target age group for COPD is 45 years and above. It is important to note that if left untreated, COPD can cause severe damage to the lungs and ultimately death. The two most frequent obstructive diseases associated with COPD are; emphysema and chronic bronchitis. In addition to present treatment options, clinical research studies are directed to investigate potential treatment options for people suffering from moderate to severe COPD.
The fundamental aim of this blog is to enlighten you about the consequences of smoking. Cover every aspect of COPD including symptoms, risk factors, and diagnostic approaches. To learn more about COPD and Asthma continue reading.
What is COPD?
Chronic Obstructive Pulmonary Disease (COPD) is characterized by progressive airflow limitation and irreversible obstruction of the airways. It is a chronic inflammatory lung disease with irreversible obstruction of the airways, predisposing people to breathing problems. The reduced airflow is the result of the airway and parenchymal (lining containing alveoli to allow gaseous exchange) inflammation.
The collective term “COPD” is used for both, emphysema (inflammation of the airways or bronchial tubes) and chronic bronchitis (damage to the lining of the air sacs in the lungs).
Risk factors for COPD:
“Smoking” acts as an important risk factor in developing COPD. The risk of developing COPD is directly proportional to the number of cigarettes you smoke daily. Therefore, developing COPD in less than 10 pack years is unusual. The longer you smoke the greater your chance of getting COPD.
In addition to active smoking, elderly people 40 years or above with a history of smoking are also vulnerable to developing COPD. Other risk factors include:
- Alpha 1-antitrypsin deficiency
- Occupation (coal miners, cadmium exposure, chemicals, fumes)
- Chronic asthma
- Cannabis smoking
- Air pollution
- Breathing secondhand smoke
Identifying COPD:
The beginning of COPD (Chronic Obstructive Pulmonary Disease) can often look like choking and gasping. It is one of the first signs of COPD that may happen while exercising at first. You may sometimes wake up at night feeling breathless.
COPD mirrors the symptoms of other illnesses, especially those similar to that experienced by asthmatics as mild symptoms such as intermittent cough and shortness of breath. As the condition progresses, the severity of symptoms increases and tends to worsen over time. Therefore, it is essential to visit your pulmonologist in case of persistent breathlessness, chronic cough with sputum production, and frequent respiratory infections to infer a definitive diagnosis.
Commonly reported symptoms are:
- Persistent chest cough (prolonged to 8 weeks in adults and 4 weeks in children) with phlegm production (clear white, yellow, green)
- Lack of energy
- Dyspnea worsened by physical exertion
- Wheezing
- Chest tightness
- Weight loss
- Intermittent exacerbations; in advanced stages
- Headache due to hypercapnia (carbon dioxide retention)
On physical examination, “barrel-chest” an increased anteroposterior diameter of the chest is often present. Some other signs indicative of COPD are hyper-resonant percussion notes with decreased breath sounds.
Self-evaluation to Rule Out COPD:
You must always visit your doctor to confirm the diagnosis. However, self-evaluation is crucial to identifying any silent killers wandering inside your body and preserving lung function in COPD. In case you think of yourself as a possible COPD patient you can perform a little exercise while checking yourself with a stopwatch. Take a full breath and hold it for one second. Then, with your mouth open, blow out as hard and fast as you can till you feel your lungs are completely emptied, in no more than 4 to 6 seconds (meaning that you can blow no more air out even though you try).
Blood Tests:
Laboratory blood tests are not essential to diagnose COPD (Chronic Obstructive Pulmonary Disease). To rule out other causes of breathing problems and detect health problems that may occur concurrently with COPD, blood tests are used. They can, however, provide important information about the cause of COPD.
Lab findings to look for in COPD patients are:
- CBC: Increased hematocrit level
- ECG: Right atrial hypertrophy and right ventricular hypertrophy
Pulmonary Function Testing (PFT):
To see how well the lungs are functioning pulmonary function tests (PFTs), spirometry, and arterial blood gas analysis are the noninvasive diagnostic tests of choice. The PFTs measure lung volume, capacity, rates of flow, and gas exchange.
Chest X-ray:
While a chest x-ray may not reveal COPD until it has progressed to the severe stage. A chest X-ray or chest CT aids in determining the extent of the disease. The chest C-ray images of COPD patients reveal:
- Enlarged lungs
- Air pockets (bullae)
- A flattened diaphragm
- Small tubular heart
- Increased anteroposterior diameter of the chest
Is COPD painful?
Pain induced by COPD is typically felt in the shoulders, neck, lower back, and chest and can be accentuated by just walking. The etiological cause of pain is directly or indirectly proportional to the blowing up of the lungs, exerting stress on the chest wall, diaphragm, and spine.
Unfortunately, the blend of pain, anxiety, difficulty sleeping, and difficulty breathing can harm your quality of life.
Osteoporosis, a condition involving bone loss is another common exacerbating factor for pain production in COPD patients. Approximately, 35% of COPD patients tend to have osteoporosis. The link is due to either or all of the following factors: COPD inflammation, the use of steroid medication in COPD management, a smoking history, poor nutrition, or inactivity.
While developing a pain management regime “Origin of Pain” and “State of Progression” should be considered. The right strategy to relieve COPD-associated pain includes:
- Altering breathing strategy: Slow breathing, pursed lip breathing, diaphragmatic breathing.
- Healthy diet intervention: Avoid eating oily foods to minimize bloating, small but frequent meal consumption, and diminish salts to reduce water retention.
- Pain killers: Acetaminophen, Ibuprofen, and Opioids (in the advanced stage but in smaller doses).
- Pulmonary rehabilitation: It is one of the best advents for expanded lungs and anxiety management.
- Anti-depressants: To help tame anxiety and emotional stress exacerbating pain in COPD patients.
Why is Asthma Mistaken for COPD?
Asthma, characterized by airway hyperreactivity and variable airflow obstruction is a chronic inflammatory ‘reversible disorder’. The two respiratory conditions entail a classic triad of symptoms such as wheezing, breathlessness, cough, and chest tightness. The “diurnal episodic pattern” of asthma enables differentiation from COPD when all the previously mentioned similarities make the two conditions look alike.
A detailed insight into the following factors can help differentiate between the two conditions:
- Age: The age of initiation is an important distinguishing feature between asthma (often starts in childhood) and COPD (current or former smokers >40 year years).
- Etiological factors: Asthma is mostly the result of exposure to a combination of environmental allergens and genetic influences. On the other hand, long-term smoking plays a vital role in the initiation of COPD.
- Triggers: With asthma and COPD, different spectrums of triggers are associated. While asthmatic reaction worsens on exposure to cold air, allergen, and exercise, COPD aggravates in response to respiratory infections (flu and pneumonia).
Treatment:
The damage caused to the lungs is degenerative i.e., can not be reverted. Currently, no cure exists for reversing the damage. However, treatment options including surgery (lung volume reduction surgery, lung transplant, and bullectomy), and lifestyle modifications are available to slow the disease’s progression and control symptoms.
The most viable treatment option for most COPD patients is bronchodilators. Bronchodilators are medications that relax and widen your airways, making breathing easier a major struggle for COPD-acquired patients.
For the majority of COPD strugglers short-acting bronchodilator inhalers (beta-2 agonist inhalers such as salbutamol and terbutaline and beta-2 antagonist inhalers) are regarded as the first line of therapy.
A revolutionary treatment COPD treatment approved by the FDA, Zephyr Valves is a breakthrough device. It helps patients with severe COPD and emphysema breathe easier without undergoing risks associated with major surgery.
A clinical research organization in Michigan is devoted to conducting clinical trials in pulmonology and other therapeutic areas, aiming to explore novel treatment options that might help COPD patients.
Management options include stopping smoking and avoiding exposure to secondhand smoke. This is one of the most important things you can do if you have COPD.
Outlook:
Both asthma and COPD are long-term conditions that can’t be cured, but the outlook for each differs. The disease goes away completely in some cases of childhood asthma, after childhood. Whereas COPD stays for life and tends to worsen over time.
Although both Asthmatics and COPD (Chronic Obstructive Pulmonary Disease) patients respond well to smoking cessation and airway-opening medications (bronchodilators), the lung function partially reverses in asthma only, not in COPD.
A recommended rule for all COPD patients, irrespective of the presence or absence of hypercapnia is maintaining oxygen saturations of 88% – 92%.
The expected lifespan of COPD patients can be up to the 70s, the ’80s, or ’90s in case of mild symptoms and the absence of any other health problem like heart disease or diabetes.
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