COPD: Symptoms, Causes, Diagnosis, Treatment & Prevention

 

Damage to the lungs results in chronic obstructive pulmonary disease (COPD), a persistent lung ailment. Damage to the airways that restrict airflow into and out of the lungs causes swelling and irritation, also known as inflammation. Obstruction is the term used to describe this restricted airflow. Breathing difficulties, a daily cough that produces mucus, and wheezing—a tight, whistling sound in the lungs—are among the symptoms.

The term "chronic obstructive pulmonary disease" (COPD) refers to conditions of the lungs and airways that cause breathing difficulties. Individuals with COPD may have damage to their lungs' air sacs, airway inflammation and scarring, or both. COPD includes both chronic bronchitis and emphysema. Treatments can control symptoms and reduce flare-ups.

Long-term exposure to irritating smoke, fumes, dust, or chemicals is the most common cause of COPD. Cigarette smoke is the most frequent cause.

Chronic bronchitis and emphysema are the two most common types of COPD. People with COPD may experience these two conditions in a variety of ways, they typically coexist.

Inflammation of the lining of the tubes that carry air into the lungs is known as chronic bronchitis. We refer to these tubes as bronchi. The inflammation produces more mucus and prevents normal airflow into and out of the lungs. The lungs' tiny air sacs, known as alveoli, are harmed in emphysema. Too little oxygen may pass into the bloodstream through the damaged alveoli.

COPD is treatable, even though it can worsen over time. Most people with COPD can manage their symptoms and enhance their quality of life with the right care. Effective treatment can also reduce the risk of lung cancer and heart disease, further diseases associated with COPD.

Also Read: Whooping Cough: Symptoms, Causes, Complications, Diagnosis, Treatment & Prevention

 What is Chronic obstructive lung disease (COPD)?

The term "chronic obstructive pulmonary disease" (COPD) refers to several irreversible lung and airway conditions that make breathing difficult. You are diagnosed with COPD if you have either emphysema or chronic bronchitis.

Among the alterations in your lungs and airways caused by COPD are:

• Less elasticity in your lungs' air sacs (alveoli) and airways.

• Inflammation, airway narrowing, and scarring (fibrosis).

• Your airways are thick with mucus.

• Damaging the walls that separate your alveoli. This makes them bigger and holds them in the air.

• People with COPD frequently experience exacerbations, or worsening symptoms, such as coughing, wheezing, thicker mucus, and extreme difficulty breathing. You may have to visit the hospital if your condition exacerbates.

As time goes on, COPD gets worse. Flare-ups occur more frequently and become more severe. Although some people deteriorate more quickly, this typically takes years or decades.

Symptoms:

The symptoms of COPD frequently don't show up until significant lung damage has occurred. Over time, symptoms typically get worse, particularly if smoking or other irritating exposures persist.

COPD symptoms can include:

• Difficulty breathing, particularly when engaging in physical activity.

• Whistling or wheezing noises during breathing.

• Persistent coughing that could produce a lot of mucus. The mucus could be greenish, yellow, white, or clear.

• Feeling heavy or tight in the chest.

• Feeling extremely tired or lacking energy.

• Frequent infections of the lungs.

• Losing weight without intending to. As the illness progresses, this could occur.

• Ankle, foot, or leg swelling.

Additionally, people with COPD are likely to experience periods of worsening symptoms rather than the typical daily variation. An exacerbation is the term for this period of worsening symptoms (eg-zas-er-bay-shun). Days or weeks may pass between flare-ups. Triggers like odors, cold air, air pollution, colds, or infections can all contribute to them. 

 Symptoms could consist of:

• Breathing difficulties or exerting more effort than usual.

• Tightness in the chest.

• Coughing more frequently.

• Increased mucus or variations in its thickness or color.

• Fever.

Causes:

Tobacco use is the primary cause of COPD in developed nations. People in the developing world who live in homes with poor ventilation and are exposed to fumes from burning fuel for cooking and heating frequently develop COPD. Another cause of COPD is prolonged exposure to chemical dusts, fumes, and vapors at work.

Long-term smokers may not always exhibit the symptoms of COPD, but they may still have lung damage that impairs their ability to breathe. Before a more comprehensive examination reveals a different diagnosis, some smokers develop less common lung conditions that could be mistaken for COPD.

The effect on the lungs

Through two sizable tubes called bronchi, air enters the lungs after passing through the trachea, a windpipe. Similar to a tree's branches, these tubes split numerous times inside the lungs. Numerous smaller tubes, known as bronchioles, terminate in groups of microscopic air sacs, known as alveoli.

The walls of the alveoli are extremely thin and packed with tiny blood vessels. These blood vessels allow oxygen from the air we breathe to enter the bloodstream. At the same time, a gas called carbon dioxide, which is a waste product of the body, enters the alveoli and is breathed out.

As you breathe out, the alveoli's inherent flexibility pushes out old air and lets in fresh air. Elasticity is another name for this stretchiness.

The lungs are injured by prolonged exposure to irritants, such as smoking. This damage limits the lungs' capacity to remove carbon dioxide from the bloodstream and supply oxygen by preventing air from freely entering and exiting the lungs. Effective airflow in the lungs is prevented by two primary conditions:

Emphysema. The alveoli's delicate walls and elastic fibers are destroyed by this lung disease. In contrast to the numerous healthy small air spaces, the damaged inner walls of the alveoli may be destroyed, resulting in a single, large air space that is difficult to empty. As a result, the alveoli's surface area for exchanging carbon dioxide and oxygen is reduced. Additionally, the large alveoli trap old air, making it impossible for enough fresh air to get in.

Chronic bronchitis. The bronchial tubes narrow and become inflamed in this condition. As a result, there is less space for air to flow through the thicker tubes. The irritation produces more mucus, which further obstructs the narrowed tubes. The attempt to remove mucus from the airways causes an ongoing cough.

Smoke from cigarettes and other irritants

Long-term cigarette smoking is the primary cause of lung damage that results in COPD in the great majority of Americans. However, since not all smokers develop COPD, there are probably other factors at work. Gene alterations that increase a person's risk of developing the illness could be one such factor.

Cigarette smoke, secondhand smoke, pipe smoke, air pollution, and dust, smoke, or fume exposure at work are some additional irritants that can lead to COPD.

Deficiency in alpha-1-antitrypsin

A gene mutation that is passed down through families causes COPD in around 1% of cases. This type of emphysema is genetic. Alpha-1-antitrypsin (AAT) is a protein whose levels in the body are decreased by this gene. To help shield the lungs from harm from smoke, fumes, and dust, AAT is produced in the liver and released into the bloodstream.

Alpha-1-antitrypsin (AAT) deficiency, a disorder marked by low levels of this protein, can result in lung diseases like COPD, liver damage, or both. When there is an AAT deficiency, symptoms usually start earlier in life, and there is typically a family history of COPD.

Risk factors:

Among the risk factors for COPD are:

• Smoke from tobacco. Smoking cigarettes for a long time is the biggest risk factor for COPD. Your risk increases with the number of years and packs you smoke. Smoking marijuana, pipes, and cigars may also increase your risk. COPD is also a risk for those who inhale a lot of secondhand smoke.

• Asthma. The illness known as asthma causes the airways to constrict, swell, and possibly produce more mucus. One risk factor for COPD development could be asthma. Smoking and asthma together further increase the risk of COPD.

• Exposure at work.  Long-term occupational exposure to smoke, vapors, dusts, and chemical fumes can irritate and swell the lungs.  The risk of COPD may increase as a result.

•  Fuel-burning fumes.  People in the developing world are more likely to develop COPD if they live in homes with poor airflow and are exposed to the fumes from burning fuel for cooking and heating.

•  Genetics.  Some people develop COPD as a result of an AAT deficiency brought on by a gene mutation that runs in families.  It is uncommon to have this genetic type of emphysema.  Some smokers may be more susceptible to COPD due to additional genetic factors.

Complication:

many complications can arise from COPD, such as:

• Infections of the respiratory system. Colds, the flu, and pneumonia are more common in people with COPD. Any respiratory infection has the potential to worsen lung tissue damage and make breathing considerably more difficult.

• Cardiac problems. COPD can increase the risk of heart disease, including heart attacks, for unclear reasons.

• Lung cancer. Lung cancer is more likely to strike people with COPD.

• Elevated blood pressure in the arteries of the lungs. High blood pressure in the arteries supplying blood to the lungs can be a symptom of COPD. We refer to this condition as pulmonary hypertension.

• Depression and anxiety. Breathing difficulties may prevent you from engaging in enjoyable activities. Additionally, anxiety and depression can occasionally be brought on by a serious medical condition like COPD.

Testing and Diagnosis:

 A healthcare professional will examine you and inquire about your medical history diagnose COPD.  In addition to testing your lung function, they may take pictures of your lungs.

 They might inquire about things like:

•  Have you ever smoked or do you currently smoke?

•  Have you been exposed to dust or air pollutants for an extended period?

•  Does anyone else in your family suffer from liver disease, COPD, or other lung conditions?

•  When you exercise, do you experience dyspnea?  while you're sleeping?

•  Have you had a persistent cough or wheezing fit?

•  Do you have a phlegm cough?

Which tests are used by medical professionals to diagnose COPD?

 The following tests may be used by your healthcare provider to help diagnose COPD:

•  Tests for pulmonary function.  Spirometry and other tests can be used by healthcare professionals to assess the function of your lungs.

•  Oximetry of the pulse.  This test measures the amount of oxygen in your blood using a device on your finger.

•  Imaging examinations.  CT scans or chest X-rays can check for lung abnormalities brought on by COPD.

•  Test for arterial blood gas.  This blood test measures your levels of carbon dioxide and oxygen.

•  Exercise Test.  This is how your doctor determines whether exercise causes your blood's oxygen level to drop.

• EKG, or electrocardiogram. This test examines the function of the heart and eliminates heart disease as a potential cause of dyspnea.

• Blood tests. To determine whether you may have Alpha-1 antitrypsin deficiency, your healthcare provider may measure your levels of the protein AAT.

• Genetic testing. Your doctor may perform a blood test to look for genetic alterations if they believe a genetic condition may be the source of your lung problems.

Treatment:

What is the treatment for COPD?

COPD has no cure. Improving your symptoms and preventing and managing exacerbations are the main goals of treatment. Your healthcare provider might suggest:

• Programs to help people stop smoking. The progression of COPD can be slowed down by quitting smoking.

• Inhaled medications. Steroids and bronchodilators can open your airways and reduce inflammation. These may be available as a liquid to use in a nebulizer or in an inhaler.

• Oxygen treatment. To raise your oxygen levels, you might require more oxygen.

• Rehabilitation for the lungs. This program of education and exercise can help you manage COPD and strengthen your lungs.

• Corticosteroids. During an exacerbation, you may require a course of steroids to reduce inflammation.

• Positive airway is pressure. To help you breathe, particularly during an exacerbation, your doctor may prescribe a BiPAP machine.

• Antibiotics. Your doctor might recommend antibiotics if you frequently get bacterial lung infections in order to stop infections and flare-ups.

• Reduction of lung volume (LVR).  Your doctor might recommend surgery or a valve procedure that lowers the trapped air in your lungs if you have severe COPD and are a good candidate.

•  Clinical trials.  New treatments are tested in clinical trials to determine their efficacy and safety.  If a new treatment seems like a good fit, your provider may suggest one.

Prevention:

Avoiding smoking, secondhand smoke, and other lung-damaging pollutants is the best method to prevent COPD.

Respiratory infections are more common in people with COPD, and they can cause severe exacerbations of symptoms or even pneumonia. You can lower your chance of contracting infections by:

• Getting all the recommended vaccinations, such as those for COVID-19, pneumococcal pneumonia, and the flu.

• Frequently washing your hands.

• Disinfecting surfaces.

• If your healthcare provider advises it, wear a mask around other people.

• Avoiding crowded areas, particularly when COVID cases are high and the cold and flu seasons are upon us.

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