Chronic obstructive pulmonary disease or COPD is an umbrella term that refers to a group of lung diseases that block airflow during exhalation, which makes it increasingly difficult to breath. Emphysema and chronic asthmatic bronchitis are the two main conditions that make up COPD. In all cases that damage to the airways eventually interferes with the exchange of the oxygen and carbon dioxide in the lungs (mayo). COPD is the third leading cause of death in the United States. It is estimated that there is currently 16 million people in the United States diagnosed with COPD, with as many as 14 million people still being undiagnosed.
Men are seven times more likely to be diagnosed with emphysema than women. As COPD develops over time it is most commonly seen in people over 40 years. “It is estimated that 5 to 7 percent of adult’s who are current or former smokers have moderate reductions in lung function and 3 to 5 percent have severe reductions” (copd-international). The mortality rate has increased 22% in just the last decade alone (copd-international). As a general rule symptoms of COPD do not usually appear until there has been significant damage to the lungs, and they will worsen over time.
The signs and symptoms of COPD can vary depending on which of the lung disease is more prominent, and many people have many symptoms at the same time. The symptoms are usually shortness of breath, wheezing, chest tightness, chronic cough with or with out mucus, fatigue and many respiratory infections (ncbi) (mayo). COPD is typically caused by long term exposure to airborne irritants such as tobacco smoke, dust, chemical fumes and air pollutions. However the leading cause of COPD is smoking. The more a person smokes the more likely they are to develop COPD.
There are rare cases where non-smokers can develop COPD because they lack a protein called alpha-1 antitrypsin (ncbi) (mayo) Because COPD refers to obstruction in the lungs caused by chronic asthmatic bronchitis and emphysema many people with COPD have both of these conditions. Chronic asthmatic bronchitis causes inflammation and narrowing of the airways that lead into the lungs. This then can cause a cough and wheezing sounds when a person breathes. Chronic asthmatic bronchitis also increases mucus production, which then leads to the further blockage of the narrowed tubes (mayo).
Emphysema damages the tiny air sacs in the lungs called the alveoli’s in two major ways. Alveoli are clustered like grapes and emphysema gradually destroys the inner walls of these clusters. This then reduces the amount of surface area available to exchange oxygen for carbon dioxide. Emphysema also makes the alveoli walls weaker and less elastic so they collapse with exhalation trapping air in the alveoli. This causes major shortness of breath, as the chest wall muscles have to work harder to expel the air (mayo). There are different factors that increase the risk of developing COPD significantly.
The number one risk factor is exposure to tobacco smoke. The more years a person smokes and the more packs of cigarettes a person smokes will make the risk even greater. People who smoke pipes, cigars and marijuana are also at a greater risk. Second hand smoke is also very significant with COPD, the longer a person is exposed to tobacco smoke the greater their risk of developing COPD. Also long term exposure to chemical fumes, vapors and dusts can irritate and inflame the lungs. Age and genetics can also increase a person’s risk in developing COPD.
Because COPD develops slowly over years, older people have a higher risk then that of a younger person. Genetics also can play a role as stated before there is a rare genetic disorder called alpha-1 antitrypsin deficiency, and research has shown there may be other genetic factors that play a role in making certain smokers more susceptible to this disease (mayo). A person who has been diagnosed with COPD also has a higher number of respiratory infections such as frequent colds the flu or pneumonia. Each of these infections make it that much harder to breath and can produce further irreversible damage to the lung tissue.
COPD may also cause high blood pressure in the arteries that bring the blood to the lungs which is called pulmonary hypertension, the amount of stress that this puts on the right ventricle of the heart can cause swelling in the legs and ankles. COPD increases the risk of heart attacks and depression, if a person cannot breath they cannot get the proper amount of exercise and they will loose the ability to do the things they used to enjoy (mayo). If the patient shows symptoms of COPD and has a history of exposure to lung irritants there are several test that may be performed to get a definite diagnose of COPD.
A chest x-ray is usually the first test that will be done. This can show emphysema and can rule out other lung problems such as lung cancer or heart failure. Next a computerized tomography or CT scan of the lungs can help detect emphysema and see how advanced the COPD may be. Blood work will also tell the medical provider a lot of information on the patient’s current health. An arterial blood gas analysis will measure how well the lungs are brining oxygen into the blood and how much carbon dioxide is being removed.
There can also be an analysis of the cells in the sputum that is coughed up, this test also can rule out lung cancer. If the patient has a cough that is productive, identifying a bacterial pathogen and treating it could prevent the patient from getting pneumonia. Last a pulmonary function test or PFT is the most common lung function test and the most important in diagnosing COPD. During this test the patient will blow into a large tube connected to a spirometer, the machine then measures how much air the lungs can hold and how fast they can expel the air from their lungs.
This is a very important machine as it can detect COPD even before symptoms have shown, and repeating this test at different time periods will show the progression of the COPD and if treatment is working (mayo). Even though there is no cure for COPD and the damage to the lungs cannot be undone, there are treatments that can control symptoms and reduce the risks and complications that come with COPD. The most important thing a person with COPD can do to improve their health is to stop smoking, if a person with COPD continues to smoke the disease will continue to get worse and eventually lead to death.
There are different types of medications that are used to treat COPD some have to be taken on a daily bases and others just as needed. Bronchodilators that are usually inhalers will relax the muscle around the airways. This can relieve coughing and shortness of breath. There are also inhaled steroids such as corticosteroid medications that can reduce airway inflammation and help the patient to breath better, and if a patient has an infection such as acute bronchitis, pneumonia and influenza they will be prescribed antibiotics to treat these infections so they do not irritate the COPD even farther (mayo).
There are also different forms of therapy such as oxygen therapy and pulmonary rehabilitation programs. If the patient isn’t receiving enough oxygen in the blood they may need supplemental oxygen. A pulmonary rehabilitation program typically combines education, exercise training, and nutrition advice along with counseling. These programs are very beneficial to the patient as they usually include many health care providers such as physicians, physical therapists, respiratory therapists, exercise specialist and dietitians.
All of these specialists can make the program special for each patients care (mayo). If these types of treatments are not working for the patient and they have sever emphysema they may be candidates for surgery. There are two forms one is a lung volume reduction surgery which is when a surgeon removes small wedges of damaged lung tissue to create extra space in the chest cavity to give the diaphragm more room, and the other would be a lung transplant. There are many people who live with COPD everyday.
The best way to improve their health is lifestyle changes, and being aware of the symptoms. If the patient continues to exercise, eat healthy and to not smoke they will still have COPD but their symptoms will not be as bad and they will be able to live a healthy life. Work Cited http://www. copd-international. com/library/statistics. htm http://www. mayoclinic. com/health/copd/DS00916/method=print http://www. ncbi. nlm. gov/pubmedhealth/PMH000153/? report=print