Chronic obstructive pulmonary disease (COPD)

Definition

COPD is the abbreviation for chronic obstructive pulmonary disease. The disease is also known by its abbreviation COPD ( chronique obstructive pulmonary disease ). Although this sneaky disease is widespread, it often goes unnoticed in its early stages. COPD causes a progressive narrowing of the airways with consequences, above all, of respiratory disorders. COPD is an incurable disease.

Bronchitis and Emphysema
COPD includes chronic bronchitis and emphysema (pulmonary)1 . Another way of defining or presenting COPD is to talk about the association of two diseases, precisely chronic bronchitis and emphysema. Strictly speaking, we should rather speak, in the plural, of chronic systemic diseases of respiratory origin that affect the bronchi. In this case, however, we will focus on the singular, ie COPD.

In COPD, especially bronchitis, the bronchial tubes are inflamed and contain mucus (see illustration below).

Alveoli
Healthy lungs have about 300 million alveoli2 . It is within the alveoli that gas exchange between carbon dioxide and oxygen takes place. During COPD, gas exchange is disturbed.

Epidemiology

– COPD kills more than three million people worldwide each year. It is one of the leading causes of death3.

– In the United States, in 2013, COPD was the 4th leading cause of death. After cardiovascular disease, cancer and medical errors, but before suicides. In 2021, 16.4 million people had COPD in the United States4.

Chronic Bronchitis
In the United States, chronic bronchitis affects approximately 9 million Americans.5 . Women are more affected than men.

Emphysema
In the United States, emphysema affects approximately 2 million Americans6 . Men are more affected than women. Most people with emphysema also have chronic bronchitis.

Causes

COPD is caused by prolonged exposure to irritating gases or particles, most commonly from cigarette smoke.

In detail, the causes of COPD are:

– Smoking , mainly cigarette smoke and less cigar or pipe smoke. This is the main cause of COPD.
Note that when a person smokes, we often tend to minimize the first signs of the disease, which is often described as “smoker’s cough”.
Smokers over the age of 45 are more often affected by COPD.
Secondhand smoke also increases the risk of COPD.

– Dust or pollutants. People who are exposed to dust in their work – for example in agriculture and industry – and therefore inhale irritating substances can also suffer from COPD. Polluting agents, especially from cars, can also increase the risk.

– Solid fuels at home. The use of solid fuels such as coal or wood at home favors the occurrence of COPD.

– Asthma . Asthma may be a risk factor for COPD7 . The risk is increased in asthmatic smokers.

– Genetics. A deficiency in one gene ( alpha-1-antitrypsin ) is believed to be the cause of approximately 1% of COPD cases8.

Symptoms

COPD symptoms usually don’t appear until significant lung damage occurs, and they usually get worse over time, particularly if exposure to cigarette smoke continues.
The main symptoms of COPD, after a progressive narrowing of the airways, are:
– Dyspnoea, that is, difficulty in breathing, such as shortness of breath. In advanced cases, people with COPD may experience shortness of breath without exercising.
– Chronic cough
– Production of sputum and sputum
– Wheezing – Chest tightness – Sputum  Frequent respiratory infections – Unintentional weight loss

Progression of the disease
It is a disease with a progressive evolution, that is, breathing difficulties increase over the years, especially during the practice of physical exercise.
COPD is incurable.

Complications

Severe complications of COPD can develop in the lungs (with serious breathing problems), but heart problems can also occur.

People with COPD have an increased risk of developing heart disease, lung cancer , pulmonary hypertension and depression. Likewise, someone who has a chronic lung disease such as COPD may be at greater risk for serious illness and complications from Covid-19.9.

Diagnosis

Diagnosis is primarily made through lung function tests , the purpose of this test is primarily to measure the amount of air moving in and out of the lungs, as well as the amount of oxygen delivered to the bloodstream.10 . But as the diagnosis of COPD is not obvious, the medical team, mainly pulmonologists, may resort to other diagnostic techniques:
– X-rays of the lungs (in English Chest-X-Ray)
– Computed tomography
– Laboratory tests (eg measurement blood carbon dioxide levels)

Treatments

There are no treatments capable of curing the disease, certain measures can slow the progress of COPD and combat certain symptoms in the respiratory system. Treatment varies greatly depending on the patient and the advanced stage of the disease (mild, moderate, severe and very severe). One of the goals of treatments is mainly to combat COPD crises, called exacerbations (in English: exacerbations). It is important to note that even with adequate treatment, a patient may experience one or more exacerbations and require hospitalization.11.

Medicines Drug
treatment helps to inhibit bronchial inflammation and regular training improves physical performance.
The drugs used are generally bronchodilators and inhaled corticosteroids. Inhaled tiotropium is also often used for COPD. In severe or very severe stages, corticosteroids (eg prednisone)12 can be taken in both injectable and tablet form.
In an advanced stage of the disease (severe and especially very severe stage), affected people need an additional supply of oxygen (oxygen therapy). It often occurs in a hospital setting.

Antibiotics
In the United States, the American College of Physicians13 estimated in 2021, based on a study, that people with COPD should be treated with antibiotics in case of suspected bacterial bronchitis for a maximum of 5 days. A short but effective antibiotic course can limit antibiotic resistance in our societies. Long-term treatment with antibiotics does not reduce the number of attacks (exacerbations) of COPD14.

Surgery
In some cases, surgery may be performed by the medical team to remove some damaged tissue. Surgery is reserved primarily for cases of emphysema that have not responded favorably to drug treatment.

Prevention

– Don’t smoke and avoid exposure to secondhand smoke to reduce your risk of getting COPD. Definitely try to stop smoking. This is the main tip to follow.

– Avoid cold air, in winter or during cold weather wear a mask or put a handkerchief in your mouth before going outside.

– Prevent infectious respiratory diseases like pneumonia. Get vaccinated against certain strains that lead to pneumonia, the flu, or Covid-19.

– Exercise regularly to increase your lung capacity.

Tips – Good advice

– Air travel can sometimes be problematic for people with COPD due to the decreased concentration of oxygen in the cabin at flight altitude. That said, complications during air travel remain rare.15.

– A pulmonary rehabilitation program can be proposed by the nursing team. The idea is to better understand COPD and try to change your lifestyle. The Mayo Clinic network of hospitals , considered the best hospital in the world (or network of hospitals), has put in place a program of pulmonary rehabilitation (in English: pulmonary rehabilitation ) to take good care of COPD.

Jeanne Kenney
 | Website

I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

Leave a Reply

Your email address will not be published. Required fields are marked *