Tobacco smoking is the most common cause for many leading diseases. The other factors such as air pollution and genetics played a smaller role. In the developing world one of the common sources of air pollution is from poorly vented cooking and heating fires. Long term exposure to these irritants causes an inflammatory response in the lungs resulting in narrowing of the small airways and breakdown of lung tissue and lung diseases like COPD. Chronic obstructive pulmonary disease also known as chronic obstructive lung disease and chronic obstructive airway disease. Most people with chronic bronchitis have COPD. COPD is a lung disease that makes it hard to breathe. It is caused by damage to the lungs over many years, usually from smoking. COPD is often a mix of two diseases
- Chronic bronchitis – In chronic bronchitis the airways that carry air to the lungs get inflamed and make a lot of mucus. This can narrow or block the airways making it hard to breathe.
- Emphysema – The tiny air sacs in the lungs are like balloons. As we breathe in and out they get bigger and smaller to move air through lungs. But with emphysema, these air sacs are damaged and lose their stretch. Less air gets in and out of the lungs which makes feel short of breath.
There are several things that may increase risk of developing chronic obstructive pulmonary disease (COPD) many of which can be avoided. It can be reduced by not smoking and avoiding exposure to certain substances at work.
- Smoking – Smoking is the main cause of COPD and is thought to be responsible for around 90% of cases. The lining of the airways becomes inflamed and permanently damaged by smoking and this damage cannot be reversed. Up to 25% of smokers develop COPD.
- Passive smoking – Exposure to other people’s smoke increases the risk of COPD.
- Fumes and dust – Exposure to certain types of dust and chemicals at work including grains, isocyanates, cadmium and coal has been linked to the development of COPD even in people who do not smoke. The risk of COPD is even higher breathe in dust or fumes in the workplace.
- Air pollution – Air pollution may be an additional risk factor for COPD.
- Genes – There is a rare genetic tendency to develop COPD called alpha-1-antitrypsin deficiency. This causes COPD in a small number of people. Alpha-1-antitrypsin is a protein that protects your lungs. Without it the lungs can be damaged by other enzymes that occur naturally in the body. People who have an alpha-1-antitrypsin deficiency usually develop COPD at a younger age often under 35.
- Shortness of breath.
- Chest tightness.
- Frequent respiratory infections.
- Lack of energy.
- Weight loss.
- Spirometry : This is to assess how well lungs work a breathing test called spirometry is carried out. You will be asked to breathe into a machine called a spirometer. The spirometer takes two measurements the volume of air you can breathe out in one second called the forced expiratory volume in one second and the total amount of air you breathe out called the forced vital capacity. You may be asked to breathe out a few times to get a consistent reading. The readings are compared with normal measurements for age which can show if airways are obstructed.
- Chest X-ray : A chest X-ray will show whether u have another lung condition which may be causing symptoms such as a chest infection or lung cancer.
- Blood test : A blood test will show whether symptoms could be due to anaemia as this can also cause breathlessness.
- Electrocardiogram (ECG) and echocardiogram : An electrocardiogram (ECG) or echocardiogram may be used to check the condition of heart. An ECG involves attaching electrodes to arms, legs and chest to pick up the electrical signals from heart. An echocardiogram uses sound waves to build a detailed picture of heart. This is similar to an ultrasound scan.
- Computerised tomography (CT) scan : Some people may need a CT scan. This provides more information than an X-ray and can be useful in diagnosing other lung diseases or assessing changes to lungs due to COPD.
Smoking cessation – Stopping smoking is the most effective way for people with COPD to help themselves feel better and is the only proven way to reduce the rate of decline in lung function. Stopping smoking at an early stage of the disease makes a huge difference. Any damage already done to the airways cannot be reversed, but giving up smoking can slow the rate at which the condition worsens. If COPD is in the early stages and symptoms are mild, no other treatments may be needed. Even people with fairly advanced COPD are likely to benefit from quitting, which may prevent further damage to the airways.
- Oxygen therapy – If there isn’t enough oxygen in blood, may need supplemental oxygen. There are several devices to deliver oxygen to lungs, including lightweight, portable units that can take with to run errands and get around town. Some people with COPD use oxygen only during activities or while sleeping. Others use oxygen all the time. Oxygen therapy can improve quality of life and is the only COPD therapy proven to extend life.
- Pulmonary rehabilitation program – These programs typically combine education, exercise training, nutrition advice and counseling. Pulmonary rehabilitation may shorten hospitalizations, increase ability to participate in everyday activities and improve quality of life. Talk to doctor about referral to a program.
Surgery – Surgery is an option for some people with some forms of severe emphysema
- Lung volume reduction surgery – In this surgery, surgeon removes small wedges of damaged lung tissue from the upper lungs. This creates extra space in chest cavity so that the remaining healthier lung tissue can expand and the diaphragm can work more efficiently. In some people this surgery can improve quality of life and prolong survival.
- Lung transplant – Lung transplantation may be an option for certain people who meet specific criteria. Transplantation can improve ability to breathe and to be active but it is a major operation that has significant risks such as organ rejection and it obligates to take lifelong immune-suppressing medications.
- Short-acting bronchodilator inhalers : Short-acting bronchodilator inhalers deliver a small dose of medicine directly to your lungs, causing the muscles in your airways to relax and open up. There are two types of short-acting bronchodilator inhaler: beta-2 agonist inhalers, such as salbutamol and terbutaline, antimuscarinic inhalers, such as ipratropium The inhaler should be used when you feel breathless and this should relieve the symptoms.
- Long-acting bronchodilator inhalers : If a short-acting bronchodilator inhaler does not help relieve your symptoms, your GP may recommend a long-acting bronchodilator inhaler. This works in a similar way to a short-acting bronchodilator, but each dose lasts for at least 12 hours. There are two types of long-acting bronchodilator inhalers: beta-2 agonist inhalers, such as salmeterol, formoterol and indacaterol antimuscarinic inhalers, such as tiotropium, glycopyronium and aclidinium.
- Steroid inhalers :Steroid inhalers, also called corticosteroid inhalers, work by reducing the inflammation in your airways. If you are still getting breathless or having flare-ups even when taking long-acting bronchodilator inhalers GP may suggest including a steroid inhaler as part of treatment. Most people with COPD will be prescribed a steroid inhaler as part of a combination inhaler.
- Get regular exercise. Regular exercise can strengthen your heart and lungs which helps relieve from symptoms.
- Maintain a healthy weight. Being overweight can worsen asthma symptoms.
- Eating plenty of fruits and vegetables may increase lung function.
- Wear a face mask to warm the air you breathe.