Chronic Obstructive Pulmonary Disease (COPD)
Posted July 1, 2008 7:01 PM
Posted in
(COPD)
Definition
Chronic obstructive pulmonary disease (COPD) is a disease in which the lungs have difficulty expelling oxygen-depleted air. If all the space in the lungs is taken up by air that should be expelled, there is no room for fresh air, full of oxygen. The term COPD refers to both the diseases emphysema and chronic bronchitis . Although changes to lung tissue differ with the two diseases, the causes and treatment are similar.
Chronic Bronchitis
© 2008 Nucleus Medical Art, Inc.
Causes
COPD develops due to:
- Cigarette smoking
- Inhaling toxins or other irritants
- Genetic predisposition that can make a person's lungs more susceptible to damage from smoke or pollutants (includes alpha-1-antitrypsin deficiency)
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
- Smoking cigarettes
- Long-term exposure to second-hand or passive smoke
- Family members with COPD
- Exposure to pollutants
- History of frequent childhood lung infections
- Age: 50 or older
Symptoms
Early symptoms of COPD include:
- Coughing in the morning
- Coughing up clear sputum (mucus from deep in the lungs)
- Wheezing
- Shortness of breath with activity
As the disease progresses, symptoms may include:
- Increased shortness of breath
- Choking sensation when lying flat
- Fatigue
- Trouble concentrating
- Heart problems
- Weight loss
- Breathing through pursed lips
- Desire to lean forward to improve breathing
- More frequent flare-ups (periods of more severe symptoms)
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam.
Tests may include:
- Chest x-ray —x-rays of the chest that may detect signs of lung infection
- CT scan —a type of x-ray that uses a computer to make pictures of structures inside the chest
- Blood tests—to assess the amount of oxygen and carbon dioxide in the blood
- Lung function tests
Treatment
There is no treatment to cure COPD. Treatment aims to ease symptoms and improve quality of life.
Treatment includes:
Smoking Cessation
Quitting smoking slows progression of the disease. Doctors consider it the most important part of treatment. Smoking cessation programs may include behavior modification and medications to help you gradually taper off cigarettes.
Environmental Management
Limiting the number of irritants in the air you breathe may help make breathing easier. Avoid smoke, dust, smog, extreme heat or cold, and high altitudes.
Medication
Medications may be taken by mouth or inhaled. Nebulizers and inhalers deliver drugs directly to the lungs. Drugs for COPD may work in the following ways:
- Opening the airways
- Relaxing the breathing passages
- Decreasing inflammation
- Helping thin secretions and bring up mucus from the lungs
- Treating lung infections (antibiotics)
- A review of 21 trials found that shorter antibiotic treatment (five days or less) is as effective as longer treatment (more than five days) in people with chronic bronchitis and mild-to-moderate COPD episodes.*
Oxygen
Oxygen is given to supplement the air you breathe in. It can increase energy levels and heart and brain function by increasing the amount of available oxygen.
Flu Prevention
Because COPD makes patients prone to flu and pneumonia , doctors recommend getting vaccinated to help reduce the risk of getting severe pneumococcal disease. Avoid being around people who are sick.
Exercise
Special exercises can strengthen chest muscles and make breathing easier. Physical activity builds endurance and improves quality of life. Follow your doctor's recommendations for activity levels and restrictions.
Breathing and Coughing Techniques
Special methods of breathing can help bring more air into and force trapped air out of the lungs. Coughing helps clear the lungs of mucus.
Nutrition
- Maintain a normal weight. Excess weight causes the lungs and heart to work harder.
- Eat a healthy diet that is low in saturated fat and rich in fruits, vegetables, and whole grain foods.
- Eat several small meals during the day. It makes breathing easier.
- Avoid gas-producing foods. Large meals and excess gas swell the stomach, which pushes up on the diaphragm.
- Drink fluids to keep mucus thin.
Lifestyle Changes
- Pace your activities.
- Learn relaxation techniques and other methods to manage stress.
- Seek emotional support from professionals, family, and friends. Anxiety can increase the rate of respiration, making breathing more strenuous.
Surgery
A small number of patients may benefit from surgery.
RESOURCES:
American College of Chest Physicians
http://www.chestnet.org
American Lung Association
http://www.lungusa.org/
CANADIAN RESOURCES:
BC Health Guide
http://www.bchealthguide.org/
The Canadian Lung Association
http://www.lung.ca
References:
American Lung Association website. Available at: http://www.lungusa.org . Accessed October 11, 2005.
Eisner MD, Balmes J, Katz PP, et al. Lifetime environmental tobacco smoke exposure and the risk of chronic obstructive pulmonary disease. Environmental Health: A Global Access Science Source . 2005;4:7.
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ . Accessed October 11, 2005.
National Lung Health Education Program website. Available at: http://www.nlhep.org/ . Accessed October 11, 2005.
*6/4/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : El Moussaoui R, Roede BM, Speelman P, Bresser P, Prins JM, Bossuyt PM. AbstractShort-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies. Thorax. 2008;63:415-422. Epub 2008 Jan 30. Review.
Last reviewed October 2007 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.
Source: EBSCO
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