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Chronic Obstructive Pulmonary Disease (COPD)

By Apollo 24|7, Published on- 23 November 2022 & Updated on -

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  • Symptoms: Shortness of breath and difficulty in breathing while doing activities, tightness of chest, constant cough; swelling in ankles, feet, and legs; phlegm production, coughing up mucus, lack of energy
  • Causes: Exposure to tobacco or harmful chemicals or pollutants, active or passive smoking, chronic bronchitis and emphysema
  • Risk factors: Individuals with asthma or poor lung condition, genetic condition, individuals who smoke or get exposed to dust or chemicals
  • Severity: Mild to severe
  • Which doctor to consult: Pulmonologist

Overview

Chronic obstructive pulmonary disease, commonly called COPD, is a group of long-term lung diseases that make breathing difficult.

Most individuals with COPD experience chronic bronchitis and emphysema, two common lung disorders. The conditions vary in severity among individuals, but COPD is preventable and treatable.

COPD is a chronic condition that progresses gradually over time. It can limit the daily activities of individuals, and they can have trouble climbing up the stairs, doing exercises, or simply performing daily tasks.

The diseases can be managed and treated if detected early. But individuals often ignore the early warning signs, and the condition is diagnosed when it's too late. If the disease is left untreated, it will lead to several other problems like heart problems and respiratory infections.

Individuals who smoke tobacco or are exposed to irritants or air pollutants daily suffer from COPD. Also, lung infections can be another reason for COPD.

When to Consult a Doctor?

Several factors may indicate that an individual needs to visit the doctor for COPD. Sometimes, the symptoms may go away with home remedies, but most of the time, they gradually progress and worsen.

An individual should talk to the doctor immediately if he/she notices the symptoms are not improving. The common symptoms that indicate an individual should consult a doctor for COPD include:

  • Shortness of breath
  • Difficulty in breathing while performing daily activities
  • Lack of energy or extreme fatigue
  • Frequent wheezing or coughing
  • Losing weight rapidly
  • Tightness of chest
  • Blue fingernails or lips
  • Swollen feet, fingers, and ankles

One should consider visiting a pulmonologist as soon as more symptoms arise. Many patients initially confuse the symptoms with the common flu and do not visit a doctor until the disease progresses to the second stage.

Diagnosis

Once a patient visits a pulmonologist, the doctor will ask about the patient's family medical history, lifestyle habits, symptoms, and whether the patient smokes or has been exposed to any harmful chemicals or pollutants.

The doctor will then perform a physical test to check if the ankles are swollen, listen to breathing to understand the lung condition and examine the nose and throat for any signs of infection. They will also check blood pressure, pulse, and weight loss history as part of the physical examination.

1. Lab Tests

Spirometry is a pulmonary functioning test used to measure the functioning of the lungs. For this, the patient has to blow air into a tube attached to a machine to analyse how much air can be pumped by the lungs.
Other tests include pulse oximetry to measure the oxygen in the blood, a six-minute walk test and lung volume and diffusing capacity measurement.

2. Imaging Tests

Chest X-rays or CT scans may be performed to detect lung cancer or other lung and heart diseases. These imaging tests help to rule out other possible causes of shortness of breath or similar symptoms.

Treatment:

Different treatment options are available for patients with COPD. The treatment depends on the severity of the disease, age, and physical condition of the patient.

1. Home Care:

Patients with COPD may have to make some lifestyle changes to improve their health. This can be adopted at home with a doctor's guidance.

Popular home remedies for COPD include:

  • Quiting smoking and protection oneself from pollutants or irritants (both first and second-hand)
  • Practicing regular breathing exercises
  • Going for regular walks or practicing light exercise
  • Adopting a healthy diet that includes a lot of fresh fruits and vegetables
  • Staying hydrated
  • Avoiding anything that can worsen the symptoms of COPD
  • Taking measures to improve immunity
  • Getting enough sleep
  • Getting vaccinated against pneumonia and flu

2. Medication:

Bronchodilator inhalers are one of the first options for treating patients with COPD. Different types of inhalers are prescribed according to the needs of the patients. Short-acting bronchodilator inhalers are common.

Using a bronchodilator widens the passage of the lungs and results in improved breathing. The inhalers can be used whenever a patient feels breathlessness.

Doctors may also use theophylline tablets or capsules. They may also prescribe other antibiotics to prevent infection, clear up the mucus, and reduce coughing.

These medicines can keep the symptoms in check and manage COPD. Depending upon the severity of the issue, doctors may prescribe steroids to manage the disease. Supplemental oxygen may also be required at different stages.

3. Surgical Treatment: 

No surgery can cure COPD or ease the symptoms of the disease. But Lung Volume Reduction Surgery (LVRS) is a surgical method to remove emphysematous lung tissue. This helps improve breathing and increases the lung capacity of patients with COPD. Surgery is a rare procedure.

4. Alternative Management:

Alternative management is often used with the standard treatment of COPD. Although there is no sufficient research on this, many consider massage therapy, acupuncture, and meditation to manage the symptoms of COPD. 

These alternative ways do not cure COPD but can improve the quality of life and increase the efficiency of the standard treatment. These can also help in managing the anxiety and stress associated with the disease.

There is also a pulmonary rehabilitation program that is aimed at increasing awareness among patients with COPD. This involves group sessions with individuals suffering from COPD. Professionals provide mental support to patients and help them understand their physical condition. They also provide physical training to make them understand their capabilities.

Doctors suggest different alternative management of COPD alongside the standard course of treatment. This is ideal for patients who are at high risk.

Risks & Complications if Left Untreated

If COPD is left untreated, the disease progresses faster, and problems like heart issues and lung infections become common. Patients will catch cold more frequently.

Since COPD causes breathing issues, when left untreated, the disease can damage the lung tissue, and patients will suffer from breathing trouble while performing daily activities.

COPD should be treated early or as soon as it is diagnosed. It can interfere with daily activities and reduce lifespan. The disease can increase the risk of heart attacks and respiratory infections and cause sudden death. Patients are also at risk of increased comorbidities and cardiovascular diseases, which are a serious concern.

Additional Information

There are different stages of COPD, and the disease progresses through these stages over time. In the early stage, the symptoms of COPD are not noticeable. This worsens and reaches the severe stage.

Since the disease worsens over time, it is best to get proper treatment as soon as it is diagnosed.

The four stages of COPD include:

  • Early Stage: The First Stage

The first stage, i.e., the early stage, is when the symptoms are barely noticeable. The only symptoms include a heavy cough and mucus production with it.

The doctor may conduct a spirometry test to check the symptoms. Depending upon the test results, a doctor may prescribe an inhaler to open up the passage of the lungs. Doctors may prescribe additional medicines to prevent further infection or slow the condition's progression.

  • Mild Stage: The Second Stage

The FEV1 value determines the stage of COPD. If the symptoms are not diagnosed at stage 1, it progresses to stage 2 gradually. The symptoms for this stage may include increased coughing, excessive mucus production, difficulty breathing or running out of breath even while walking.

Usually, most people are diagnosed with COPD at this stage because the symptoms are prominent.
Many patients have to take steroids or oxygen at this stage. Doctors may also recommend bronchodilator medication for improved airflow into the lungs.

  • Severe Stage: The Third Stage

The third stage is when the symptoms flare up. Patients quickly get tired from daily activities, and breathing and coughing worsen.

Other symptoms like fever, chills, tightness of the chest, and frequent infection are common.
Patients suffering from stage 4 of COPD need oxygen.

  • Very Severe Stage: The Fourth Stage

This is the most severe stage, where the blood oxygen levels are low, and patients are at high risk of heart or lung failure. Patients may experience breathing trouble even while they are sitting idle.
At this stage, the doctor may recommend surgery to improve COPD.
 

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Frequently Asked Questions

Patients with asthma and COPD show similar warning signs like shortness of breath, wheezing and lung blockage. But the two are different medical conditions caused by various factors. Individuals with asthma may or may not develop COPD and vice versa. The primary cause of COPD is smoking, and it is a chronic and progressive disease. Asthma is usually triggered by allergens like pollen, dust, and animal fur.

COPD has got no cure. As a result, this disease is chronic and progresses from stage one to stage four over the years. So, COPD is a lifelong condition. But there are ways to slow the progression of the disease, and an early diagnosis and treatment can prove to be highly beneficial for patients with COPD. An individual's age, health, and symptoms are important in determining the course of treatment and how well the disease can be managed.

It's best to avoid smoking if a person is diagnosed with COPD. Individuals who smoke are bound to experience symptoms of COPD. So, if a person smokes, quiting it immediately to will be wise to prevent the disease from worsening. Also, he/she should avoid long-term passive smoke and inhaling chemicals, dust, or irritants. If an individual finds it challenging to quit smoking, considering joining different programs to help him/her quit the habit can be helpful.