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COPD General - Chronic Obstructive Pulmonary Disease
What Is COPD?
COPD stands for chronic obstructive pulmonary disease. There are 2 major diseases included in COPD: 1) chronic bronchitis, and 2) emphysema. In both, narrowed bronchi make it hard to exhale. In chronic bronchitis, enlargement of the mucous glands and too much mucus production contribute to the narrowing. In emphysema, narrowing comes from damage to the bronchi themselves and is more severe. Inflammation triggered by inhaled irritants also contributes to COPD.
What Causes COPD?
Smoking accounts for about 85% of COPD cases. Heavy smokers are at highest risk. Secondhand smoke and other inhaled toxins account for COPD in some nonsmokers. In others, an inherited protein deficiency is to blame. But in some cases, the cause is unknown.
COPD starts gradually and progresses slowly. At first, there are no symptoms. Little by little, problems appear, usually in middle-aged people.
Most patients with COPD have mixed features of chronic bronchitis and emphysema. Many patients also have 2 to 3 flare-ups each year. These are abrupt flare-ups that are often triggered by lung infections. Symptoms get much worse, and aggressive treatment may be needed.
Your doctor will ask about your smoking history and exposures to secondhand smoke, fumes, and dust. Be sure to report any family history of COPD, particularly if your symptoms began in young adulthood and you haven´t been exposed to tobacco. You´ll also be asked about symptoms of cough, phlegm, shortness of breath, wheezing, fatigue, and weight changes.
Your chest exam is the most important part of the exam. With chronic bronchitis, your doctor may hear wheezing and abnormal gurgling sounds. With emphysema, your chest may be enlarged and sound hollow when your doctor taps on it.
Tests and x-rays.
FEV1 values depend on a person´s age, sex, and height. Doctors can diagnose COPD and estimate how bad it is based on how a patient´s FEV1 compares to normal. By repeating lung function tests, doctors can tell if COPD is getting worse and tailor therapy to the stage of the disease.
If you have emphysema, your chest x-ray will show enlarged lungs. Scarring and large, air-filled cavities may also be evident. CT scans can show damage at an earlier stage, but no imaging test can gauge the severity of COPD or predict its outcome.
In many cases, your doctor will order additional tests, such as complete blood counts, an EKG to look for heart strain, an analysis of your sputum, and a test to measure the oxygen in your blood.
Avoid tobacco and secondhand smoke.f
Good nutrition is also important.
Preventing infection is essential.
Early treatment is important.
Quick relievers/rescue inhalers.
Since most COPD medicines are inhaled, your doctor may prescribe a handheld device or inhaler. Be sure to ask for instructions on how to use your inhaler. Doctors also may prescribe anti-inflammatory drugs and antibiotics, as needed, to treat flare ups and respiratory infections. Contact your doctor immediately if your breathing becomes worse, if you develop a fever, or if your phlegm becomes thicker, discolored, or more abundant.
COPD patients with low blood oxygen levels can benefit from long-term, round the clock oxygen therapy. For home use, oxygen can be stored in cylinders or generated by machines called oxygen concentrators. Portable tanks can provide several hours of oxygen away from home. Safe oxygen therapy requires physician supervision and responsible cooperation by patients and household members.
Some patients with severe emphysema may benefit from special types of lung operations.
Expert evaluation by experienced physicians is mandatory. A few COPD patients may be eligible for lung transplantation.
Even when COPD causes lung damage, early diagnosis, treatment, and lifestyle changes can slow the process, ward off complications, and improve your quality of life.