Chronic obstructive pulmonary disease (COPD)

Overview

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that leads to a blockage of airflow from the lungs. It commonly arises from two conditions: emphysema and chronic bronchitis. When diagnosed with COPD, it implies that the patient exhibits symptoms or has both of these damaging lung conditions. As COPD progresses, breathing can become increasingly challenging.

• Chronic bronchitis: This is an inflammation of the bronchial tubes’ lining, which transports air to and from the lungs’ air sacs (alveoli). When triggered, the tubes undergo swelling, leading to the accumulation of mucus (commonly known as “phlegm” or “snot”) along the inner lining. This build-up constricts the opening of the tubes, resulting in difficulty in both inhaling and exhaling air from the lungs. Daily coughing and mucus (sputum) production are its main symptoms.
• Emphysema: Emphysema is a condition where the alveoli at the end of the tiniest air channels (bronchioles) of the lungs are destroyed as a result of harmful exposure to cigarette smoke and other irritating chemicals and particulate matter.

The air sacs are essential for transporting carbon dioxide out and oxygen into the circulation. Emphysema damage obliterates the air sac walls, making it challenging to take a full breath.

Heart disease, lung cancer, and a number of other diseases are more likely to occur in people with COPD.

COPD, while being a chronic and progressive disease, is manageable with appropriate treatment. Patients with COPD can achieve effective symptom control, experience an improved quality of life, and reduce the risk of developing other associated medical conditions through proper care.

Symptoms

The symptoms of COPD often go unnoticed until significant damage to the lungs has occurred, and they tend to worsen gradually, particularly in cases of ongoing exposure to smoking.

COPD signs and symptoms may include:

• Persistent cough that occasionally produces sputum that may be clear, white, yellow, or greenish in color.
• Problem taking deep breaths.
• Breathing difficulties, particularly when exercising.
• Wheezing
• Chest tightness
• Frequent respiratory infections
• Lack of energy
• Unintentional weight loss.
• Ankle, foot, or leg swelling

Individuals with COPD are prone to experiencing exacerbations, which are episodes characterized by a worsening of their symptoms that can persist for several days or longer.

When patients with COPD identify early signs and symptoms of exacerbation, it is recommended that they promptly inform their healthcare provider. This allows for potential modifications in treatment or the prescription of different medications to address the symptoms effectively. It is important to note that altering or discontinuing the medication regimen should never be done without prior consultation with a healthcare provider.

In the event that symptoms fail to improve or worsen despite treatment, or if signs of infection such as fever or changes in sputum are observed, it is crucial to seek immediate medical attention.

If an individual experiences difficulty breathing, pronounced cyanosis (bluish lips or nail beds), rapid heartbeat, dizziness, or difficulty maintaining focus, it is imperative to seek emergency medical attention without delay.

Causes

The primary cause of COPD is smoking. People who are exposed to fumes from burning fuel for cooking and heating in inadequately ventilated homes frequently acquire COPD.

Although many smokers with extended smoking histories may experience decreased lung function, only a small percentage of chronic smokers acquire clinically apparent COPD. Smokers can acquire other less typical lung diseases. They may be incorrectly diagnosed with COPD up until a more complete examination is done.

To force air out of the body, the lungs rely on the natural flexibility of the bronchial tubes and air sacs. When patients exhale, some air is retained in the lungs due to the COPD-induced loss of their flexibility and overexpansion.

COPD cause may also include:

• Smoking and other irritants: The primary cause of lung damage in the vast majority of COPD patients is chronic cigarette smoking. However, given that not all smokers acquire COPD, there may be additional factors at play, such as a genetic predisposition to the condition.

Other irritants that can lead to COPD include air pollution, exposure to dust, smoke, or fumes at work, and cigar, pipe, and secondhand smoke.

• Alpha-1-antitrypsin (AAT) deficiency: AAT deficiency is a rare inherited disorder that could cause emphysema. A condition that results in low amounts of the protein alpha-1-antitrypsin causes COPD in roughly 1% of patients. AAT is produced in the liver and secreted into the bloodstream in order to help in protecting the lungs. A lack of alpha-1-antitrypsin can result in lung, liver, or both types of diseases. Adults with COPD related to Alpha-1 Antitrypsin (AAT) deficiency are offered treatment options similar to those used for individuals with more prevalent forms of COPD. In some cases, the AAT protein can be replaced to cure the condition and possibly stop additional lung damage.

Risk factors

The following factors increase the risk of COPD:

• Age: Older people who are more than 65 years old.
• Gender: Female are more prone to get this condition than men.
• Smoke exposure: Long-term cigarette smoking is the main risk factor for COPD. The risk increases with the patient’s smoking history and pack count. Smokers who use pipes, cigars, or marijuana, as well as those who are exposed to a lot of secondhand smoke, may also be at risk.
• Medical condition: A risk factor for developing COPD is a chronic inflammatory airway disease called asthma. The risk of COPD is further increased when smoking is combined with asthma.
• Occupational exposure: The lungs can get irritated and inflamed from prolonged exposure to chemical fumes, vapors, and dusts at work.
• Fumes exposure: People in the developing world are more likely to develop COPD if they are exposed to the fumes from burning fuel for cooking and heating in inadequately ventilated buildings.
• Genetics: Some cases of COPD are brought on by the rare genetic condition known as alpha-1-antitrypsin deficiency. Certain smokers may be more prone to the disease due to other genetic variables.