Chronic Obstructive Pulmonary Disease COPD – Prevention and Treatment

Chronic obstructive pulmonary disease, or COPD, is a long-lasting obstruction of the airways that occurs with chronic bronchitis, emphysema, or both. This obstruction of airflow is progressive and leads to a limitation of air flow to and from the lungs, causing breath shortness. The limitation of airflow is poorly reversible and usually gets progressively worse over time.
In chronic bronchitis, the airways become inflamed, the bronchial walls thicken and the loss of supporting alveolar (air space) attachments limit airflow by allowing the airway walls to deform and narrow the airway lumen. Emphysema also destroys the walls of these air spaces.

Causes of COPD

• The primary risk factor for COPD is chronic tobacco smoking. Almost all life-long smokers will develop COPD. While COPD occurs in 15% of the cigarette smokers, tobacco accounts for as much as 90% of the risk factors. Secondhand smoke or environmental tobacco smoke also increase the risk of respiratory infections and can result in a decreased lung function.
• Occupational exposures: exposure to workplace dusts found in coal mining, gold mining, and the cotton textile industry and chemicals such as cadmium, isocyanates, and fumes from welding are factors in the development of airflow obstruction.
• Air pollution: the effect of this factor is small when compared to that of cigarette smoking.
• The use of solid fuels for cooking and heating may cause high levels of indoor air pollution, which may then lead to the development of COPD.
• Alpha1-antitrypsin (AAT) deficiency – Alpha1-antitrypsin (AAT) is a protein in the body that is produced by the liver and helps protect the lungs from damage. In AAT deficiency, the liver does not produce enough of this protein. It is the only known genetic risk factor for COPD.

Signs and symptoms of COPD

The signs of COPD are consequences of the anatomical changes caused by the disease:

• barrel chest
• pursed-lip breathing
• productive cough
• cyanosis

One of the most common symptoms of COPD is shortness of breath (dyspnea). However, it does not usually occur until the sixth decade of life (in people aged 50-59 years). Over the years, dyspnea gets gradually worse so that it can manifest during everyday activities such as housework. In the advanced stages of COPD, dyspnea can become so bad that it is manifested by patient during rest, and so it is constantly present. It is closely associated with lung function decline.

Other symptoms of COPD are:

• persistent cough
• sputum or mucus production
• wheezing
• chest tightness
• tiredness

The following may also occur as COPD worsens:

• Intervals between acute periods of worsening of dyspnea (exacerbations) become shorter
• Cyanosis (discoloration of the skin)
• Failure of the right side of the heart
• Anorexia and weight loss

Consequences of

- COPD can lead to death if not properly treated
- The symptoms of COPD can make handling a variety of tasks become extremely difficult. Thus, the disease can affect the patients’ work abilities, which can cause them losing their jobs.
- The lungs can be damaged permanently as a consequence of this disease and the patient might have to permanently breathe with the help of apparatuses.

Associated disorders

Various infections are commonly associated with COPD. Next to them, some of the other diseases that are associated with COPD are:

• chronic bronchitis
• emphysema
• pneumonia

COPD prevention

There is currently no cure for COPD; however, chronic obstructive pulmonary disease is both a preventable and treatable disease. The only measures that have been shown to reduce mortality are smoking cessation and supplemental oxygen.

• The first and most important prevention method is quit smoking; this helps in preventing and reducing the symptoms of the disease to a major extent.
• Eliminate exposure to smoke by not allowing people to smoke in your home and by choosing the designated nonsmoking areas when you are in public spaces.
• Air pollutants in your home should be controlled.
• Respiratory infections during cold and flu season are a major problem, so treat these infections as soon as possible.

Treatment of chronic obstructive pulmonary disease

The goal of the treatment of COPD is to improve your daily living and quality of life by preventing symptoms and exacerbations, thereby preserving optimal lung function.
There are many surgeries available but only giant bullectomy and lung volume reduction surgeries have proven to be useful:

• Bullectomy: Bullectomy is the removal of the giant bullae, which are air-filled spaces affected by emphysema located in the lung periphery.
• Lung volume reduction surgery (LVRS): Those who undergo this surgery have symptoms caused by severe emphysema, marked hyperinflation. Surgeons generally remove 20-30% from the upper part of each lung, which is usually the most damaged area by tobacco smoking. The theory is that the removal of a portion of the diseased lung increases the airway diameter in the remaining lung, thus improving lung function and airflow, which, in turn, reduces the symptoms.
• Lung transplantation: Lung transplantation is a relatively new surgical therapy for people with advanced lung disease. Those selected to receive a transplant should have a life expectancy without transplant of 2 years or less due to COPD.

Drugs treatment

• Anticholinergic drugs cause airway smooth muscles to relax by blocking stimulation from cholinergic nerves. Ipratropium is the most widely prescribed short acting anticholinergic drug. Tiotropium is the most commonly prescribed long-acting anticholinergic drug in COPD.
• Corticosteroids: Corticosteroids act to reduce the inflammation in the airways. Some of the more common corticosteroids in use are prednisone, fluticasone, budesonide, mometasone, and beclomethasone.
• Theophylline is a bronchodilator and phosphodiesterase inhibitor that in high doses can reduce symptoms for some people who have COPD.

Home remedies

• Acupuncture, acupressure help to relieve symptoms
• Anti-smoking programs
• Exercise – aerobic exercise may help to relieve some COPD symptoms. Breathing exercises can be an important part of a comprehensive pulmonary rehabilitation program.
• Yoga – meditation and stress reduction techniques, as well as strengthening exercises and controlled breathing routines may be good for treating COPD.
• Eating a healthy, balanced diet is especially important for COPD sufferers. Their diets should include plenty of fruits and vegetables, nuts, and whole grains.
• Herbs – eucalyptus, red clover and saw palmetto all can be used to treat bronchitis. Garlic has antioxidant properties and may help to fight infections.