Chronic obstructive pulmonary disease (COPD) is a chronic disease that is preventable but not curable. Exposure to irritants like smoke results in irreversible damage to the lungs. It causes inflammation of the airways aka ‘chronic bronchitis’ and destruction of lung tissue aka ‘emphysema’. This eventually affects lung function, making it harder for air to flow in and out of the lungs, and decreases its ability to absorb oxygen and get rid of waste gas carbon dioxide.
Who gets COPD?The main cause of COPD is cigarette smoking. People exposed to second hand smoke or have long term exposure to air pollution can also develop the condition. A small number of patients are genetically predisposed to COPD due to alpha-1-deficiency, which is a protein needed to protect the lungs. Overall, it tends to affect older people.
Tests to diagnose COPD
A doctor will take a detailed history to evaluate for symptoms, and to screen for risk factors (smoking history or exposure to dust/fumes). They will also do a physical examination to listen for wheeze.
A spirometry (otherwise known as lung function test) is done to see how well/poorly the lungs work. It involves blowing air into a mouthpiece connected to a tubing and machine.
Chest X-ray is done to look at images of the lung. Blood tests are also done to evaluate oxygen/carbon dioxide levels in the body.
It is important to stop smoking. Smoking cessation improves survival. Smoking cessation programs are available to provide support and guidance; prescription medications can also be given to help alleviate withdrawal symptoms of quitting smoking.
Patients with COPD are recommended to be vaccinated against pneumococcus (a type of bacterial pneumonia) and influenza virus.
Medications consist of bronchodilators and inhaled steroids in the form of inhalers. If taken daily, it may help to prevent hospitalisations and relieve symptoms.
Patients with severe COPD may end up having low oxygen levels in the blood. This causes breathlessness and may result in organ failures. Patients who fit the criteria for oxygen therapy will be assessed for suitability by doctors, and subsequently they will be prescribed either an oxygen concentrator or an oxygen tank to use at home. Oxygen therapy should be used for at least 15 hours a day for it to improve survival rates. Patients using oxygen therapy should not smoke as there is increased risk of combustion.
This is a program that is recommended to patients with severe breathlessness. It encompasses exercise training, patient education about their condition and on how to use their medications, dietary advice, and psychological counseling.
Acute/Chronic Non-Invasive Ventilation (NIV)
Patients who have severe flare ups of their COPD condition or have chronic retention of carbon dioxide and low oxygen levels, may be offered NIV. This entails wearing a snug-fitting mask that covers the mouth and nose, which is then connected to a portable machine that pushes air into the lungs. It helps to partially support the act of breathing and allows the breathing muscles to rest. This ultimately relieves breathlessness and improves overall oxygen levels and helps to get rid of waste products like carbon dioxide.