COPD, or chronic obstructive pulmonary disease, is a condition in which the airways in the lungs become broken down and narrowed. Sometimes the air sacs are also damaged. To understand why COPD develops, it is important to understand how the lungs work. Normally, air that we breathe passes from the nose and mouth through the airways to the tiny air sacs of the lung, called alveoli. In the air sacs, oxygen that we breathe passes through the walls of air sacs into the bloodstream. Carbon dioxide passes in the reverse direction, out of the bloodstream, back into the alveoli, and is then eliminated by breathing out. Carbon dioxide is a waste product of the body's metabolism, and must be regularly removed.
In people who develop COPD, irritating gases and particles are inhaled while smoking or breathing smoke filled air (secondhand smoke) or other fumes or particles. These gases and particles can injure the airways and lungs and cause swelling. Over time, the inflammation becomes chronic, damages the lung tissue, and may cause scarring. This lung damage makes it more difficult to breathe in and out and makes it harder for oxygen and carbon dioxide to pass across the air sac walls in and out of the blood.
Reasons For Airflow Blockage
Any disease that interferes with airflow out of the lungs can cause COPD. Most people with COPD have chronic bronchitis and emphysema, and some also have asthma.
Chronic Bronchitis
Chronic bronchitis is the term used to describe people who have a chronic cough that produces sputum. Chronic bronchitis can scar the airways and reduce airflow.
Emphysema
Emphysema is the term used to describe damage to the air sacs in the lung. This damage can also restrict airflow.
Asthma
Asthma is a chronic inflammatory disorder of the airways. The chronic inflammation leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning. Treatment is usually successful in reversing inflammation and airway narrowing. In a minority of people with asthma, the chronic inflammation permanently restricts airflow. When this airway narrowing cannot be completely reversed with treatment, the person is said to have COPD.
COPD RISK FACTORS
- Smoking
- Abnormal sensitivity and exaggerated response to inhaled substances ie-secondhand smoke, workplace exposure to environmental dust or organic material, or air pollution.
- Genetics-deficiency of alpha-1 antitrypsin
COPD SYMPTOMS
- There may be no or mild symptoms at first
- Coughing and spitting up phlegm
- Wheezing
- Shortness of breath with activity or even at rest
- Fatigue
- Morning headaches
COPD DIAGNOSIS
- Pulmonary function test=Spirometry. It’s the best test for diagnoses. (We do this in our office.) It gives us the staging of the disease and we use it to monitor
- Pulse Oximetry
- Arterial Blood Gas
- Rule out Alpha-1 antitrypsin deficiency
COPD TREATMENT
- Most important is quit smoking!!!
- Stage 1-mild COPD= Short-acting bronchodilator when needed
- Stage 2-Moderate COPD= Short-acting bronchodilator when needed, regular treatment with one or more long-acting bronchodilators, and Pulomonary Rehabilitation.
- Stage 3-Severe COPD=Short-acting bronchodilator when needed, Regular treatment with one or more long-acting bronchodilators, pulmonary rehabilitation, Inhaled glucocorticoids if significant symptoms, lung function response, or if repeated exacerbations.
- Stage 4-Very severe COPD=Short-acting bronchodilator when needed, Regular treatment with one or more long-acting bronchodilators, Inhaled glucocorticoids if significant symptoms, lung function response, or if repeated exacerbations, treatment of complications, rehabilitation, long-term oxygen therapy if chronic respiratory failure, consider surgical tx’s.