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Chronic Obstructive pulmonary disease or COPD is a chronic disease in which airflow from the lungs is obstructed. In a healthy, functioning human body, air enters the lungs through two large tubes, the bronchi, extending from the windpipe. These tubes divide many times over into multiple smaller tubes ending in very tiny sacs of air. The air sacs have extremely thin walls lined with capillaries through which the air a person inhales enters the bloodstream. During this respiration, carbon dioxide, a waste gas of metabolism is exhaled. The natural elasticity of the bronchial tubes and air sacs allows the air to pass out of the body. While COPD is a condition that reduces the elasticity of the walls of these tubes, allowing them to over expand, which leads to some air remaining trapped in the lungs during exhalation.
Chronic obstructive pulmonary disease can develop through continuous long-term exposure to and inhalation of irritant gases, most common of which is cigarette smoke. The most common conditions that can lead to airway obstruction are emphysema and chronic bronchitis. Emphysema occurs when exposure to harmful gases causes ruptures and damage to the air sacs causing them to collapse and impair the flow of air out of the lungs. Bronchitis is a condition of inflammation of the bronchial tubes’ lining, making them narrower. This makes airflow out difficult. In chronic bronchitis, the lungs may produce more amounts of mucus, further narrowing the air passage.
Over 65 million people worldwide suffer from the chronic obstructive pulmonary disease with varying severity – the number expected to continue rising over the next half-century. While only 20 to 30 percent of chronic smokers actually develop COPD, many develop other lung-related conditions that may be misdiagnosed as COPD until a detailed evaluation of their condition is made. This is due to the fact that the biggest risk factor for COPD is a cigarette addiction. The longer the habit persists, the greater the risk becomes. Pipe, cigar, and marijuana smokers are at risk too. If people are exposed to high levels of second-hand smoke for a long period of time, they may be at risk of developing COPD as well. Smokers who also have asthma, have an increased vulnerability to the disease.
Mineworkers, brick kiln workers and other industry workers who are regularly exposed to chemical fumes and dust may risk lung inflammation and eventually COPD. Additionally, some rare cases of COPD may be caused by a genetic disorder called alpha-1-antitrypsin deficiency.
As the condition develops after long term exposure has caused significant lung damage, symptoms of the chronic obstructive pulmonary disease normally begin to appear after the age of 40. Tightness in the chest and shortness of breath is one of the foremost signs of COPD. Chronic cough and mucus production are also common, particularly characteristic of those with chronic bronchitis. Wheezing and discomfort due to mucus build up in the lungs upon waking up may also occur. Other symptoms may include a lack of energy, susceptibility to other respiratory infections, unexplained weight loss, blueness of lips and fingernail beds and swelling in the ankles or feet.
People with COPD are known to go through periods where the symptoms exacerbate far more than usual. These spells can last for several days.
People are often misdiagnosed with chronic obstructive pulmonary disease, particularly former smoker, when they may have some other less common lung disease. In a similar fashion, many of those who actually have COPD may not be diagnosed until the disease has advanced to a point where interventions have far less of an effect.
The diagnosis of COPD will require the doctor to evaluate all the symptoms through a series of tests and examinations. The doctor will also review the medical history of the patient as well as occupational or otherwise exposure to irritants, particularly smoking habits. This information is vital to developing an accurate diagnosis.
The doctor may order lung function tests. These tests measure the amount of air a patient can inhale and exhale and determine if enough oxygen is being delivered to the blood. Spirometry is one such test in which the patient is required to blow into a large tube that is connected to a machine called a spirometer. This machine determines how much air the lungs can hold and how fast can the air be blown out. Spirometry is able to detect COPD before symptoms are obvious and can help in tracking the progression of the disease. Other lung tests can be conducted to determine lung volumes and diffusing capacity of the lungs.
Imaging tests may also be conducted to develop a better idea of the health and state of the lungs. Chest X-rays can be ordered which can reveal emphysema and also give a chance for other problems such as heart failure to be ruled out. CT scans can also help in the detection of emphysema or to screen for lung cancers.
Arterial blood gas analysis is a blood test used to measure the ability of lungs to bring oxygen to and remove carbon dioxide from the blood. Other lab tests are not as useful in diagnosing COPD but they can help in ruling out other conditions. Additionally, tests can be conducted to determine if the person has alpha-1-antitrypsin deficiency which may cause COPD. This test is usually only recommended if there is a family history of developing COPD, especially at an age younger than 45.
Although no cure for chronic obstructive pulmonary disease exists, mild forms of it can be controlled by little else other than smoking cessation. More advanced cases of the disease may require more aggressive forms of therapy to control symptoms and reduce the risk of complications but are still not completely hopeless scenarios.
The most important and immediate step is to quit smoking. This keeps the disease from worsening and allows other treatment methodologies to take actual effect. Nicotine replacement products and support groups may be recommended to help facilitate the transition and avoid relapses.
Bronchodilators are medications, usually taken through an inhaler, that can help relax the muscles in the airways to alleviate breathing problems. Short-acting bronchodilators taken before activities or long-acting bronchodilators for everyday use may be prescribed based on the severity of the disease. Other medication including corticosteroids could be recommended for short term use to reduce inflammation.
Lung therapies may be recommended during moderate to severe cases of COPD. Most common of these is oxygen therapy, which utilizes different devices to supply oxygen to the lungs. These units can be used just during activities or long term based on the patient’s requirements. Pulmonary rehabilitation programs may also be recommended to help manage symptoms through lifestyle changes.
Severe forms of emphysema may require surgery for treatment. Lung volume reduction surgery can remove damaged tissue from the lungs. Other procedures that may be recommended are lung transplants and bullectomies.