What Is COPD?
COPD is a chronic lung disease that makes it hard to breathe. It’s a type of obstructive lung disease, which means air can’t flow freely into your lungs.
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COPD is an umbrella term for lung conditions including bronchitis and emphysema. It causes breathing problems, a chronic cough and regular chest infections. It is a progressive disease, with most people being diagnosed later in life.
As COPD is a common condition affecting older adults and those who smoke, you may well have been diagnosed with this or know someone who has.
Although due to the symptoms and the fact that it arise later on in life, many people
do not realize that they have it.
In the UK, it is thought that 3 million people have COPD,
and 2 million are undiagnosed.
Due to this, there are many efforts made to raise the awareness of COPD as a way to increase early diagnosis and help with the treatment of what can be a debilitating condition.
The British Lung Foundation defines COPD as:
“a group of lung conditions including bronchitis and emphysema. They make it difficult to empty air out of the lungs because your airways have been narrowed.”
What Does It Stand For?
What Does It Include?
It encompasses a group of lung conditions, including:
‘chronic bronchitis’ and ’emphysema.’
Both can occur together but are two different types of conditions.
Chronic Bronchitis, which is caused by the overproduction and hypersecretion of mucus. This leads to worsening airflow obstruction, causing
inflamed and narrowed airways.
Emphysema is pulmonary, therefore referring to the lungs.
Emphysema is known as an obstructive lung disease because the airflow upon exhalation is either slowed down or stopped.
This is due to over-inflated (or baggy) air sacs – also known as alveoli – in your lungs.
This make it harder for air to move in and out.
Check out THIS diagram created by the British Lung Foundation as a way to see how both conditions affect the lungs.
As is the case with other conditions affecting the lungs, such as asthma,
there are notable symptoms associated with the onset and development of COPD.
- The cough is often the very first symptom to occur and is one of a productive nature. Sufferers of COPD will cough up phlegm, medically known as ‘sputum.’
- It tends to come and go but over time, it usually becomes more persistent. This is also known as long-term or ‘chronic’.
- Ever heard the term ‘smokers cough?’ The early stages of this disease showcase this.
- As a cough can be a symptom of so many other health conditions, many people whose cough resembles that of COPD often do not realize that this is what they have until the next symptom, which is…
Breathlessness or ‘shortness of breath’ & Wheezing
- This will often be accompanied with a wheeze
- The breathlessness may not develop in conjunction with the cough. In fact, it may only present itself when you take on physical exertion.
For example, by climbing the stairs or doing the housework.
- With breathlessness and wheezing, smoking will only make these symptoms worse over time. As this symptom is directly associated with your breathing, any challenges faced with this can become worrisome.
- Because COPD damages your airways, you will provide more mucus than normal. If Once expelled through the mouth, ‘sputum’ is formed.
- You tend to cough up a lot of sputum each day.
- This can be clear, white, yellow or greenish depending on whether or not you are getting a…
- If you have COPD, you will be much more likely to suffer with chest infections.
- An infection can be seen as a worsening of symptoms.
This is also known as an exacerbation.
- When you have a chest infection, the symptom of breathlessness and wheezing with a cough may become worse.
- You may cough up excess sputum with a chest infection and this sputum will likely be yellow or greenish.
- The bacteria which lead to chest infections cause between 20% and 60% of COPD exacerbations.
Viruses, such as the common cold are also a cause of COPD exacerbations. In fact, one such study shows a subject exacerbation risk of 30 times greater with a cold present.
COPD & Asthma
There are common misdiagnosis when it comes to COPD and asthma.
For those who have been diagnosed with COPD, it means that the airways have become narrowed permanently.
The use of inhaled medications can help to open the airways again, in a limited capacity.
When it comes to asthma, the narrowing of your airways comes and goes. This is often due to the prevalence and exposure to certain triggers.
These can range from dust or pollen, to tobacco smoke and chemicals.
Inhaled medication can help to open the airways.
If you find that breathlessness and other symptoms, such as coughing, chest tightness and mucus production are change depending on the day
if you often wake up in the night with a wheeze, it’s more likely you have asthma.
One of the main causes of COPD is smoking, while asthma is due to an allergic or inflammatory reaction.
COPD is a progressive disease. The allergic reactions in patients with asthma, can be reversible.
COPD usually develops after age 40 and often becomes a chronic disease of lung function. Asthma may develop in people of almost any age.
Treatments of COPD include bronchodilators.
Treatments for asthma include inhaled corticosteroids.
Initial symptoms, such as a cough, wheezing and shortness of breath in both COPD and asthma can be similar, leading to common misdiagnosis
Both conditions can also take on more severe symptoms, such as respiratory distress.
Deaths can also occur in both COPD and asthma
People can also is have symptoms of both asthma and chronic obstructive pulmonary disease.
This combination is known as Asthma-COPD Overlap Syndrome
For some people, COPD is caused by a genetic condition.
This is known as alpha-1 antitrypsin deficiency and was discovered in the early 1960’s.
However, this deficiency – also known as AAT – accounts for only
1–2% of all COPD cases.
This determines that there are other variants in the genome which are likely to be associated with COPD characteristics,
which various genetic studies are concluding.
COPD is an increasing problem in old age, with it being most commonly diagnosed after the age of 45.
It is usually considered a disease of the elderly, however there have been instances of individuals with AAT deficiency develop COPD of similar severity at a younger age.
In one survey of individuals with the gene deficiency of AAT, it highlighted that 44.4% of participants reported retiring early due to AATD.
Smoking is the leading cause of COPD.
Unlike the other two risk factors, this one can be omitted altogether, although studies show that this often isn’t the case.
Adhering to the British Thoracic Society criteria, one study found that the the population attributable risk of COPD due to smoking was 50%.
In another study, results highlighted that in addition to the eosinophilic airway inflammation observed in patients with COPD and asthma, smoking
actuates neutrophilic airway inflammation.
There are a few different ways your GP can test you for COPD.
☆ Spirometry ☆
If you fall into a risk bracket or feel that you may have the tell-tale signs and symptoms of COPD a spirometry test could confirm your diagnosis.
Spirometry is a simple test of how well your lungs work.
It is a common and effective diagnostic test that can be undertaken at your GP practice or clinic.
★ THE TEST ★
You will be asked to take a very deep breath and blow out as fast as you can into a machine until no more air comes out.
Spirometry can detect COPD before symptoms develop.
Your test results can help to set your treatment goals.
☆ Other tests ☆
Your GP may also want you to have a chest X-ray alongside other tests.
Whilst not necessarily a diagnostic confirmation, it can suggest the presence of COPD.
You may also need to have an arterial blood gas test.
This determines the oxygen level in your blood.
This test can also show how well your lungs are able to move oxygen into your blood and remove carbon dioxide from your blood.
A blood gas sample can also be venous, from a vein or pre-existing IV.
Studies show the same results can be obtained in a more simple and less painful way.