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Chronic Obstructive Pulmonary Disease (COPD)

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Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of disability affecting people from all around the world. Studies reveal that untreated COPD can lead to other health problems, such as sleep disturbances, depression, cardiovascular problems and increased mortality.

There is currently no cure for COPD however, with the right support and proper treatment strategy, one can manage its symptoms effectively.

What Is COPD?

Chronic Obstructive Pulmonary Disease, also known as COPD, is a common lung condition characterized by obstruction of the air passages inside the lungs, known as the bronchi. COPD occurs due to the narrowing of the bronchi. The term COPD includes two medical conditions: Chronic Bronchitis and Emphysema.

Chronic Bronchitis

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) defines chronic bronchitis as the presence of a chronic cough for at least 3 months in a year and lasting for at least 2 consecutive years in the absence of other causes.

Emphysema

Emphysema refers to the enlargement and destruction of the walls of the sac-like airspaces that make up the lungs.

What Causes COPD

The leading cause of Chronic Obstructive Pulmonary Disease is cigarette smoking. Other causes include long term exposure to noxious respiratory irritants such as fumes, air pollutants and dust. Very rarely, COPD is caused by a genetic condition known as alpha-1 antitrypsin deficiency.

COPD is primarily the result of chronic lung irritation. When lung irritants are inhaled, they pass through the bronchi inside the lungs. Bronchi are tubes that carry air in and out of the lungs. As noxious substances pass through the bronchi, they irritate the inner lining of these air-carrying tubes. This activates the body’s immune system and inflammatory responses which, in turn, send signals to increase the production of mucus. The body produces mucus to provide a protective coat to help prevent the bronchi from being further damaged by noxious respiratory irritants. At the same time, the bronchi are instinctively narrowed to reduce the amount of noxious airborne particles entering the lungs. This is a natural defence mechanism of the human body.

Unfortunately, just like too much of anything can be harmful; similarly repeated exposure to respiratory irritants is what leads to COPD. When the protective narrowing mechanism of the bronchi occurs repeatedly, this starts to not only obstruct the flow of harmful particles entering the lungs, but also the flow of clean air itself. This is why COPD patients experience breathlessness.

At the same time, there is an increase in the size and number of cells that line the bronchi because the body wants to produce more mucus to protect the lungs from further damage. Unfortunately, this leads to the production of excessive amounts of mucus. Too much mucus is what comes out as phlegm, or sputum during a cough.

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The symptoms of COPD can vary from person to person, depending on the severity of the disease. The most common symptoms are;

  • Shortness of breath, especially when performing high-energy, or moderate-energy activities
  • A persistent wheezing sound
  • Chronic cough with phlegm
  • Chest tightness
  • Fatigue
  • Frequent respiratory infections
  • Sleep disturbances
  • Bluish discolouration of the tongue in very severe cases
  • Coughing up blood
  • Unintentional weight loss.

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There is currently no cure for COPD. Once the damage is done, it is difficult to reverse it. However, you can prevent it from progressing to an advance stage and reduce its symptoms by adopting certain lifestyle changes and by taking medications.

Tips to Manage COPD

Stop Smoking

Quitting cigarette smoking is the most effective way to reduce the risk of developing COPD, as well as its progression to a more severe stage. Cigarette smoke contains over 4000 harmful chemicals.

It is difficult to stop smoking, but not impossible. Research shows that a proper framework and adequate time investment can ensure up to 25% successful quit rates. Research also shows that over 72 hours of quitting smoking, breathing becomes easier and over 3 to 9 months, wheezing reduces and lung function improves by 10%.

There are numerous smoking cessation clinics and programs that facilitate this process. These programs are well-established, most of which comprise of a five-step program.

Patients who still experience difficulties in quitting smoking are offered nicotine patches, or gums, for a short period of time and are slowly weaned off from theses substitutes.

Avoid Lung Irritants and Get Fresh Air

Apart from cigarette smoke, there are other numerous respiratory irritants that can trigger the same effects as cigarette smoke and promote COPD. Such irritants include chemical fumes, dust, second-hand smoke, insect killer sprays and paint aerosols.

It is always wise to keep the windows and doors wide open when spraying paint, or using insect sprays. Keep the windows closed if your house, or office, is situated in an area prone to air pollution. You may find it useful to wear a mask if your job consists of constant exposure to fumes, dust, and other types of respiratory irritants. To select the ideal mask, look for one that is tight, but comfortable, has high filter efficiency, is highly breathable and splash resistant.

Have Some Rest

Getting enough rest is not a luxury, but a necessity. Your body needs adequate rest to reset itself. Unfortunately, COPD makes getting quality sleep more difficult because frequent coughs and breathing problems disturb sleep patterns. Also, carrying out activities that require lots of efforts throughout the day can make you breathless.

Eat the Right Foods

While a healthy diet will not help you in eliminating COPD, it can help you feel better, healthier, and happier. Research shows that a diet low in carbohydrates may help COPD patients reduce their production of carbon dioxide.

Stay Well Hydrated

Keeping yourself well hydrated is vital if you suffer from a persistent cough. This is because water has the ability to thin mucus thus preventing it from accumulating inside the lungs. The recommended daily intake of water for most individuals is around 6 to 8-ounce glasses a day. Keeping yourself well hydrated throughout the day will also help you feel more active and refreshed.

Try Breathing Exercises

Health experts recommend practising breathing exercises to improve lung function. A medical review published by the Annals of Rehabilitation Medicine Journal in 2019 reported that patients who practised breathing exercises for COPD experienced a significant improvement in breathing and quality of life, as compared to the group that did not do the exercises.

The ‘‘Belly Breathing’’ technique, also known as the diaphragmatic breathing exercise (DBE), helps strengthen the diaphragm. To practice the diaphragmatic breathing exercise, simply lie down on the sofa, place your hands onto your belly and breathe in while pushing your stomach outwards and exhale while pulling your stomach inwards.

Another simpler yet effective technique is the ‘‘Pursed-lip’’ breathing exercise. To perform this technique, breathe in through your nose and exhale through pursed lips.

Most hospitals and clinics also have a pulmonary rehabilitation program that aims at improving abnormal breathing patterns, reducing respiratory symptoms, and improving the overall quality of life of COPD patients.

Use a Humidifier to Reduce Mucus

Mucus build-up can be annoying. COPD patients may sometimes experience difficulties in coughing up mucus. Experts recommend using an air humidifier to reduce air dryness, especially during winter when the heating systems are left running for long hours. Humidified air helps loosen mucus making it easier to clear the airways. A humidifier should, however, be cleaned on a daily basis to prevent the risk of infections. Some humidifiers also have air filters that need to be changed regularly. Every humidifier is different, so follow the instructions that come with the product.

Consider Medical Help

While there are numerous ways of reducing the symptoms of COPD, severe COPD may sometimes not resolve readily. Persistent symptoms require help from a professional respiratory physician specialist, or a qualified medical doctor. Doctors will usually prescribe a bronchodilator and an anti-inflammatory medication to open up the airways and clear excess mucus. Most of the medications for COPD come in the form of inhalers so that the agent can directly penetrate the airways. In severe cases, your doctor will want to administer the bronchodilator in an aerosolized form through a piece of transparent mask-like equipment called a nebuliser.

The NHS recommends getting the flu shot once a year if you suffer from COPD. Flu shots are offered free of charge to anyone suffering from Chronic Obstructive Pulmonary Disease.

Always Be Prepared for an Emergency

Very often, COPD patients experience an acute exacerbation of COPD. Most of the time, this occurs due to a chest infection. In this case, it is wise to always seek professional support before the infection worsens, causes more mucus production that can, in turn, further block the passage of air to the lungs. The doctor will prescribe an antibiotic if he, or she, feels that the infection is of bacterial origin.

Also, always make sure to have an inhaler containing a short term bronchodilator on you. Experts advise to always carry your inhalers wherever you go and to always check and refill your supply of medications. Note that an acute exacerbation of COPD can lead to further lung damage.

Get Emotional Support

COPD can trigger anxiety, depression, and stress due to the fear of not being able to breathe properly. If you feel that Chronic Obstructive Pulmonary Disease is making your life miserable, look for the right support and emotional assistance. You might find it useful to join a support group to find other people who face similar challenges. Also, you should not feel hesitant to seek support from the members of your family.

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There are various support groups out there, all ready to give you a helping hand. Health experts recommend seeking support as soon as possible, as there are various strategies that will help you improve the quality of your life. We’ve compiled a list of some useful organizations dedicated to the management of lung problems and COPD;

British Lung Foundation

Nara - The Breathing Charity

Chest, Heart & Stroke Scotland

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Medical terms are often baffling and difficult to fully understand. To help, we have listed some frequently used terms below.

Alpha-1 antitrypsin deficiency. Alpha-1 antitrypsin deficiency is a genetic condition characterised by lung and liver disease. Patients with AAT deficiency present with chronic obstructive pulmonary disease and emphysema

Bronchi and bronchioles – the bronchi and bronchioles are the tube-like airways that allow the passage of oxygen into the lungs and carbon dioxide out of the lungs. Each lung is made up of 30,000 tiny bronchioles

Wheezing: Wheezing is the high pitched whistling sound produced when someone with lung problems breathes. It is most commonly heard during expiration