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COPD – A General Overview

COPD stands for Chronic Obstructive Pulmonary Disease. People with this disorder suffer from an impairment of airflow into their lungs, making breathing increasingly difficult over time. Since smoking cigarettes is considered the primary cause of this disorder, quitting smoking is imperative to reducing your risk of developing this disease. However, not everyone who smokes will develop this disorder; other factors include genetics, age, body mass index, and family history.

The National Heart Lung Blood Institute estimates that 13 million Americans (about 5% of the population) suffer from this disorder. This number includes both men and women, but nearly three times as many men have the disease as women.

African Americans and Native Americans are at greater risk of developing this disease than Caucasians. However, smoking habits are not the only factor that puts someone at risk. Other factors include genetics, age, pollution, occupational exposures, a history of asthma, and a family history of this disease.

There are two major forms of COPD: Emphysema and Chronic bronchitis.

Emphysema:

is the destruction of lung tissue. This occurs partly due to an injury caused by cigarette smoke inhalation, but also due to genetic predisposition and respiratory infections. In severe cases, the damage to the lung parenchyma causes air sacs to become enlarged and collapse, resulting in impaired gas exchange between the blood and alveoli. As a result, patients may experience shortness of breath at rest and/or fatigue during physical activity.

Chronic bronchitis:

It is a disease that can cause chronic coughing and spasms of the airways. CB is caused by inflammation of the mucous membranes lining the trachea and bronchi. This inflammation causes the mucus to become thick and sticky, making it difficult to cough out.

COPD has become one of the leading causes of death worldwide. According to the World Health Organization’s (WHO) report in 2012, chronic obstructive pulmonary disease was the 4th leading cause of death globally. In 2013 alone, it caused over 3 million deaths across the world. This number is expected to increase by over 60% by 2030.

There are two types of tests used to diagnose COPD: spirometry and blood tests. Spirometry measures how well your lungs perform during normal breathing. Blood tests check levels of certain substances that help regulate breathing and keep the lungs healthy.

What are the various stages of COPD?

• The first stage is called Bronchiectasis. This occurs due to repeated exposure to noxious particles and gasses from cigarette smoke. Once these particles enter the airways, they cause damage to the mucous lining. The mucus then becomes thickened, which makes breathing difficult.
• In stage two, emphysema begins. There is a loss of elasticity in the alveoli and surrounding tissue that causes them to lose their ability to expand fully against pressure. When this happens, air cannot easily move through the lung tissue. As a result, the lungs fill with fluid, causing shortness of breath. These changes lead to chronic inflammation and scarring.
• Stage three is known as Airway Obliteration. Here, fibrosis has developed, making it impossible for normal airflow to take place.
• Stage four is known as Restrictive Lung Disease. In this stage, the muscles around the airways become tight, narrowing the passageways. This limits airflow and results in increased difficulty breathing.
• In stage five, the lungs have become severely damaged and this is irreversible. If left untreated, emphysema can develop into chronic bronchitis.

What are the various causes of COPD?

Smoking:

Smoking is the primary cause of chronic obstructive pulmonary disease. 

Air Pollution:

Air pollution can also lead to Chronic Obstructive Pulmonary Disease. An estimated 679,000 deaths have occurred due to outdoor air pollution each year. While these pollutants are often invisible they still cause health problems among individuals who inhale them.

Genes:

Genetic factors may also contribute to the development of this disease. People who inherit genes that predispose them to develop Chronic Obstructive Pulmonary Disease are at greater risk of contracting the disease. Other genetic issues like alpha-1 antitrypsin deficiency could lead to Chronic Obstructive Pulmonary Disease if not diagnosed early. Research shows that over 25% of people with COPD have this particular gene defect. However, many doctors do not test for this deficiency because it does not affect everyone.

What are the symptoms of Chronic Obstructive Pulmonary Disease?

• Shortness of breath (dyspnea)
• A wheezing cough
• The feeling of chest tightness
• Coughs that are chronic and produce mucus (sputum) that may be clear, white, yellow, or green
• Infections of the respiratory system
• Having a lack of energy
• Loss of weight unintentionally (in the later stages)
• Inflammation of the ankles, feet, or legs

When someone experiences this symptom they often notice that they have to stop doing activities like cooking, cleaning, gardening or even taking a shower. People who suffer from COPD may not experience these symptoms until the condition becomes more advanced. While shortness of breath is generally the first sign of the disease, others may experience other symptoms including chest tightness, cough, pain in the back or side, weight loss, and changes in appetite, sleep, or mood. These symptoms can make life challenging for people with COPD and affect their daily lives.

Treatment for Chronic Obstructive Pulmonary Disease

COPD sounds scary at first, but let’s look at some ways to avoid getting this chronic condition. The treatment for COPD is a combination of medication and lifestyle changes.

• Medication helps open up the airways and relax the muscles around them.
• Lifestyle changes include quitting smoking, eating healthy, exercising regularly, and managing stress levels.
• Avoid Secondhand Smoke – Smoking cigarettes can greatly increase your risk for Chronic Obstructive Pulmonary Disease. Not only does secondhand smoke irritate the lungs, but it increases the chance of developing COPD. If a smoker leaves their cigarette lying around, they are exposing other people to harmful chemicals, including nicotine, tar, carbon monoxide, ammonia nitrate, and hydrogen cyanide.
• Eat Well – If you want to avoid getting Chronic Obstructive Pulmonary Disease, eat well! You don’t need to go vegan, but eating plenty of fruits, vegetables, whole grains, nuts, legumes, seeds, lean protein, and healthy fats will help reduce inflammation and keep your immune system strong.
• Exercise Regularly – Start slowly if you have not exercised before. Do some light walking at first, and build from there.
• Stress can make COPD worse. When people feel stressed out, they tend to have higher levels of cortisol, a hormone released from the adrenal glands. Cortisol helps regulate our body’s response to stress. However, too much cortisol can lead to inflammation and damage to the lining of the lungs. Managing stress can help Chronic Obstructive Pulmonary Disease symptoms.

Medications for Chronic Obstructive Pulmonary Disease

• Albuterol (salbutamol): Albuterol is used to treat asthma attacks and other respiratory conditions that cause breathing difficulties. This medication works by relaxing muscles in the lungs and airways, allowing them to open wider and breathe easier.
• Fluticasone/Salmeterol (flunisolide/salmeterol): Fluticasone is a corticosteroid used to treat asthma symptoms. Salmeterol is a long-acting beta-agonist that helps relax muscles in the lungs and bronchial tubes. They work together to reduce inflammation and ease breathing problems.
• Terbutaline (terbutaline sulfate): Terbutaline is used to treat shortness of breath caused by exercise or colds. It’s a quick-relief medicine that can help your body get rid of mucus and loosen tight muscles in the chest.

Diet recommendations for people with Chronic Obstructive Pulmonary Disease

• Avoid processed foods that are high in sodium and refined sugars. These foods can cause your body to retain water, making you feel bloated and uncomfortable.
• Eat plenty of fruits and vegetables. They contain fiber, vitamins, minerals, antioxidants, and other phytonutrients that help keep your immune system strong.
• Limit alcohol consumption. 
• Drink plenty of fluids throughout the day. This helps flush out mucus from your lungs.
• Avoid smoking cigarettes. Smoking causes inflammation and damage to lung cells.
• Take care of yourself. Exercise regularly, get enough sleep, and eat healthy food.

A new study shows the link between poor sleep and the risk of Life-Threatening COPD flare-ups

A study published in the American Journal of Respiratory and Critical Care Medicine found that people who reported poor sleep quality were at increased risk of experiencing a severe exacerbation of chronic obstructive pulmonary disease.

The researchers analyzed data from 4,845 patients with moderate to severe COPD enrolled in the UPLIFT® trial. They found that those who had poor sleep quality experienced a higher rate of hospitalization due to acute COPD exacerbations than those who did not report poor sleep quality.

“This study provides further evidence that sleep disturbance may contribute to worsening symptoms and increase the risk of hospitalization among patients with COPD,” said lead author Dr. David A. Sackett, professor of medicine at Harvard Medical School and director of the Division of Pulmonary Diseases at Brigham and Women’s Hospital in Boston. Poor Sleep Tied to Increased Rate Of Death In Patients With Chronic Obstructive Pulmonary Disease: In a separate analysis of data from the same cohort of participants, the researchers found that poor sleep quality was associated with a nearly twofold increase in mortality over five years.

Living with Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease requires lifelong management. The symptoms of COPD are usually worse at night than during the day. You may have trouble sleeping. Your cough may wake you up at night. Your voice may get hoarse. You may find yourself waking up often during the night because of coughing. You may feel tired even if you sleep well at night and may have trouble getting enough rest. Sometimes you may need to spend extra time resting. You may have trouble doing things around the house. You may have trouble climbing stairs and trouble walking long distances.

What’s the outlook for people with Chronic Obstructive Pulmonary Disease?

People who have COPD often experience shortness of breath, wheezing, coughing, chest tightness, and even emphysema. The outlook for people with COPD is not good. They are at risk of developing lung cancer, heart failure, pneumonia, and other respiratory diseases. They may also develop chronic bronchitis, osteoporosis, and depression.