CHRONIC OBSTRUCTIVE PULMONARY DISEASE
What is Chronic Obstructive Pulmonary Disease?
A group of lung diseases characterized by limited airflow through
the airways with variable degrees of air sack enlargement and
lung tissue destruction. The diseases emphysema and chronic
bronchitis are the most common forms of chronic obstructive
pulmonary disease.
The leading cause of COPD is smoking, which can lead to the two most common forms of this disease, emphysema and chronic bronchitis. Prolonged tobacco use causes lung inflammation and variable degrees of air sack (alveoli) destruction. This leads to inflamed and narrowed airways (chronic bronchitis); or permanently enlarged air sacks of the lung with reduced lung elasticity (emphysema).
After tobacco-use, other risk factors for COPD are passive smoking (exposure of nonsmokers to cigarette smoke from others), male gender, and working in a polluted environment.
What are the Symptoms of Chronic Obstructive Pulmonary Disease?
-
Shortness of breath (dyspnea) persisting for months to years
-
Wheezing
-
Decreased exercise tolerance
-
Cough with or without phlegm
How is Chronic Obstructive Pulmonary Disease Diagnosed?
An examination often reveals increased work involved in breathing: nasal flaring may be evident during air intake, and the lips may be pursed (the shape lips make when you whistle) while exhaling. During a flare of disease, chest inspection reveals contraction of the muscles between the ribs (intercostal retraction) and the use of accessory breathing muscles. The respiratory rate (amount of breaths per minute) may be elevated, and wheezing may be heard through a stethoscope. A chest X-ray can show an over-expanded lung (hyperinflation) and a chest CAT scan (CT) may show emphysema. A sample of blood taken from an artery (arterial blood gas) can show low levels of oxygen (hypoxemia) and high levels of carbon dioxide (respiratory acidosis). Pulmonary function tests show decreased airflow rates while exhaling and over-expanded lungs.
How is Chronic Obstructive Pulmonary Disease Treated?
Treatment for COPD includes inhalers that dilate the airways (bronchodilators) and sometimes theophylline. The COPD patient must stop smoking. In some cases inhaled steroids are used to suppress lung inflammation, and, in severe cases or flares, steroids by pill or IV are given. Antibiotics are used during flares of symptoms as infections can often worsen COPD. Chronic, low-flow oxygen, non-invasive ventilation, or intubation may be needed in some cases. Lung volume reduction surgery for COPD is a controversial surgical therapy currently undergoing national trials to determine efficacy. Lung transplant is sometimes performed.
» top