Chronic Obstructive Pulmonary Disease (COPD)

Emphysema develops when the alveoli are damaged by toxins.
DO you cough? Do you bring up phlegm? Do you get breathless? Do you wheeze?

If the answer is yes to any of the questions above, then you may be suffering from undiagnosed respiratory disease.

More than 80 million people in China will die in the next 25 years from respiratory disease.

Smoking is prevalent. You only have to look around you. Tobacco smoke damages your lungs through direct inhalation (active smoking) and indirect exposure (passive smoking).

There is also concern about the under-diagnosis of respiratory disease and lack of public awareness of symptoms and treatment.

This article will focus on chronic obstructive pulmonary disease (COPD) which is one of the major causes of morbidity and mortality worldwide.

What Is COPD?

COPD primarily encompasses two related respiratory conditions known as chronic bronchitis and emphysema. Persistent airway inflammation features in chronic bronchitis and this leads to coughing, phlegm production, breathlessness and wheezing.

Lung tissue destruction occurs in emphysema causing the organ to lose its natural elasticity. As a result, air becomes trapped in the lungs when the airways collapse during exhalation. This leads to hyper-inflation of the lungs.

Oxygen delivery from the lungs into the bloodstream is also diminished. This is because the tiny air sacs in the lungs become enlarged and are no longer able to function properly.

COPD Symptoms

They tend to set around your middle 30s. Symptoms are gradual over time. You may not notice anything amiss until a problem may be at hand.

You may notice that you get a little breathless when climbing stairs or have difficulty keeping up with your contemporaries. You cough quite often or bring up thick phlegm, especially when you wake up in the mornings.

You may even hear yourself wheeze on occasions. You may find that you are unable to gain weight. Perhaps, you are losing weight without dieting or exercising. Pay attention to these symptoms as they may be pointing towards an underlying respiratory disease such as COPD.

What Do You Need To Do?

If you suspect that you have a respiratory condition, visit a respiratory physician without delay. Early diagnosis and treatment may prevent further problems.

It may also minimise deterioration of your condition and avert hospitalisation. The doctor will take your detailed history and do the appropriate investigations.

Full Respiratory Function Test

You will be required to undergo a simple procedure known as spirometry which simply involves you blowing into a machine via a mouthpiece. This will allow basic measurement of respiratory function to determine whether you have narrowing of your airways.

You may be required to undergo further tests to assess the volume of your lungs. In people with COPD, there is air trapping where the lungs may become hyper-inflated.

Another test is the diffusion study which involves breathing in a mixture of gas. This test will determine whether you have damage in the tiny lung air sacs which may affect the transport of oxygen from your lungs into your bloodstream.

The three tests above are commonly performed together and are known collectively as a full respiratory function test.

A chest X-ray will be required to assess your lungs. This will usually be followed up by a CT scan of your chest should there be any abnormality detected on your X-ray.

COPD Treatment

The aim of treatment in COPD is to provide symptomatic relief as well as to minimise flare-ups and hospitalisation.

There are generally two forms of medication. One is delivered through inhaler devices and the other ingested as oral tablets.

Inhaler therapy opens up the airways in your lungs. It also dampens down airway inflammation. This will enable you to breathe better. It will also help you to feel less breathless. You may feel more energetic.

Inhaled medication can also be delivered through a spacer or nebuliser device. The latter is the usual mode of treatment for patients.

Oral tablets work in conjunction with inhaler therapy. They are complementary by helping the airways stay open as well as keeping inflammation in check.

Sometimes, a flare-up requiring hospitalisation occurs. Do not worry if this happens as people with COPD are more prone to chest infections.

It is best to be always on the look out for chest infections. If treated early, a full blown flare-up may be avoided.

A machine to help breathing may sometimes be required for hospital patients. Some people with COPD may find that they need oxygen therapy at home.

Surgery for COPD may be an option but only for the select few. It is complex and difficult with many potential complications. The same criteria apply to lung transplantation.

It is now well recognised that a multi-disciplinary approach is best with COPD. This is known as pulmonary rehabilitation. It involves the expertise of healthcare providers from various specialties. These usually consist of respiratory specialists, physiotherapists, nurses, occupational therapists, counsellors and dieticians.

Warning Signs

COPD may affect your heart when it causes the blood vessels in your lungs to constrict and harden. This results in an increase of pressure in your lungs which causes your heart to strain as it struggles to pump blood to the lungs.

You may experience ankle swelling as a result. You may also find that you are unable to lie flat when you sleep because of breathlessness.

If you cough up blood or notice streaks of it in your phlegm, see your respiratory specialist without delay. You may also be losing weight for no apparent reason. You must be wary of these symptoms as COPD is associated with an increased risk of lung cancer.

Living with COPD

There are many people with COPD who live fulfilling lives. Learn more about the condition. Get support from your healthcare providers. Living with COPD may be difficult but understanding it will make the journey easier.