Chronic Obstructive Pulmonary Disease (COPD): Symptoms, Stages, Causes, Risks, Complications, Diagnosis, Treatment and Prevention

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Illustration of COPD

1Overview

The air exchange occurs in our lungs. When you inhale, the air passes into the nose down to the pharynx, trachea and to the bronchial tubes that branch into the left and right bronchioles. Gas exchange takes place in the alveoli of the lungs, which expands when it is filled with air. The respiratory system is responsible for delivering oxygen to the body by gas exchange and filtering the air people breathe in.

When there are pathogens present inside the lungs, an inflammatory response will start and produce mucus that will serve as a barrier and protector the will be later expelled in the form of sputum.

Diseases of the respiratory system

Chronic Obstructive Pulmonary Disease or COPD is a collective term of diseases that involves the inflammation and infection of the airways in the lungs.  Emphysema, asthma and chronic bronchitis are some of the diseases under Chronic Obstructive Pulmonary Disease. Most COPD cases that are left untreated can lead to Heart diseases

Asthma

It is a condition where there is a hypersensitivity reaction caused by an allergen.
The airway suddenly constricts causing the person to have difficulty in breathing.
Wheezing is heard during an asthma attack accompanied by chest pain.

Chronic Bronchitis

This is an inflammation of the lining of the airway specifically the bronchioles.
The defense mechanism acts on the lungs to eliminate the causative agent, which results
in the production of mucous. These mucous can effectively narrow the airway passages resulting in difficulty in breathing.

Emphysema

The alveoli, the air sacs of the lungs are the place where the oxygen and carbon dioxide exchange. In emphysema, the alveoli are enlarged and damaged causing the air to be trapped inside the sacs. If this happens, there will be no new oxygen to be distributed throughout the body.

2Symptoms

Some patients with chronic obstructive pulmonary disease (COPD) are asymptomatic until the condition progress. Symptoms of COPD include:

  • Excessive coughing
  • Wheezing sound can be heard upon breathing
  • Fatigue may be present
  • Shortness of breath
  • Tightness of the chest or even pain

Emergency intervention is given to a person whose condition worsens, and symptoms are life threatening, this includes:

  • Cyanosis
  • Cannot talk or breathe properly
  • Decrease in level of consciousness
  • Tachycardia

3Stages

The chronic obstructive pulmonary disease can be classified into stages for the doctors to know how severe the COPD progressed and determine the proper course of treatment.
This process of staging is called GOLD system.

The GOLD system or Global Initiative for Chronic Obstructive Lung Disease is a way to determine what treatment is suited for the patient. The GOLD system bases it through these following criteria:

  • How many times are you confined in a hospital due to COPD
  • The symptoms that the patient is experiencing
  • Number of times your COPD occurs
  • The use of Spirometer to measure the volume of air and how fast it is when the person exhales.

 GRADE 1 (Mild COPD)

People having a grade 1 stage of COPD may not notice the symptoms at first. There is a limitation of airflow in the lungs, and if the patient may have symptoms, they will most likely experience mild coughing and attribute it to other illness like a common cough and colds.

GRADE 2 (Moderated COPD)

The airway becomes more restricted, allowing a little air to pass through. Symptoms are starting to be noticed by the patient like coughing with excessive sputum and fatigue while doing the activities of daily living accompanied by shortness of breath.

GRADE 3 (Severe COPD)

Severe symptoms are evident as the coughing persist. Airway blockage worsens as the patient finds it hard to breathe, pains in the chest may be felt and fatigue will be noticed even in the little amount of activity is done. Patients having these symptoms are seeking help to medical practitioners.

GRADE 4 (Very Severe COPD)

This stage, the patient will experience life threatening symptoms and can lead to respiratory failure. The quality of life of the patient is impaired, and when left untreated it could cause devastating damage to the body.

4Causes

Smoking is the number one cause of chronic obstructive pulmonary disease (COPD).
The damage inflicted by the cigarette to the lungs is great that it destroys the alveolar sacs. Other diseases like Emphysema and chronic bronchitis is also one of the causes of COPD.

Other causes of COPD are:

  • Premature babies whose lungs did not develop will have problems like chronic lung disease
  • Genetic factors like alpha-1 antitrypsin deficiency cause COPD. This protein protects and coats the lungs to prevent damage. Chronic smokers have little or less of these due to the chemicals present in the cigarettes.
  • Exposure to harmful chemicals like factory emissions and pollution produced by cars.

5Risk Factors

Chronic obstructive pulmonary disease (COPD) risk factors may include the following but not limited to:

  • Age, the capacity of the lungs decreases hence it is vulnerable to diseases and damage.
  • Babies who are born premature and doesn’t have any surfactant in the lungs may be at risk of lung damage in the future.
  • The lack of the protein, Alpha-1 antitrypsin deficiency can affect the integrity of the lungs.
  • Exposures to chemicals like factory smoke can affect the people living near it.
    Long exposure to the fumes can have harmful effects on a person’s body not only in the lungs but also the heart.
  • Chronic smokers. The chemical content of the cigarette like, nicotine can destroy the air sacks (alveoli) of the lungs.

6Complications

Having COPD can affect the quality of life of a person may it be psychological or physical, sometimes it is both. Depression is one of them, the usual activities of daily living are not possible due to restrictions of the body.

Cancer of the lungs is also a possible complication of COPD, the damages received by the lungs can activate the cancer cells and can easily spread in the nearby areas aside from the lungs.

Infections are rampant due to the decreased immunity of the body. The protective layer of the lungs is impaired hence bacteria or viruses can enter easily in the system.

7Diagnosis

In diagnosing chronic obstructive pulmonary disease, the doctor will first assess the patient, ask the past medical history and the family history. Chest X-ray is done to view the lung structure and to see if there are any blockages in the lungs. Spirometry is done to know what is the volume and speed of the air when the patient will exhale.

Other tests may be done as ordered:

  • Oximetry: is done to see the saturation of oxygen in the body. The level of oxygen in the body will determine if the patient will need oxygen treatment.
  • Electrocardiogram (ECG): this done to rule out any heart-related problems based on the symptoms that the patient is having.
  • The amount of oxygen in the body, as well as the carbon dioxide and acid, is determined by arterial blood gas test.

8Treatment

Prescribed medications are used to treat COPD:

Steroids

Steroids can help minimize the progression of COPD. It is usually taken for only five days.

Antibiotics

Antibiotics are used to treat current infection in the lungs. The anti-inflammatory effect of antibiotics can help lower the inflammation of the airways.

Phosphodiesterase-4 inhibitors

It has an anti-inflammatory effect on the lungs thus dilates the airways for better airway passage.

Bronchodilators

As the name implies, it dilates the airway by relaxing the muscles to enhance the passage of air for better breathing.

To prevent the progression of the COPD, Lifestyle changes should be done including invasive procedures.

  • Stop smoking: Avoiding smoking can stop the disease to a stage that it can be managed without any severe consequences.
  • Rehabilitation program: It helps and educates the person about the disease. Professionals will help and address your diet, exercise and also the psychological aspect.
  • Oxygen therapy: A portable oxygen tank will be required to the patient to supplement the deficiency in the body.

Surgery

Lung transplant

Replacing the lung that was damaged will enhance the condition of the patient. Some risks like organ rejection are also discussed with the patient before proceeding with the surgery.

Bullectomy

A bulla is a dead space that can interrupt in the breathing and exchange of oxygen inside the lungs. Therefore it is removed to avoid such complications.

9Prevention

Avoid Smoking, which is the number one prevention for COPD to stop the damage incurred by the chemicals in the cigarette. Proper ventilation is a must for better air circulation in the house and buildings.

Have a regular check-up from your doctor to monitor your health status and to prevent any complications that are accompanied by the disease. Patients who are suffering from COPD must me annually vaccinated like flu vaccines, pneumococcal vaccines and pertussis vaccine. These vaccines may prevent complications in the future because once the COPD patient gets the flu or pneumonia, there is a great chance that it will cause life threatening complications to the patient.