When airways become narrowed and the flow of air gets limited to and from the lungs, the result is shortness of breath. Over a period of time the condition gets progressively worse and the restraint of the airflow is weakly reversible. It is due to tobacco smoking that this disease is caused duet to noxious particles of gas, triggering an inflammatory response in the lungs. Chronic emphysema is inflammatory response in the alveoli causing destruction of the tissues in the lung. While chronic bronchitis also called blue bloater is an inflammatory response in the larger airways. When people cough up sputum on a regular basis, this can be diagnosed clinically. Acute exacerbations are caused by air pollution and infections which is the natural course of COPD with sudden occasional worsening of the symptoms.
Lung function tests are required for diagnosis of this disease. As far as management strategies are concerned the patient has to undergo rehabilitation, vaccinations, drug therapy in which inhalers are often used and smoking cessation. In worse cases the patient may have to undergo lung transplantation or oxygen therapy on a long term. Chronic obstructive pulmonary disease is also called as CORD which is chronic obstructive respiratory disease, COAD which is chronic disruptive airway disease and COLD (chronic obstructive lung disease). The disease has been ranked and six leading cause of death two decades back. Due to demographic changes in many countries all over the world and increased smoking amongst people this disease is projected to be the fourth leading cause of death in the next two decades.
Causes of COPD:
Chronic tobacco smoking is the primary risk factor for COPD. Many cases are being identified all over the world due to chronic tobacco smoking. The average number of years of smoking is multiplied by the average number of cigarette packages smoked daily. With cumulative smoke exposure the likelihood of developing the diseases increases with age. It is sure that many life long smokers will develop COPD, unless other diseases like cancer, cardiovascular, extra-pulmonary and other smoking related diseases do not claim lives before hand.
Prolonged and intense exposure to a workplace dusts found in chemicals such as isocyanates and cadmium, cotton textile industry, fumes from welding, dusts found in gold mining as well as coal mining, have been implicated in the development of airflow obstruction. Workers exposed to these dust particles as well as those who smoke chronically are said to develop COPD. Even the non smokers have been implicated in the airflow obstruction in the lungs. A preventive lung disease which is distinct from COPD is caused due to strong silica dust disclosure. Exposure to a smaller amount strong silica dust exposure has also been linked to a condition like the COPD. As compared to the effect of cigarette smoking, effect of occupational pollutants on the lungs appear to be substantially less important.
Air pollution is a also a contribution factor for COPD which slows down normal growth of lungs. In developing countries, women are exposed to fuels such as animal dung and wood which are also common causes of COPD in women. The disease can also be genetic in the sense that relatives of person affected with COPD who smoke than unrelated smokers. There are also other risk factors like airway constriction caused due to irritants inhaled and also bronchial hyper-responsiveness which is a characteristic of asthma. A diet high in cured meats and repeated lung infection may also be related to the development of the COPD disease.
Symptoms and signs:
Shortness of breath is one of the most common symptoms of COPD. Breathing requires a lot of effect and the affected person tends to feel out of breath many a times, feeling as if they are not getting enough air to breathe. Demands of the lungs are greatest when a person is exercising and sometimes during vigorous exercises the person may notice dyspnea.
Tiredness, mucus production, sputum production, chest tightness, wheezing, and persistent cough there are some other symptoms of COPD. Respiratory failure is developed by people with very severe COPD. A bluish discoloration of the lips caused by lack of oxygen in the blood leads to cyanosis. Twitching, drowsiness and headaches are caused due to excess carbon dioxide in the blood. Advanced COPD called corpulmonale, is the result of strain on the heart due to extra work required to pump blood through the affected lungs through the heart.
Some of the other common signs are enlargement of the chest which is called hyperinflation particularly in the front to back distance, breathing through pursed lips, a rapid breathing rate called tachypnea, taking longer time to breathe out than breathing in, crackles or wheezing sounds in the lungs, which can be heard through a stethosocpe, and barrel chest which is caused due to increased lateral to antero posterior proportion of the chest.