Chronic obstructive pulmonary disease, or COPD, is an umbrella term for lung conditions that block air flow and cause difficulty breathing.
There are two main types of COPD: emphysema and chronic bronchitis. According to the National Heart, Lung and Blood Institute (NHBLI), most people suffer from COPD. (1)
“Think of COPD as a spectrum of diseases, with chronic bronchitis at one end and emphysema at the other,” said Jeffrey Michelson, MD, a pulmonologist at Wellstar Medical Group in Marita, Georgia.
What Is Emphysema?
Emphysema occurs when the air sacs (alveoli) in the lungs become damaged and dilated, causing respiratory distress. Past research has shown that each lung has an average of 4,480 million alveoli. (2)
As you breathe, the alveoli expand and grow, carrying oxygen to the blood in small capillary vessels within its thin walls. When you breathe, the alveoli fall off easily, and expel carbon dioxide from the body through the airways.
In patients with emphysema, the alveolar walls deteriorate and the air sacs lose their normal elasticity, breaking the airway to the lungs (bronchioles).
“Symptoms of emphysema deal with progressive shortness of breath that limits activity,” says Dr. Michelson. Other common symptoms include chronic cough, recurrent respiratory infections, wheezing, loss of appetite and fatigue.
What Is Chronic Bronchitis?
Bronchitis is an inflammation of the bronchial tubes (airways), which carry air to and from the lungs. When the bronchial tubes become swollen, the lining of the airways, or mucous membrane, swells and thickens. It also produces a large amount of mucus.
Bronchitis can be either severe or chronic. Acute bronchitis is usually the result of a temporary infection and inflammation of the lungs and is usually caused by the same virus that causes the common cold and flu. Most cases of acute bronchitis clear up in a few days.
Chronic bronchitis is a very serious, incurable lung disease that involves persistent cough breaks that indicate structural changes in the bronchial system. In addition to a cough full of mucus, people with chronic bronchitis suffer from shortness of breath, chest tightness, wheezing and fatigue.
Signs and Symptoms of COPD
COPD symptoms can develop slowly. At first there may be no obvious sign.
Early signs and symptoms of COPD can be mild and include:
A persistent cough that may contain mucus, called a “smoking cough”
Chest tightness
Grunting
Dyspnea, or shortness of breath that is worse than activity
Fatigue
When the condition worsens, other symptoms may occur, such as:
Cyanosis, a bluish tinge to the skin, especially on the beds of lips and nails
Weight loss
Fast heartbeat
Swelling or swelling in the legs and ankles
In severe cases, COPD can also cause mental confusion and disorder.
People with COPD often suffer from symptom worries, or usually occur when environmental air pollution increases.
The Stages of COPD and Their Symptoms
The Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) – which was launched in partnership with the NHLBI, the National Institutes of Health (NIH), and the World Health Organization (WHO) – Established a system for determining COPD
Gold guidelines break down the severity of COPD into four stages. The maximum amount of air in the lungs per second is FEV1. FEV1 is low, a person’s lung capacity and COPD are just as severe.
By comparing a patient’s FEV1 with the expected values ​​considered healthy, a doctor calculates the percentage that determines at what stage a person has COPD. (3)
The four stages or degrees of COPD are:
Mild COPD is a feature of FEV1, about 80% of the expected value
Mild COPD, characterized by between 50% and 80% FEV1
Severe COPD, characterized by an FEV1 of between 30% and 50%
Very severe COPD, characterized by less than 30% FEVV1
Another COPD-related measurement is the Compulsory Critical Ability (FVC) test, which measures the amount of air a person can exhale after exhaling.
The ratio of FVC to FVC1 is used to determine lung capacity – an FVV1 / FVC ratio is considered to be approximately 80% healthy. All four COPD stages are characterized by a FEV1 / FVC ratio of less than 70%. (3)
Step 1: Mild COPD
Mild COPD involves a small amount of air flow.
Symptoms may include:
Some cough
Mucus or sputum cough
Difficulty breathing or shortness of breath (dyspnea)
If the patient smokes, treatment may include a short-acting bronchodilator and smoking cessation.
Step 2: Moderate COPD
With mild COPD, the airflow begins to deteriorate.
Symptoms, such as mild COPD, include:
Whooping cough
Increase in wholesale production
Dyspnea
Treatment may include long-term inhalers and pulmonary rehabilitation.
Step 3: Severe COPD
Severe COPD means that lung function is severely impaired, and this condition has a significant effect on the patient’s quality of life.
In addition to chronic cough, salivation, and dyspnea, severe COPD symptoms include:
Weight loss
Fatigue and difficulty exercising
Respiratory infections
Stage 3 COPD treatment aims to manage the symptoms of the disease. Treatment options are the same as stages 1 and 2, and may include inhaled corticosteroids.
Stage 4: Extremely severe or terminal COPD
Severe COPD, also called end-stage COPD, means that the patient has difficulty breathing. The disease begins to affect the heart and circulatory system.
In addition to severe COPD symptoms, end-stage COPD symptoms include:
Blurred lip or nail bed (cyanosis)
Chronic respiratory failure
Treatment may require oxygen therapy or surgery.
Causes and Risk Factors of COPD
All types of COPD, including syphilis and chronic bronchitis, are caused by itching caused by inhaled air.
Smoking is the leading cause of COPD, although non-smokers can also be affected. According to the American Lung Association, between 85 and 90 percent of all COPD cases are caused by cigarette smoking. ()) Still, 1 in 4 Americans with COPD have never smoked, the Centers for Disease Control and Prevention (CDC) notes. (5)
Most people who develop COPD symptoms are at least 40 years old. People under the age of 40 can also get COPD, but this is not uncommon.
In rare cases, emphysema may be caused by a deficiency of hereditary Alpha-1 antitrypsin (A1AT). People with this deficiency have lower levels of protein in the liver, which can damage the lungs if exposed to airborne pathogens.
Unlike some cases of emphysema, chronic bronchitis is not caused by a genetic disorder called alpha-1 antitrypsin (A1AT) deficiency.
Other causes of COPD include:
Indoor pollution
Exposure to dust and chemical fumes in the workplace
Asthma
Recurrent respiratory infections in childhood
Exposure to smoke and other air pollutants
How Is COPD Diagnosed?
Diagnosis of COPD usually involves reviewing patients’ health history as well as performing certain tests.
To determine if you have COPD, your doctor will usually look for symptoms, smoking habits, exposure to airborne itching, and a family history of COPD or a genetic disorder. Alpha-1 will start by asking questions about anti-trypsin (A1AT) deficiency, which can cause emphysema.
A physical examination is performed to examine the strength and function of your lungs and heart, and to look for any visible symptoms of COPD, such as sinusitis.
Your doctor may order one or more lung function tests, such as:
Spirometry This involves dropping into a tube attached to a spirometer, a machine that measures the flow of air in and out of the lungs. This is often the only test to diagnose COPD.
Bronchial provocation test In this test, the patient undergoes sporometry after inhaling a specific drug (methacholine or histamine) to assess the sensitivity of your lungs. This test is rarely ordered.
Practice the tolerance test. It can detect dyspnea and assess how exercise affects your heart and lungs’ ability to provide oxygen, and removes carbon dioxide from the bloodstream. This test is rarely used to diagnose COPD but to explore alternative diagnoses.
Exercise for the Destruction Test It meets your body’s oxygen needs during rest and exercise.
Your doctor may also order blood tests and imaging scans, such as:
Arterial blood gas tests measure your lungs’ ability to exchange gas by measuring the amount of oxygen and carbon dioxide in your blood.
A1AT deficiency blood test
Chest X-rays are performed to look for enlargement of the lungs, bronchial spots, and the formation of air-filled cavities in the lungs called cataracts.
Computerized tomography (CT) scans CT scans provide more information than a normal X-ray, such as whether there is inflammation in the air.
Other diagnostic tests may also be necessary, such as an electrocardiogram (EKG), bronchoscopy (where a thin tube with a camera is inserted into the airways to examine the lungs), and a lung or bronchial biopsy.
Learn more about COPD diagnosis
Treatment and medication options for COPD
Treatment focuses on relieving symptoms, improving quality of life, and correcting lifestyle habits that can worsen the condition.
To slow the progression of the disease, to stop smoking, to stop smoking and to avoid irritation in the lungs. It is necessary.
Pulmonary rehabilitation, which can improve your well-being, may include:
Breathing l. A specific exercise or activity plan to strengthen the muscles used
Breathing strategies
Psychological counseling
Dietary changes to maintain a healthy weight
Medications that may be part of the treatment for COPD may include
Bronchodilators (annealers) for opening airways
Steroids to reduce airway inflammation
Antibiotics to treat respiratory infections