COPD stands for chronic obstructive pulmonary disease. Many hear COPD and think of it as a disease unto itself. However, it is really a complex of conditions characterized by airflow limitation that is not fully reversible. This airflow limitation is usually both progressive (gets worse over time) and associated with an abnormal inflammation of the airways. In simpler terms, when trying to exhale or breathe out, the flow of the breath or air is irreversibly obstructed and can never return to its normal state. The airway will always constrict when trying to breathe out. This traps air in the lungs and makes it increasingly difficult to breathe.
Cigarette smoking is the single largest causative factor in COPD. Other causes include occupational dusts and chemicals, outdoor air pollution and passive second hand smoke exposure. Since COPD is a disease that gradually progresses over time, it could take years before someone actually felt short of breath. Most likely, someone will develop a chronic cough and begin to produce more and more throat secretions (phlegm) before they ever have any airway obstruction. This can offer a unique opportunity to identify smokers at risk for COPD, and then intervene before the disease becomes a major health problem. Conversely, many with COPD may never develop a chronic cough or increase in throat secretions. A disease like COPD may simply manifest differently from one person to the next.
Today, there are many more treatment options for sufferers of COPD. There are newer generations of drugs available and better science that facilitate better treatment design and modalities. In addition, COPD has truly become a multi-disciplinary disease. Physical therapists, occupational therapists, nutritionist, respiratory therapists, behaviorists, psychologists, etc. all work together to help these patients attain a higher quality of life.
Treatment is founded on a staging of the disease, based on the symptoms one has. The first treatment is simple avoidance. Smoking cessation is the most powerful tool anyone can use. There is evidence to suggest the progression of the disease does in fact, slow down when the causative factor, smoking, has been removed. COPD is perhaps, the most preventable disease because its primary agent of cause is smoking tobacco.
Because COPD constricts the airway, the next treatment is using what's called a short acting bronchodilator. These medications dilate or widen the narrowed or obstructed airways. This enables the patient to exhale completely and these medications usually last anywhere between four and six hours.
Adding a long acting version of these drugs and inhaled steroids is the next level of treatment used. The longer acting bronchodilators help with the constricted airways, while the steroids hope to reduce the inflammation or swelling found within the airways. Pulmonary rehab is also considered at this point and can be an effective in elevating the patient's quality of life. After this, long term use of supplemental oxygen is used and it's here when people begin to discuss surgical options.
People with COPD often have a high prevalence of other diseases as well. The treatment for COPD may not be the only treatment required. For instance, many with COPD also have cardiovascular disease. Others may have osteoporosis or frequent respiratory infections. Still others may have clinical depression or develop diabetes. The impaired lung function has long-term implications on metabolism and the normal state of many organ systems such as the skeleton, heart, brain and skeletal muscle. The treatment of COPD can become quite complex and in some cases, very difficult, in the presence of some of these other diseases.
Although smoking prevalence has decreased in the past decade, more needs to be done to relieve the weight placed on society and the health care industry. Worldwide, an estimated 8.8% of all deaths (4.9 million) are caused by tobacco. A recent survey from the American Lung Association reveals that almost half of all COPD patients experience shortness of breath while washing and dressing. The survey goes on to report that nearly one quarter of the COPD respondents consider themselves an invalid.
