Medical Effects:COPD What is it?

Chronic obstructive pulmonary disease (COPD) (also called 'hut lung') is a disease characterized by a progressive airflow limitations caused by an abnormal inflammatory reaction to the chronic inhalation of particles. The damage to the lung cannot be reversed. "COPD is a major and increasing health problem, which is predicted to become the third commonest cause of death and the fifth commonest cause of disability in the world by 2020." (N Engl J Med: 1999;340:1881-1887)

"The damage to your lungs cannot be reversed."

"From a review of data from all over the world, it is clear that tobacco is not the only cause of COPD."
(Chest, 117/2/Feb. 2000 Supplement)

"The rise of both wood burning smoke and COPD since 1965 could be correlated. Is anyone looking into it? With developed nations allowing and promoting business and citizens to create wood smoke in all areas it is on the rise. COPD Resource Network, including support pages.(Off Site) COPD is up 163% since 1965. It is one of the diseases related to particulate pollution. This site stresses the importance of COPD but does not make any connection with increasing wood smoke exposure." ED

"COPD is a major and increasing health problem, which is predicted to become the third commonest cause of death and the fifth commonest cause of disability in the world by 2020. While there have been major advances in the understanding and management of asthma, COPD has been relatively neglected and there are no current therapies that reduce the inevitable progression of this disease. However, because of the enormous burden of disease and escalating health care costs, there is now renewed interest in the underlying cellular and molecular mechanisms and a search for new therapies, resulting in re-evaluation of the disease. Despite its enormous global importance, there has been relatively little research into COPD and it is the most underfunded disease in relation to the global burden of disease." (N Engl J Med 1999;340:1881-1887)

Healthline provides a very comprehensive overview of COPD as a critical starting point for individuals and/or their loved ones.

WHAT IS CHRONIC OBSTRUCTIVE PULMONARY DISEASE? Clinical Reference Systems, Annual 2000 p325, Thanks to:

Chronic obstructive pulmonary disease (COPD) is a condition in which airflow from the lungs is permanently obstructed.

The most common form of COPD is a combination of chronic bronchitis and emphysema that causes a loss of lung function. It occurs mostly after age 40 and affects twice as many men as women.

How does it occur?

Chronic bronchitis and emphysema result from irritation of your airways over a long time, usually by cigarette smoke or air pollution. Bronchitis and emphysema can occur separately but often develop together. [ED: note that wood smoke should be included on this list. ]

In chronic bronchitis, the airways are narrowed by swelling and become infected with bacteria. The infection causes yellow or green sputum that blocks the narrow airways and makes breathing difficult.

In emphysema, the tiny air sacs in the lungs become damaged. The walls of the air sacs stretch and rupture, which causes a decrease in the ability of the lungs to exchange carbon dioxide and oxygen.

COPD causes strain on and enlargement of your heart (cor pulmonale), increased blood pressure in your lungs (pulmonary hypertension), and swelling of your legs and ankles (edema).

What are the symptoms?

COPD usually has symptoms of both chronic bronchitis and emphysema. These symptoms may include: deep, persistent cough, producing yellow or green phlegm (sputum); wheezing; shortness of breath, difficulty breathing; rapid breathing; blue-purple color in the skin (cyanosis); swelling in the legs, ankles, and feet.

How is it diagnosed?

The health care provider will ask you about: daily symptoms and decreased activity level because of symptoms; smoking habits; exposure to irritants such as aerosol sprays and industrial chemicals; exposure to air pollution.

Your provider will give you a physical exam and may use the following lab tests: pulmonary function test (you breathe into a tube to measure airflow into and out of your lungs); chest x-ray; blood tests; electrocardiogram (ECG); CT scan;

How is it treated?

The damage to your lungs cannot be reversed, so treatment aims to relieve symptoms and prevent the condition from getting worse:

Breathing can be made easier with bronchodilator medication, which relaxes and widens the airways. Some of these medications are taken in pill or liquid form and some are inhaled.

Long-acting drugs called inhaled sympathomimetics can be used in a nebulizer. A nebulizer is a device used to inhale aerosol medicine through a facemask.

Corticosteroid medications may be given to reduce inflammation.

Infection can be treated with antibiotics and medication to loosen the sputum and help you cough it up.

Leg swelling can be treated with diuretics.

The following may also be recommended to improve your symptoms: exercise, such as walking or riding a stationary bicycle 3 or 4 times a day for 5 to 15 minutes; breathing exercises; oxygen therapy to make breathing easier; using a humidifier to increase air moisture; changing your work environment to reduce exposure to irritants; drinking at least 8 glasses of fluid a day. If secretions are difficult to cough up, the doctor may have a nurse or family member help clear your bronchial tubes using one of the following: Chest percussion: Striking a part of your chest with short, sharp blows;
Postural drainage; Helping you assume a position that helps drain secretions from the lungs.

How long will the effects last?

COPD cannot be cured.

How can I take care of myself?

Follow your health care provider's advice for treating COPD. Take all your medication.

If you smoke, quit.

Avoid other people's smoke, air pollution, and extreme variations in temperature and humidity.

Ask about getting your flu and pneumonia shots.

Eat nutritious foods.

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