The A, B, Cs of lung disease COPD
World Chronic Obstructive Pulmonary Disease (COPD) Day was marked in November and the theme was “It’s not too late,” to raise awareness worldwide. Efforts to improve early diagnosis, develop new treatments and better predict patients’ prognoses are leading to renewed optimism in the fight against one of the world’s most prevalent respiratory diseases.
COPD is a non-communicable lung disease that progressively robs sufferers of breath. COPD is the fourth leading cause of death worldwide, causing more than three million deaths every year. Upto half the sufferers don’t even know they have it.
The term COPD is commonly used to describe a person who has chronic bronchitis, emphysema, or a combination of these long term lung conditions that cause difficulty in breathing. Chronic obstructive airways disease (COAD) is also a term that has been used.
In COPD the airways of the lungs get inflamed and become obstructed or blocked.
Statistics from statistical division of Ministry Of Health
COPD is more common among men than women (63.1 per1000 versus 41.2 per 1000), though currently prevalence of COPD in women is increasing. Yet, perhaps one quarter to one half of people with clinically significant COPD do not know that they have the disease, hence the need for widespread awareness programmes for early detection.
How common is COPD in Sri Lanka?
According to the Ministry of Health and clinical research conducted by myself and other professionals during the last two decades, there’s an increasing number of COPD patients seeking treatment in Sri Lanka. (please see table above)
Why is it important to recognize COPD early?
COPD can seriously affect every part of your body, particularly as the disease progresses. Exacerbations or flare ups (acute worsening of your symptoms) can further affect the patient’s quality of life. The good news, however, is that early detection and treatments can slow down the worsening of your symptoms, improve your activity and prevent flare ups.
Who is at risk?
Tobacco smoking is the commonest cause which attributes for 75% of COPD cases.
Those exposed to:
- Occupational dust and chemicals including vapors and fumes.
- Coal and gold mining
- Cement exposure
- Cotton industry workers
- Grain handlers & farmers
- Indoor air pollution eg. burning Mosquito coils
- Cooking & heating with biomass fuel, especially in women in developing countries.
- Outdoor air pollution.(vehicle emissions, smoke from factories)
- Age & hereditary factors.(>40 years)
- Genetically related. E.g. alpha 1 antitrypsin deficiency
- Respiratory infections in early childhood(rarely)
Symptoms
- Shortness of breath (Most important symptom)
- Chronic cough- more than two years
- Wheezing
Is asthma and COPD the same?
No. In bronchial asthma, the symptoms are episodic and there is reversible air way obstruction. The symptoms appear usually in childhood and there are many trigger factors. COPD is common in later life among people who have had exposure to a known noxious substance which causes this disorder.
Why is it important to stop smoking?
Stopping smoking is the single most important step in slowing the progression of COPD. Smoking is the major cause of COPD.
Although lung function declines gradually with age, this process is accelerated by smoking. A 45-year-old smoker who stops smoking now will experience a less rapid decline in lung function and ability to do activities than if he continued to smoke until 65 years of age.
If I have COPD what should I do?
Most importantly stop smoking and take protective measures to avoid inhaling unwanted substances, by wearing masks and other protective devices.
Seek treatment without delay. Effective management of COPD is based on a partnership between the patient, carer, family, and your health care team.Medications are available as tablets; Inhalers and intravenous drugs, depending on your disease stage.
If you have severe disease, adopt life style changes to promote your health -eating a healthy diet and getting regular exercise.
You may need a psychiatrist’s help to improve your psychological status. You may need long term oxygen therapy if you have severe disease.
Can I have chest infections frequently if I have COPD?
Yes. You are more prone to develop respiratory tract infections than the other people. A yearly influenza vaccine and every 5 yearly pneumococcal vaccination have been shown to reduce risk of deaths and hospital admissions.
Treatment
If you follow the treatments correctly, the natural progression of disease will be delayed and you will have a better quality of life, also fewer hospitalizations and complications. If you don’t get treatment, the disease will progress and affect most of the organs in your body.
You are at risk of getting heart attacks, strokes, muscle weakness (difficult in walking), bone fractures, diabetes and ultimately you may end up in respiratory failure (failure of lungs).
How do we prevent COPD?
Avoid active and passive tobacco smoking. Use alternative options for the traditional hearth or keep your traditional kitchen separate. Patients may be able to slow or even stop the progress of COPD by reducing their exposure to risk factors for the disease. Without treatment, however, COPD is generally a progressive disease, and as the disease gets worse patients become breathless during everyday activities such as climbing a flight of stairs, walking the dog, or even getting washed and dressed in the morning.