Definition

Chronic obstructive pulmonary disease, abbreviated as COPD, is an inflammatory lung disease that occurs chronically over a long period. COPD causes airflow obstruction from the lungs and encompasses several conditions, such as emphysema and chronic bronchitis.

COPD is established as the third leading cause of death worldwide. In 2019, 3.32 billion deaths were attributed to COPD, with 80 percent of these deaths occurring in low- and middle-income countries.

COPD predominantly affects middle-aged or older individuals who smoke, with many unaware they have the condition.

COPD is progressive, worsening over time and causing persistent symptoms. Despite its progressive nature, COPD can be treated, and proper management can help control symptoms and improve quality of life.

Causes

The primary cause of COPD in developing countries is tobacco smoking. The longer one smokes, the higher the likelihood of developing COPD.

In developing countries, COPD often arises from exposure to smoke from burning fuels used for cooking in poorly ventilated homes. Additionally, rare genetic issues such as alpha-1 antitrypsin deficiency can predispose individuals to lung disorders, including COPD.

Risk factor

Several risk factors contribute to COPD, including:

• Exposure to tobacco smoke, particularly long-term exposure to cigarette smoke.
• Asthma, a chronic airways inflammation, can increase the risk of developing COPD.
• Exposure to workplace dust and chemicals leads to lung irritation and inflammation.
• Exposure to smoke from burning fuels is common in developing countries due to poor ventilation during cooking.

Symptoms

COPD symptoms often go unnoticed until significant lung damage occurs. Symptoms typically worsen over time, especially with continued exposure to cigarette smoke or other lung irritants. Symptoms may include:

• Shortness of breath, especially during physical activity
• Wheezing
• Chest tightness
• Chronic cough, often accompanied by the production of mucus or sputum
• Frequent respiratory infections
• Fatigue
• Unintended weight loss
• Swelling in the legs, particularly at the ankles
• People with COPD may experience exacerbations, where symptoms worsen over several days

Diagnosis

History and physical examination

In making a diagnosis, your doctor will:

• Ask about your symptoms.
• Perform a physical examination of the chest and listen to your breath sounds using a stethoscope.
• Inquire about your smoking history.
• Calculate your body mass index (BMI).
• Ask about family history of lung problems.

Diagnostic tests

After the initial evaluation, your doctor may perform additional tests to confirm the diagnosis, including:

• Spirometry test assesses lung function by measuring airflow into and out of the lungs.
• Chest X-ray, to identify lung abnormalities.
• Blood tests, to detect conditions that mimic COPD symptoms, such as anemia or polycythemia, and to check for alpha-1 antitrypsin deficiency.

Your doctor may also conduct other tests, such as an EKG, echocardiogram, peak flow test, blood oxygen test, CT scan, or phlegm sample, to further evaluate your condition.

Management

COPD has no cure, but early diagnosis and treatment are crucial for symptom management and reducing exacerbation risk. Treatment may include:

• Smoking cessation.
• Inhalers and medications to alleviate breathing difficulties.
• Pulmonary rehabilitation to improve symptom control.
• Lung surgery or transplantation in severe cases.
• Complications COPD is progressive and can impair daily activities due to shortness of breath, leading to financial burdens.

Complications

COPD is a progressive condition that can worsen over time. As a result, sufferers may struggle to carry out daily activities due to difficulty breathing. This condition can also lead to financial burdens because those with COPD may find it challenging to work and require funds for treatment.

Prevention

Genetically caused interstitial lung disease cannot be prevented. However, you can reduce the risk of developing interstitial lung disease by controlling other causes with the following steps:

• Use face protection such as respirators when exposed to hazardous substances.
• Quit smoking.
• Get flu and pneumonia vaccinations to prevent infectious diseases.

When to see a doctor?

Visit your doctor if your symptoms worsen or remain unchanged despite treatment. Watch for signs of infection, such as fever or changes in sputum color.

If you're over 35, have a history of smoking, or experience continuous COPD symptoms, seek medical attention promptly. Early diagnosis and treatment can improve outcomes and help manage symptoms. Promptly seek medical care if you experience shortness of breath or cyanosis, indicating oxygen deficiency.