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Urban Healthcare Initiative Program

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

What is COPD?

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease that makes it harder to breathe over time. The term COPD actually includes two different respiratory conditions, specifically chronic bronchitis and emphysema.

ABOUT COPD

Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough. which may or may not produce mucus. COPD progressively worsens, with everydday activities such as walking or dressing becoming difficult. While COPD is incurable, it is preventable and treatable.

The two most common conditions of COPD are emphysema and chronic bronchitis and they have been the two classic COPD phenotypes. Emphysema is defined as enlarged airspaces (alveoli) whose walls have broken down resulting in permanent damage to the lung tissue. Chronic bronchitis is defined as a productive cough that is present for at least three months each year for two years. Both of these conditions can exist without airflow limitation when they are not classed as COPD. Emphysema is just one of the structural abnormalities that can limit airflow and can exist without airflow limitation in a significant number of people. Chronic bronchitis does not always result in airflow limitation but in young adults who smoke the risk of developing COPD is high. Many definitions of COPD in the past included emphysema and chronic bronchitis, but these have never been included in  GOLD report definitions. Emphysema and chronic bronchitis remain the predominant phenotypes of COPD but there is often overlap between them and a number of other phenotypes have also been described.

ONSET OF COPD

COPD TRENDS is predominately diagnosed in men and women older than 40 years of age. And even though COPD is more common in men, more women die from this disease each year then men.

The rate of COPD continues to increase worldwide due to smoking and worsening air pollution. While there is no cure for COPD, you can take steps to feel better, stay more active, and slow disease progression.

COPD SYMTOMS

COPD symptoms often don’t appear until significant lung damage has occurred, and they usually worsen over time, particularly if smoking exposure continues.

Signs and symptoms of COPD may include:

  • Shortness of breath, especially during physical activities
  • Wheezing
  • Chest tightness
  • A chronic cough that may produce mucus (sputum) that may be clear, white, yellow or greenish
  • Frequent respiratory infections
  • Lack of energy
  • Unintended weight loss (in later stages)
  • Swelling in ankles, feet or legs

People with COPD are also likely to experience episodes called exacerbations, during which their symptoms become worse than the usual day-to-day variation and persist for at least several days.

PRESENTATION AND RISK FACTORS

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. It’s typically caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions.

The main cause of COPD in developed countries is tobacco smoking. In the developing world, COPD often occurs in people exposed to fumes from burning fuel for cooking and heating in poorly ventilated homes.

Only some chronic smokers develop clinically apparent COPD, although many smokers with long smoking histories may develop reduced lung function. Some smokers develop less common lung conditions. They may be misdiagnosed as having COPD until a more thorough evaluation is performed.

Risk factors

Risk factors for COPD include:

  • Exposure to tobacco smoke. The most significant risk factor for COPD is long-term cigarette smoking. The more years you smoke and the more packs you smoke, the greater your risk. Pipe smokers, cigar smokers and marijuana smokers also may be at risk, as well as people exposed to large amounts of secondhand smoke.
  • People with asthma. Asthma, a chronic inflammatory airway disease, may be a risk factor for developing COPD. The combination of asthma and smoking increases the risk of COPD even more.
  • Occupational exposure to dusts and chemicals. Long-term exposure to chemical fumes, vapors and dusts in the workplace can irritate and inflame your lungs.
  • Exposure to fumes from burning fuel. In the developing world, people exposed to fumes from burning fuel for cooking and heating in poorly ventilated homes are at higher risk of developing COPD.
  • Genetics. The uncommon genetic disorder alpha-1-antitrypsin deficiency is the cause of some cases of COPD. Other genetic factors likely make certain smokers more susceptible to the disease.
COPD AND SMOKING

The Largest Cause of COPD is a History of Smoking Cigarettes
Habitual smoking can inflame the linings of the airways in the lungs and can make the airways lose their elastic quality. Other external factors that put you at risk of developing COPD are exposure to air pollution, secondhand smoke, and occupational dust or chemicals.

Heredity can also play a role. Scientists have discovered what’s known as an alpha-1-antitrypsin deficiency, which is the source of a small proportion of cases of COPD. Researchers also suspect that other genetic factors may make certain smokers predisposed to the disease.

HOW DOES COPD DESTROY THE LUNGS

COPD is a group of lung disorders. Emphysema and chronic bronchitis are the two main conditions included in this category. These conditions attack your lungs in different ways.

Emphysema

Emphysema destroys the walls between the air sacs in your lungs. This creates larger but fewer air sacs. The total surface area for gas exchange therefore becomes smaller. The lungs also have trouble supplying oxygen to the tissues of the body and getting rid of carbon dioxide.

This damage also reduces the amount of air your lungs can hold and move. As a result, you may not have the lung capacity to do normal tasks. This will cause you to grow tired and breathless quickly.

Bronchitis

Bronchitis inflames and irritates the lining of your airways. Over time, chronic bronchitis causes the lining to grow thick and inflexible. When your airways can’t properly clear themselves, excess mucus will become a problem. Eventually your airways will become very rigid and clogged by mucus. This makes breathing difficult. You may find that you’re out of breath much faster than normal. You may also feel tired more easily.

HOW YOUR LUNGS ARE AFFECTED

Air travels down your windpipe (trachea) and into your lungs through two large tubes (bronchi). Inside your lungs, these tubes divide many times — like the branches of a tree — into many smaller tubes (bronchioles) that end in clusters of tiny air sacs (alveoli).

The air sacs have very thin walls full of tiny blood vessels (capillaries). The oxygen in the air you inhale passes into these blood vessels and enters your bloodstream. At the same time, carbon dioxide — a gas that is a waste product of metabolism — is exhaled.

Your lungs rely on the natural elasticity of the bronchial tubes and air sacs to force air out of your body. COPD causes them to lose their elasticity and over-expand, which leaves some air trapped in your lungs when you exhale.

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