COPD is currently the third leading cause of death worldwide and the only leading cause of death for which mortality is rising. Up to 60-85% of people with COPD (mostly mild/moderate severity) are undiagnosed.
People with COPD have a chronic inflammation in the airways (bronchi) of their lungs (chronic bronchitis) or the air sacs (alveoli) in their lungs are damaged (emphysema). They often have both at the same time. If bronchi are chronically inflamed, they become swollen and less air can pass through them. A persistent cough and mucous congestion are often signs of an inflammation. If the small air sacs in the lungs become damaged, the blood flowing through the lungs can no longer absorb as much oxygen or freely get rid of carbon dioxide, the waste product of breathing. These two broad processes coexist and overlap in varying degrees in virtually everyone with COPD. The reasons for this variability and its clinical importance are poorly understood.
COPD is diagnosed by a breathing test called a Pulmonary Function Test (PFT). Changes can also sometimes be seen on chest x-rays or chest CAT scan. COPD is chronic and progressive; however, its progression can differ markedly between individuals. Most COPD patients who stop smoking will experience a slowing in the decline of lung function.
Many (not all) patients with COPD experience days-long episodes of increased dyspnea, cough, and sputum production, called COPD exacerbations. Most COPD exacerbations occur at home, resulting in increased use of bronchodilators, impaired function and enjoyment of life; more severe COPD exacerbations require systemic steroids, antibiotics, and sometimes hospitalization.
Treatment for COPD includes the use of inhaled bronchodilators (to open up airways), inhaled corticosteroids (to decrease inflammation), supplemental oxygen in patients with low blood levels, and pulmonary rehabilitation which is a program of exercise and education to improve exercise capacity, quality of life, and help patients manage their disease more effectively.
Source:
Linda Nici, MD
Providence VA Medical Center
Chair, ATS Council of Chapter Representatives
Four Facts About COPD
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