COPD: Devastating but preventable

Chronic obstructive pulmonary disease (COPD) is a lung disease that makes it hard to breathe. In people with COPD, the airways (the branching tubes that carry air within the lungs) become narrow and damaged. This makes people feel out of breath and tired.

COPD can be a serious illness. It cannot be completely cured and it usually gets worse over time. But there are treatments that can help with symptom relief.

In people who develop COPD, irritating gases and particles are inhaled while smoking or breathing smoke filled air (secondhand smoke) or other fumes or particles. These gases and particles can injure the airways and lungs and cause swelling (inflammation). Over time, the inflammation becomes chronic, damages the lung tissue, and may cause scarring. This lung damage makes it more difficult to breathe in and out.

The most common cause of COPD is smoking. Smoke can damage the lungs forever and cause COPD. People can also get COPD from breathing in toxic fumes or gases.

Other factors that increase the risk of developing COPD include an abnormal sensitivity and exaggerated response to inhaled substances (called airway responsiveness), other exposures such as secondhand exposure to smoke and workplace exposure to environmental dust or organic materials, or exposure to air pollution, and rarely, COPD can also run in families.

COPD usually causes no or mild symptoms at first, but as the disease progresses, symptoms usually worsen. The most common symptoms include; coughing and spitting up mucus, wheezing (a whistling or squeaking noise as you breathe), and shortness of breath with activity or even at rest, fatigue, morning headaches.

People who have had COPD for a while are also at increased risk for chest infections such as pneumonia, developing lung cancer and heart problems such as heart failure.

The diagnosis of COPD is made by taking a proper history of the complaints, any individual risk factors to developing the disease and then carrying a thorough physical examination. Some medical investigations are available to confirm the diagnosis and determine the severity of the disease.

A special procedure used to diagnose COPD called spirometry is often used. During spirometry, the patient takes a deep breath and then blows out as fast and hard as they can into a tube. A machine connected to the tube measures how much air is blown out of one’s lungs and how fast they can blow.

If the results of the spirometry are NOT normal, the doctor will give a medicine in an inhaler. Then he or she will test again. This will help the doctor or nurse find out if one’s problem is caused by COPD or another lung problem, such as asthma. People with asthma usually get normal results after they use an inhaler. People with COPD do not.

In health centres without spirometry, chest radiography such as chest X-ray imaging can be done and this can sometimes help the health care provider to diagnose this condition.

After the diagnosis of COPD is made, the doctor will determine which treatment to give depending on the severity of the disease.

Unfortunate to note, currently there is no cure for COPD; however, many treatments are available for the symptoms and complications of this disorder. Most patients require ongoing treatment to keep symptoms under control.

Most people use pills, inhalers or a combination that help open up their airways or that decrease swelling in the airways. Often people need more than one inhaler at a time. As the disease gets worse, some people need to use oxygen.

The first and most important part of any treatment plan for COPD is for smokers to stop smoking. This is true regardless of how long ago you were diagnosed with COPD and how severe your disease is. Studies of people with COPD show that worsening of the disease is slowed in people who stop smoking.

Dr. Shyaka is a General Practitioner at Rwanda Military Hospital.