Chronic obstructive pulmonary disease (COPD) is a fairly common chronic lung disease, causing slow progressive damage to the lungs. This results in recurrent sickness and progressive disability. The problem occurs due to gradual recurrent damage to and narrowing of lung airways (tubes that carry air to and fro from the lungs to the exterior). This causes cough with expectoration and breathlessness on exertion. The expectoration may be scanty or profuse, whitish or green or yellow, or foul-smelling, depending on the extent of irritation of the airways and the type of infection. Along with it, a person may get recurrent wheezing and a feeling of tightness in the chest. Smoking, both passive and active is the most common cause of COPD. Apart from this, chronic or recurrent exposure to dust, and fumes of any kind, also results in COPD. One may get COPD after recovering from some lung ailment like tuberculosis. A person suffering from bronchial asthma can develop COPD later in life. Genetic factors are also implicated. Productive cough and breathlessness on exertion are common symptoms of COPD. The severity of symptoms varies as per the extent of damage to the airways. Acute or chronic respiratory failure can occur as a complication of COPD. Due to recurrent cough with expectoration, an individual is likely to develop recurrent infections of the upper and or lower respiratory tract. Lung cancer is a known complication of long-standing, COPD. An affected individual with COPD is prone to develop right-sided heart failure over time. This occurs as a sequel to chronic oxygen deficiency of small blood vessels of the lungs, imposing stress on the heart. Due to the recurrent sickness, and breathlessness on exertion, one feels tired easily and is unable to do as much work as before. He/she may have progressive weight loss as well. Being obese tends to aggravate the symptoms. Diagnosis of COPD is based on clinical history and typical clinical features. X-ray and CT scan of the chest will show the typical changes of COPD, in and around the airways and in the lungs. Lung function tests when done will reveal airway obstruction, which is not reversed by bronchodilators (drugs that open blocked airways). If arterial blood gases are estimated, they may show low blood oxygen levels. Once COPD starts in a person, it is usually progressive and irreversible. However, if detected and treated promptly in the early stages, the progress can be stopped. Treatment involves the use of bronchodilator drugs, either as inhalers, tablets, or injections, depending on the severity of the condition. Antibiotic use is frequent, as recurrent cough with expectoration makes one prone to recurrent infection. Corticosteroids are also used frequently to reduce the ongoing inflammation in the airways. Recurrent antibiotic and steroid use can reduce the immunity of the person, making him/her more prone to infections. Repeated steroid use increases the risk of adverse effects of corticoids. These include peptic ulcer, facial swelling, thinning of the skin, an increased tendency for bruising, etc. One should be aware of COPD and adopt measures to prevent it. If one has been smoking, quitting it at the earliest can help prevent the development of COPD. Steps should be taken to avoid exposure to smoke, fumes, and dust of any kind. The use of face masks is very beneficial in preventing exposure to dust or fumes of any kind. Taking a balanced, nutritious diet, and maintaining a healthy weight, and lifestyle, are also useful. It is also beneficial to avoid stress, both physical, as well as mental. Stress in any form leads to the release of adrenalin, corticoids, and other chemicals, which tend to enhance blood pressure, pulse rate and aggravate breathlessness. Different breathing exercises done regularly help to prevent COPD. If COPD has already developed, its progress can be prevented. Dr Rachna Pande is a specialist in internal medicine.
