COPD

COPD (Chronic obstructive pulmonary disease)

What is COPD?

Chronic obstructive pulmonary disease (COPD) is a progressive disease which is characterised by airflow limitation that is not fully reversible. The airflow limitation is associated with inflammation in the lungs caused primarily by tobacco smoke, but also by air pollution or other noxious particles or gases.

COPD is one of the world’s most common chronic diseases, with an estimated 600 million sufferers worldwide.

How do you get COPD?

The most common cause of COPD is cigarette smoking, with other types of tobacco smoking also being strong risk factors. Other causes include heavy exposure to occupational dusts and chemicals (vapours, irritants and fumes) and indoor and outdoor air pollution.

How serious is COPD?

The airflow limitation in COPD patients is progressive and often becomes debilitating, or even life-threatening.
Symptoms of COPD include breathlessness, dyspnoea (difficulty breathing), cough, chest tightness and increased secretion of sputum. Many patients are kept awake at night by their symptoms.
In addition to their everyday symptoms, patients with more severe COPD suffer acute exacerbations of symptoms or episodes of worsening of symptoms requiring medical intervention which often require hospitalisation. Infection and air pollution are the most common causes of an exacerbation.
The main symptom of an exacerbation is increased breathlessness, often accompanied by wheezing, chest tightness, increased cough and sputum, and fever. Exacerbations may also be accompanied by non-specific complaints such as malaise, insomnia, fatigue, depression, and confusion. Exacerbations tend to result in worsening of baseline symptoms, with some patients never completely recovering from an exacerbation.

GOLD - the Global Initiative for Chronic Obstructive Lung Disease, endorsed by the World Health Organisation and the US National Heart, Lung and Blood Institute - identifies four stages of COPD:

• Stage 0 refers to people at risk of COPD. At this stage, individuals              have normal lung function, but suffer chronic cough and sputum production. 
• Stage I refers to mild COPD, there may be mild airflow limitation but you may be unaware that lung function has started to decline. You may not yet have any COPD symptoms, or you may have symptoms of chronic cough and excessive mucus. People at this stage are not likely to associate symptoms with the disease process and therefore, rarely seek treatment.
• Stage II refers to moderate COPD, airflow limitation worsens and you may start to notice symptoms, particularly shortness of breath upon exertion along with cough and sputum production.  It is during this stage most people typically seek medical treatment. 
• Stage III refers to severe COPD, limitation of airflow significantly worsens, shortness of breath becomes more evident and COPD exacerbations are common. If you reach this stage, you may notice a decrease in your activity tolerance and an increase in fatigue-ability. 
• Stage IV refers to very severe COPD. By the time a COPD patient reaches this stage their quality of life is greatly impaired and COPD exacerbations can be life threatening. Airflow limitation is severe and chronic respiratory failure is often present at this stage, and may lead to life threatening
  

How long does COPD last?

GOLD recommends that patients with mild (Stage 1) COPD should be treated with a bronchodilator on an as-needed basis to reduce symptoms. Patients with moderate-to-severe COPD (Stages 2 and 3) should receive a bronchodilator, plus inhaled glucocorticosteroids if they have a lung function response to glucocorticosteroids, or repeated exacerbations requiring medical intervention.

How is COPD treated?

Management of COPD requires a long-term therapeutic approach:

• Stopping smoking is the single most effective step in slowing the progression of the disease.
• Other risk factors should also be avoided.
• Drugs help to control symptoms, while rehabilitation programs and physiotherapy may be useful to clear sputum and improve exercise tolerance and health-related quality of life.
• Patients with severe disease often require a variety of treatment approaches.

GOLD recommends that patients with mild (Stage 1) COPD should be treated with a bronchodilator on an as-needed basis to reduce symptoms. Patients with moderate-to-severe COPD (Stages 2 and 3) should receive a bronchodilator, plus inhaled glucocorticosteroids if they have a lung function response to glucocorticosteroids, or repeated exacerbations requiring medical intervention.

Any medical information on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. Click here for more important information.