What is COPD?
COPD stands for Chronic Obstructive Pulmonary Disease, and its hallmark is a spirometry that detects airflow obstruction; However, this is a functional fact of the lung and as such is due to numerous causes, the most important of which is tobacco, although other agents that penetrate the bronchi and alveoli can cause inflammation and distortion of the pulmonary architecture leading to the aforementioned obstruction, such as toxic inhalants in the workplace, chronic infections with scarring capacity such as tuberculosis, aspirations, whether direct, when swallowing, or indirect such as gastroesophageal reflux, or allergens with continuous exposure. Several causes may coincide in a COPD patient.
What types of COPD can we differentiate?
Depending on the distortion of the bronchial and lung architecture caused by chronic inflammation, we can observe: emphysema type, which affects more the distal part, alveoli, or bronchitis type, which affects more the bronchial wall; then there are intermediate types with characteristics of emphysema and bronchitis. If we are guided by the clinical features, there are types that expectorate and others that do not, there are patients who have a strong bronchospastic component and others who do not, and finally COPD, who flare up frequently – 2 or more episodes per year – and others who do not.
Where do we find the causes of COPD?
Tobacco, chronic lower airway infections, continuous toxic inhalants, allergens. A mixture of several of the above.
What are its symptoms?
Dyspnea of effort, chronic cough and expectoration, in that order, that is to say, that the dyspnea of effort that in addition is progressive, universal, not so the cough or the expectoration.
How is this disease treated?
Avoiding the agent linked to chronic inflammation such as tobacco or occupational agents to stop the deterioration of lung function and treat three points: the permanent bronchodilation either with beta-adrenergics or antimuscarinics, the infection that arises permanently or occasionally and in many cases the underlying inflammation that in some cases is similar to asthma and therefore susceptible to inhaled corticosteroids or macrolides in the long term. Occasionally, when oxygen pressure is low, an extra supply is needed during the 8 hours of sleep or 16 hours a day. Respiratory muscle rehabilitation is desirable in advanced COPD and when the bronchial component is predominant to help expectorate more effectively.