What is COPD and what are the symptoms?
COPD stands for Chronic Obstructive Pulmonary Disease and describes a disease secondary to lung damage caused by years of inhaling tobacco smoke. Inhalation of other fumes or vapors can cause the disease, although to a lesser degree.
COPD produces an irreversible loss of lung capacity due to alveolar destruction and chronic bronchial inflammation. In addition, the natural defensive capacity of the lungs is diminished and infections or exacerbations requiring urgent medical attention are not uncommon.
The symptoms are those derived from this loss of respiratory capacity:
- Fatigue on exertion
- Chronic cough
- Frequent expectoration
- Sensation of lack of air
- Chest tightness.
In severe cases, we can also detect rest fatigue, need for oxygen, respiratory support and swelling in feet and legs. In very severe cases it can cause death.
Is there a cure for COPD and how is it treated?
Lung damage is irreversible, as the lung has a limited regenerative capacity. Thus, the alveoli that are destroyed do not form again. In this sense there is no cure and the term chronic is coined. But the disease is not necessarily progressive.
In early stages, stability is achieved if the causative factor (smoking) is removed, treatment is used to reduce bronchial inflammation and a respiratory rehabilitation program is carried out. In severe cases, supplemental oxygen should also be used, which improves quality of life and survival.
On the other hand, relapses or exacerbations of the disease are common, often caused by respiratory infections. Preventing and treating these infections in time avoids worsening lung damage. These are the mainstays of treatment, although the patient should be treated globally and other conditions that worsen the clinical condition, such as obesity or malnutrition, heart or spinal problems, should be improved.
How is it diagnosed?
It should be suspected in patients who have been smokers for years, and a clinical pneumological evaluation should be carried out to establish whether a lung capacity test is necessary. This determines whether there is bronchial obstruction and its severity. In addition, it is the test that will allow us to monitor the patient’s progress. Computed tomography (CT) is also used to assess lung morphology.
Other explorations that can be requested are thoracic radiography and quantified perfusion scintigraphy. In advanced stages, a carbon monoxide diffusion test and a 6-minute walk test are added to assess adaptation to physical exertion.
How can the factors that can worsen COPD be avoided?
The most important thing is the complete cessation of smoking by the patient. This is the way to stop the progression of the disease. If the patient needs it, the pulmonologist can effectively help him/her to stop smoking.
Treatment of chronic bronchial inflammation, if needed, usually with inhaled medication, helps to optimize lung capacity. It prevents exacerbations and improves quality of life. Regular aerobic exercise also prevents disease progression. Finally, repeated respiratory infections can make it worse, so preventing them is a great help to achieve stability. In this regard, influenza and pneumococcal vaccination have been shown to prevent relapses.
When is oxygen necessary in such patients?
In advanced stages of the disease, the number of destroyed alveoli makes the lungs unable to capture the necessary oxygen from the air to maintain an adequate body metabolism. In these cases we increase the percentage of oxygen in the air breathed by adding oxygen to avoid hypoxemia (lack of oxygen in the blood). In moderate phases oxygen may be required for exertion or sleep. To determine this, specific tests of exercise capacity and nocturnal oximetry are performed.
Can a person with COPD lead a normal life?
In the initial stages of the disease, they can lead a full and normal life with practically no need for treatment. The problem is that it is often diagnosed late, as the symptoms appear in more advanced stages. However, following medical treatment, check-ups by a specialist in Pneumology and completing a respiratory rehabilitation program, most patients can achieve a normal life with few limitations. In some cases of very severe and progressive disease, a lung transplant may be required.