COPD or Chronic Obstructive pulmonary disease as defined by GOLD[1], is a disease which is characterized by significant restriction of airflow in the lungs and is not fully reversible.

It includes emphysema, Chronic bronchitis with chronic airflow obstruction and small airway diseases with chronic obstruction. The entire spectrum of disease can have several similarities with the severity and extent of symptoms often varying. COPD causes you to gasp for air.

Adequate oxygen cannot enter, while secretions trapped inside airways cannot come, out creating a vicious cycle of disease, progressively destroying the quality of life.

Symptoms of COPD

The smokers cough is often classical. Coughing, shortness of breath, breathlessness, wheezing, noisy respiration, gasping for air with increase trouble with air pollution, difficulty carrying on with daily activities are all common. Often a chest infection can precipitate acute symptoms. That is how Chronic obstructive pulmonary diseases(COPD) frequently presents in the ER. The sad part is that many do not get diagnosed until the advanced stages. With each smoke, every breath, you take, it becomes a little more painful.

What happens in COPD?

The airway mucosa is already sensitized to the allergens like cigarette smoke, dust particles and starts secreting fluids. The more they secrete mucus, the more blocked the rest of the airway becomes. The chemicals secreted then causes the small bronchiolar muscles to constrict. The entire process narrows the airway and causes the excess secretions to remain trapped inside. Your lungs, which should have air, is now filled with sticky fluid or mucus, which gets more viscous and more difficult to extrude with time. They also weigh down the alveoli and can make them collapse.

What are the Risk factors of COPD

Chronic smoking

The numbers of cigarettes per day, duration of smoking life, age of first puff are all critical. Passive and second-hand smoking exposure, even in utero reduces lung growth significantly and significant postnatal pulmonary function. Stopping smoking is a must in all cases!

Airway responsiveness

Environmental pollutants, both indoor and outdoor, have a role to play. Indoor air pollution associated with biomass used as fuel for cooking causes COPD more commonly in women in rural India, urban slums, and the Government’s Ujwala Yojna is helping fight this.

Airway hyperresponsiveness, excessive broncho constrictions, and the Dutch theory: Asthma, chronic bronchitis, and emphysema are influenced by environment and genetics, and all have hypersensitive airways as one of the significant factors.

What are the stats to support the killing potential of COPD?

• COPD is the third most serious cause of death after heart disease and cancer.
• Women are two times more at risk of being diagnosed with chronic bronchitis.
• Women are also more likely to be diagnosed with emphysema than men. [2]
• The healthcare cost of COPD is as much as $50 billion in the US [2],[3].
• Chronic obstructive pulmonary disease (COPD) affects 251 million lives globally.
• 15 million deaths annually are related to COPD.
• Greater than 90% of COPD-related deaths occur in low and middle-income countries.
• Three out of the five leading causes of deaths in India are lifestyle or noncommunicable diseases. COPD is the second biggest cause of death in that group [3]

Treatment of COPD

The main prongs of treatment are:

Smoking cessation Nonnegotiable

Oxygen therapy In chronically hypoxaemic patients influences the natural history of the disease in COPD. Nowadays, there are compact and portable oxygen machines which help in delivering oxygen and maintain a good quality of life.

Medicines and other therapy is aimed at improving the quality of life by reducing symptoms and decreasing the number and severity of acute exacerbations. They range from bronchodilators, anticholinergic agents B2 agonists, inhaled and parenteral glucocorticoids

For mild to moderate COPD to manage acute exacerbations inhaled glucocorticoids help to reduce the severity, duration, and frequency of such attacks. There are several user-friendly inhalers and nebulizers for personal use, which are discreet and portable.

Severe to very severe COPD may need the help of portable oxygen delivery devices to help you maintain your daily activity. SimplyGo and SimplyGo Mini help with precisely that.

Mechanical ventilation

Noninvasive positive pressure ventilation can save lives. Patient selection needs to be carefully done. Invasive in a hospital setting

Role of Surgery: Lung surgery in a very select group of people.

Pulmonary rehabilitation for COPD

COPD causes daily activities to become challenging. While medicines play their role, you can do a lot through lifestyle interventions to improve lung function and prevent further deterioration. This is multidimensional and needs, breathing exercises, nutrition, meditation and the right frame of mind to work. The changes are well documented and consistent over a longer duration. Pulmonary rehabilitation helps reduce respiratory distress, fatigue and improves the emotional state of patients.  It also enhances the sense of control you feel over the disease condition and increases the feeling of wellbeing.

It would help if you stopped tobacco smoking now!

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Lifestyle tips for those with COPD

Individual health choices and lifestyle changes are essential consistently.It would help if you stopped tobacco smoking now.No cigarette, bidi, hookah, or cigar. Tobacco smoke of any kind is not your good friend. Smoking doesn’t work with a disclaimer. Once you get hooked, the damage is done.

There is no back button once permanent damage occurs. Addictions are often genetically hardwired, and the child of a smoker is not only passively inhaling cigarette smoke but is also getting addicted at the same time. You can fight this, but you need to start now.

The government and community must come forward to stop cigarette smoking. We also need to make the world greener to decrease pollution for reducing the allergen load.

What can you do if you suspect you have COPD?

Get checked up and diagnosed on time. Your doctor will ask several questions and examine you. A chest Xray, Pulmonary function test is the first step, and often a High resolution computed tomography of the chest may be needed. CT scan is the definitive diagnostic tool for emphysema

Conclusion: What can you do today?

Reduce allergen load: Stop Smoking

Ensure healthy lifestyle and moderate exercise. Singing, Yoga swimming, all help improve pulmonary capacity and airflow. Take medicines after professional medical advice. Avoid self-medication and erratic medication schedule. Control dyspepsia and acidity, as it can be a trigger. Remember, your health is your wealth.

If you need the assistance of medical devices, don’t delay. Intervention on time is essential to prevent long term complications and quality of life issues.

Individuals need to be responsible for their health. Choosing a poison because it makes you feel good is not okay. Stricter action for selling tobacco-related products, higher taxes, punitive action for selling to underage needs to work at the ground level. The world is sharing the healthcare burden, but it’s you who is smoking who will gasp for air. To know more: 1800 258 7678 or log onto www.philips.co.in

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References :

• GOLD
• https://www.medicalnewstoday.com/articles/314991.php
• https://juniperpublishers.com/ijoprs/pdf/IJOPRS.MS.ID.555599.pdf
• Harrison’s textbook of Internal medicine