Chronic obstructive pulmonary disease or COPD is a group of diseases in which the passivity of the airways is broken, making it difficult for patients to breathe.

Emphysema and chronic asthmatic bronchitis are the two most common diseases in the COPD group.

In all cases of COPD, the defeat of the respiratory tract, which disrupts the exchange of oxygen and carbon dioxide in the lungs.

Chronic obstructive pulmonary disease is one of the leading causes of disability and mortality worldwide. Most obstructive pulmonary diseases are caused by prolonged smoking and could be prevented if the sick people gave up this habit on time. In COPD, lung damage is mostly irreversible, so treatment is aimed at combating symptoms.

Causes of COPD.

In COPD, lung damage is primarily due to chronic asthmatic bronchitis or emphysema. Many patients with COPD have both, and another disease.

Chronic asthmatic bronchitis.

This is a chronic disease in which there is inflammation and constriction of the respiratory tract. This can lead to shortness of breath, coughing and wheezing during breathing. Chronic asthmatic bronchitis increases the production of mucus in the bronchi, which additionally blocks the narrowed respiratory tract.

Emphysema.

This progressive disease damages the tender air sacs at the ends of the bronchioles - the alveoli. Alveoli are collected together, like bunches of grapes, and emphysema gradually destroys the inner walls in these "clusters," reducing the surface available for gas exchange. In addition, emphysema makes the walls of the alveoli soft and less elastic, because of what they fall off when exhaling air. In patients with emphysema, dyspnea is present, they actively work as auxiliary muscles during breathing. Patients with emphysema do not tolerate heavy loads.

COPD is usually caused by prolonged exposure to air stimuli:.

• Cigarette smoke.

• Dust particles.

• Industrial smog.

• Aggressive chemicals.

Risk factors of COPD.

The main known risk factors for chronic obstructive pulmonary diseases include:.

Effects of tobacco smoke.

Smoking is the most significant risk factor for COPD. The longer you smoke cigarettes, the more likely the development of obstructive pulmonary disease. People who are exposed to secondhand smoke are also at risk. According to some sources, the inhalation of marijuana smoke can damage the lungs like tobacco smoke.

Effect of dust and chemicals.

Long exposure to such air irritants at work leads to inflammation and obstructive changes in the lungs. With this, many occupational diseases are associated with workers in "dirty" industries, chemical plants, coal mines.

Age.

COPD is slowly progressing over many years, so that in most people the symptoms of these diseases appear at least 30-40 years.

Genetics.

A rare genetic disease, called deficiency of alpha-1-antitrypsin, is the cause of some cases of COPD. Researchers believe that genetic factors make individuals more sensitive to the damaging effects of tobacco smoke. If these people smoke, they have faster problems with the lungs.

Symptoms of COPD.

In general, the symptoms of COPD may not appear until the patient's lungs are severely damaged. Symptoms of the disease over time only worsen, especially if a person continues to smoke or does not receive treatment. Patients with COPD from time to time experience episodes of exacerbations of their illness, when its symptoms deteriorate sharply. The signs of different obstructive pulmonary diseases may differ.

Most patients with chronic obstructive pulmonary disease have more than one of the following symptoms:.

• Shortness of breath.

• Chrohes with breathing.

• Chest tightness.

• Chronic cough.

Diagnosis of COPD.

If you have COPD symptoms or a history of exposure to air irritants in the past (especially tobacco smoke), the doctor may prescribe one of the following tests:.

Chest X-ray.

In some people, X-rays can show emphysema - one of the most common COPD. More importantly, X-rays can exclude lung cancer and certain heart diseases.

CT scan.

With CT, a series of images is taken under a variety of different angles, which allows obtaining detailed "slices" of the patient's internal organs. Lung scanning makes it possible to identify emphysema, tumors and other abnormalities.

Blood arterial blood gas analysis.

This blood test shows how well the lungs enrich our blood with oxygen and remove carbon dioxide. Blood for analysis can be taken from the artery passing through your wrist.

Sputum examination.

The analysis of cells in sputum, which you refractor, will help to identify the cause of problems with the lungs and exclude cancer. If you have a productive (wet) cough, the doctor will prescribe a sputum analysis to determine the infection that caused the disease.

Analysis of lung function.

Spirometry is a common way to check how well the lungs work. During this procedure, you will be asked to breathe in a special tube. The machine will measure the amount of air that your lungs can hold, and also how much you can exhale it. Spirometry can detect chronic obstructive pulmonary disease at an early stage, even before the onset of symptoms of the disease. This test can be repeated several times at regular intervals, which will help the doctor monitor the development of the disease.

Treatment of chronic obstructive pulmonary diseases.

Chronic obstructive pulmonary disease can not be completely cured, because lesions are usually irreversible. But the treatment will help control the symptoms of the disease, reduce the risk of complications, reduce the frequency of exacerbations and improve the quality of your life.

To give up smoking.

This is the most important step in the treatment of COPD, if you still smoke. Quit smoking is the only way to stop lung damage, which can eventually lead to even death. But quitting was never a simple matter. And you may need help from a doctor. Talk with your doctor - he can prescribe you a nicotine patch or other nicotine substitutes.

Medication.

For the treatment of COPD, such groups of drugs can be used:.

• Bronchodilators. These drugs are usually administered in the form of an inhaler. They relax the smooth musculature of the bronchi and expand the airways. As a result, it becomes easy to breathe. Depending on the problem, you may need two inhalers: long-acting (for daily prevention of seizures) and short-acting (for arresting an attack and before physical exertion).

• Inhalational steroids. Corticosteroid hormones in the form of an inhaler are a convenient means for relieving the inflammation of the respiratory tract. But prolonged use of these drugs can cause osteoporosis, hypertension, diabetes, cataracts and other serious complications. These drugs are usually prescribed for people with severe COPD.

• Antibiotics. Respiratory infections, such as acute bronchitis, can exacerbate chronic obstructive pulmonary disease. Antibiotics help to suppress pathogenic flora in the respiratory tract, but they are recommended to take only when absolutely necessary.

Non-drug treatment.

• Oxygen therapy. If there is not enough oxygen in your blood, you may need additional oxygen. There are many different devices for oxygen supply, including small and convenient devices that you can carry around the city. Some patients need oxygen only during exercise or during sleep. Another oxygen mask is needed constantly.

• Rehabilitation programs for patients with COPD. These programs usually combine training, exercise, nutrition advice and counseling. In developed countries, these programs are widespread. They work at many major medical centers in the USA. They involve pulmonologists, physiotherapists, nutritionists, psychotherapists.

Surgical treatment of COPD.

Surgical treatment is required for some patients with severe emphysema, which is not helped by medication:.

• Decreased lung volume. In this operation, the surgeon removes small fragments of damaged lung tissue. This creates additional space in the chest cavity, allowing the remaining lungs to work more efficiently. This operation is very risky, and its long-term advantages in comparison with drug treatment are not obvious.

• Lung transplantation. With severe emphysema, one of the exits can be transplantation of one lung. Such an operation improves the ability to breathe and live a more active life. But the studies did not show a significant prolongation of life for such patients. In addition, it may take a long time to wait for a suitable donor. Therefore, the decision to transplant the lung is quite complicated.

Prevention of exacerbations.

Even under condition of treatment, you can experience sudden exacerbations of the disease. Exacerbations can be so severe that they lead to pulmonary insufficiency. Such episodes arise as a result of respiratory infections, cold weather on the street, high air pollution. If your symptoms suddenly become worse, tell your doctor as soon as possible.

Advice for patients.

If you suffer from COPD, the following can help you:.

• Respiration control techniques. Your doctor will show you the best positions and techniques for controlling breathing during seizures.

• Airway cleaning. When COPD mucus accumulates in the bronchi. For better separation of mucus, you need to breathe moistened air, drink plenty of fluids. Your doctor may prescribe an expectorant.

• Regular exercise. Of course, during physical exertion, patients with COPD can hardly breathe. But regular medical exercises can strengthen your respiratory muscles. A suitable set of exercises you will be advised by a doctor.

• Healthy diet. A healthy diet will support your strengths. If you are obese, you need to get rid of excess kilograms. With insufficient weight the doctor can advise you special dietary supplements and enhanced nutrition.

• To give up smoking. Remember that smoking is the leading cause of COPD. Passive smoking is also harmful to the lungs, so if a smoker lives in the house, influence it. Defend your right to healthy air at work if your colleagues smoke. In many countries, the rights of non-smoking workers are protected by law.

• Vaccination.

Respiratory infections provoke exacerbation of chronic lung diseases. Annual vaccinations against influenza and other seasonal diseases will help you avoid exacerbations.

• Avoid crowding people. If you need to go to places of mass congestion, do not forget the protective mask.

• Do not breathe cold air. Remember that cold air provokes spasm of the bronchi - cover your mouth and nose with a scarf or a handkerchief if you are walking in the frost.

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