Chronic obstructive pulmonary disease (Lung disease)

Author: Helan Hussein Mussa

KEMSA Medical Data Base Chronic obstructive pulmonary disease (Lung disease)
http://sphweb.bumc.bu.edu/otlt/MPH-Modules/PH/RespiratoryHealth/RespiratoryHealth5.html

General

Chronic obstructive pulmonary disease (COPD) is a disease that over time (progressively) leads to breathlessness. A patient with this disease will also show other symptoms such as whistling sound coming from the lungs while breathing (wheezing) and couching up large amount of slimy material called mucous.

COPD includes two main conditions:

  • Emphysema: the walls of small air sacs inside the lungs are destroyed. Patient has difficulty to breathe out air.
  • chronic bronchitis: the lining of the airways is inflamed and swelled. Lots of mucous is produced and blocking airways.

COPD is one of the top ten causes of deaths worldwide.[1]

[1] http://sphweb.bumc.bu.edu/otlt/MPH-Modules/PH/RespiratoryHealth/RespiratoryHealth5.html

Causes

Multiple factors can lead to COPD, such as genetics and environmental exposures over a long time. One of the leading cause for lung diseases is smoking. A cigarette smoke contains close to 4 000 toxic substances and at least 50 carcinogens (substances that can cause cancer).[1] When the smoke is released into the air, it can stay in the air for up to two hours and a half.[2] This means it is not only harmful for the person smoking, but also for the people around the person (called passive smoking). Especially it is harmful for children if smoking is done for example inside the house or car.

To understand the disease, it is important to know how the lungs function. The air that is breathed goes into the windpipe then to tubes (bronchial tubes) inside the lungs. Here the tubes branches into thousands smaller tubes, called bronchioles. These in turn ends in small air sacs called alveoli. The air sacs are elastic. When you breathe in, each air sac fills up with air. When you breathe out, the air sacs deflate and the air goes out.

In COPD the following conditions causes difficulty in breathing; losing elasticity, walls between air sacs being destroyed, the walls of the airways becoming inflamed and thick, and more mucous being produced and obstructing the airways.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164725/

[2] https://www.nhs.uk/chq/pages/2289.aspx?categoryid=53

Symptoms

Shortness of breath, coughing, frequent airway infections and decreased physical activity can be the symptoms of a patient with COPD.[1]

Diagnosis

Usually the patient is middle aged or older, and the symptoms help to make a diagnosis. Spirometry is a device that doctor will use to measure lung function.

Treatment

The patient must stop smoking at once to not further damage the lungs. Patient is also recommended to become more physically active, and avoid polluted environments. Treatment with medicine will aim to dilate the lung tubes (beta-2-agonsits) and decrease the inflammation (glucocorticoids).

Prognose

If patient doesn’t stop smoking and follow his treatment plan, lung function can decrease faster and lead to respiratory failure.

[1] https://www.sundhed.dk/borger/patienthaandbogen/lunger/illustrationer/praesentationer/hvad-er-kol/