Causative and risk factors
A normal lung consists of numerous air ways and air sacs. These structures are elastic. Thus they inflate on inhalation and deflate on exhalation.
In COPD, the airways and the air sacs lose their elasticity. Their walls of the airways become thickened and inflamed. Excessive mucus is produced which clogs the airways.
Smoking is the leading cause of COPD. Genetic deficiency of alpha 1 antitrypsin is the causative factor in 1 in each 100 patients of COPD. Other factors implicated in the causation include air pollution and regular exposure to dust, chemicals, fumes etc.
Clinical presentation
The patient develops chronic cough with expectoration. He becomes out of breath very easily, especially during physical activities. The patient experiences tightness in the chest region and wheezing can be heard. There is a tendency to catch respiratory infections frequently. Cyanosis or bluish discoloration of the lips and fingernails may be seen. The patient is usually fatigued and has a tendency to catch respiratory infections frequently.
The patients may experience exacerbations of these symptoms several times a year.
Diagnosis/Tests
The main diagnostic feature of COPD is the presence of chronic cough for at least 3 months a year, for a period of at least 2 consecutive years.
After a thorough history taking and physical examination, the patient is advised to undergo a chest X-ray and pulmonary function tests. Other tests include measurement of arterial blood gases and sputum examination. A CT scan of the chest may be performed.
Treatment
The patient is advised to quit smoking and to avoid occupational exposure to fumes, chemicals etc. as far as possible. Breathing exercises are recommended to the patients to improve lung capacity. Medications such as bronchodilators, corticosteroids etc. are prescribed in the form of inhalers or oral pills. Antibiotics are given whenever an underlying infection is suspected. Rarely surgical intervention is necessary. Surgery may be performed to reduce the lung volume. Rarely lung transplantation is performed.
COPD is a progressive disorder which usually worsens with age, especially if the aggravating factors are not removed.
