Chronic Obstructive Pulmonary Disease
Chronic obstructive pulmonary disease (COPD) is mostly characterized with irreversible stenosis of airways and primary dyspnea. The most common etiology is smoking. Actually smoking 1 pack of cigarettes a day for 20 years is considered to be risky for development of COPD. Aside from smoking, working in a polluted environment and some specific occupational exposures are also known to lead to COPD. Furthermore, non-smokers may still suffer from this condition due to passive inhalation of smoke. However, this latter group of non-smokers usually face COPD because of exposure to fumes produced by cooking in a small room or burnt biomass (manure, tandoori fireplaces). Patients are mostly above the age of 50 and the majority of them are males, which is consistent with the statistic that there is a larger smoker population among males.
Patients tend to present with complaints of long-term wheezy respiration, coughing, phlegm discharge and dyspnea when they consult a physician. An examination is bound to reveal how lung sounds are modified in accordance with airway stenosis. A final diagnosis can be obtained by identifying such stenosis through a respiratory function test. Chest x-rays also provide findings indicative of airway stenosis and obliteration of pulmonary tissue. One of the primary reasons why this group of patients should obtain a chest x-ray is that they are also in the high risk group for lung cancer.
Therapy involves inhaled drugs aimed at correcting airway stenosis and reported complaints as much as possible. While oral COPD drugs are available, inhaled drugs still constitute the most basic approach. Oral drugs are added when they do not suffice. The disease may get exacerbated from time to time as the influences of infection, polluted air and cardiac insufficiency keep building up. In such cases, antibiotics, cortisone or diuretics may be administered, depending on the patient’s needs.
At advanced stages of COPD, usual complaints may be accompanied with cyanosis of finger tips and lips, marked decrease in physical capacity and edema in lower extremities. These require evaluation of whether respiratory failure is present or not. A patient with lowered oxygen levels should receive long-term oxygen therapy at home. More severe COPD patients develop not only oxygen insufficiency, but also high carbon dioxide levels. Their treatment requires oxygen support and use of a breathing apparatus.
Still the best way of preventing adverse progress is to quit smoking and receive flu and pneumonia vaccinations on time and regularly. Additionally, it is necessary to treat symptoms of exacerbation, initiate oxygen and respiratory support, if needed, and make sure that patients are monitored by a pulmonary medicine physician, so that possible risks of lung cancer are detected in advance.