Chronic obstructive pulmonary disease is a long-term condition of the lungs where the flow of air to the lungs is restricted (obstructed). Symptoms include cough and breathlessness. The condition is most often caused by smoking and the most important treatment is to stop smoking. Inhalers are commonly used to ease symptoms. Other treatments such as steroids, antibiotics, oxygen, and mucus-thinning (mucolytic) medicines are sometimes prescribed in more severe cases, or during a flare-up (exacerbation) of symptoms.

What causes COPD?
Smoking is by far the biggest risk factor for COPD. The lining of the airways becomes inflamed and damaged by smoking. Cigarette smoking is the biggest risk factor.

Air pollution may cause some cases of COPD, or make the disease worse. Air pollution can be indoor air pollution or outdoor air pollution. Indoor air pollution seems to be involved in more cases of COPD than outdoor air pollution. Indoor air pollution includes fumes from indoor fires or stoves, and dust, fumes or chemicals present in some workplaces. The combined effect of exposure at work to air pollutants and smoking increases the chances of developing COPD.

A small number of people have a hereditary (genetic) risk of COPD due to very rare protein deficiencies that can lead to lung, liver and blood disorders. (The condition is called alpha 1 antitrypsin deficiency. Less than 1 in 100 cases of COPD are due to this.


COPD symptoms-


Cough is usually the first symptom to develop. It is produced with phlegm (sputum). It tends to come and go at first, and then gradually becomes more persistent (chronic). You may think of your cough as a 'smokers cough' in the early stages of the disease. It is when the breathlessness begins that people often become concerned.
Breathlessness (shortness of breath) and wheeze may occur only when you exert yourself at first. For example, when you climb the stairs. These symptoms tend to become gradually worse over the years if you continue to smoke. Difficulty with breathing may eventually become quite distressing.

Sputum - the damaged airways make a lot more mucus than normal. This forms sputum. You tend to cough up a lot of sputum each day.

Chest infections are more common if you have COPD. A sudden worsening of symptoms (such as when you have an infection) is called an exacerbation. Wheezing with cough and breathlessness may become worse than usual if you have a chest infection and you may cough more sputum. Sputum usually turns yellow or green during a chest infection. Chest infections can be caused by germs called bacteria or viruses. 
Other symptoms of COPD can be vaguer. Examples are weight loss, tiredness and ankle swelling.

What is the difference between COPD and asthma?


COPD and asthma cause similar symptoms - in particular difficulty breathing (breathlessness). However, they are completely different diseases. Briefly:

In COPD there is permanent damage to the airways. The narrowed airways are fixed, and so symptoms are persistent (chronic). Treatment to open up the airways is therefore limited.

In asthma, there is inflammation in the airways which makes the muscles in the airways narrow (constrict). This is temporary so the narrowing comes and goes. So, the symptoms tend to come and go, and vary in severity from time to time. Treatment to reduce inflammation and to open up the airways usually works well.

COPD is more likely than asthma to cause an ongoing cough with phlegm (sputum).

Waking at night with breathlessness or wheeze is common in asthma and uncommon in COPD.

COPD is rare before the age of 35, whilst asthma is common in under-35s.

There is more likely to be a history of asthma, allergies, eczema and hay fever (so-called atopy) in people with asthma.

Do I need any tests?

The most common test used in helping to diagnose the condition is called spirometry. This is a breathing test. You will be asked to breathe or blow into a small machine called a spirometer which will measure how well your lungs are working. This test can help make a diagnosis of COPD.


A chest X-Ray show signs of COPD and can be used to help exclude other serious conditions (including lung cancer). Occasionally, a special CT scan of the chest - high-resolution CT - is needed. A blood test to make sure you are not anemic is often helpful.

A pulse oximeter is a device which can be clipped on to your finger. It measures your heart rate (pulse) and the amount of oxygen in your circulation (oxygen saturation). Lower levels than normal tend to be found in people who have COPD, especially if you have a flare-up (exacerbation) of your symptoms.

COPD treatment-

Smoking cessation is the most important step towards treatment.
Inhalers

The main treatments are medications given in devices called inhalers. The medicine within the inhaler is in a powdered form which you breathe in (inhale). The medicines in standard inhalers reach the lungs better if used with a spacer device. Inhalers include one, two or even three types of medicines. They may include:


A bronchodilator agent - this is a medicine which opens up (dilates) the airways. Some work quickly but don't last very long; others are longer-acting.
A steroid - these reduce the inflammation in the airway, thereby reducing the swelling. This, in turn, adds to the space available for air to pass.
A medicine which helps to dry up the secretions produced by the airways.
Home oxygen
This may help some people with severe symptoms or end-stage COPD. It does not help in all cases. Unfortunately, just because you feel breathless with COPD it does not mean that oxygen will help you. Great care has to be taken with oxygen therapy. Too much oxygen can actually be harmful if you have COPD.
Regular follow up in OPD is an essential part of treatment success.

Chronic Obstructive Pulmonary Disease - Know More About It!

COPD, which is short for Chronic Obstructive Pulmonary Disease, is a severe form of lung disease that is characterized by increased breathlessness and obstruction of airflow from the lungs. People who are suffering from COPD are at an increased risk of developing lung cancer, heart diseases and many other conditions. It includes progressive lung diseases such as chronic bronchitis, emphysema, few forms of bronchiectasis and refractory (non-reversible) asthma. The former two are the most common conditions contributing to COPD. 

Chronic bronchitis induces inflammation in the airway that carries air to the lungs and fills it with mucus. This either completely blocks the airway or narrows it, causing difficulty in breathing. However, in emphysema, the air sacs inside the lungs which inflate and deflate as you breathe in and out, lose their elasticity due to which less air comes in and goes out leaving you breathless.

The best way to treat COPD is to quit smoking. Your doctor may also prescribe you medications or ask you to enroll in a lung rehab program. 

Causes:

Smoking: Smoking is one of the most common causes of COPD. This is because smoking is known to destroy the stretchy fibers in people's lungs and irritate the airways. Even passive smoking is unhealthy. About 90% of the people having COPD are current or former smokers. 
Genetics: Some individuals suffer from COPD even after refraining from smoking. Genes might be at the helm of COPD in such a case. AATD i.e. Alpha -1 Antitrypsin Deficiency, is a protein in the lungs, the lack of which is one of the most common genetic factor causing emphysema. 
Environmental Factors: Breathing in harmful pollutants present in your environment is also one of the causes of COPD. Fumes, dust or certain chemicals are a few examples of harmful lung irritants. Organic cooking fuel may also cause COPD. Exposing yourself to the aforementioned environmental factors for a prolonged period of time increases your risk of developing COPD substantially. 
Symptoms:

Shortness of breath especially after exercising
Wheezing
Tightness in your chest
Unintended weight loss
Lack of energy
Frequent respiratory infections
Wheezing
Cough accompanied by mucus
Diagnosis:

Physical Exam where your doctor monitors the functioning of your lungs. 
Questioning about your past health (Smoking or other harmful lung irritants).
Spirometry and other breathing tests.
Chest x-rays and other tests to eliminate other problems which could be causing your symptoms.

World Chronic Obstructive Pulmonary Disease Day - Know More About COPD!

COPD or Chronic Obstructive Pulmonary Disease is a lung disease wherein, it gets difficult for a person to breathe due to thickening and inflammation of airways. World COPD day is being celebrated on 16th November, in order to, raise  wareness about COPD. It is a group of progressive lung diseases, the most common ones of which are emphysema and chronic bronchitis. Emphysema destroys your lungs  air sacs while bronchitis leads to the inflammation and narrowing of your bronchial tubes.

Symptoms of COPD

The early symptoms of COPD include occasional shortness of breath, especially after physical exercise, mild and recurrent cough and having the urge to clear your throat many times. You may start avoiding physical activities eventually. Other symptoms, which follow include wheezing, chest tightness, chronic cough with mucus, an urge to clear mucus from the lungs, frequent flu, colds and fatigue.

Factors behind it
Smoking accounts for being the major cause of COPD in developed countries. Commonly, people over the age of 40 with a history of smoking are affected with COPD. The more you smoke, more are your chances of getting the condition increase. Exposure to chemicals and harmful fumes may also cause COPD. Long-term exposure to polluted air and inhaling dust are other causes. The deficiency of a protein called alpha-1-antitrypsin is also said to cause COPD.

Diagnosis
COPD is diagnosed on the basis of several tests and examinations. They include spirometry, which is a noninvasive test for assessing lung function, imaging tests such as a chest X-ray or CT scan which provides an image of the lung for observation. An arterial blood gas test is also carried out for measuring blood oxygen levels.

Treatment
The treatment options for COPD include the following:

Medication: Bronchodilators are used for relaxing the muscles of your lungs  airways which simplify breathing. They are taken via inhalers. Glucocorticosteroids may be added to reduce inflammation.
Oxygen therapy: When your blood oxygen levels are low, oxygen is given via masks and nasal prongs which help you to breathe better.
Surgery: Surgery is carried out in the case of severe COPD or when other treatment methods fail. Bullectomy is a common surgical procedure used, in which the large air sacs or  bullae  are removed from the lungs. The lung volume reduction surgery is also carried out in which damaged lung tissues are removed. Lung transplant is required in extreme cases.
Lifestyle changes: You need to make some lifestyle changes to alleviate the symptoms of COPD which include the following:
Quit smoking in case you are a regular smoker.
Avoid any form of second-hand smoke and chemical fumes.
Consume all the essential nutrients required by your body.
Consult a doctor about your exercise patterns.
In case you experience any symptom of COPD, you should consult a doctor immediately for quick diagnosis and proper treatment.

World COPD Day Special - Facts You Should Know About COPD

COPD stands for Chronic Obstructive Pulmonary Disease and is generally used to describe a broad category of diseases. These include chronic bronchitis, emphysema, non-reversible asthma as well as some forms of bronchiectasis. All of these diseases, however, can be prevented from getting worse by taking similar measures as the causes of these diseases are very similar.

Here are the ways to prevent COPD exacerbations:
1. Cleanliness: It is crucial that you do not allow infections to set in. Infections are probably the worst type of exacerbation possible in COPD. All you need to do to prevent infection is to take a little care to ensure good hygiene. Wash your hands often and do not allow people with colds or flu to come close to you.

2. Take vaccines: Make sure your flu and pneumonia shots have not been missed.

3. Take medicines: It is crucial that medicines for your lungs are taken on schedule, if you have COPD. The possible medicines which you could take if your doctor prescribes it includes inhaled beta-agonists, steroids and anticholinergics.

4. Spirometry: Doctors often recommend the use of the portable Spirometry device, Spirometer, in case of COPD. Spirometers check the condition of the lungs by measuring various parameters to see how well the lungs are working. Spirometers can easily measure FEV1, a parameter which measures how much air can you blow out in one second. This is especially great if you do not know whether your condition has exacerbated or not.

5. Corticosteroid: It is another type of medicine used, which can prevent COPD exacerbations. In its place, even inhaled beta-agonists or anticholinergics can also be used.

Preventing COPD Exacerbations!

Pulmonary hypertension mainly occurs due to narrowing of the arteries of the lungs as a result of which the flow of blood is restricted. In this kind of condition, blood fails to carry oxygen to your heart and thus your heart gets adversely affected. The blood pressure of your body will get increased to a great extent if this situation remains untreated, thus leading to bdreadful consequenses, specifically situation like heart failure, serious pulmonary diseases, blood clots in lungs and congenial heart defects, etc.

There are certain forms of pulmonary hypertension, which are serious in nature and worsen with time, so much so that they are even fatal at times. It also includes forms which are non curable in nature, however, in order to improve the quality of life, symptoms can be reduced with proper treatment. The treatment for pulmonary hypertension is often complex and it takes some time to find the most appropriate treatment and requires extensive follow-up care. Your doctor might also need to change your treatment if it's no longer effective. However, when pulmonary hypertension is caused by another condition, your doctor will treat the underlying cause whenever possible.

Common treatments for pulmonary hypertension:

Medications

1. Blood vessel dilators (vasodilators): vasodilators open narrowed blood vessels. They are one of the most commonly prescribed vasodilators for pulmonary hypertension is epoprostenol (flolan, veletri). The drawback to epoprostenol is that the effect lasts only for few minutes. This drug is continuously injected through an intravenous (iv) catheter via a small pump that you wear in a pack on your belt or shoulder.

2. Ventavis: another form of the drug, iloprost (ventavis), can be inhaled six to nine times a day through a nebulizer, a machine that vaporizes your medication. Because it's inhaled, it goes directly to the lungs.

3. Treprostinil (tyvaso, remodulin, orenitram): it is another form of the drug, which can be given four times a day and can be inhaled or can be taken as an oral medication and can also be administered through injection.

4. Endothelin receptor antagonists: these medications reverse the effect of endothelin, a substance in the walls of blood vessels that causes them to narrow. These drugs may improve your energy level and symptoms. However, these drugs shouldn't be taken if you're pregnant. Also, these drugs can damage your liver and you may need monthly liver monitoring.

6. Sildenafil and tadalafil: sildenafil (revatio, viagra) and tadalafil (cialis, adcirca) are sometimes used to treat pulmonary hypertension. These drugs work by opening the blood vessels in the lungs to allow blood to flow through more easily.

6. High-dose calcium channel blockers: these drugs help relax the muscles in the walls of your blood vessels. They include medications, such as amlodipine (norvasc), diltiazem (cardizem, tiazac, others) and nifedipine (procardia, others). Although calcium channel blockers can be effective, only a small number of people with pulmonary hypertension respond to them.

7. Soluble guanylate cyclase (sgc) stimulator: soluble guanylate cyclase (sgc) stimulators (adempas) interact with nitric oxide and help relax the pulmonary arteries and lower the pressure within the arteries. These medications should not be taken if you're pregnant. They can sometimes cause dizziness or nausea.

8. Anticoagulants: your doctor is likely to prescribe the anticoagulant warfarin (coumadin, jantoven) to help prevent the formation of blood clots within the small pulmonary arteries. Because anticoagulants prevent normal blood coagulation, they increase your risk of bleeding complications. Take warfarin exactly as prescribed, because warfarin can cause severe side effects if taken incorrectly. If you're taking warfarin, your doctor will ask you to have periodic blood tests to check how well the drug is working. Many other drugs, herbal supplements and foods can interact with warfarin, so be sure your doctor knows all of the medications you're taking.

9. Digoxin: digoxin (lanoxin) can help the heart beat stronger and pump more blood. It can help control the heart rate if you experience arrhythmias.

10. Diuretics: commonly known as water pills, these medications help eliminate excess fluid from your body. This reduces the amount of work your heart has to do. They may also be used to limit fluid buildup in your lungs.

11. Oxygen: your doctor might suggest that you sometimes breathe pure oxygen, a treatment known as oxygen therapy, to help treat pulmonary hypertension, especially if you live at a high altitude or have sleep apnea. Some people who have pulmonary hypertension eventually require continuous oxygen therapy.

Surgeries

1. Atrial septostomy: if medications don't control your pulmonary hypertension, this open heart surgery might be an option. In an atrial septostomy, a surgeon will create an opening between the upper left and right chambers of your heart (atria) to relieve the pressure on the right side of your heart.

2. Lung transplantation: in some cases, a lung or heart lung transplant might be an option, especially for younger people who have idiopathic pulmonary arterial hypertension.

Reducing complications

1. The complications need to be reduced by taking proper health care. Healthy diet needs to be taken regularly along with proper medications. Smoking should be stopped and exercising sessions should be attended daily without any fail

2. Overweight or obesity needs to be controlled properly for reducing the complications. Specialized caring strategies need to be maintained for avoiding severe kinds of health complications that are quite annoying.

Pulmonary Hypertension: How to Treat It?

The lungs are made of tubes through, which air passes in and out for exchange of gases, taking in alveoli. It is a disease of alveoli to which finer air conducting tubes are attached. Over a period of time, with age and exposure to various agents, these tubules get obstructed. The amount of air that can pass through these is reduced, leading to reduced oxygen supply to the lungs and thereby the various body organs.

Symptoms
The symptoms of copd can be easily understood if we realize how copd is caused. The progressive blockage of the air tubes causes less oxygen to reach the tissues, which is the most essential agent for all tissues and organs to function. Reduced supply produces a generalized limitation in physical activity. There are two main components to copd - chronic bronchitis and emphysema. The symptoms indicative of copd are as follows:
1. Chronic cough - also referred to as smoker's cough, the cough is relentless and does not subside with regular cough treatment. This is one of the first indications of copd.
2. Mucus buildup - there is constant buildup of mucus which gets expelled during coughing. The person never feels completely clear of mucus, and the regular cough expectorants do not help relieve the symptoms.
3. Fatigue associated with limited activity - as noted earlier, the reduced capacity of the organs limits their activities. Therefore, regular activities like walking short distances or climbing stairs can induce fatigue.
4. Shortness of breath - the above fatigue is associated with shortness of breath, even with small physical exertion. A person with copd will see marked tiredness and reduced ability to perform routine chores and feel a tightness in the chest.
5. Wheezing - passage of air through the obstructed air tubes produces a whistling sound or wheezing. It is more pronounced when there is mucus accumulation in the airways.
Rarely, frequent respiratory infections, more frequent flu attacks, swelling of the feet and ankles, cardiovascular disease, weight loss, and morning headaches.

Treatment
While there is no cure for copd, once it sets, the following are some ways to slow its progression and reduce severity of the symptoms:
1. Bronchodilators - dilate the air tubes and ease flow of air
2. Corticosteroids - help reduce inflammation and thereby improve airflow through the tubes
3. Flu vaccination - helps curb the frequent flu attacks
4. Antibiotics - to contain infections
5. Pulmonary rehabilitation - a combination of breathing exercise and patient education to improve lung function.
6. Oxygen therapy - in very severe cases, oxygen may be required.
7. Lifestyle changes - eating healthy foods, preventing exposure to dust and smoke, quitting smoking, breathing exercises, bi-annual medical check-ups to monitor lung functions are essential.

Knowing that you have copd is the first step towards managing copd, which can be managed effectively.

Chronic Obstructive Pulmonary Disease - Symptoms and Treatment

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