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:
1. 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. 
2. 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. 
3. 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:
1. Shortness of breath especially after exercising
2. Wheezing
3. Tightness in your chest
4. Unintended weight loss
5. Lack of energy
6. Frequent respiratory infections
7. Wheezing
8. Cough accompanied by mucus

Diagnosis:
1. Physical exam where your doctor monitors the functioning of your lungs. 
2. Questioning about your past health (smoking or other harmful lung irritants).
3. Spirometry and other breathing tests.
4. Chest x-rays and other tests to eliminate other problems which could be causing your symptoms.

All About COPD!

Chronic Obstructive Pulmonary Disease or COPD for short is a respiratory disease that makes it increasingly difficult to breathe; the lungs stop functioning properly. There are mainly two categories of COPD which are emphysema and chronic bronchitis. The primary reason for COPD is longstanding exposure to substances such as cigarette smoke, chemical fumes and air pollutants that damage the lungs gradually.

Initially, the symptoms of COPD may be really mild but over time it may become extremely severe. These include symptoms such as:

Shortness of breath
Coughing with mucous formation
Wheezing or gasping
Tightness in the chest
Feeling tired constantly after doing normal daily activities or after exercising.
In the long run, the damages can prove to be permanent.

Of the two subtypes mentioned, bronchitis is when the airways become inflamed as well as narrowed. People suffering from bronchitis tend to produce sputum which is basically a combination of mucus and saliva.
And the other subtype, Emphysema is the condition when the air sacs in the lungs become affected. The air sacs degenerate and become baggy with lots of holes in it. This, in turn, traps air. This narrows the airways making it difficult to breathe. In COPD, there is a narrowing of the lungs because:

The lining of the airway becomes inflamed
The lining of the airways which is elastic flops
The tissues of the lungs become damaged so there is an exertion on the airway.
COPD, in the long run, can lead to a number of health complications such as heart disorders, lung cancer, respiratory infections, depression and high blood pressure. COPD is treatable but not curable because it is a life-long condition. The following are some of the treatment methods for COPD:

Oxygen Therapy- If you are experiencing low levels of oxygen then opting for a portable oxygen unit will be extremely beneficial.
Medication- Bronchodilators help in relaxing the airway muscles for comfortable breathing. These medications are usually taken via an inhaler. Other medications include corticosteroids, theophylline, vaccines and antibiotics/antivirals.
Surgery- Surgery is usually advised as the last step when the COPD condition has become so severe that all other methods of treatment have failed. This is, more possible, in the case of emphysema. There are mainly two surgical methods: one is bullectomy when the surgeons remove the damaged air sacs. The other method is lung volume reduction which removes the lung tissues that have become damaged.
Adopting certain lifestyle changes can provide relief for the time being. Such alterations include:

Quit smoking immediately, if you haven t already.
Try to avoid passive smoking as much as possible. Passive smoking is as damaging as firsthand smoking.
Give your body the daily dose of nutrition so that the immune system doesn t falter as well.

Better Living with COPD - A Patient Guide!

Myth: COPD is an incurable chronic lung disease mainly affecting the aged people (above 60 years).
Fact: There is no denying the fact that COPD is indeed a chronic disorder that severely affects the lungs and its functioning. However, with timely diagnosis and treatment, the condition and the deleterious consequences can be managed and controlled significantly. Since COPD triggers breathing problems (the airflow from the lungs gets obstructed), the use of bronchodilators, oxygen therapy or corticosteroids can be highly beneficial. Though COPD is rare among young adults, the condition can affect people in their late 30's or early 40's as well.

Myth: COPD only affects people who smoke.
Fact: Smoking is one of the triggers for COPD, but the condition can also affect people who have never smoked in their lifetime. Factors such as neonatal chronic lung disease or prolonged exposure to substances that cause lung irritation and damage (toxic industrial fumes and chemicals) can play a pivotal role in triggering COPD. COPD can also be a genetic predisposition.

Myth: People with COPD should avoid exercise and physical activities.



Fact: Mild to moderate exercise (especially breathing exercise) are indeed helpful and go a long way in the effective management of COPD. Exercising regularly (for 20-30 minutes or as the doctor recommended) help to lower the blood pressure and improve the circulation that provides fruitful results for people with breathing problems. However, doctors do advise people with shortness of breath to avoid strenuous exercise.

Myth: COPD only affects the lungs.
Fact: With time and left unmanaged and untreated, COPD acts as a catalyst making a person more susceptible to heart ailments. In some cases, the condition can also trigger depression and anxiety.

Myth: In the case of COPD, giving up on smoking will not produce any positive results.
Fact: Giving up on smoking may not help to reverse the damage that has already been caused by COPD. However, quitting smoking along with proper medications and lifestyle changes does help to control the condition better. In some instances, there were also significant improvements in the associated symptoms (such as shortness of breath, fatigue, wheezing, a chronic cough).

Myth: COPD is another name for Asthma.
Fact: Many people confuse COPD with Asthma. Though some symptoms may appear identical (such as wheezing, shortness of breath), the conditions are different and so are their treatments. In case you have a concern or query you can always consult an expert & get answers to your questions.

COPD - Are You Aware Of These Myths & Facts?

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?

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!

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