Progressive means that this disease gets worse over time. These are chronic inflammatory diseases characterized by airflow obstruction. People suffering from COPD are at a higher risk to be diagnosed with other heart problems, lung cancer and various other conditions. It has no cure, but with proper management and appropriate treatment, a person can achieve control over the symptoms, reduce the risk of other associated diseases and also lead a quality life.

How Does COPD Affect The lungs?

When a person breathes, the air travels from the windpipe (trachea) and reaches down to the lungs through two tubes called bronchi. The bronchi divides into many smaller tubes like a branch of a tree, the smaller tubes are called bronchioles. At the end of the small tubes are small sacs (alveoli). Alveoli have fragile walls that consist of tiny blood vessels (capillaries). The air passes through these blood vessels and enters the body’s bloodstream, and carbon dioxide is exhaled at the same time. The lungs rely on the elasticity of the bronchial tubes and the air sacs push the air out of the body. COPD causes damage to these tubes and sacs and eventually they over-expand, leaving some air trapped in the lungs even after a person exhales.

With COPD, the airways of the lung become inflamed, and flow of air in and out decreases. This results in less oxygen being supplied to the body, and it gets difficult for carbon dioxide to leave the body, which leads to COPD symptoms. COPD can cause coughing along with mucus, wheezing, breathlessness, and chest tightening. Smoking cigarette is one of the leading causes of COPD. A person suffering from COPD can have other respiratory infections like influenza or flu. Also, it is well established that not all smokers are diagnosed with COPD. It is also caused due to long-term exposure to irritants.

What Causes COPD?

Though cigarette smoking is one of the major reasons for a person to be diagnosed with COPD, there are other factors as well, that contribute to the development of COPD. Most people with COPD are at least at the age of 40 or above and they mostly have a history of smoking. Genetic susceptibility and other irritants are also risk factors for COPD.

Here is a list of risk factors for COPD:

• Exposure to Tobacco smoke – cigarette smokers, cigar smokers, marijuana smokers and even pipe smokers are at a higher risk of developing COPD. People who are exposed to secondhand smoke too often can also develop COPD.
• People with Asthma – Asthma is a chronic lung disease, and it can be a risk factor for a person to develop COPD
• Genetics – Alpha-1-antitrypsin deficiency is a rare condition of a genetic disorder, and it can cause COPD.
• Exposure to Tobacco smoke – cigarette smokers, cigar smokers, marijuana smokers and even pipe smokers are at a higher risk of developing COPD. People who are exposed to secondhand smoke too often can also develop COPD.
• Workplace exposure to chemicals and dust – Long term exposure to irritants such as vapour, fumes, chemicals, dust can inflame the lungs and may contribute to the development of COPD.
• Household air pollution – Prolonged exposure to household smoke emitted from fuel burning such as wood, agricultural waste, and animal dung attribute in the development of COPD.

Symptoms of COPD

COPD makes it difficult for a person to breathe. Initially, symptoms can be mild but as the diseases progress, these symptoms can become severe and frequent or continuous. Often, it is not diagnosed until the condition reaches an advanced stage as people might not know how to recognize the early signs and symptoms of COPD. The primary symptoms of COPD are:

• Producing an excess amount of mucus (phlegm)
• Chest tightening
• Coughing
• Wheezing
• Shortness of breath (dyspnea) after exercising or even after climbing a few stairs
• Frequent respiratory infections such as cold and flu

In later stages of COPD, a person may experience fatigue, weight loss, blue or grey fingernails (a sign of a low oxygen level in your blood), inability to talk, feeling confused, etc. and these symptoms would require immediate medical attention.

Types of COPD Diseases

Emphysema and Chronic Bronchitis are the two main diseases that contribute to COPD. These conditions might also occur at the same time, but the symptoms and severity of these conditions vary from person to person. Refractory asthma is also part of COPD disease.

• Chronic bronchitis is caused due to the inflammation of the airway linings of the lungs. These airways carry air to and from the air sacs of the lungs. One of the significant signs of chronic bronchitis is a daily cough and mucus production. The symptoms include breathing problems, frequent infections, and disability.
• Emphysema is a condition where damage is caused to the fragile walls and elastic fibers of the alveoli. When a person exhales, small airways collapse out of the lungs. The damage to sacs is irreversible and it results in permanent holed in the lung tissue.
• Refractory Asthma does not react to standard medications used for asthmatics. It may also be called an irreversible asthma condition.

Diagnosis and Treatment of COPD

Along with the questions asked by the doctor about symptoms and family history, there can be few tests recommended for confirming the diagnosis of COPD. One of the most reliable ways to diagnose COPD is the spirometry test that measures the speed and amount of air a person can blow out of the lungs. Another test called oximetry can help to estimate how much oxygen is present in a person’s blood (oxygen saturation). Other tests that can help to diagnose COPD are blood tests, peak flow test, ECG, chest X-ray, CT scan, etc.

The first step towards managing COPD would be to stop smoking. At times if breathing is affected, the person might be asked to use an inhaler. Pulmonary rehabilitation is an exercise programme designed for people suffering from lung diseases, such as COPD. Other treatment for COPD includes long-term oxygen therapy, nebulized medicine, or even surgery for patients with severe COPD.

COPD in Women

The number of deaths caused due to COPD is higher in women as compared to men. It can be because women’s lungs are more vulnerable to lung diseases. Estrogen may play a role in the worsening of lung disease in women.

How is COPD Related with Asthma?

COPD is a collection of disease and refractory asthma is a part of it. Thus, it is possible for a person to suffer from both COPD and asthma. It is known as asthma-COPD overlap syndrome (ACOS). Symptoms of asthma and COPD are often similar. At times, asthmatics might not realize that they have COPD. Asthma is triggered by allergens, and these allergens can make COPD symptoms worse. If these symptoms are left untreated, an asthmatic has higher chances of developing COPD. COPD and asthma are not the same, but COPD can be caused by asthma. COPD can be developed due to long-term exposure to certain environmental risk factors, often at workplaces. This same risk factor can also be a cause of occupational asthma.

To diagnose COPD or asthma, spirometry is a common test, and the doctor will ask the patient’s family history too. Asthma can be managed but COPD is a progressive disease and its symptoms will only get worse. However, after medications, the progression of COPD can slow down. There is no cure for both asthma and COPD, but treatment aims to manage symptoms and have a better quality of life with these conditions. Early diagnosis can help to improve the overall function of the lungs.

Complications in Health

Many other health problems accompany COPD. People suffering from COPD are at a higher risk of being diagnosed with any of these conditions:

• Respiratory infections
• Lung cancer
• High blood pressure in lung arteries
• Heart problems
• Depression

COPD requires long-term disease management and it significantly impacts on a person’s lifestyle. Having an action plan for emergencies will help to be prepared. COPD reduces life expectancy but with treatment and management of symptoms, it is more comfortable to live a life with this chronic disease. The doctor will be in the best position to evaluate a person’s health and then give an idea of what to expect.

It’s something that you suffer from because you have been exposed to some factor that causes COPD, for extended periods of time. Smoking is the most common cause of COPD.

Most people with COPD, have at least some history of smoking. Even people who do not smoke can suffer if they keep breathing in someone else’s smoke However, not all smokers get COPD. COPD can also occur in people who have long term exposure to lung irritants either at home or at workplace.

Some of these harmful lung irritants include fumes from cooking stoves or room heaters. Individuals who have worked for many years in places where the air is very dusty, smoky or polluted like coal mines and industries such as cement, textiles, chemicals and electro-plating of jewellery are also at risk of COPD. In rare cases, a person who has never smoked or had long-term exposure to lung irritants can get COPD due to a genetic disorder that he/she is born with

Over time, breathing in tobacco smoke or other harmful particles irritates the airways and affects the lungs’ stretchy fibres.

COPD is most common in people older than 40, because it usually takes years for the lung damage to cause Symptoms of COPD.

By the time clear symptoms show up, it may have already damaged your lungs. Sometimes, symptoms may be mistaken for other diseases or ageing. So, it is important to watch out for symptoms of COPD specially if you are at high risk of COPD. The most common
ones include –

• Occasional shortness of breath/breathlessness, especially after exercise
• Long-lasting or recurrent cough
• Mucus (phlegm) production

The above symptoms worsen with time. If not treated early, COPD may cause breathlessness while doing simple tasks such as getting dressed and eating. Sometimes, breathing takes an extra effort and you may find that you’re losing weight and getting weaker.

It is essential to diagnose the symptoms of COPD because leaving them untreated or misdiagnosed can worsen the condition. The treatment can only slow down the progress of the disease. Appropriate diagnosis will lead to the suitable treatment needed to manage and control the symptoms. There is no single test to confirm the diagnosis of COPD.

Though there is no cure for COPD, treatments are available, to help a person suffering from COPD to lead a better life. Often, people might not recognize or experience COPD symptoms in the initial stage of the disease. As COPD is a progressive disease, the symptoms worsen over time. It is not until later that these symptoms become unavoidable, and that is when a person might consider going through diagnosis. A person must not wait until the symptoms get worse, because times are valuable for treatment and with early diagnosis, it is possible to slow down the progression of the disease quickly.

Who Should Get Tested?

Anyone with age ≥40 years and following symptoms must consider getting tested for COPD:

• Long-term exposure to irritants such as smoke, fumes, chemicals, air pollution, biomass smoke, etc.
• Chronic, productive coughing
• Wheezing
• Shortness of breath (Dyspnea)
• Chest tightening

Also, if a person has a family history of COPD or is a smoker, it is important to get tested. To diagnose COPD or the two diseases under it, chronic bronchitis and emphysema, the doctor may ask some questions. The doctor needs to gain information about the causes and symptoms of the condition, which will help in diagnosing the disease. Here are a few questions the doctor may ask:

• If there is any history of smoking
• What are the symptoms experienced and how often
• In what situation and what time do the symptoms occur or worsen
• If there is a family history of any lung diseases
• Can recommend few, simple breathing tests
• If the person has exposed to chemicals, dust, or fumes for a long-term
• If coughing is chronic and there is an excess of mucus secretion

Tests for Diagnosing COPD

After a series of these questions, a thorough physical examination, and recording the medical history, the doctor may recommend some tests to confirm the diagnosis of COPD. Mentioned below are the various tests available for COPD diagnosis:

• Spirometry– This is an easy test that can help in confirmation of COPD. A device called spirometer is used for this test. A person is asked to blow out all the air from his lungs, into the mouthpiece of the spirometer. This test measures the amount of air a person can blow out in the first second, and the amount of air a person can completely blow out of his or her lungs. These two numbers are denoted as Forced Expiratory Volume (FEV1) and Forced Vital Capacity (FVC), respectively. A spirometry test can also help to determine the severity of COPD. The results are compared to other people’s results of the same, age, gender and height.
• Peak Flow Test – A peak flow test can help to measure how quickly a person can blow air out of the lungs. This test is often also used for the diagnosis of asthma. This test is done with the help of a peak flow meter. It requires, blowing as hard as possible into the peak flow meter. A person must repeat this process three times, and the highest of the three readings is considered to be the personal best.
• Chest X-Ray – A chest X-ray can be done to detect any problem in the lungs, which might have caused symptoms that are similar to COPD. A chest X-ray can help to identify lung cancer or chest infections. It can show changes in the lungs, or identify any complication that stems from heart-related problems. Images of an X-ray might not confirm the diagnosis of COPD if the disease is in the initial stage, but it may show flattened diaphragm, enlarged lungs or air pockets (bullae).
• CT Scan – A chest computed tomography or a CT scan, is helpful in COPD diagnosis and it can determine if the disease is worsening. It can help to identify changes occurring due to COPD such as enlarged arteries of the lungs. This test will also help to know if a person is suffering from emphysema, and at an earlier stage as compared to an X-Ray. It is sometimes used to measure the severity of emphysema within the lungs. The images of a CT scan can further help to know if the symptoms are caused due to any other condition of the heart or lungs.
• Blood Tests – A blood test can identify other condition such as iron level (anaemia) or the high level of red blood cells in the blood (polycythaemia) which can be the reason for a person to experience symptoms similar to COPD.

Another important test is to know if the person has the rare genetic condition called Alpha 1 Antitrypsin Deficiency, as it might be the cause of a person being diagnosed with COPD. This is also done with a blood test.

Arterial blood gas test is done to measure the levels of oxygen and carbon dioxide. It helps to determine the severity of COPD and if oxygen therapy is needed. This is done through a blood test

• Sputum Examination – If a person is experiencing productive cough (cough with mucus) doctor can ask for a sputum test to be done. Examining the sputum helps to know the cause of symptoms. Sputum examination can help to identify lung cancer or bacterial infection. This test can be beneficial in diagnosing COPD.
• An Echocardiogram – This test is done to mainly determine if the shortness of breath is caused due to a heart problem as opposed to a lung problem. The doctor might recommend an echocardiogram (ECG or EKG). As the disease progresses the shortness of breath can lead to cardiac issues such as heart failure, heart attack and abnormal heart rhythm. An EKG can help to determine any disturbance in the heart rhythm, and it can measure the electrical activity of the heart.

Things To Keep In Mind Before COPD Diagnosis Testing

Before going for these tests, one must consult with their doctor about the medications they are currently taking. It is better to talk to the doctor, as before spirometry or EKG tests, things like, caffeine, smoking or even exercise might affect the test results. It is necessary to follow the pre-test instructions for accurate results. Some of the above mentioned tests might give results instantly, such as spirometry and peak flow test, whereas other tests may take a couple of days or a couple of weeks. Getting accurate test results is essential for diagnosing the condition and following an effective treatment plan based on test results.

The accurate results of diagnosis will further help the doctor and the patient to have a proper plan of controlling and managing the symptoms of the condition. Also, each person has different symptoms and level of severity; therefore, suitable medications are to be taken, and custom-made action plan should be formed with the doctor’s guidance. Regular reviewing and monitoring the condition becomes necessary as COPD worsens with time, and signs of the progression slowing down means that the medications are effective.

Having COPD does not mean you cannot lead a full life. With the right medication, a proper diet and lifestyle changes you can achieve good symptom control and quality of life.

Say no to smoking

If you’re a smoker, stop smoking. This is the single most important lifestyle change you need to make. Staying away from smoking, no matter how long you have had the habit, helps reduce the damage to the lung tissues. Now, there are products that can help you quit smoking. Your doctor can tell you about these.

Avoid other lung irritants

Apart from smoking, there could be other factors that are irritating your lungs such as second-hand smoke, chemical fumes and dust, which should be avoided.

Take the right medication regularly

Medications can reduce symptoms and cut down on flare-ups. COPD medication helps the airways in 2 ways – widening them and reducing the swelling. All the latest medication for COPD are highly effective, and they help improve your quality of life. Most of the medicines are available in an inhalation form – as inhalers are safer. One needs to take the medication regularly (as the doctor prescribes) to control the symptoms.

Sometimes, COPD can cause the oxygen levels in the blood to drop. Before you start getting tense about it, this phenomenon can be easily tackled with supplemental oxygen.

Vaccines

People who have COPD have difficulty clearing their lungs of bacteria, dusts and other pollutants in the air and are therefore more likely to get lung infections, that may cause further damage to the lungs So you may need to get a flu vaccine every year.

To keep it under control and manage it effectively, you need to follow your doctor’s advice thoroughly. The symptoms may not entirely go away, however, with proper treatment and lifestyle changes you can continue living your life to the fullest.

Active lifestyle

Activities such as walking or yoga can help strengthen your respiratory system, which basically means you can breathe better.

There are no specific dietary restrictions for controlling COPD, however, it is important to follow a wholesome diet for your overall health. Moreover, with a healthy diet and regular exercise, there’s no reason for COPD to cause you more trouble.

Pulmonary rehabilitation program

it’s a formal program where a team of specialists  help you build your fitness and breathe as well as you possibly can.  The specialists — ranging from dieticians to social workers guide you on managing your problem, by providing counselling teaching breathing exercises help in quitting smoking, using the inhaler and other medications correctly and eating a healthy diet.

Be prepared

Ensure that you always have emergency contact information in a place where you can access it. It might even be prudent to stick a copy of your emergency numbers, medicines and doses in a place you frequent regularly – like the refrigerator, and your phone.

If breathing becomes difficult, go to your doctor or to a hospital immediately, as it could be an emergency.

It can be a relief to talk to others who understand – join the Breathefree community and talk to thousands of people who have conquered their breathing problems.