COPD (Chronic obstructive pulmonary disease) is an incurable disease and the fourth leading cause of death in the world, and yet it is not well known. Let’s find out what it is and how to prevent it.
Chronic obstructive pulmonary disease is a progressive pathology that effects the bronchi and the lungs and is characterized by progressive airflow limitation that makes breathing difficult. The main symptoms are a deep, productive cough with phlegm and dyspnea (shortness of breath).
COPD affects approximately 20% of adults over 40 worldwide and there is a higher incidence in smokers as they get older. Globally, the disease is steadily increasing mostly due to global pollution and the rise in the number of chain smokers in developing countries. Death rates are currently around 3 million people per year, making it the fourth leading cause of death in the world, and according to the most recent calculations, it will become the third leading cause of death in the world in 2030, right behind cardiovascular diseases and tumors.
Around 50% of patients with COPD die within 10 years of diagnosis. The disease can be prevented and treated, but remains incurable.
Stages of COPD
There are four stages of COPD:
- Mild: frequent, chronic cough with phlegm. Slight limitations to breathing.
- Moderate: increased limitations in breathing, dyspnea, coughing and bronchial secretion. It may take weeks to heal from a cold.
- Severe: coughing with bronchial secretion becomes even more frequent and shortness of breath makes it impossible to carry out some everyday activities.
- Very severe: shortness of breath is present even during rest, making it impossible to carry out even simple everyday activities such as eating, bathing and getting dressed. Relapses are frequent and increasingly more serious, increasing the risk of hospitalization and death.
The main causes are:
- Smoking. Chain-smoking is the number one cause. This also includes secondhand smoke. The relationship is ruthlessly proportional. The more smoke a person inhales, the more damage is done to lung tissue. Symptoms normally progress more rapidly in patients that continue to smoke or are subjected to secondhand smoke.
- Asthma and other respiratory diseases.
- Air pollution (smog and dusts from the environment, vehicle emissions, heaters, air-conditioning units, etc.)
- Chemical products, dust, smoke. Chemical fumes, dusts, chemical substances (i.e. silica, cadmium and products of combustion). People can be exposed to these substances at work or at home.
- Respiratory tract infections (bronchitis, pneumonia, pleurisy).
- Genetic predisposition. There is an extremely rare genetic disease known as alpha-1 antitrypsin deficiency that can cause the disease.
Recently, zinc has also been found to have a role in the onset of the disease.
Treatment cannot cure the disease, but it can:
- Alleviate the symptoms
- Treat complications
- Greatly reduce disability
For smokers, the first step in treating the disease is to quit smoking. This is especially effective in the first stages of COPD. Quitting could impede some of the first changes the body goes through and slow down the rate of decline in lung function in successive stages.
Other treatments, many that are present within Patient Support Programs, include:
- Environmental changes. Necessary in cases of exposure to harmful environments.
- Drugs. Normally bronchodilators are prescribed. For the treatment of acute infections, antibiotics may be necessary. Corticosteroids are used to reduce inflammation in the airways. For relapses, an oral corticosteroid called prednisone is often prescribed.
- Physical activity. Regular exercise increases resistance, even though it does not directly improve lung function.
- Correct nutrition. A balanced diet helps improve resistance to infection. Drinking enough fluids can help keep mucus watery and easy to drain
- Supplemental oxygen.If the lungs are not bringing enough oxygen into the blood, oxygen therapy can increase the ability to exercise and relieve eventual heart failure.
- Lung-volume reduction surgery. This surgery removes the most severely diseased portions of the lungs, allowing less damaged areas to expand better. The long-term effects of this procedure, however, are still unknown.
- Lung transplants or heart-lung transplants. Transplants are rarely an option and only in very serious cases of COPD.
Defense against COPD: prevention and early diagnosis
As can be predicted, in order to prevent the onset and evolution of COPD, exposure to tobacco smoke, dusts in the workplace and internal and external environmental pollution must be avoided.
Given that the disease progressively worsens, early diagnosis is equally important. When should you suspect the onset of COPD? The following is a list of characteristics and symptoms to consider:
- Over 40 years old
- Continual shortness of breath that worsens with physical activity
- Chronic cough, even without phlegm, generally in the mornings for at least 3 months during each of 2 consecutive years
- Chronic production of phlegm
- History of exposure to risk factors (normally cigarette smoke)
- Familial disposition
- Rapid breathing
- A bluish discoloration of the skin, lips or nails
- Development of a barrel chest
- Use of neck muscles to breathe
- Abnormal sounds
- Signs of heart failure (swollen legs and ankles)
To improve prevention, early diagnosis and treatment, various associations including the Italian COPD Patients Association have drawn up a manifesto requesting that general practioners take part in the complete management of the disease.
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