Dr Kumar's BASIC HEALTHCARE FOR ALL
COPD, short for Chronic Obstructive Pulmonary Disease, is a chronic condition or an inflammatory disease of the lungs, in which the alveoli, or the terminal air sacs of the respiratory tract of the lungs, have lost their elasticity and become stretched out and filled with stale air. As a result, the tiny blood vessels in the sacs cannot perform their normal function of picking up a fresh supply of oxygen while getting rid of carbon dioxide and other waste products; thus the breathing process gets laboured and rather inefficient. This disease is progressive, and over a period of time it obstructs the flow of air in the lungs and subsequently causes and results in almost constant difficulty in breathing.
Prolonged exposure to cigarette smoke, gases or particulate
matter can lead to this condition. The condition transcends all age
brackets meaning it can affect anyone from young teenagers to aged adults.
People who contract this disease are at an enhanced probability of
developing cardiovascular complications and and associated pulmonary
Compliance is the ability of lungs and thorax to expand. Surfactant decreases the alveolar surface tension, as seen in cases of premature infants suffering from infant respiratory distress syndrome. At the end of the expiration, compressed surfactant phospholipid molecules decrease the surface tension to very low, near-zero levels. Pulmonary surfactant thus greatly reduces surface tension, increasing compliance allowing the lung to inflate much more easily, thereby reducing the work of breathing. It reduces the pressure difference needed to allow the lung to inflate. The lung's compliance decreases and ventilation decreases too when lung tissue becomes diseased and fibrotic. Alveoli can generally be compared to gas bubble in water, as the alveoli are wet and surround a central air space. The surface tension acts at the air-water interface and tends to make the bubble smaller.
Most patients aren't really aware of their developing symptoms of COPD ... until the lungs have suffered widespread damage, especially if they continue with their smoking routine. The routine symptom is productive coughing (expectorating sputum) ... this is usually accompanied by appreciable breathing difficulty and tight chestedness. Prolonging symptoms include definite weakness, may be accompanied by weight loss as well. Just as in 'bronchitis' there may be frequent exacerbations of COPD bouts. As the disease progresses the frequency of such bouts increases.
The primary cause of emphysema is smoking, although air pollution, occupational exposure to toxic chemicals and gases, chronic bronchitis and other lung disorders, and even an inherited tendency to develop the condition may also be responsible. Diagnosis begins with gathering background information about the patient, especially in regard to smoking or any history of bronchitis and/or asthma. This is followed by a physical examination with particular attention to lung function. A definitive diagnosis required a simple test called spirometry (picture at the top, above), in which the subject takes deep breath and then exhale as much air as he/she can as quickly as possible. The test indicates whether the subject can empty the lungs normally. Other diagnostic studies include lung X-rays, lung scans, and blood studies to check for signs of infection and measure levels of oxygen and carbon dioxide reaching the body's tissues.
Emphysema has no cure as such, but
proper medical treatments can relieve its symptoms, slow the progression
of the disease, and help to delay any impending disability. Drug therapy
usually includes the use of bronchodilators - medications that relax the
airways and facilitate the flow of air in and out of the lungs. These
drugs are usually taken at regular intervals several times a day, rather
than only when symptoms appear. Corticosteroid drugs, in either oral or
inhaled form, may be prescribed to counter lung inflammation, and even
antibiotics may be given, not only to treat airway infections but also as
prophylaxis to prevent them. Annual flue shots (pic below) are a
particularly important preventive measure, as is immunization against
pneumococcal pneumonia, because these illnesses can in fact be
life-threatening for any person who has emphysema. Some severe cases may
even require supplemental oxygen, administered through tube in the
nostrils. This can be administered at home, although hospitalization is
sometimes necessary. An experimental operation in which 20 to 30 percent
of the damaged lung tissue is removed has brought dramatic improvement to
some patients with advanced emphysema. Reducing the size of the distended
lungs allows more room for the remaining tissue to inflate while healing.
Still, the operation doesn't anyhow halt the progression of the disease.