COPD stands for chronic obstructive pulmonary disease. Many hear COPD and think of it as a disease unto itself. However, it is really a complex of conditions characterized by airflow limitation that is not fully reversible. This airflow limitation is usually both progressive (gets worse over time) and associated with an abnormal inflammation of the airways. In simpler terms, when trying to exhale or breathe out, the flow of the breath or air is irreversibly obstructed and can never return to its normal state. The airway will always constrict when trying to breathe out. This traps air in the lungs and makes it increasingly difficult to breathe.
There are two different types of emphysema. The first is called genetic emphysema or alpha-1 antitrypsin deficiency. This is not caused by smoking but it is still a devastating disease. The second and more common type, is the one associated with smoking. It is characterized by destruction of the airway and air sacs in the lungs. Inflammation also plays a role in the disease. The airway itself is inflamed (swollen) along with the surrounding mucous glands. So with emphysema, you have inflamed, irritated airways producing lots of secretions, leading down to destroyed air sacs. This is quite a situation and easily points to the reason why COPD places such a burden on our health care system and is the fourth leading cause of death worldwide.
Cigarette smoking is the single largest causative factor in COPD. Other causes include occupational dusts and chemicals, outdoor air pollution and passive second hand smoke exposure. Since COPD is a disease that gradually progresses over time, it could take years before someone actually felt short of breath. Most likely, someone will develop a chronic cough and begin to produce more and more throat secretions (phlegm) before they ever have any airway obstruction. This can offer a unique opportunity to identify smokers at risk for COPD, and then intervene before the disease becomes a major health problem. Conversely, many with COPD may never develop a chronic cough or increase in throat secretions. A disease like COPD may simply manifest differently from one person to the next.
Treatment is founded on a staging of the disease, based on the symptoms one has. The first treatment is simple avoidance. Smoking cessation is the most powerful tool anyone can use. There is evidence to suggest the progression of the disease does in fact, slow down when the causative factor, smoking, has been removed. COPD is perhaps, the most preventable disease because its primary agent of cause is smoking tobacco.
People with COPD often have a high prevalence of other diseases as well. The treatment for COPD may not be the only treatment required. For instance, many with COPD also have cardiovascular disease. Others may have osteoporosis or frequent respiratory infections. Still others may have clinical depression or develop diabetes. The impaired lung function has long-term implications on metabolism and the normal state of many organ systems such as the skeleton, heart, brain and skeletal muscle. The treatment of COPD can become quite complex and in some cases, very difficult, in the presence of some of these other diseases.
Although smoking prevalence has decreased in the past decade, more needs to be done to relieve the weight placed on society and the health care industry. Worldwide, an estimated 8.8% of all deaths (4.9 million) are caused by tobacco. A recent survey from the American Lung Association reveals that almost half of all COPD patients experience shortness of breath while washing and dressing. The survey goes on to report that nearly one quarter of the COPD respondents consider themselves an invalid.