COPD: causes, symptoms, treatment

Did you know, that the fourth most common cause of death worldwide is a lung disease that is often caused by smoking, particularly in developed countries? It is known as chronic obstructive pulmonary disease, or COPD for short. It is estimated that COPD affects around 400,000 people in Switzerland. Every year, around 1.3% of the population falls ill – and around 4,000 people in Switzerland die from this disease every year.

What is COPD?

With COPD, the lungs no longer work properly due to irreparable damage. Firstly, damage occurs in the bronchial tubes, where fine hairs are located that filter and remove harmful particles from the air we breathe.

In people with COPD, these hairs are damaged, causing secretions to accumulate in the bronchial tubes. This leads to the bronchial mucosa becoming permanently inflamed – and therefore thickened. This narrows the airways and restricts the function of the lungs.

Secondly, COPD also damages the alveoli and the tissue around them. This impairs the ability of the alveoli to absorb oxygen from the air and release carbon dioxide into the environment. If this gas exchange is impaired, the blood oxygen level drops.

Together with the narrowing of the bronchial tubes, this makes it more difficult to exhale air and causes the lungs to inflate too much. This leads to shortness of breath with little exertion, for example when climbing stairs.

Symptoms

“The most common symptoms include shortness of breath, usually in the morning, and a chesty cough with phlegm, which is more commonly known as smoker’s cough,” says Professor Silvia Ulrich, who is Head of the Clinic for Pneumology at University Hospital Zurich. The symptoms are exacerbated by a respiratory infection, for example.

What are the initial symptoms of COPD?

Overview of the most important symptoms of COPD:

• Persistent cough, usually in the morning
• Increased mucous production with phlegm
• Noisy breathing
• Deterioration in physical performance
• Increasing shortness of breath; initially under exertion, later also at rest

Causes

Ulrich says that most of those affected by COPD in developed countries are smokers. “One in two older people who smoke develop COPD.”

Whereas in the past many more men smoked and were affected by COPD, today the ratio between men and women has almost equalised, as many more women now also smoke.

Passive smokers and children of parents who smoke can also get sick, which is why you shouldn’t smoke indoors.

Risk factors of COPD

However, on a global scale, around a third of all COPD patients don’t fall ill as a result of smoking. Particularly in developing countries, poor air quality causes COPD. This can be smoke from an open fireplace for cooking in poorly ventilated rooms such as yurts in Central Asia, for example, as Professor Ulrich knows from a recent trip to Kyrgyzstan. “In developing countries, more women than men are affected by COPD, because they cook over the fires.” Their children often also suffer from this illness.

Painters, carpenters and farmers also frequently suffer from COPD, as they are regularly exposed to harmful substances such as dust, chemicals or vapours at their workplaces over long periods of time.

Diagnosis

As chronic obstructive pulmonary disease is often only recognised at an advanced stage, it is important to raise awareness of the symptoms of the disease. The World Health Organisation has therefore developed a risk test to improve the diagnosis and treatment of COPD worldwide. “Anyone who meets several of the criteria should contact their family doctor to do a test to check their lung volume,” says Ulrich.

Classification of severity according to GOLD

Source: pflege.de

* Global Initiative for Chronic Obstructive Lung Disease (GOLD)
** The FEV₁ value (forced expiratory volume in 1 second) is determined by means of a lung function test: The higher the percentage, the more efficient the lung function.

Therapy and treatment

There is no cure for COPD and the lung damage is irreversible. “The most important thing you can do is to quit smoking completely,” says Ulrich. Only symptoms of the disease can be treated with medication and medical equipment.

In cases of chronic oxygen deficiency and cardiac insufficiency, additional oxygen can be administered via small tubes into the nostrils to supply the body with more oxygen.

Inhalers, which widen the airways and make breathing easier, can help with shortness of breath. If the sites of inflammation in the lungs are widespread and the patient’s condition worsens significantly, they can be given cortisone for inhalation.

Depending on the diagnosis, lung surgery may be required to reduce the lung volume.

Bronchoscopic lung volume reduction surgery involves the use of a bronchoscope to insert one-way valves into damaged pulmonary lobes. These reduce the lung volume at the affected areas to provide neighbouring areas with more oxygen. This procedure is only suitable for patients who do not smoke, are of normal weight and whose lung damage is more pronounced in one area than in the rest of the lung.

Keyhole technology is used to remove part of the diseased lung through several small openings in the chest. This also reduces the lung volume and ensures that the less affected areas of the lungs can work better – and thus ease the patient’s shortness of breath.

How high is life expectancy with COPD?

“To improve the course of the disease, it is very important that patients give up smoking,” says Professor Ulrich. It is also important to avoid further complications, such as pneumonia or heart failure. “We therefore recommend that COPD patients get vaccinated against the flu and pneumonia bacteria, known as pneumococci,” adds Ulrich.

The prognosis for COPD also depends on the severity of the disease, getting the right treatment and, above all, whether those affected can quit smoking.

This is because life expectancy with COPD is generally lower for smokers. “On average, around ten minutes of life are lost with every cigarette smoked. This applies to all smokers.”