Chronic Obstructive Pulmonary Disease (COPD) | کرونِک آبسٹرکٹِو پلمونری ڈزیز

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Chronic Obstructive Pulmonary Disease (COPD) | کرونِک آبسٹرکٹِو پلمونری ڈزیز

Chronic Obstructive Pulmonary Disease (COPD)

We all have a pair of lungs, one on each side of the chest.  Air is inhaled through the nostrils or mouth which travels down from trachea (wind pipe) into the lungs through the tubular branches called bronchi.  The bronchi further breaks down into smaller branches  called bronchioles which in the  end open in the small microscopic sac like structure referred as alveoli, where the oxygen absorption in blood occurs and carbondioxide comes out from the blood.


Chronic obstructive pulmonary disease (COPD) is a respiratory condition that cause congestion or restriction in air flow and makes breathing difficult.

Commonly COPD is of two main types: Chronic bronchitis and Emphysema

Chronic bronchitis occurs due the inflammation and swelling in the inside lining of the bronchi resulting in too much mucus secretions that makes breathing difficult.

Emphysema is caused by the gradual damage of alveoli (air sacs) making breathing difficult.

Most patients suffer with both types of COPD at the same time.  This disease progresses over the years and becomes more problematic overtime.

Understanding how the lungs are affected is important to understand COPD.  When we  breathe in, the air travels down the trachea (wind pipe) and into the lungs through bronchial tubes (two tubes at the top of the lungs).  These tubes divide into smaller tubes similar to a tree without leaves (bronchioles).  At the end of each bronchiole are alveoli (sacs that look like bunches of grapes).  There are very small blood vessels (capillaries) within the alveoli and these are what take oxygen into the bloodstream.

The alveoli and bronchioles are naturally flexible in structure  to be able to inflate with air , but when the patient has COPD, they are partially collapse and lose their stretchiness, trapping some air in the lungs when air is breathe out.

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There are a variety of symptoms associated with this condition, including:

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  • Shortness of breath more noticeable with exercise or walking
  • Chest tightness
  • Chronic cough with sputum
  • Wheezing
  • Frequent respiratory infections
  • Excess mucus upon waking up in the morning
  • Fingernail bed or lip blueness
  • Lack of energy

COPD is mainly caused by continuing exposure/ contact to irritants or substances polluting the air, that includes:

  • Air pollutants
  • Chemical fumes
  • Dust particles

These substances affect or damage the inside lining of the lungs and airways.

Tobacco smoking is the most common cause of COPD; it is estimated that about 80% of COPD cases occurs in long-time smokers.  Airway blockage is the main aspect of this disease and these are caused by:

  • Chronic bronchitis: This is characterized by the bronchial tubes becoming narrowed and inflamed (irritated and swollen).  These tubes get even more narrow because the lungs also produce more mucus (sticky substance).  In an attempt the clear the airways, a chronic cough develops.
  •  Emphysema: The alveoli are little sacs and the stretchy fibers and their walls are very fragile.  COPD takes advantage of this fragility and destroys them.  This impairs the airflow out of the lungs due to the airways collapsing upon inhaling. 

Alpha-1-antitrypsin deficiency is responsible for about one percent of cases of COPD.  This is a genetic disorder characterized by low level of alpha-1-antitrypsin, a type of protein.  This protein is secreted into the bloodstream after being created in the liver and it works to protect the lungs.  In some cases, further lung damage can be prevented by replacing the missing protein.

Risk factors for COPD include:

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  • Tobacco smokers and people exposed to tobacco smoke
  • Industrial workers who are exposed to certain chemicals and dust
  • Genetics (some cases are caused by an alpha-1-antitrypsin deficiency)
  • Being at least 35 years of age

This condition is commonly misdiagnosed. If a doctor suspects this condition, the following tests may be recommended:

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  • Chest X-ray: This can help to rule out other lung conditions. It can also show emphysema.
  •  Spirometry: This test will determine how well the lungs are working
  • Arterial blood gas analysis: This shows how well the lungs are removing carbon monoxide and bringing oxygen into the blood.
  •  CT scan: This can determine whether or not you are a surgical candidate for COPD and it can detect emphysema. It may also be used to rule out lung cancer.
  •  Pulmonary function testing: Patient is asked to blow into a machine to see how fast you can get air out of your lungs and how much air you can hold in them. It can be used for early-stage COPD and it is also useful to track the progress after diagnosis.

There are many medications available that may help to reduce complications and treat the symptoms of the disease.  However, COPD symptoms can be largely reduced or controlled by quitting smoking.

Medications may include:

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  • Bronchodilators: These medications work to relax the muscles that surround the airways. This can help to make breathing easier and reduce shortness of breath and coughing.
  •  Steroids: These medicines aid in preventing attacks and reduce airway inflammation. They are not suitable for every patient.  They can be given as inhalers or oral tablets.
  •  Antibiotics: These are necessary when a bacterial lung infection occurs, such as pneumonia.

Some patients may require oxygen for breathing support when the blood oxygen levels is low. 

COPD is a serious condition especially in elderly patients and it can lead to complications, when not properly treated:

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  • Respiratory infections: Having COPD increases the risk of infections, such as the flu, colds and pneumonia.
  •  Depression: This condition can impact quality of life and this may cause depression in some people.
  •  High blood pressure: The arteries that feed the lungs can be impacted causing pulmonary hypertension.
  •  Heart problems: It is not understood why, but the risk of heart problems is increased with COPD.
  •  Lung cancer: Those who smoke with this condition have a higher risk of lung cancer.

COPD is something people can live with and there are measures that can slow down lung damage, including:

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  • Control your breathing:   There are different techniques to aid in controlling breathing.  A respiratory therapist or your doctor can help with things like teaching you relaxation techniques and breathing positions.
  •  Exercise regularly:    Exercise can seem very difficult with this condition, but it does help to strengthen respiratory muscles and improve endurance.
  •  Avoid pollution and smoke:    Do what you can to avoid areas that are known to be smoky and polluted.
  • Clear your airways: Drinking plenty of water, controlled coughing and a humidifier helps to keep airways clear.
  •  Eat a healthy diet:    This promotes better overall health and helps to improve strength and energy.
  •  Get regular checkups:    Your doctor needs to see you on schedule even if you are feeling great to keep a close eye on your condition.
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