Combitide Starhaler
Combitide Starhaler
Sun Pharma
Sun Pharma

Chronic obstructive pulmonary disease (COPD)

Chronic obstructive pulmonary disease (COPD) is an umbrella term for people with lung disorders including chronic bronchitis, emphysema, or both. In COPD it becomes hard for you to breathe. COPD includes two main illnesses: chronic bronchitis and emphysema. Most people who have COPD have both of these conditions.Normal human lungs have 2 main parts: bronchial tubes (also called airways) and alveoli (also called air sacs). The air moves down your trachea (or wind pipe) through your bronchial tubes and into your alveoli when you breathe. From the alveoli, oxygen goes into your blood while carbon dioxide moves out of your blood.

The lining in your bronchial tubes gets red, swollen, and full of mucus if you have chronic bronchitis. This mucus blocks your tubes and makes it hard to breathe. If you have emphysema, you lose alveoli. This makes it hard for you to get oxygen into and carbon dioxide out of your blood. It also makes it harder to exhale (breathe out).

  • In most cases of COPD, smoking is the cause. There is no doubt about this. The lining of the airways becomes inflamed and damaged by smoking. About 3 in 20 people who smoke one packet of cigarettes (20 cigarettes) per day, and 1 in 4 40-per-day smokers, develop COPD if they continue to smoke. For all smokers, the chances of developing COPD is between 1 in 10 and 1 in 4.
  • In some cases of COPD, air pollution and polluted work conditions cause or make the disease worse. The combined effect of occupational exposure to air pollutants and smoking increases the chances of developing COPD.
  • In a lesser percentage of patients, people have a genetic (hereditary) risk of COPD due to very rare protein deficiencies that can lead to lung, liver and blood disorders. (The condition is called alpha-1-antitrypsin deficiency). Less than 1 in 100 cases of COPD are due to this.
  • Nevertheless, people who have never smoked, rarely develop COPD. (Passive smoking remains, however, a potential cause.)

COPD risk factors include:

  • Tobacco smoke exposure. The most significant risk factor for COPD is long-term cigarette smoking. The more years you smoke and the more packs you smoke, the greater your risk. Pipe smokers, cigar smokers, marijuana smokers and people exposed to large amounts of secondhand smoke also are at risk.
  • Asthmatics patients who smoke. The combination of asthma, a chronic airway disease, and smoking increases the risk of COPD even more.
  • Exposure to dusts and chemicals in some factory workers. Long-term exposure to chemical fumes, vapors and dusts in the workplace can irritate and inflame your lungs.
  • Increasing age. COPD develops slowly over years, so most people are at least 35 to 40 years old when symptoms begin.
  • Genetic makeup. An uncommon genetic disorder known as alpha-1-antitrypsin deficiency is the source of some cases of COPD. Other genetic factors likely make certain smokers more susceptible to the disease.
  • In most cases, cough is the first symptom to develop. It is productive with sputum (phlegm). It tends to come and go at first, and then gradually becomes more persistent (chronic). You may think of your cough as a 'smokers cough' in the early stages of the disease. People become concerned when the breathlessness begins.
  • Exertion or mild activity may lead to breathlessness (shortness of breath) and wheeze. This activity could be as simple as climbing a flight of stairs. These symptoms tend to become gradually worse over the years if you continue to smoke. Difficulty with breathing may eventually become quite distressing.
  • Expectoration of sputum - the damaged airways make a lot more mucus than normal. This forms sputum (phlegm). You tend to cough up a lot of sputum each day.
  • Infections of the lungs are more common if you have COPD. Sudden deterioration of symptoms (such as when you have an infection) is called an exacerbation. Wheezing with cough and breathlessness may become worse than usual if you have a chest infection and you may cough more sputum. Sputum usually turns yellow or green during a chest infection. Chest infections can be caused by bacteria or viruses. Bacteria (which can be killed using antibiotics) cause about 1 in 2 or 3 exacerbations of COPD. Viruses (not killed with antibiotics) are a common cause of exacerbations too, particularly in the winter months. Up to 1 in 3 exacerbations may be caused by the common cold virus.
  • In all other cases, the symptoms of COPD can be more vague. Examples are weight loss, tiredness and ankle swelling.
  • Pain in chest pain and expectoration of blood (haemoptysis) are not common features of COPD. It is possible to have slightly blood-streaked sputum when you have a chest infection. However, chest pain, blood in the sputum or coughing up just blood, should always be reported to a doctor. This is because other conditions need to be excluded (like angina, heart attack or lung cancer).

COPD can be associated with many complications which include:

  • Infections of respiratory tract. People with COPD are more susceptible to colds, the flu and pneumonia. Any respiratory infection can make it much more difficult to breathe and produce further damage to the lung tissue. An annual flu vaccination and regular vaccination against pneumococcal pneumonia help prevent some infections.
  • Raised blood pressure. COPD may cause high blood pressure in the arteries that bring blood to your lungs (pulmonary hypertension).
  • Problems associated with heart. For reasons that aren't fully understood, COPD increases your risk of heart disease, including heart attack.
  • Cancer of lungs and respiratory tract. Smokers with chronic bronchitis have greater risk of developing lung cancer than do smokers who don't have chronic bronchitis.
  • Symptoms of depression. Difficulty breathing can keep you from doing activities that you enjoy. And dealing with serious illness can contribute to development of depression. Talk to your doctor if you feel sad or helpless or think that you may be experiencing depression.

It is common to miss a diagnosis of COPD former smokers are often told they have COPD when in reality they have another less common lung condition. Likewise, many persons who truly do have COPD aren't diagnosed until the disease is far advanced and interventions are less effective.

Presence of symptoms of COPD and a history of exposure to lung irritants especially cigarette smoke can indicate the disease and your doctor may recommend these tests:

  • Pulmonary function tests. Most common test in this category is spirometry. During this test, you'll be asked to blow into a large tube connected to a spirometer. This machine measures how much air your lungs can hold and how fast you can blow the air out of your lungs. Spirometry can detect COPD even before you have symptoms of the disease. It can also be used to track the progression of disease and to monitor how well treatment is working.
  • Chest X-ray. Emphysema, one of the main causes of COPD, can be diagnosed on chest X ray. An X-ray can also rule out other lung problems or heart failure.
  • CT scan. Emphysema can be detected on CT scan and it can also help determine if you might benefit from surgery for COPD. CT scans can also be used to screen for lung cancer, which is more common among people with COPD than it is among those who smoked but didn't develop COPD.
  • Arterial blood gas analysis. In this test, measurement is done to find out how well your lungs are bringing oxygen into your blood and removing carbon dioxide.

COPD treatment aims to help you feel better, control your symptoms, and reduce your risk of complications. Your treatment options include:

  • Smoking cessation: The most important thing you can do is stop smoking if you are a smoker who has COPD. This will help to stop or slow the damage to your lungs and is the only way to keep your symptoms from getting worse. Talk to your doctor about how to stop smoking. The sooner you stop smoking, the better chance you have of living longer and being healthier.
  • Drug therapy: One or more medicines may be prescribed to make you feel better and help you breathe. These medicines may include:
    • Antibiotics: These medicines help treat bacterial respiratory infections, which can make your symptoms worse.
    • Bronchodilators: These medicines help relax the muscles around your airways and may make it easier for you to breathe.
    • Steroids: These medicines may help make it easier for you to breathe, but usually are only used in people who have more severe COPD.
  • Taking vaccination: In general, influenza and pneumonia are the diseases that can be prevented by vaccines. These infections can make your symptoms worse or cause more lung damage. Talk to your doctor about when and how often you should receive vaccines.
  • Oxygen therapy: Oxygen therapy might be needed in some people who have more advanced COPD. You breathe the oxygen through tubes that you put in your nose or through a mask that goes over your mouth and nose.
  • Pulmonary rehabilitation: There are setups available for pulmonary rehabilitation that help you manage your disease by creating a team of health professionals to help you learn about your disease, receive counseling, and create exercise and eating plans tailored to your needs.
  • Surgery: Patients who have very serious COPD may benefit from surgery in rare instances. They might have a lung reduction operation or a lung transplant. These surgeries are usually done only in people who have not done well with other treatments.

You might use a small handheld canister to take inhaled medicines, or you might use a nebulizer machine to deliver a specific amount of medication to your lungs. A nebulizer machine turns liquid medicine into a vapor (like a cloud) that you can breathe. This machine is often used to treat people who have more serious COPD. It also helps people who have trouble using handheld inhalers.

Generally your doctor or his trained staff will tell you how to take your medicine. It is important to follow your doctor's instructions carefully so that your lungs receive the right amount of medicine.

Follow these steps to feel better and slow the damage to your lungs:

  • Breathing control. Discuss techniques for breathing more efficiently throughout the day with professionals. Also be sure to discuss breathing positions and relaxation techniques that you can use when you're short of breath.
  • Clear your airways.mucus tends to collect in your air passages in COPD and can be difficult to clear. Controlled coughing, drinking plenty of water and using a humidifier may help.
  • Exercise regularly. Regular exercise can improve your overall strength and endurance and strengthen your respiratory muscles, although it may seem difficult to exercise when you have trouble breathing.
  • Eat healthy foods. Maintain your strength with a healthy diet. If you're underweight, your doctor may recommend nutritional supplements. If you're overweight, losing weight can significantly help your breathing, especially during times of exertion.
  • Avoid smoke and air pollution. It's important to avoid places where others smoke, in addition to quitting smoking. Secondhand smoke may contribute to further lung damage. Other types of air pollution also can irritate your lungs.
  • Regular follow up is important even if you're feeling fine. It's important to steadily monitor your lung function. And, be sure to get your annual flu vaccine in October or November to help prevent infections that can worsen your COPD. Ask your doctor when you need the pneumococcal vaccine.

Chronic obstructive pulmonary disease (COPD) is an umbrella term for people with lung disorders including chronic bronchitis, emphysema, or both. In COPD it becomes hard for you to breathe. COPD includes two main illnesses: chronic bronchitis and emphysema. Most people who have COPD have both of these conditions.Normal human lungs have 2 main parts: bronchial tubes (also called airways) and alveoli (also called air sacs). The air moves down your trachea (or wind pipe) through your bronchial tubes and into your alveoli when you breathe. From the alveoli, oxygen goes into your blood while carbon dioxide moves out of your blood.

The lining in your bronchial tubes gets red, swollen, and full of mucus if you have chronic bronchitis. This mucus blocks your tubes and makes it hard to breathe. If you have emphysema, you lose alveoli. This makes it hard for you to get oxygen into and carbon dioxide out of your blood. It also makes it harder to exhale (breathe out).

  • In most cases of COPD, smoking is the cause. There is no doubt about this. The lining of the airways becomes inflamed and damaged by smoking. About 3 in 20 people who smoke one packet of cigarettes (20 cigarettes) per day, and 1 in 4 40-per-day smokers, develop COPD if they continue to smoke. For all smokers, the chances of developing COPD is between 1 in 10 and 1 in 4.
  • In some cases of COPD, air pollution and polluted work conditions cause or make the disease worse. The combined effect of occupational exposure to air pollutants and smoking increases the chances of developing COPD.
  • In a lesser percentage of patients, people have a genetic (hereditary) risk of COPD due to very rare protein deficiencies that can lead to lung, liver and blood disorders. (The condition is called alpha-1-antitrypsin deficiency). Less than 1 in 100 cases of COPD are due to this.
  • Nevertheless, people who have never smoked, rarely develop COPD. (Passive smoking remains, however, a potential cause.)

COPD risk factors include:

  • Tobacco smoke exposure. The most significant risk factor for COPD is long-term cigarette smoking. The more years you smoke and the more packs you smoke, the greater your risk. Pipe smokers, cigar smokers, marijuana smokers and people exposed to large amounts of secondhand smoke also are at risk.
  • Asthmatics patients who smoke. The combination of asthma, a chronic airway disease, and smoking increases the risk of COPD even more.
  • Exposure to dusts and chemicals in some factory workers. Long-term exposure to chemical fumes, vapors and dusts in the workplace can irritate and inflame your lungs.
  • Increasing age. COPD develops slowly over years, so most people are at least 35 to 40 years old when symptoms begin.
  • Genetic makeup. An uncommon genetic disorder known as alpha-1-antitrypsin deficiency is the source of some cases of COPD. Other genetic factors likely make certain smokers more susceptible to the disease.
  • In most cases, cough is the first symptom to develop. It is productive with sputum (phlegm). It tends to come and go at first, and then gradually becomes more persistent (chronic). You may think of your cough as a 'smokers cough' in the early stages of the disease. People become concerned when the breathlessness begins.
  • Exertion or mild activity may lead to breathlessness (shortness of breath) and wheeze. This activity could be as simple as climbing a flight of stairs. These symptoms tend to become gradually worse over the years if you continue to smoke. Difficulty with breathing may eventually become quite distressing.
  • Expectoration of sputum - the damaged airways make a lot more mucus than normal. This forms sputum (phlegm). You tend to cough up a lot of sputum each day.
  • Infections of the lungs are more common if you have COPD. Sudden deterioration of symptoms (such as when you have an infection) is called an exacerbation. Wheezing with cough and breathlessness may become worse than usual if you have a chest infection and you may cough more sputum. Sputum usually turns yellow or green during a chest infection. Chest infections can be caused by bacteria or viruses. Bacteria (which can be killed using antibiotics) cause about 1 in 2 or 3 exacerbations of COPD. Viruses (not killed with antibiotics) are a common cause of exacerbations too, particularly in the winter months. Up to 1 in 3 exacerbations may be caused by the common cold virus.
  • In all other cases, the symptoms of COPD can be more vague. Examples are weight loss, tiredness and ankle swelling.
  • Pain in chest pain and expectoration of blood (haemoptysis) are not common features of COPD. It is possible to have slightly blood-streaked sputum when you have a chest infection. However, chest pain, blood in the sputum or coughing up just blood, should always be reported to a doctor. This is because other conditions need to be excluded (like angina, heart attack or lung cancer).

COPD can be associated with many complications which include:

  • Infections of respiratory tract. People with COPD are more susceptible to colds, the flu and pneumonia. Any respiratory infection can make it much more difficult to breathe and produce further damage to the lung tissue. An annual flu vaccination and regular vaccination against pneumococcal pneumonia help prevent some infections.
  • Raised blood pressure. COPD may cause high blood pressure in the arteries that bring blood to your lungs (pulmonary hypertension).
  • Problems associated with heart. For reasons that aren't fully understood, COPD increases your risk of heart disease, including heart attack.
  • Cancer of lungs and respiratory tract. Smokers with chronic bronchitis have greater risk of developing lung cancer than do smokers who don't have chronic bronchitis.
  • Symptoms of depression. Difficulty breathing can keep you from doing activities that you enjoy. And dealing with serious illness can contribute to development of depression. Talk to your doctor if you feel sad or helpless or think that you may be experiencing depression.

It is common to miss a diagnosis of COPD former smokers are often told they have COPD when in reality they have another less common lung condition. Likewise, many persons who truly do have COPD aren't diagnosed until the disease is far advanced and interventions are less effective.

Presence of symptoms of COPD and a history of exposure to lung irritants especially cigarette smoke can indicate the disease and your doctor may recommend these tests:

  • Pulmonary function tests. Most common test in this category is spirometry. During this test, you'll be asked to blow into a large tube connected to a spirometer. This machine measures how much air your lungs can hold and how fast you can blow the air out of your lungs. Spirometry can detect COPD even before you have symptoms of the disease. It can also be used to track the progression of disease and to monitor how well treatment is working.
  • Chest X-ray. Emphysema, one of the main causes of COPD, can be diagnosed on chest X ray. An X-ray can also rule out other lung problems or heart failure.
  • CT scan. Emphysema can be detected on CT scan and it can also help determine if you might benefit from surgery for COPD. CT scans can also be used to screen for lung cancer, which is more common among people with COPD than it is among those who smoked but didn't develop COPD.
  • Arterial blood gas analysis. In this test, measurement is done to find out how well your lungs are bringing oxygen into your blood and removing carbon dioxide.

COPD treatment aims to help you feel better, control your symptoms, and reduce your risk of complications. Your treatment options include:

  • Smoking cessation: The most important thing you can do is stop smoking if you are a smoker who has COPD. This will help to stop or slow the damage to your lungs and is the only way to keep your symptoms from getting worse. Talk to your doctor about how to stop smoking. The sooner you stop smoking, the better chance you have of living longer and being healthier.
  • Drug therapy: One or more medicines may be prescribed to make you feel better and help you breathe. These medicines may include:
    • Antibiotics: These medicines help treat bacterial respiratory infections, which can make your symptoms worse.
    • Bronchodilators: These medicines help relax the muscles around your airways and may make it easier for you to breathe.
    • Steroids: These medicines may help make it easier for you to breathe, but usually are only used in people who have more severe COPD.
  • Taking vaccination: In general, influenza and pneumonia are the diseases that can be prevented by vaccines. These infections can make your symptoms worse or cause more lung damage. Talk to your doctor about when and how often you should receive vaccines.
  • Oxygen therapy: Oxygen therapy might be needed in some people who have more advanced COPD. You breathe the oxygen through tubes that you put in your nose or through a mask that goes over your mouth and nose.
  • Pulmonary rehabilitation: There are setups available for pulmonary rehabilitation that help you manage your disease by creating a team of health professionals to help you learn about your disease, receive counseling, and create exercise and eating plans tailored to your needs.
  • Surgery: Patients who have very serious COPD may benefit from surgery in rare instances. They might have a lung reduction operation or a lung transplant. These surgeries are usually done only in people who have not done well with other treatments.

You might use a small handheld canister to take inhaled medicines, or you might use a nebulizer machine to deliver a specific amount of medication to your lungs. A nebulizer machine turns liquid medicine into a vapor (like a cloud) that you can breathe. This machine is often used to treat people who have more serious COPD. It also helps people who have trouble using handheld inhalers.

Generally your doctor or his trained staff will tell you how to take your medicine. It is important to follow your doctor's instructions carefully so that your lungs receive the right amount of medicine.

Follow these steps to feel better and slow the damage to your lungs:

  • Breathing control. Discuss techniques for breathing more efficiently throughout the day with professionals. Also be sure to discuss breathing positions and relaxation techniques that you can use when you're short of breath.
  • Clear your airways.mucus tends to collect in your air passages in COPD and can be difficult to clear. Controlled coughing, drinking plenty of water and using a humidifier may help.
  • Exercise regularly. Regular exercise can improve your overall strength and endurance and strengthen your respiratory muscles, although it may seem difficult to exercise when you have trouble breathing.
  • Eat healthy foods. Maintain your strength with a healthy diet. If you're underweight, your doctor may recommend nutritional supplements. If you're overweight, losing weight can significantly help your breathing, especially during times of exertion.
  • Avoid smoke and air pollution. It's important to avoid places where others smoke, in addition to quitting smoking. Secondhand smoke may contribute to further lung damage. Other types of air pollution also can irritate your lungs.
  • Regular follow up is important even if you're feeling fine. It's important to steadily monitor your lung function. And, be sure to get your annual flu vaccine in October or November to help prevent infections that can worsen your COPD. Ask your doctor when you need the pneumococcal vaccine.
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