CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Is a lung ailment that is characterized by a persistent blockage of airflow from the lungs Chronic obstructive pulmonary disease (COPD) is a life-threatening lung disease that interferes with normal breathing it is more than a smokers cough. Diseases that fall under the scope of COPD include emphysema , chronic bronchitis and bronchiectasis.

EPEDEMIOLOGY:
An estimated 64 million people have COPD worldwide in 2004. (1) More than 3 million people died of COPD in 2005, which is equal to 5% of all deaths globally that year. Almost 90% of COPD deaths occur in low- and middleincome countries. The disease now affects men and women almost equally, due in part to increased tobacco use among women in high-income countries. Total deaths from COPD are projected to increase by more than 30% in the next 10 years without interventions to cut risks, particularly exposure to tobacco smoke.

Risk factors:
COPD is preventable. The primary cause of COPD is tobacco smoke (including second-hand or passive exposure). Other risk factors include: indoor air pollution (such as solid fuel used for cooking and heating); outdoor air pollution; occupational dusts and chemicals (vapors, irritants, and fumes); frequent lower respiratory infections during childhood. Total deaths from COPD are projected to increase by more than 30% in the next 10 years unless urgent action is taken to reduce underlying risk factors, especially tobacco use.

Who is at risk?

At one time, COPD was more common in men, but because of increased tobacco use among women in high-income countries, and the higher risk of exposure to indoor air pollution (such as solid fuel used for cooking and heating) in lowincome countries, the disease now affects men and women almost equally.

TYPES OF COPD

A. EMPHYSEMA

It is a common type of COPD in which the alveoli, or air sacs of the lungs, become damaged causing them to enlarge and burst. Because the air sacs are the cells in the lungs where oxygen and carbon dioxide are exchanged, damage in this area makes it difficult for people with emphysema to expel air from their lungs. This causes a build up of carbon dioxide in the body.

Emphysema is an irreversible, end-stage process that progresses slowly over many years. Currently, there is no cure, but treatment of emphysema may improve quality of life. In 2005, 3.8 million people in the United States were diagnosed with emphysema. Of those, 54.4% were male and 45.6% were female.

PRIMARY CAUSES:

Smoking
Remains the major cause of emphysema. Cigarette smoking damages the cilia in the lungs which normally help clear away mucus and secretions. This creates blockage in the airways. Cigarette smoke also causes inflammation and irritation in the lungs leading to an increase in mucus production. Too much mucus in the lungs places you at an increased risk for lung infections, as mucus provides bacteria with the perfect hide-away.

 Air Pollution
Also plays a role in the development of emphysema. Like that of its damaging counterpart smoking, air pollution causes airway inflammation and irritation that eventually destroys healthy lung tissue. You may be surprised, however, to learn that even indoor air can be polluted.

 Deficiency of the enzyme, alpha-1-antitrypsin Those who are afflicted with alpha-1antitrypsin deficiency are susceptible to irritants in the environment such as smoking, second-hand smoke, air pollution and allergens that, over time, cause symptoms of chronic obstructive pulmonary disease such as emphysema.

Signs and Symptoms:

The primary symptoms of emphysema are: Shortness of breath Rapid breathing Wheezing Chronic cough, with, or without, sputum Decreased exercise tolerance Loss of appetite leading to weight loss Barrel chest

Eventually, those who suffer from emphysema may progress to respiratory failure which occurs after a slow, insidious disease process.

Complications:
Frequent infection of the upper respiratory tract (airways).

Pneumonia (lung infection). Respiratory failure. Heart failure. Death.

Diagnostic Testing
The patient's reported symptoms and history provide the initial

clues upon examination. Diagnostic tests include:

Chest X-rays
Pulmonary Function Tests Arterial Blood Gases Complete Blood Count

Treatment Options
The major objective of treatment of emphysema is to improve the quality of life, slow the progression of the disease and treat the airways to relieve their apparent lack of oxygen. Treatment options include:

Oxygen Therapy
1-2 litres per minute

Bronchodilators & Aerosol therapy