COPD
Overview
Chronic Obstructive Pulmonary Disease (COPD) is a type of obstructive lung disease characterized by long-term breathing problems and poor airflow. The main symptoms include shortness of breath and cough with sputum production. COPD is a progressive disease, meaning it typically worsens over time.
Causes
Tobacco smoking is the primary cause of COPD, with factors such as air pollution and genetics playing a smaller role. In the developing world, one of the common sources of air pollution is from poorly vented cooking and heating fires.
Pathophysiology
COPD is caused by noxious particles or gas, most commonly from tobacco smoking, which triggers an abnormal inflammatory response in the lung. The inflammatory response in the larger airways is known as chronic bronchitis, which is diagnosed clinically when people regularly cough up sputum. In the alveoli, the inflammatory response causes destruction of the tissues of the lung, a process known as emphysema.
Diagnosis
COPD should be considered in anyone over the age of 35 to 40 who has shortness of breath, a chronic cough, sputum production, or frequent winter "bronchitis" and a history of exposure to risk factors for the disease. Spirometry is then used to confirm the diagnosis. In contrast to asthma, the airflow reduction does not improve significantly with the administration of medication.
Management
COPD is a preventable and treatable disease but not curable. It is the fourth leading cause of death in the world. The primary goal of management is to reduce symptoms and improve quality of life. Management strategies include: quitting smoking, vaccinations, rehabilitation, and often inhaled bronchodilators and steroids. Some people may benefit from long-term oxygen therapy or lung transplantation.
Epidemiology
Worldwide, as of 2010, COPD affected approximately 329 million people or nearly 5% of the population. In 2011, it ranked as the fourth leading cause of death, killing over 3 million people. The disease affects men and women almost equally, as there has been increased tobacco use among women in the developed world.