Chronic Obstructive Pulmonary Disease (COPD)

A chronic obstructive pulmonary disease often occurs for the first time between the ages of 35 and 40. However, in many people the disease is only diagnosed after the age of 50.

Chronic obstructive pulmonary disease is a long-term condition that makes breathing difficult and can seriously affect everyday life and quality of life.

The term COPD (chronic obstructive pulmonary disease) is often used to describe this clinical picture. Usually it is a combination of chronic bronchitis and emphysema.

Chronic bronchitis

As the name suggests, this is a chronic (continuous) inflammation of the airways (bronchi) in the lungs. The symptom is a cough that lasts for at least 3 months and is accompanied by sputum.

The bronchi produce excessive mucus to help keep the airways moist. The resulting cough and the narrowing of the airways lead to discomfort and shortness of breath.

Emphysema

In pulmonary emphysema, the alveoli are damaged or painfully overstretched. The oxygen can no longer be transported efficiently into the blood. The air bubbles collapse and can no longer maintain the microscopic airways (bronchioli resparitorii). This leads to breathing difficulties.

What are the symptoms of chronic obstructive pulmonary disease?

The symptoms of COPD often develop slowly over several years. The main symptoms can range from shortness of breath, wheezing and tightness in the chest to coughing with increased sputum.

A doctor uses a variety of factors to determine whether COPD is mild, moderate, or severe. First he finds out what symptoms the patient has. He checks whether the patient is easily out of breath and how much the patient is restricted by the problem in daily life.

Next, he would like to find out whether the patient often suffers from respiratory infections (colds or flu), whether there is chronic sputum and how often the patient has been sick in the past. It is worth noting that patients with COPD often develop respiratory infections.

The serious COPD

Serious COPD may also have other symptoms that could indicate serious lung disease:

• blue discoloration of the skin (cyanosis)
• Water retention, which can lead to swollen feet, ankles, and legs
• Severe tiredness
• Weight loss

What causes chronic obstructive pulmonary disease?

Most of the cases are caused by smoking. Passive smoke exposure, especially in infancy, can also increase the risk of COPD.

Long-term exposure to dust or chemicals at work can also lead to this. In addition, air pollution can also be responsible for the progression of the disease. 

Risk factors

Other risk factors are also possible . For example:

• Lung disease in the family
• Family history of asthma (with chronic disease)
• Childhood lung and respiratory problems

Test and diagnosis options

In order to obtain a diagnosis, the doctor will arrange various tests that are intended to determine the state of health more closely. These tests are more reliable than the patient’s statements made during the medical history.

Of course, it is important to find out whether the patient is an (ex) smoker or whether there is dust, dirt or gas exposure.

Tests that explore the health background are, for example:

• The pulmonary function test. The spirometry test checks lung function. To do this, the patient has to blow into a so-called “spirometer”. The most important measurements for a diagnosis include the values ​​of the vital capacity and the values ​​of the one-second capacity.

• Computed tomography or x-ray of the back. These examinations can indicate COPD. Imaging tests can also help identify other conditions with similar symptoms.
• Arterial blood gas analysis. These tests measure the volume of oxygen and carbon dioxide in the blood. These values ​​help in assessing lung function.

Complications of lung disease

• Anxiety and depression
• Heart failure
• Type 2 diabetes
• Pulmonary hypertension (high blood pressure in the arteries and blood vessels in the lungs)
• Polyglobulia (increased concentration of hemoglobin in the blood)
• Osteoporosis (a condition in which the bones become weaker and more porous, increasing the risk of fractures.)

When should you see a doctor?

If the sick person is or has been a smoker, is older than 35 years and has the following symptoms:

• When there is difficulty breathing and the person is constantly gasping. Often this symptom is noticeable for the first time during physical activity.
• Cough with sputum (coughing up the phlegm) that lasts all day for several days.
• If the person regularly has respiratory infections (cold, flu).

What can be done

The most important thing is to  stop smoking immediately. The cough improves, breathing difficulties decrease, and further respiratory tract injury can be prevented.

However, COPD is considered an ongoing disease for which there is unfortunately no cure. A revision of the already existing damage to the lungs is also excluded. However, there are treatment options that can slow the progression of the disease and improve lung function.