COPD (Chronic obstructive pulmonary disease)
Chronic obstructive pulmonary disease (COPD) is a progressive disease which is characterised by airflow limitation that is not fully reversible. The airflow limitation is associated with inflammation in the lungs caused primarily by tobacco smoke, but also by air pollution or other noxious particles or gases.
COPD is one of the world’s mos t common chronic diseases, with an estimated 600 million sufferers worldwide.
How do you get COPD?
The most common cause of COPD is cigarette smoking, with other types of tobacco smoking also being strong risk factors. Other causes include heavy exposure to occupational dusts and chemicals (vapours, irritants and fumes) and indoor and outdoor air pollution.
How serious is COPD?
The airflow limitation in COPD patients is progressive and often becomes debilitating, or even life-threatening.
The airflow limitation in COPD patients is progressive and often becomes debilitating, or even life-threatening.
Symptoms of COPD include breathlessness, dyspnoea (difficulty breathing), cough, chest tightness and increased secretion of sputum. Many patients are kept awake at night by their symptoms.
In addition to their everyday symptoms, patients with more severe COPD suffer acute exacerbations of symptoms or episodes of worsening of symptoms requiring medical intervention which often require hospitalisation. Infection and air pollution are the most common causes of an exacerbation.
The main symptom of an exacerbation is increased breathlessness, often accompanied by wheezing, chest tightness, increased cough and sputum, and fever. Exacerbations may also be accompanied by non-specific complaints such as malaise, insomnia, fatigue, depression, and confusion. Exacerbations tend to result in worsening of baseline symptoms, with some patients never completely recovering from an exacerbation.
GOLD - the Global Initiative for Chronic Obstructive Lung Disease, endorsed by the World Health Organisation and the US National Heart, Lung and Blood Institute - identifies four stages of COPD:
- Stage 1 refers to mild COPD. At this stage, there is mild airflow limitation, but patients may be unaware that their lung function is abnormal.
- Stage 2 refers to moderate COPD. By this stage the airflow limitation is causing symptoms like shortness of breath on exertion. Patients usually seek medical attention at this stage.
- Stage 3 refers to severe COPD. By this stage, airflow limitation is severe. Patients usually experience repeated exacerbations that almost always have an impact on patient's quality of life.
- Stage 4 refers to very severe COPD. By this stage, airflow limitation is severe and chronic respiratory failure which may lead to complications involving the heart.
How long does COPD last?
There is no cure for COPD, but treatment can help patients manage their condition. The average stay in hospital for an acute exacerbation is approximately ten days.
How is COPD treated?
Management of COPD requires a long-term therapeutic approach:
- Stopping smoking is the single most effective step in slowing the progression of the disease.
- Other risk factors should also be avoided.
- Drugs help to control symptoms, while rehabilitation programs and physiotherapy may be useful to clear sputum and improve exercise tolerance and health-related quality of life.
- Patients with severe disease often require a variety of treatment approaches.
GOLD recommends that patients with mild (Stage 1) COPD should be treated with a bronchodilator on an as-needed basis to reduce symptoms. Patients with moderate-to-very severe COPD (Stages 2 to 4) should receive a bronchodilator. Inhaled glucocorticosteroids may be added (Stages 3 and 4) if they have a lung function response to glucocorticosteroids, or repeated exacerbations requiring medical intervention.
Last Updated: 4/22/2008
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