By Sowmya Srinath, Research Associate

Chronic Obstructive Pulmonary Disease (COPD) is a subdivision of respiratory disease characterized by blockage in the airways or obstruction in the air flow to the lungs. Chronic bronchitis, emphysema, asbestosis, pneumoconiosis and pulmonary neoplasm are few of the diseases that fall under COPD.

COPD is often mistaken for asthma as the symptoms of both these diseases are similar. In most cases, patients of both these diseases suffer from wheezing, coughing and shortness of breath. As asthma is more common and the awareness of COPD is relatively less, COPD patients often go for asthma treatments.

The major causes for COPD are respiratory disorder. Chronic bronchitis occurs as a result of an inflammation or irritation in the bronchi (airways) lungs. When the airway is irritated, thick mucus accumulates in it. During coughing, this mucus is thrown out as sputum. This also leads to tightness of the chest and breathing problems.

Emphysema is a condition within which patients suffer due to loss of elasticity of the lung tissue as well as destruction of the capillaries and structures supporting the alveoli.

Smoking is a major cause of COPD and chain smokers have almost 25 per cent risk of developing COPD. Occupational hazards like exposure to arsenic, zinc, asbestos and other toxic chemicals can lead to COPD

The different stages of COPD are classified as:

Stage 0: People at risk of COPD
             The population suffering from chronic cough and sputum production as well as chain smokers (in most cases) is supposed to be under stage 0.

Stage1: Mild COPD
            This is a condition where people suffer due to limitation in the airflow, but are unaware that they have abnormal lung functions.

Stage2: Moderate COPD
            In this stage people suffer due to shortness of breath on exertion. They usually take medical assistance to solve this problem.

Stage 3: Severe COPD
             In this condition, the airflow limitation is severe, the symptoms are severe and the patients in most cases require supplementary oxygen.

The diagnosis of COPD is in accordance with the symptoms that signify the stage of the disease. It is a very long and complex procedure that involves a series of tests. All these tests are done to avoid confusion with other diseases.

A complete and detailed medical history analysis and physical examination is very important to diagnose the stage of the disease and as well as the various causes for this condition.

The various tests include:

Pulmonary Function testing: These tests determine the breathing ability and habits of the patients. The different types of pulmonary function testing are spirometry, ling volumes and diffusing capacity.

Spirometry measures the amount of air inhaled and exhaled as well as the rate of inhalation and exhalation. Lung volume test provide detailed information about the functioning of the lungs and abnormalities associated with it (if any). Diffusing capacity tests shows the amount of oxygen transferred to blood and

Bronchodilator reversibility testing: This test makes use of medicines and spirometry to check the ease of breathing in the airways by relaxing the tightened muscles. The results of these tests would also help in diagnosis of other respiratory diseases. This would also help the doctor determine the kind of treatments required for the patients.

Chest X-Rays: Chest X-rays would help the doctor determine if the patient is suffering due to symptoms of other diseases like heart failure, asthma etc.

Arterial Blood Gas: This test determines the oxygen level in the blood. This would help the physicians determine the amount of oxygen to be supplied to the patients.

COPD has a variety of treatments for people in different stages of the disease. But it is important to note that COPD is incurable and these treatments are mainly to reduce the symptoms of the disease.

These medicines open the airways by relaxing the tightened muscles in the airways. There are two different types of bronchodilators; short acting and long acting bronchodilators. Both forms of the medicines have to be inhaled through inhalers so that that is sent directly to the lungs. Short acting bronchodilators are usually preferred for mild COPD while long acting bronchodilator is prescribed for severe COPD.

Exercise programs to train patients in order to strengthen the muscles in the airways to reduce the symptoms of COPD can help to ease the breathing of patients.

Patients suffering from severe forms of COPD usually opt for surgeries. The surgeries performed are bullectomy, lung volume reduction surgery and in some cases lung transplant.

In bullectomy, large bullae (air spaces) in the lungs that are formed during the breakage of the air sacs are removed. These bullae usually interfere with breathing and when removed, ease the breathing procedure.

In lung volume reduction surgery the damaged tissue of emphysema patents is removed. This increases the life expectancy of the patient.

Lung transplants are preferred in extreme case where patients are unable to breathe. In this situation, the lung of person is replaced by the healthy lung from a donor.

Oxygen therapy is one of the best ways to treat patients who have low amounts of oxygen in their blood. This treatment involves supplying oxygen from reservoirs where oxygen is stored in either liquid or gaseous form. The devices used to supply oxygen are; concentrators (which separate oxygen from natural air, purifies it and provides to patients), liquid oxygen systems (which have oxygen in liquid form and when converted to gaseous form are supplied to patients) and cylinders with compressed oxygen that is supplied to patients after the patient reaches a normal state.

The incidence of COPD and associated diseases are increasing. Hence there are many organizations and association formed to tackle COPD at a global scale. The Global Initiative for Chronic Obstructive Lung Disease (GOLD), British Lung Foundation and many such international organizations are taking initiatives to spread the awareness of COPD in an effort to reduce incidence and fatalities.