Preventing COPD

Enlarged view of lung tissue showing the diffe...

Enlarged view of lung tissue showing the difference between healthy lung and COPD (Photo credit: Wikipedia)

The incidence of chronic obstructive pulmonary disease (COPD), the third leading US cause of death, is reaching epidemic proportions. It is progressive to death and the leading cause is smoking cigarettes.

Differential diagnosis of COPD from asthma is important. Asthma is most likely in patients if they had airway obstruction or a bad chest in childhood.

COPD is characterised by emphysema or chronic bronchitis both of which are due to narrowing of the airways in the lungs. Noxious chemicals usually from tobacco smoke cause an abnormal inflammation in the lungs. Other pollutants such as dust or chemicals in the environment or workplace have also been implicated as possible causes of lung damage associated with COPD.

Smoking is a major risk factor for COPD and cessation is a major preventative approach. Tobacco smoking contributes 80-90% of the risk of developing COPD. The age of starting relates to mortality as does the total pack years and the current smoking status.
Not all smokers get COPD, but those who are susceptible to cigarette smoke or at risk of COPD and then smoke will cause considerable damage to their lungs. These people can add considerable time to their lifespan but then they may still die of COPD just at an older age.

In those with COPD two factors improve survival and they are smoking cessation and oxygen therapy. All other treatments merely improve quality of life and to prevent
hospitalisations and exacerbations.

Getting people to quit though isn’t easy as the nicotine in cigarettes is extremely addictive. Only a small number will quit on advice from their doctor. Nicotine patches or replacement increase the success rate, but medication, such as a nicotine agonist, bupropion or a nicotine receptor agonist varencicline can improve levels further.

Oxygen therapy is the second important medical intervention for people with COPD and it helps them live longer, with better quality of life if they have respiratory failure. Some patients with COPD have to be on long-term oxygen therapy.

For medical management of COPD symptoms, there are many pharmacologic options such as anti-cholinergics, beta-agonists and corticosteroids. These medicines can be used in combination and are often done so in COPD patients.

In patients who have severe exacerbations, antibiotics are required as there is very high mortality if severe attacks are not treated aggressively.

Prevention of the progression of COPD using lifestyle changes is often limited in its success due to the difficulty in reducing risk factors. Exercise and weight reduction and theoretically effective strategies, but often difficult to institute.

In conclusion, the best preventative COPD strategy is smoking cessation and removal of the individual from any environmental irritants.


2 Responses to “Preventing COPD”

  1. “this is very interesting. thanks for that. we need more sites like this. i commend you on your great content and excellent topic choices.”

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