Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease or COPD is a progressive lung disease that makes it difficult to breath. Progressive because the disease worsens over time. It is a collection of lung diseases, which includes chronic bronchitis, emphysema and chronic obstructive airways disease. COPD involves inflammation and thickening of the airways and also destruction of the tissue of the lung where oxygen is exchanged.

To understand the effect of COPD on the lungs and breathing, it becomes extremely important to first understand how the lungs work? Every time a human body breathes in, air passes through the windpipe into the lung airways called bronchial tubes. In the lungs, these bronchial tubes branch into thousands of smaller tubes called bronchioles. At the end of these bronchial, are air sacs called alveoli, which are like little balloons. When the body breathes in, these sacs stretch and get filled with air, and once the body breathes out, they shrink back down. The walls of these air sacs are filled with tiny blood vessels called capillaries. When the air sacs are filled with air, oxygen goes into the capillaries, which further carries it through the blood stream to all parts of the body. At the same time, carbon dioxide (a waste material) passes out of the capillaries into the air sacs and then the body breathes out.

COPD is a condition in which the bronchial tubes become inflamed and narrowed and the air sacs get damaged. Smoking cigarettes is the most common cause of lung injury. As the lungs become more damaged over time, the difficulty in breathing increases. If the damage becomes severe, it may result in disturbance to the oxygen flow in the bloodstream make it difficult to get rid of the excess carbon dioxide.

COPD causes the following changes in the lungs and airways:

• Air sacs and airways lose their ability to stretch
• The walls of the air sacs are destroyed
• The walls of the airways become thickened and inflamed
• Airways become clogged with mucus (a slimy substance)

There are two main forms of COPD:

• Chronic Bronchitis – the lining of the airways is constantly irritated and inflamed. This causes the lining to thicken. Lots of thick mucus forms in the airways, making it hard to breathe.
• Emphysema – the walls between many of the air sacs are damaged. As a result, the air sacs lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. If this happens, the amount of gas exchange in the lungs is reduced.

Both forms of COPD cause damage to your airways and interfere with the absorption of oxygen and the release of carbon dioxide.

How severe is COPD?

COPD is the third leading cause of death in the US. It causes serious long-term disability and early death. In the United States more than 11 million people are known to have COPD and up to 24 million may have the disease due to some not even knowing it. The number of people dying from COPD is growing. Its prevalence increases with age. Men are more likely to have the disease, but the death rate for men and women is about the same.

Causes

• Smoking – The major cause of COPD is smoking. The poisons in the cigarette smoke weaken the lung’s defense against infections, narrow air passages, cause swelling in air tubes and destroy air sacs. About 80-90% of all COPD is caused by cigarette smoking. Passive smoking may also increase the risk of COPD.
• Genetic – A small number of people have a rare form of COPD called alpha-1 deficiency related emphysema. This form of COPD is caused by an inherited lack of a protective protein in the blood.
• Occupations – Research suggest that numerous occupations are linked with a possible increases chance of getting COPD –
  • Agriculture
  • Brick making
  • Mining
  • Construction
  • Plastics
  • Petroleum
• Toxic Chemicals – Exposure to toxic chemicals such as silica and cadmium
• Environmental Factors – Air pollution may be an additional risk factor for COPD.

Symptoms

Symptoms of chronic obstructive pulmonary disease (COPD) usually develop over a number of years, and hence the individual may not be aware you have the condition. COPD does not usually become noticeable until after the age of 35 and most people diagnosed with the condition are over 50 years old.

Symptoms include the following:

• Cough, usually worse in the mornings and productive of a small amount of colorless sputum
• Acute chest illness
• Breathlessness: The most significant symptom, but usually does not occur until the sixth decade of life
• Wheezing: May occur in some patients, particularly during exertion and exacerbations
• Weight loss
• Extreme tiredness
• Swollen ankles

The symptoms may worsen in the winter season. These symptoms may not always caused by COPD, but if the individual has them, it’s advisable to diagnose it.

Severe Symptoms of COPD

• Blue or gray lips or fingernails (signs of low blood oxygen)
• Lack of mental alertness
• Rapid heartbeat
• Difficulty breathing and talking
• Symptoms get worse

Treatment

• Conventional Treatment

Conventional treatment depends on the cause and the severity of the symptoms of COPD. The first and the most essential step for smokers with this condition id to ‘Quit Smoking’. The treatment includes:

• Avoidance of pollutants, lung irritants, and secondhand smoke
• Yearly influenza vaccination and vaccination against pneumonia (usually every five years).Getting the flu or pneumonia may worsen emphysema and its symptoms.
• Bronchodilators – These medications help open constricted airways and are best for mild emphysema. It includes the inhalers albuterol and Atrovent and the drug theophylline.
• Steroids – Steroids can be consumed via inhaler or pill form and reduce inflammation; however, they can have side effects – such as weakened bones and increased risk of high blood pressure and diabetes – when used for long periods of time.
• Antibiotics – Antibiotics can relieve the increased shortness of breath that can occur with respiratory infections such as bronchitis and pneumonia but can increase antibiotic resistance when used continually.
• Supplemental oxygen – Additional oxygen may help people who have severe emphysema with lowered oxygen levels. Supplemental oxygen is an entirely symptomatic treatment, and will not affect the progression of the disease.
• Surgery – In a procedure called lung volume reduction surgery, physicians remove small portions of diseased lung tissue, which may help remaining lung tissue work more efficiently. In extremely severe cases, people with COPD may require a lung transplant.
• Pulmonary rehabilitation – This type of rehabilitation program helps people with COPD learn how to cope with the disease with a combination of education, exercise, breathing techniques, and behavioral intervention.

• How we treat COPD?

At our center we believe in killing the root cause of the disease. We find our comprehensive approach extremely useful for COPD, where we study the life history of the patient and carefully evaluate for every possible trigger in the diet, workplace and home environment. Then testing is performed, including comprehensive allergy testing. Breathing tests may be utilized during allergy testing to help confirm the effect of triggers. Each inhalant, food, or chemical is tested individually at our Center, so patients can often see for themselves the effects of different substances on their breathing capacity.  The treatment includes:

• Quit Smoking
• Mucolytic – Mucolytics are medicines that make the mucus (sputum), which is made in your lungs, less thick and sticky and easier to cough up. These are available as capsules, tablets or oral liquids.
• Restore Anti-oxidant Defense – Long-term exposure to irritants—from smoking in most cases but also from secondhand smoke or environmental pollutants—creates a storm of free radical damage and inflammation that narrows the airways and destroys the alveoli, the tiny, honeycomb-like sacs in the lungs where the capillaries pick up oxygen and release carbon dioxide. So restoring anti oxidant defense becomes a logical treatment option. It includes: CoQ-10 (Product)
  • Glutathione – nebulized glutathione treatments are a tremendous help to stabilize the airway
  • Green tea (EGCG)
  • Resveratrol
  • Vitamin A
  • Vitamin C
  • Vitamin E
• Chinese Herbs – Chinese medicinal mushroom cordyceps, which is nontoxic and may be useful in slowing the progression of chronic lung disease. Cordyceps has also been studied for improving lung efficiency in athletes, and might offer benefits for those with compromised functions. Eucalyptus oil is a common expectorant. Adding a few drops to the humidifier may help you breathe easier.
• Increase dietary sources of carotenes, such as carrots, sweet potatoes, yellow squash and leafy green vegetables
• Omega-3 fatty acids – These help in decreasing inflammation. This may help improve the breathing. For example – flaxseed, soybeans, canola oil, walnuts, and cold-water fatty fish like salmon, herring, mackerel, and sardines.

It may also includes

• Yoga Breathing techniques
• Acupuncture                            

With our dedication and commitment and a lot of help from you as patients, we are able to treat COPD in the best way possible and ultimately help the patient live a healthy life……..