COPD (chronic obstructive pulmonary disease) is a pathology that is accompanied by inflammation in the organs of the respiratory system. The reasons may be environmental factors and a number of others, including smoking. The disease is characterized by regular progress, leading to a decrease in the functionality of the respiratory system. Over time, this leads to respiratory failure.
Mostly the disease is observed at the age of 40 years and older. In some cases, patients with COPD are admitted to the hospital at a younger age. As a rule, this is due to a genetic predisposition. Also, there is a great risk of getting sick from those who smoke for a very long time.
Risk group
The diagnosis of COPD in adult men in Russia is observed in every third person who has crossed the threshold of 70 years. Statistics allow us to confidently say that this is directly related to tobacco smoking. There is also a clear connection with the way of life, namely the place of work: the likelihood of developing pathology is higher in the case when a person works in harmful conditions and with great dust. It affects living in industrial cities: here the percentage of cases is higher than in places with clean ecology.
More often, COPD develops in older people, but with a genetic predisposition, you can get sick at a young age. This is due to the specifics of the generation of connective lung tissue by the body. There are also medical studies that allow us to argue about the relationship of the disease with the prematurity of the child, since in this case there is not enough surfactant in the body, because of which, at birth, the tissues of the organs cannot correctly crack down.
What do scientists say?
COPD, causes of the disease, treatment methods - all this has long attracted the attention of doctors. In order to have sufficient materials for research, a data collection was carried out, during which cases of the disease were studied in rural residents and urban residents. Information was collected by Russian doctors.
It was possible to identify that if we are talking about those who live in the village, the village, then with COPD, the severe course often becomes ineffectual, and in general, pathology torments a person much more. Often, villagers observed endobronchitis with purulent discharge or tissue atrophy. Complications of other somatic diseases occur.
It has been suggested that the main reason is the low qualification of medical care in rural areas. In addition, it is impossible to do spirometry in villages, which smoking men aged 40 and over need.
How many people know COPD - what is it? How is it treated? What happens with this? Largely due to ignorance, lack of awareness, and fear of death, patients become depressed. This is equally characteristic of both urban residents and rural residents. Depression is additionally associated with hypoxia, which affects the patient’s nervous system.
Where does the disease come from?
The diagnosis of COPD today is difficult, since it is not known exactly why the pathology develops. However, it was possible to identify a number of factors that provoke the disease. Key aspects:
- smoking;
- adverse working conditions;
- climate;
- infection
- protracted bronchitis;
- pulmonary diseases;
- genetics.
About the reasons in more detail
Effective prevention of COPD is still under development, but people who want to maintain their health should have an idea of how various factors affect the human body, provoking this pathology. Realizing their danger and eliminating harmful factors, you can reduce the likelihood of developing a disease.
The first thing that deserves mention in connection with COPD is, of course, smoking. Equally negatively affects both active and passive. Now medicine confidently says that smoking is the most important factor in the development of pathology. The disease provokes both nicotine and other components contained in tobacco smoke.
In many ways, the mechanism of the appearance of the disease during smoking is associated with that which provokes pathology when working in harmful conditions, since here a person also breathes air filled with microscopic particles. When working in dusty conditions, in alkali and steam, constantly breathing chemical particles, it is impossible to keep the lungs healthy. Statistics show that the diagnosis of COPD is more often performed by miners and people working with metal: grinders, polishers, metallurgists. Also, welders and employees of pulp mills, agricultural workers are affected by this disease. All these working conditions are associated with aggressive dust factors.
An additional risk is associated with inadequate medical care: others do not have qualified doctors nearby, others try to avoid regular medical examinations.
Symptomatology
COPD disease - what is it? How is it treated? How to suspect him at home? This abbreviation (as well as its decoding is a chronic obstructive pulmonary disease) and to this day does not say anything to many. Despite the widespread pathology, people do not even know what risk their lives are at. What to look for if you suspect a pulmonary disease and suspect that it could be COPD? Remember that at first the following symptoms are characteristic:
- cough, mucous sputum (usually in the morning);
- shortness of breath, initially occurring during exercise, over time accompanying rest.
If with COPD an exacerbation, then usually the cause is an infection, which affects:
- shortness of breath (increases);
- sputum (becomes purulent, excreted in a larger volume).
With the development of the disease, if chronic obstructive pulmonary disease has been diagnosed, the symptoms are as follows:
- heart failure;
- heartache;
- fingers and lips become cyanotic;
- bones ache;
- muscle weakness;
- fingers thicken;
- nails change shape, become convex.
The diagnosis of COPD: stages
It is customary to distinguish several stages.
The beginning of the pathology is zero. It is distinguished by the production of sputum in a large volume, a person regularly coughs. Lung function at this stage of the development of the disease persists.
The first stage is the period of the development of the disease, in which the patient chronically coughs. Lungs regularly produce large amounts of sputum. When examining the respiratory system, it is possible to identify minor obstruction.
If a moderate form of the disease is diagnosed, it differs in clinical symptoms (described earlier) that manifest themselves during physical exertion.
A diagnosis of COPD, stage three, means that respiratory failure becomes life threatening. With this form of the disease, the so-called "pulmonary heart" appears. Obvious manifestations of the disease: restriction of air flow during exhalation, shortness of breath is frequent and strong. In some cases, bronchial obstruction is observed, which is characteristic of an extremely severe form of pathology. It is dangerous to human life.
It’s not easy to identify
In fact, the diagnosis of COPD is made with the initial form of the disease much less often than it actually occurs. This is due to the fact that the symptoms are mild. At the very beginning, pathology often flows secretly. The clinical picture can be seen when the condition progresses to moderate severity, and the person goes to the doctor, complaining of sputum and cough.
At an early stage, episodic cases are frequent when a person coughs up a large amount of sputum. Since this happens infrequently, people rarely worry and do not go to the doctor in a timely manner. They come to the doctor later when the progress of the disease leads to a chronic cough.
The situation is getting complicated
If the disease has been diagnosed and treatment measures have been taken, it is not always, for example, alternative treatment for COPD shows good results. Often, a complication occurs due to an external infection.
With the appearance of additional infection, even at rest, a person suffers from shortness of breath. There is a change in the nature of the departments: sputum turns into purulent. There are two ways of developing the disease:
In the first case, sputum is excreted in very large volumes and regularly suffers from coughing. There are frequent cases of intoxication, bronchi suffer from purulent inflammations, cyanosis of the skin is possible. Obstruction develops strongly. Pulmonary emphysema is weak for this type of disease.
With the emphysematous type, shortness of breath is fixed respiratory, that is, it is difficult to exhale. Pulmonary emphysema predominates. The skin takes on a pinkish shade of gray. The shape of the chest changes: it resembles a barrel. If the disease has followed this path, as well as if the correct drugs were selected for COPD, the patient is highly likely to live to an advanced age.
Disease progression
With the development of COPD as complications appear:
- pneumonia;
- respiratory failure, usually in acute form.
Less commonly observed:
- pneumothorax;
- heart failure;
- pneumosclerosis.
In severe cases, pulmonary are possible:
Stability and instability in COPD
The disease can be in one of two forms: stable or acute. With a stable variant of development, no changes in the body when observing the dynamics of changes over weeks, months, can not be found. You can notice a certain clinical picture if you regularly examine the patient for at least a year.
But with an exacerbation of only a day or two already show a sharp deterioration. If such exacerbations occur twice a year or more often, then they are considered clinically significant and may cause the patient to be hospitalized. The number of exacerbations directly affects the quality of life and its duration.
In special cases, sick smokers who have previously suffered from bronchial asthma are isolated. At the same time, they speak of a "cross syndrome." The tissues of the body of such a patient are not able to consume the amount of oxygen necessary for normal functioning, which sharply decreases the body's ability to adapt. In 2011, this type of disease was no longer officially allocated to a separate class, but in practice, some doctors still use the old system.
How will the doctor detect the disease?
When visiting a doctor, the patient will have to undergo a series of studies to determine COPD or find another reason for health problems. Diagnostic measures include:
- general inspection;
- spirometry;
- a sample through a bronchodilator, which includes inhalation in patients with COPD, before and after which a special study of the respiratory system is carried out, observing changes in indicators;
- radiography, optionally, tomography, if the case is unclear (this allows you to evaluate how large the structural changes are).
Be sure to collect sputum samples for analysis of secretions. This allows us to draw conclusions about how strong the inflammation is and what kind of character it is. If we are talking about exacerbation of COPD, then we can conclude by sputum which microorganism provoked the infection, and which antibiotics can be used against it.
Bodyplethysmography is performed, during which external respiration is evaluated . This allows you to clarify the volume of the lungs, capacity, as well as a number of parameters that cannot be estimated with spirography.
Be sure to take blood for a general analysis. This makes it possible to identify hemoglobin, red blood cells, against the background of which conclusions are drawn about oxygen deficiency. If we are talking about exacerbation, then a general analysis gives information about the inflammatory process. Analyze the number of leukocytes and ESR.
Blood is also tested for gas. This allows you to identify not only the concentration of oxygen, but also carbon dioxide. You can correctly assess whether the blood is sufficiently saturated with oxygen.
ECG, ECHO-KG, ultrasound become an indispensable research, during which the doctor receives the correct information about the state of the heart, and also learns the pressure in the pulmonary artery.
Finally, fibrobronchoscopy is performed. This is such a type of study, during which the condition of the mucous membrane inside the bronchi is specified. Doctors, using special drugs, get tissue samples that allow you to examine the cellular composition of the mucosa. If the diagnosis is unclear, this technology is indispensable for clarifying it, since it eliminates other diseases with similar symptoms.
Depending on the specifics of the case, an additional visit to a pulmonologist may be prescribed to clarify the condition of the body.
We treat without medication
Treatment of COPD is a complex process that requires an integrated approach. First of all, we consider non-pharmacological measures required for the disease.
Doctors recommend:
- completely quit smoking;
- balance nutrition; include protein-rich foods;
- adjust physical activity, do not overwork;
- reduce weight to the norm, if there are extra pounds;
- regularly walk quickly;
- go swimming;
- practice breathing exercises.
And what about medicines?
Of course, drug therapy for COPD is also indispensable. First of all, pay attention to vaccines against influenza and pneumococcus. It is best to get vaccinated in October-mid-November, as further effectiveness decreases, it is more likely that there have already been contacts with bacteria, viruses, and the injection will not provide an immune response.
They also practice therapy, the main purpose of which is to expand the bronchi and keep them in good condition. To do this, they struggle with spasms and apply measures that reduce the production of sputum. The following medicines are useful here:
- theophyllines;
- beta-2 agonists;
- M-anticholinergics.
The listed drugs are divided into two subgroups:
- long acting;
- short action.
The first maintain the bronchi in normal condition up to 24 hours, the second group is valid for 4-6 hours.
Short-acting drugs are relevant at the first stage, as well as in the future, if there is a short-term need for it, that is, symptoms suddenly appear that need to be urgently addressed. But if such medications do not give a sufficient result, resort to long-acting drugs.
Also, anti-inflammatory drugs can not be neglected, since they prevent negative processes in the bronchial tree. But it is also impossible to use them outside the recommendation of doctors. It is very important that the doctor supervise drug therapy.
Serious therapy is no cause for fear.
In COPD, glucocorticosteroid hormonal drugs are prescribed. As a rule, in the form of inhalations. But in the form of tablets, such drugs are good in the period of exacerbation. They are taken at courses, if the disease is severe, developed to a late stage. Practice shows that patients are afraid to use such drugs when the doctor recommends them. This is fraught with concerns about side effects.
You should remember that more often adverse reactions are caused by hormones taken in the form of tablets or injections. In this case, not uncommon:
- osteoporosis;
- hypertension;
- diabetes.
If the drugs are prescribed in the form of inhalations, their effect will be milder due to the small dose of the active substance entering the body. This form is applied topically, acting primarily on the bronchial tree, which helps to avoid most side effects.
You also need to consider that the disease is associated with chronic inflammatory processes, which means that only long-term courses of medications will be effective. To understand whether there is a result from the selected drug, you will have to take it for at least three months, and then compare the results.
Inhaled forms can cause the following side effects:
- candidiasis;
- hoarse voice.
To avoid this, you need to rinse your mouth every time after taking the product.
What else will help?
With COPD, antioxidant preparations containing a complex of vitamins A, C, E are actively used. Mucolytic agents have proven themselves well, as they dilute the sputum produced by the mucosa and help cough up it. Oxygen therapy is useful , and in severe situations - artificial ventilation of the pulmonary system. With an exacerbation of the disease, you can take antibiotics, but under the supervision of a doctor.
Selective phosphodiesterase inhibitors - 4 - were of considerable benefit. These are quite specific drugs that can be combined with some drugs used in the treatment of COPD.
If the disease is provoked by a genetic defect, then it is customary to resort to substitution therapy. For this, alpha-1-antitrypsin is used, which, due to a congenital defect, is not sufficiently produced by the body.
Surgery
In some cases, doctors recommend seeking surgical treatment options. At the same time, doctors remove damaged elements of the lungs, and in especially difficult cases, they carry out lung transplantation.
Preventative measures
What is the prevention of COPD? Are there any effective ways to prevent the development of the disease? Modern medicine says that it is possible to prevent the disease, but for this a person must take care of his health and treat himself responsibly.
First of all, you need to give up smoking, as well as about the possibility of excluding being in harmful conditions.
If the disease is already detected, its progression can be slowed down by applying secondary preventative measures. The most productive were:
- vaccination to prevent the defeat of influenza, pneumococcus;
- regular intake of medications prescribed by your doctor. Remember that the disease is chronic, so temporary therapy will not bring real benefits;
- exercise control. This helps to train the muscles of the respiratory system. You should walk and swim more, use the methodology of breathing exercises;
- inhalers. They need to be able to use correctly, since improper operation leads to the absence of the result of such therapy. As a rule, the doctor is able to explain to the patient how to use the medication in order to be effective.