COPD Is Not Curable But Preventable

Dr Rajesh Chawla, Senior Consultant- Respiratory medicine, Indraprastha Apollo HospitalIncepted in 1996, Indraprastha Apollo Hospital is a multi-speciality tertiary acute care provider with over 700 beds in India.

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease that causes restrictions in lung airflow. The chronic airflow limitation is caused by a mixture of small airway disease (obstructive bronchiolitis) and parenchymal destruction (emphysema), the relative contributions of which vary from person to person. Chronic bronchitis and emphysema are terms that are no longer used individually and are now rather included within the COPD diagnosis. This often times remain under-diagnosed and hence become life threatening lung disease. COPD is preventable, but not curable.

Chronic obstructive pulmonary disease is a major cause of morbidity and mortality across the globe. According to World Health Organization estimates, 65 mil-lion people have moderate to severe COPD. Crude estimates suggest there are 30 million COPD patients in India. India contributes a significant and growing percent-age of COPD mortality which is estimated to be amongst the highest in the world; i.e. more than 64.7 estimated age standardized death rate per 100,000 amongst both sexes.

Facts about COPD
• COPD is currently the fourth leading cause of death in the world.

• COPD is projected to be the 3rd leading cause of death by 2030.

• Estimated a global prevalence of 251 million COPD cases in 2016 (WHO).

• 3.17 million people died of COPD in 2015 accounting for 5 percent of all deaths globally in that year.

• Globally, the COPD burden is expected to rise in coming decades because of continued exposure to COPDrisk factors (smoking and air pollution) and aging of the population.

• Many cases of COPD are preventable by avoidance or early cessation of smoking.

• COPD is not curable, but treatment can relieve symptoms, improve quality of life and reduce the risk of death.

Passive smoking; air pollution; or chemical fumes or dusts from the environment or workplace contribute to COPD. Some people who have asthma can develop COPD. Asthma is a chronic lung disease that worsens and tightens the airways. Treatment generally can converse the inflammation and narrowing that occurs in asthma.

Risk Factors
• The major factor for COPD is
smoking. Maximum number of people who have COPD smoke or used to smoke.

• People with family history of COPD are expected to develop the disease if they smoke.

• Long-term exposure to lung irritants is also a major risk factor contributing to the development of COPD.

Chronic obstructive pulmonary disease is a major cause of morbidity and mortality across the globe

Screening and Prevention
One can take steps to prevent COPD before it starts. Prevent COPD Before It Starts

• The best way to prevent COPD is to quit smoking completely. Smoking is the key factor that causes COPD.

• In case you have trouble quitting smoking by yourself, consider joining a support group.

• Also, try to avoid lung irritants that can contribute to COPD, such as air pollution, chemical fumes, dusts, and second-hand smoke, which is smoke in the air from other people smoking.

Prevent Complications and Slow the Progression
• The most important step to prevent COPD is to quit smoking. Quitting can help avoid complications and slow the development of the disease. Also try to avoid expo-sure to the lung irritants.

• Follow the treatments for COPD as prescribed by the doctor. It can help you to breathe easily, stay more active, and avoid or manage severe symptoms.

• Talk with your doctor about the flu, or influenza, and pneumonia vaccines. These vaccines lower the chances of getting these illnesses, which are major health risks for people who have COPD.

Initially, COPD may cause no symptoms or only minorindications. As the ailment gets worse, signs usually become more severe. Some common signs and symptoms of COPD are:
• An ongoing cough or a cough that produces a lot of mucus; this is often called smoker's cough.
• Shortness of breath during physical activity
• Panting or a whistling or squeaky sound while breathing
• Chest tightness
• Colds or other respiratory infections such as the flu, or influenza occurring frequently

Not everyone who has the above symptoms has COPD. Similarly, not everyone who has COPD has these signs. Some of the symptoms of COPD can be similar to the symptoms of other diseases and conditions.

The severity of the symptoms will depend on how much lung damage one have. If the patient keep smoking, the damage will occur faster than if you stop smoking.

Severe COPD can lead to other symptoms, such as swelling of ankles, feet, or legs; weight loss; and lower muscle endurance.

In some cases severe symptoms may require treatment in a hospital.
• If the patient is having a hard time catching your breath or talking.
• If the lips or fingernails turn blue or gray, a sign of low oxygen level in your blood.
• If you are not mentally alert.
• If the heartbeat is very fast.

COPD has no cure yet. However, lifestyle changes and treatments can help you feel better, stay more active, and slow the progress of the disease.

The goals of COPD treatment include:
• Relieving your symptoms
• Slowing the progress of the disease
• Improving your exercise tolerance or your ability to stay active
• Preventing and treating complications
• Improving your overall health