Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is an inflammatory condition that causes obstruction of airflow within the lungs and persistent respiratory symptoms (cough with or without expectoration and difficulty breathing). According to data from the World Health Organization, COPD is the third leading cause of death worldwide, primarily linked to smoking (70% of cases) in developed countries.

Depending on its severity, it is classified into four stages according to the GOLD classification (Global Initiative for Chronic Obstructive Lung Disease), which takes into account the results of spirometry, a test used to assess lung function. The normal forced vital capacity (FVC) value of FEV1 (the maximum amount of air expelled forcefully from a full inhalation) is 80% or greater. The stages are as follows:

• Mild COPD (GOLD 1): FVC greater than 80%.
• Moderate COPD (GOLD 2): FVC between 50% and 80%.
• Severe COPD (GOLD 3): FVC between 30% and 50%.
• Very severe COPD (GOLD 4): Less than 30% of the air in the lungs is expelled.

COPD is associated with bronchial blockage (chronic bronchitis) and lung degeneration (emphysema).

Although it is a degenerative disease with no cure, the prognosis for COPD is positive if detected and treated early. The life expectancy of patients can range from 10 to 20 years after diagnosis, although it depends on the severity of the disease and the patient's health status at diagnosis. However, if the patient quits smoking, life expectancy increases significantly. By following medical recommendations and accepting limitations, patients can maintain a good quality of life.

Symptoms

The most characteristic symptoms of chronic obstructive pulmonary disease, which in the early stages and in younger patients often go unnoticed, include:

• Chronic cough with expectoration.
• Dyspnea (shortness of breath), especially during physical exertion.
• Recurrent respiratory infections.
• Wheezing (whistling sounds in the chest).
• Chest tightness.
• Fatigue.

Normally, COPD presents in exacerbations. In other words, the symptoms appear for a certain period, usually lasting several days, and disappear for a time when treatment is followed.

Causes

The causes of COPD include:

• Smoking, which is the primary trigger in developed countries.
• Exposure to tobacco smoke, even if one doesn't smoke.
• Constant inhalation of chemicals, smoke, or dust.
• Indoor air pollution, a common cause in low-income countries, such as the use of charcoal to heat homes.
• Prematurity.
• Respiratory infections during early childhood.
• Alpha-1 antitrypsin (AAt) deficiency, a protein secreted by the liver to protect the lungs.

Risk Factors

The main factor that increases the risk of developing COPD is smoking or being a passive smoker. Additionally, people with asthma, constant exposure to toxic smoke or chemicals, and genetic disorders that prevent the production of AAt are more likely to develop it.

Complications

COPD can cause various complications, including:

• Respiratory infections such as pneumonia or the flu, which can be potentially severe for people with COPD.
• Lung cancer.
• Pulmonary hypertension.
• Mental health issues stemming from difficulty performing everyday tasks.

Prevention

The best way to prevent COPD is not to smoke or to quit smoking if already a habit. People whose jobs involve exposure to pollutants should use the proper protective equipment to minimize harm.

Flu and pneumococcal vaccinations also help prevent COPD complications.

What Doctor Treats COPD?

Pulmonologists and specialists in smoking cessation units are involved in diagnosing and treating chronic obstructive pulmonary disease. Family doctors also monitor COPD patients.