Chronic Obstructive Pulmonary Disease – Chronic obstructive pulmonary disease (COPD) is a long-term inflammation of the lungs. COPD is generally characterized by difficulty breathing, coughing up phlegm, and wheezing. COPD is a disease that often occurs in active and passive smokers.
The two conditions that most often develop into COPD are chronic bronchitis and emphysema . In chronic bronchitis, damage occurs to the airways (bronchi). In emphysema, damage occurs to the lung sacs (alveoli).
Chronic obstructive pulmonary disease (COPD) is more common in middle-aged people who smoke. Over time, the disease worsens and puts sufferers at risk of heart disease and lung cancer .
In addition, chronic obstructive pulmonary disease can also increase the risk of sufferers getting COVID-19. According to a study, people with COPD have a 5-fold higher risk of getting COVID-19 than people who do not have COPD.
Causes of Chronic Obstructive Pulmonary Disease
Chronic obstructive pulmonary disease occurs when the airways and lungs are damaged and inflamed. Some conditions that can increase a person’s risk of developing this disease include:
- Having a habit of smoking or being frequently exposed to cigarette smoke (passive smoking)
- Exposure to air pollution, for example from street dust, vehicle smoke, or factory and industrial smoke, is even one of the effects of global warming.
- Suffering from asthma , tuberculosis, HIV infection, and genetic disorders that cause a deficiency of the protein alpha-1-antitrypsin (AAt)
- Having a family history of COPD
- Aged 40 years and above
Symptoms of Chronic Obstructive Pulmonary Disease
COPD develops slowly and does not show any specific symptoms in the early stages. Symptoms only appear after many years when significant damage has occurred to the lungs.
Some symptoms that are usually experienced by COPD sufferers are:
- Shortness of breath, especially during physical activity
- A cough that doesn’t go away and may be accompanied by phlegm
- Weight loss
- Wheezing (snoring)
- Chest pain
- Weak
- Swelling in the legs
When to see a doctor
Immediately see a doctor if you experience the above symptoms, especially if accompanied by the following complaints:
- Fever
- Heart beat
- Bluish lips and fingertips
- Shortness of breath to the point of not being able to speak
- Confused and have difficulty concentrating
Diagnosis of Chronic Obstructive Pulmonary Disease
To establish a diagnosis, the doctor will ask about the patient’s symptoms and medical history, including finding out the factors that trigger COPD. After that, the doctor will perform a physical examination of the lungs using a stethoscope .
To confirm the diagnosis, the doctor will perform several supporting examinations below:
- Lung function tests (spirometry), to measure the volume of air inhaled and exhaled by the patient, and to determine whether the lungs can deliver sufficient oxygen into the blood.
- Blood tests, to measure the level of alpha-1-antitrypsin protein in the blood and to rule out the possibility that symptoms are caused by other diseases, such as anemia or polycythemia.
- Arterial blood gas analysis, to measure the levels of oxygen and carbon dioxide in the blood.
- Scans with X-rays and CT scans, to detect emphysema or other disorders in the lungs.
In addition to the above tests, doctors can also perform other examinations to determine the severity of COPD suffered by the patient. These examinations can be:
- Electrocardiogram (ECG) and ultrasound of the heart (echocardiogram), to examine the electrical conduction and structure of the heart.
- Sputum sample test, to detect possible bacterial or fungal infections.
Chronic Obstructive Pulmonary Disease Treatment
Chronic obstructive pulmonary disease cannot be completely cured. However, doctors can provide treatment to help relieve symptoms and inhibit the progression of the disease. The goal is for patients to be able to carry out normal activities.
The following are some methods of treating COPD:
1. Medicines
The drugs that are usually used to relieve COPD symptoms are inhalers in the form of:
- Bronchodilators, such as umeclidinium , aclidinium , salbutamol , salmeterol , and terbutaline
- Corticosteroids , such as fluticasone and budesonide
Depending on the patient’s condition, the doctor may prescribe the above drugs as single drugs or in combination.
If inhaled medications are unable to relieve COPD symptoms, your doctor will prescribe oral medications in the form of capsules or tablets, such as:
- Theophylline , to reduce swelling in the airways
- Mucolytics, such as ambroxol or carbocisteine to thin phlegm or mucus
- Phosphodiesterase-4 enzyme inhibitors, such as roflumilast , to clear airways
- Corticosteroids, to reduce inflammation in the respiratory tract
- Antibiotics, if there are signs of lung infection
2. Oxygen therapy
This therapy aims to provide oxygen supply to the lungs. Patients can use portable oxygen tanks that can be carried anywhere.
The length of time an oxygen tank is used depends on the patient’s condition. Some patients only use it when they are active or sleeping. However, others need to use it all day long.
3. Pulmonary rehabilitation
Pulmonary rehabilitation or chest physiotherapy aims to teach patients proper diet, physical therapy appropriate to their condition, and to provide emotional and psychological support.
4. Breathing aids
If the symptoms are quite serious, the patient must use a breathing aid in the form of a ventilator machine . A ventilator is a machine that pumps air to help the patient breathe. The ventilator is connected to the patient’s respiratory tract via a tube that is inserted into the trachea by intubation.
5. Operation
Surgery is performed if COPD symptoms cannot be relieved with medication or therapy. Types of surgery that can be performed include:
- Lung volume reduction surgery
This surgery aims to remove the damaged part of the lung so that healthy lung tissue can develop.
- Lung transplantation
Lung transplantation is an operation to remove damaged lungs and replace them with healthy lungs from a donor.
- Bullectomy
Bullectomy is an operation to remove air sacs ( bullae ) that form due to damage to the alveoli , to improve air flow.
In addition to the above treatment, there are several steps that patients must take to slow down lung damage, namely:
- Stop smoking and avoid exposure to cigarette smoke
- Avoid air pollution, such as vehicle exhaust fumes or burning.
- Using a room humidifier ( air humidifier )
- Maintain a healthy diet, drink enough water, and exercise regularly.
- Undergoing regular vaccinations, such as flu and pneumococcal vaccines
- Check yourself with a doctor regularly so that your health condition can be monitored.
Complications of Chronic Obstructive Pulmonary Disease
Chronic obstructive pulmonary disease causes sufferers to have difficulty breathing. If left untreated, sufferers can also experience serious complications, such as:
- respiratory failure
- sleep apnea
- Diabetes
- Dementia
- Pulmonary hypertension
- Drastic weight loss
- Malnutrition
- Pneumonia
- Pneumothorax
- Lung cancer
- Atrial fibrillation
- Heart failure
- Depression and anxiety
Chronic Obstructive Pulmonary Disease Prevention
COPD is a preventable disease. The main thing to do is to stop smoking and avoid cigarette smoke. If you are an active smoker, stop smoking immediately so that you can avoid complications that may occur later.
In addition, there are several efforts that can be made to prevent infection, namely:
- Get a yearly flu shot and regular pneumonia vaccine
- Wash your hands with soap and water regularly, for example before eating, when preparing food, and after going to the bathroom.
- Use personal protective equipment that meets standards when working in places with a lot of dust, smoke and gas.
- Get enough rest and sleep
- Implement a healthy, nutritious and balanced diet
- Managing stress well
- Exercise regularly for at least 30 minutes every day
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