What is chronic obstructive pulmonary disease?

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A chronic obstructive pulmonary disease (COPD) is a respiratory pathology that makes breathing difficult and progresses slowly and progressively.

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COPD patients have difficulty expelling air from their lungs. A situation that causes coughing and shortness of breath.

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Smokers are the most affected by this disease, as smoking tobacco is the main cause.

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Age and gender are predominant factors in this disease, which appears more at an advanced age, usually after 40 years, and in men.

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Understanding COPD

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Causes

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Smoking is the main cause of COPD. Other common causes are cigar or pipe smoking and breathing in chemical fumes, dust, pollution or dense smoke.

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There may also be a genetic predisposition to this disease, reflected in a family history of COPD.

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There are also other risk factors, although of lesser importance. These include underweight, childhood respiratory disease, passive exposure to tobacco smoke, air pollution, and occupational exposure (e.g. to mineral or cotton dust).

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Usual symptoms

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COPD sets in slowly and gradually, taking years to develop.

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The first manifestations of the disease are not alarming. As a result, symptoms are often underestimated until the first severe attack.

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Between the ages of 40 and 50, symptoms may include:

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  • Mild cough with clear sputum (mucus from the lungs);
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  • Shortness of breath during exercise and travel.
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At age 60, COPD can manifest as:

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  • Increased difficulty breathing;
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  • Pneumonia and other lung infections that may require hospitalization;
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  • Weight loss;
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  • Morning headaches;
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  • Leg swelling;
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  • Spitting blood.
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When a person has had COPD for some time, they may notice certain situations such as the following:

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  • The chest is wider because of the weight of the air in the lungs;
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  • The skin has a blue tint due to a decrease in oxygen in the blood ;
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  • Breathlessness, even while doing nothing.
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Symptoms of exacerbations

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Periods of worsening symptoms, called exacerbations, are a key feature of COPD. They can be triggered by infections or exposure to high levels of air pollution or pollen.

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The patient should seek urgent medical attention if he or she has the following symptoms:

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  • Cough with more yellow or greenish sputum;
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  • Shortness of breath at rest;
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  • Fever or pain in the body.
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A more severe exacerbation may result in too little oxygen in the blood (acute respiratory failure). Therefore, the person should go to a hospital emergency room immediately if he or she has the following symptoms:

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  • Intense shortness of breath (like drowning);
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  • Anxiety or confusion;
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  • Sudoresis (excessive sweating);
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  • A bluish skin.
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Comorbidities

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Patients with COPD often have other diseases (comorbidities), which may have identical risk factors, such as smoking, and contribute to their worsening.

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The most common diseases that accompany COPD are:

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  • Heart Disease;
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  • Anxiety and depression;
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  • Osteoporosis;
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  • Gastroesophageal reflux;
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  • Musculoskeletal Dysfunction;
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  • Anemia;
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  • Lung cancer;
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  • Diabetes;
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  • The metabolic syndrome.
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Diagnosis

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The diagnosis of COPD is made on the basis of presenting symptoms and by performing a spirometry test, which measures the amount of air in the lungs and the rate at which the person can exhale.

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If the amount of air exhaled by the person is low, this may indicate a narrowing of the airway and the onset of COPD.

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In addition, the following tests may be ordered: a chest X-ray, a blood test (to see if COPD is inherited) and an electrocardiogram or echocardiogram to see if the shortness of breath is due to a heart problem.

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Treatment

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COPD has no treatment because it is not possible to correct the damage to the lungs and airways.

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However, while there is no cure, steps can be taken to lessen the impact of symptoms on the patient’s quality of life. Some examples include:

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  • Quit Smoking;
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  • Reduce exposure to airborne irritants (tobacco smoke, air pollution and pollen);
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  • Prevention of respiratory infections by vaccination against bacterial infections and influenza;
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  • Take bronchodilator inhaler medications to combat shortness of breath and easy fatigue ;
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  • Having a balanced diet;
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  • Reduce excessive weight.
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Patients with severe airway obstruction and frequent exacerbations may be treated with inhaled and oral corticosteroids.

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In the most severe situations, the use of oxygen will be necessary for short periods during exacerbations.

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In cases of continuous respiratory failure, oxygen may be required on a continuous basis and, in this case, oxygen therapy should be provided for at least 16 hours per day.

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Respiratory rehabilitation

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Respiratory rehabilitation is very important for patients with COPD.

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This is an integrated intervention to improve the person’s breathing, ability to perform activities of daily living and living with the disease.

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This intervention aims to improve the physical and psychological aspects of the patient, including working on the following aspects:

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  • Promotion of physical exercise (gentle and supervised);
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  • Promotion of proper nutrition;
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  • Smoking cessation assistance;
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  • Vaccination to prevent respiratory infections caused by viruses and bacteria;
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  • Long-term oxygen therapy and/or noninvasive ventilation.
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Respiratory rehabilitation can be performed in a hospital or community setting, i.e., in health centers, clinics, or in the patient’s home.

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