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What is Chronic Obstructive Lung Disease?
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Chronic Obstructive Lung Disease (COLD) is a disease of the lungs characterised by the obstruction to the air flow in the airways of the lungs.
The narrowing of the airways together with distension of the air sacs beyond the terminal bronchioles with destruction of the alveolar walls over the course of many years damages the air sacs reducing the surface area left for the exchange of oxygen and carbon dioxide.
As a result the patient become increasingly short of breath.
What is the cause of Chronic Obstructive Lung Disease?
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Chronic Obstructive Lung Disease is associated with
1.Chronic bronchitis .
Chronic bronchitis is an ongoing inflammation of the lining of the breathing tubes (the bronchi), which is caused by bacterial infection or cigarette smoke irritation.
As the inflammation progresses, the bronchi fill up with mucus resulting in a chronic cough, as the body attempts to rid itself of the excess mucus that is irritating the lungs. The excess mucus in the bronchi also makes the diameter of the bronchi narrower and reduces the amount of air that can pass through. There is obstruction to air flow and hence breathlessness.
Smoking is the main culprit here.
2.Chronic asthma-
the narrowing of the airtubes caused by spasm of the muscles of the lining the airtubes triggered off by the allergens can cause permanent damage to the airtubes causing obstruction to airflow and hence difficulty in breathing.
3.Emphysema -
here the narrowing of the airway extends to the smaller airways or bronchioles with damage and overdistension of the air sacs resulting in obstruction and less air getting through to the lungs.
4.Chronic infection of the lungs like pneumoconiosis and tuberculosis may cause damage to the lungs with difficulty in breathing and poor air flow.
In all cases of the above conditions air flow is impeded and there is hyper inflation of the lungs.
What are the Symptoms of Chronic Obstructive Lung Disease?
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Symptoms include:
1.Cough is usually the first symptom to develop.
It is usually a wet cough with phlegm(sputum).
Initially the cough is intermittent but becomes persistent as the condition progresses.
2. Excessive sputum or mucus is produced by the damaged airways.
This results in excessive production of phlegm
3.Chronic shortness of breath or shortness of breath occurs with mild exertion.
As the illness continues, breathlessness occurs even when sitting and can be very distressing to the patient.
4.There may even be breathing difficulty when lying down.
5.Wheezing may occur due to the sound of the air trying to squeeze through narrow airways.
6.Bluish coloration of the skin due to lack of oxygen
7.Dizziness can occur if the brain does not receive enough oxygen
8.Fatigue also occur when the body does not receive enough oxygen
Besides these main symptoms, other symptoms are:
1. Nasal flaring and bulging eyes
2.Vision abnormalities
3.Anxiety, stress, and tension
4.Ankle, feet, and leg swelling
5.Unintentional weight loss
6.Headache (especially in the morning)
7.Excessive daytime sleepiness
8.Insomnia
How is the diagnosis of Chronic Obstructive Lung Disease made?
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1. medical history of cough, excessive sputum, breathlessness and their duration.
Any history of smoking,asthma, exposure to environmental toxins.
2. Physical examination for barrel-shaped chest and flattened diaphragm.
3. Pulmonary (lung) Function Testing-
this is a very important tool used to confirm COLD.
The patient is asked to into a machine called the spirometer which measures the amount of air the patient is able to blow out from his lungs.
The readings from the spirometer will confirm the diagnosis of COLD and assess the severity.
It is also used to monitor the patient's progress.
4. Chest X-ray is useful as an aid in the diagnosis of COLD(hyperinflated lungs and depressed diaphragm is typical).
It is also useful to rule out other conditions besides COLD.
It also detects any complications of COLD.
What is the Treatment of Chronic Obstructive Lung Disease?
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There is no cure for COLD.
Medications and lifestyle changes may help in the relief of symptoms and preventing the progression of the disease.
Lifestyle Changes:
1.Stop Smoking is the most important step for a COLD sufferer.
While the damage to to the lungs cannot be reversed, stopping smoking will help prevent the progression of the condition.
2. Avoid air pollution and second hand smoke in the workplace and wear a mask if the air pollution index is high
3.Pulmonary Rehabilation- this involved a structured programme which includes education, exercise training,psychosocial support and instruction proper breathing techniques.
Benefits include improvement in the ability to exercise, reduced breathlessness and fatigue resulting in improvement in the quality of life.
4.Nutrition- eat a well balanced diet.
If chewing and swallowing interfere withbreathing, take small frequent meals.
5. Rest, meditation,adequate sleep are factors which will help improve your quality of life.
Medications:
1.Bronchodilators are medicines that relax the muscles aound the airways in your lungs, It opens the airways allowing air flow in and out of the lungs to improve. Bronchodilators may be taken orally or in inhalers.
2. Corticosteroids helps reduce airway inflammation and decrease the mucus production. Again these medicines can be taken orally or in inhalers.
Side effects are less with inhalers.
3. Antibiotics are taken to treat any underlying infection.
4. Vaccinations:
a.Yearly influenza vaccination is given if there is a higher risk of pneunomia if you suffer from influenza.
b.Pneumoccal vaccination for protection against pneumococcal infection.
Oxygen Therapy:Those wth severe symptoms may benefit from a regime of oxygen therapy for at least 15 hours a day.
Surgery:
Sometime removal of section of lung which has collapsed may improve symptoms. Sometimes a few may be considered for lung transplantation.
What are the Complications of Chronic Obstructive Lung Disease?
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Most patients ends up with pneumonia and death because of the chronic progression of the disease.
Many if treated are able to live a long time before succumbing to pneumonia.
Other advice:
Air travel may be possible if the doctor deem that you are fit to travel.
Sometimes arrangement for oxygen and medications during the air flight may be necessary.
