Chronic Obstructive Pulmonary Disease

1. What is COPD?

COPD stands for chronic obstructive pulmonary disease. This is a term used for a number of conditions; including chronic bronchitis and emphysema. COPD leads to damaged airways in the lungs, causing them to become narrower and making it harder for air to get in and out of the lungs. The word ‘chronic’ means that the problem is long-term.

2. What are the signs and symptoms of COPD?

Cough, phlegm and shortness of breath can be symptoms of COPD. Some people may only may predominantly have one or two of these symptoms. The symptoms of COPD vary depending on how bad it is, and how people have adapted to their problems. In mild cases, symptoms like a cough, phlegm and shortness of breath may only be present during the winter or after a cold. In more severe cases, you may be short of breath every day. With more severe COPD, because of breathlessness, normal activities can become more difficult.

COPD can lead to feelings of anxiety because of breathlessness. People with COPD may reduce their activities to avoid becoming breathless. But by reducing activity levels you become less fit and therefore get breathless even sooner when you try to do any activity. People with COPD may adapt their lifestyles to reduce breathlessness – but keeping as fit as possible is important.

3. How common is COPD?

Like other developing countries COPD is a significant burden on the Indian healthcare system. It constitutes 30% of all visits to the pulmonology outpatient department and accounts for 1- 2.5% admissions all over India. According to WHO estimates, 65 million people have moderate to severe chronic obstructive pulmonary disease (COPD). In 2010, COPD was estimated to account for 2.7% of the disease burden and 3.2% of deaths in Europe, and for 3.1% of the global disease burden and 5.5% of deaths worldwide. It is the second commonest cause of mortality in India and the third commonest cause worldwide.

4. What are the risk factors and common causes of COPD?

The most common cause of COPD is smoking. Once you give up smoking, you gradually reduce the chances of getting COPD – and you slow down its progress if you already have it. However in developing countries like India biomass fuel exposure is equally important a cause for COPD. This is a more important cause in women. The nature of COPD due to smoking and that due to biomass exposure might be different and a subject of ongoing research. Occupational factors, such as coal dust, and some inherited problems can also cause COPD. Whether pollution is a factor is under investigation.

5. Are Asthma-COPD Overlap Syndrome Patients Receiving Optimal Therapy?

Asthma-COPD overlap syndrome (ACOS) is characterized by progressively worsening lung disease with several features usually associated with asthma and several features usually associated with COPD. ACOS is a relatively newer entity and more and more physicians are getting aware of it. Approach to ACOS is different when it comes to initiation and maintenance of therapy. Most patients suffering from ACOS are treated as COPD cases, which leads to prescription of sub optimal dose of inhaled corticosteroids leading to impaired control of the underlying lung disease.

6. How to distinguish COPD from the seasonal cough and cold?

COPD generally presents as shortness of breath and decreased exercise tolerance progressively worsening over a time period of months to years. Seasonal cough and cold, on the other hand are usually aggravated on change in temperature or on exposure to pollens, etc. People with underlying COPD can get a cold at a change of season and hence leads to a aggravation of their disease which might even lead to have a hospital admission. Hence people with COPD need to be proactive about treating a common cold.

7. Why is it most common in elderly?

Advancing age is considered as a risk factor for COPD. Long term exposure to irritant gasses like cigarette smoke or occupational exposure to noxious irritant leads to development of COPD. Prompt treatment can slow the progression of the disease and help prevent complications. Smoking cessation slows the progression of the disease as well.

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