COPD (chronic obstructive pulmonary disease) is a pathology that is accompanied by inflammation in the organs of the respiratory system. The reasons may be environmental factors and a number of others, including smoking. The disease is characterized by regular progress, leading to a decrease in the functionality of the respiratory system. Over time, this leads to respiratory failure.
Mainly the disease is observed at the age of 40 and older. In some cases, patients with COPD are admitted to the hospital at a younger age. As a rule, this is due to a genetic predisposition. There is also a high risk of getting sick in those who smoke for a very long time.
Risk group
The diagnosis of COPD in adult men in Russia is observed in every third person who has crossed the line of 70 years. Statistics allow us to confidently say that this is directly related to tobacco smoking. There is also a clear connection with the way of life, namely the place of work: the likelihood of developing pathology is higher when a person works in harmful conditions and with a lot of dust. Living in industrial cities affects: here the percentage of cases is higher than in places with cleanecology.
COPD is more likely to develop in older people, but with a genetic predisposition, you can get sick at a young age. This is due to the specifics of the generation of connective lung tissue by the body. There are also medical studies that make it possible to assert the connection of the disease with the prematurity of the child, since in this case there is not enough surfactant in the body, which is why the tissues of the organs cannot be corrected at birth.
What do scientists say?
COPD, the causes of the disease, the method of treatment - all this has long attracted the attention of doctors. In order to have sufficient materials for research, data collection was carried out, during which cases of the disease were studied in rural areas and urban residents. The information was collected by Russian doctors.
It was found that if we are talking about those who live in a village, a village, then with COPD, a severe course often becomes inconclusive, and in general, pathology torments a person much more. Often, the villagers observed endobronchitis with purulent discharge or tissue atrophy. There are complications from other somatic diseases.
It has been suggested that the main reason is the low quality of medical care in rural areas. In addition, in the villages it is impossible to do spirometry, which is required by smoking men aged 40 and over.
Do many people know COPD - what is it? How is it treated? What happens with this? Largely due to ignorance, lack of awareness, fear of death, patients become depressed. EquallyThis is true for both city dwellers and rural dwellers. Depression is additionally associated with hypoxia, which affects the patient's nervous system.
Where does disease come from?
Diagnosis of COPD is still difficult today, since it is not known exactly for what reasons the pathology develops. However, it was possible to identify a number of factors provoking the disease. Key Aspects:
- smoking;
- bad working conditions;
- climate;
- infection;
- protracted bronchitis;
- lung diseases;
- genetics.
About the reasons in more detail
Effective prevention of COPD is still under development, but people who want to maintain their he alth should understand how certain causes affect the human body, provoking this pathology. Realizing their danger and eliminating harmful factors, you can reduce the likelihood of developing the disease.
The first thing worth mentioning in connection with COPD is, of course, smoking. Both active and passive influence equally negatively. Now medicine says with confidence that it is smoking that is the most important factor in the development of pathology. The disease provokes both nicotine and other components contained in tobacco smoke.
In many ways, the mechanism of the onset of the disease when smoking is associated with the one that provokes pathology when working in harmful conditions, since here a person also breathes air filled with microscopic particles. When working in dusty conditions, in alkali and steam, constantly breathingchemical particles, it is impossible to keep the lungs he althy. Statistics show that the diagnosis of COPD is more often made in miners and people working with metal: grinders, polishers, metallurgists. Welders and employees of pulp mills, agricultural workers are also susceptible to this disease. All these working conditions are associated with aggressive dust factors.
Additional risk associated with insufficient medical care: some do not have qualified doctors nearby, others try to avoid regular medical examinations.
Symptomatics
COPD disease - what is it? How is it treated? How can you suspect him? This abbreviation (as well as its decoding - chronic obstructive pulmonary disease) to this day says nothing to many. Despite the widespread prevalence of pathology, people do not even know what risk their lives are at risk. What to look for if you suspect a lung disease and suspect that it could be COPD? Remember that the following symptoms are common at first:
- cough, mucous sputum (usually in the morning);
- dyspnoea, initially on exertion, eventually accompanying rest.
If COPD has an exacerbation, it is usually caused by an infection, which affects:
- dyspnea (increasing);
- phlegm (becomes purulent, more expelled).
When the disease develops, if chronic obstructive pulmonary disease has been diagnosed, the symptoms are as follows:
- heart failure;
- pain in the heart;
- fingers and lips turn blue;
- bones ache;
- muscles weaken;
- fingers thicken;
- nails change shape, become convex.
COPD diagnosis: stages
It is customary to distinguish several stages.
The beginning of pathology is zero. It is characterized by the production of sputum in a large volume, a person regularly coughs. The function of the lungs at this stage of the development of the disease is preserved.
The first stage is the period of development of the disease, in which the patient chronically coughs. The lungs regularly produce a large volume of sputum. Investigation of the respiratory system reveals a slight obstruction.
If a moderate form of the disease is diagnosed, it is distinguished by clinical symptoms (described earlier) that appear during exercise.
A diagnosis of COPD, stage three, means that respiratory failure becomes life-threatening. With this form of the disease, the so-called "cor pulmonale" appears. Obvious manifestations of the disease: restriction of air flow during exhalation, shortness of breath is frequent and severe. In some cases, bronchial obstructions are observed, which is typical for an extremely severe form of the pathology. It is dangerous to human life.
Not easy to spot
In fact, the diagnosis of COPD is made at the initial form of the disease much less often than it actually occurs. This is due to the fact that the symptoms are not pronounced. At the very beginning, pathology is oftenflows secretly. The clinical picture can be seen when the condition progresses to moderate severity and the person goes to the doctor complaining of phlegm and cough.
At an early stage, episodic cases are not uncommon when a person coughs up a large amount of sputum. Because it doesn't happen often, people rarely worry and don't see a doctor in a timely manner. The doctor is visited later, when the progress of the disease leads to a chronic cough.
The situation is getting worse
If the disease has been diagnosed and treatment measures taken, not always, for example, alternative treatment of COPD shows good results. Often the complication is due to a third-party infection.
When an additional infection appears, even at rest, a person suffers from shortness of breath. There is a change in the nature of the departments: sputum turns into purulent. There are two possible paths for the development of the disease:
- bronchial;
- emphysematous.
In the first case, sputum is secreted in very large volumes and regularly coughs. There are frequent cases of intoxication, the bronchi suffer from purulent inflammation, cyanosis of the skin is possible. Obstruction develops strongly. Pulmonary emphysema for this type of disease is characterized by a weak.
With emphysematous type of shortness of breath, respiratory is fixed, that is, it is difficult to exhale. Pulmonary emphysema predominates. The skin takes on a pinkish shade of grey. The shape of the chest changes: it resembles a barrel. If the disease has gone down this path, and if the correct COPD drugs have been chosen, the patient is more likely to live toold age.
Progress of disease
When COPD develops, complications appear:
- pneumonia;
- shortness of breath, usually acute.
Seen less often:
- pneumothorax;
- heart failure;
- pneumosclerosis.
In severe cases, possible pulmonary:
- heart;
- hypertension.
Stability and instability in COPD
The disease can be in one of two forms: stable or acute. With a stable variant of development, no changes in the body can be found when observing the dynamics of changes over weeks, months. You can notice a certain clinical picture if you regularly examine the patient for at least a year.
But with an exacerbation of just a day or two, they already show a sharp deterioration in the condition. If such exacerbations occur twice a year or more often, then they are considered clinically significant and may lead to hospitalization of the patient. The number of exacerbations directly affects the quality of life and its duration.
In special cases, smokers who previously suffered from bronchial asthma are isolated. In this case, they say about the "cross syndrome". The tissues of the body of such a patient are not able to consume the amount of oxygen necessary for normal functioning, which sharply reduces the body's ability to adapt. In 2011, this type of disease was no longer officially classified as a separate class, but in practice, some doctors stilluse the old system.
How can a doctor detect an illness?
When visiting a doctor, the patient will have to undergo a series of tests to determine COPD or find another cause of he alth problems. Diagnostic activities include:
- general inspection;
- spirometry;
- test through a bronchodilator, which includes inhalations for COPD, before and after which a special study of the respiratory system is carried out, observing changes in indicators;
- X-ray, additionally CT if the case is not clear (this allows you to assess how big the structural changes are).
Be sure to collect sputum samples for analysis of secretions. This allows you to draw conclusions about how strong the inflammation is and what its nature is. If we are talking about an exacerbation of COPD, then sputum can be used to draw conclusions about which microorganism provoked the infection, as well as which antibiotics can be used against it.
Body plethysmography is carried out, during which external respiration is assessed. This allows you to clarify the volume of the lungs, capacity, as well as a number of parameters that cannot be assessed with spirography.
Be sure to take blood for a general analysis. This makes it possible to identify hemoglobin, red blood cells, against which conclusions are drawn about oxygen deficiency. If we are talking about an exacerbation, then a general analysis provides information about the inflammatory process. Analyze the number of leukocytes and ESR.
Blood is also examined for gas content. This makes it possible to detect not only the concentration of oxygen, but also carbon dioxide. Cancorrectly assess whether the blood is sufficiently saturated with oxygen.
ECG, ECHO-KG, ultrasound become indispensable studies, during which the doctor receives correct information about the state of the heart, and also finds out the pressure in the pulmonary artery.
Finally, fiberoptic bronchoscopy is performed. This is a type of study, during which the condition of the mucous membrane inside the bronchi is clarified. Doctors, using special drugs, receive tissue samples that allow you to examine the cellular composition of the mucosa. If the diagnosis is unclear, this technology is indispensable for its clarification, as it allows you to exclude other diseases with similar symptoms.
Depending on the specifics of the case, an additional visit to the pulmonologist may be scheduled to clarify the condition of the body.
Treat without medication
COPD treatment is a complex process that requires an integrated approach. First of all, we will consider non-drug measures that are mandatory in case of illness.
Doctors recommend:
- quit smoking completely;
- balance your diet, include protein-rich foods;
- correct physical activity, do not overexert;
- reduce weight to the norm if there are extra pounds;
- regular slow walk;
- go swimming;
- practice breathing exercises.
And if drugs?
Of course, drug therapy for COPD is also indispensable. First of all, pay attention to vaccines against influenza and pneumococcus. The best thingto be vaccinated in October-mid-November, since then the effectiveness decreases, the likelihood increases that there have already been contacts with bacteria, viruses, and the injection will not provide an immune response.
They also practice therapy, the main purpose of which is to expand the bronchi and keep them in a normal state. To do this, they fight spasms and apply measures that reduce sputum production. The following medicines are useful here:
- theophyllines;
- beta-2 agonists;
- M-cholinolytics.
The listed drugs are divided into two subgroups:
- long acting;
- short action.
The first group maintains the bronchi in a normal state up to 24 hours, the second group acts 4-6 hours.
Short-acting drugs are relevant in the first stage, as well as in the future, if there is a short-term need for this, that is, symptoms suddenly appear that need to be urgently eliminated. But if such medicines do not give a sufficient result, they resort to long-acting medicines.
Also, anti-inflammatory drugs should not be neglected, as they prevent negative processes in the bronchial tree. But it is also impossible to use them outside the recommendations of doctors. It is very important that the doctor supervise drug therapy.
Serious therapy is no cause for fear
With COPD, glucocorticosteroid hormonal drugs are prescribed. As a rule, in the form of inhalations. But in the form of tablets, such drugs are good during the periodexacerbations. They are taken in courses if the disease is severe, has developed to a late stage. Practice shows that patients are afraid to use such drugs when the doctor recommends them. This comes with concerns about side effects.
Be aware that most adverse reactions are caused by hormones taken in the form of tablets or injections. In this case, not uncommon:
- osteoporosis;
- hypertension;
- diabetes.
If the drugs are prescribed in the form of inhalations, their effect will be milder due to the small dose of the active substance that enters the body. This form is applied topically, affecting primarily the bronchial tree, which helps to avoid most side effects.
It should also be taken into account that the disease is associated with chronic inflammatory processes, which means that only long courses of medications will be effective. To understand whether there is a result from the selected drug, you will have to take it for at least three months, and then compare the results.
Inhalation forms may cause the following side effects:
- candidiasis;
- hoarse voice.
To avoid this, you need to rinse your mouth every time after taking the remedy.
What else will help?
In COPD, antioxidant preparations containing a complex of vitamins A, C, E are actively used. Mucolytic agents have proven themselves well, as they dilute the mucosal sputum produced and help to cough it up. Useful oxygentherapy, and in case of severe development of the situation - artificial ventilation of the pulmonary system. With an exacerbation of the disease, you can take antibiotics, but under the supervision of a doctor.
Selective phosphodiesterase inhibitors - 4 have brought considerable benefits. These are rather specific drugs that can be combined with some drugs used in the treatment of COPD.
If the disease is provoked by a genetic defect, then it is customary to resort to replacement therapy. For this, alpha-1-antitrypsin is used, which, due to a congenital defect, is not produced by the body sufficiently.
Surgery
In some cases, doctors recommend turning to the possibilities of surgical treatment. At the same time, doctors remove damaged elements of the lungs, and in especially difficult cases, they perform lung transplantation.
Preventive measures
What is the practice of COPD prevention? Are there effective ways to prevent the development of the disease? Modern medicine says that it is possible to prevent a disease, but for this a person must take care of his he alth and treat himself responsibly.
First of all, you need to stop smoking, as well as about the possibility of eliminating exposure to harmful conditions.
If the disease is already detected, its progression can be slowed down by applying secondary preventive measures. The most effective showed themselves:
- vaccination to prevent influenza, pneumococcus;
- regular appointments prescribed by a doctormedicines. Remember that the disease is chronic, so temporary therapy will not bring real benefit;
- exercise control. It helps to train the muscles of the respiratory system. You should walk and swim more, use the methodologies of breathing exercises;
- inhalers. They need to be able to use them correctly, since incorrect operation leads to the absence of the result of such therapy. As a rule, the doctor is able to explain to the patient how to use the medication so that it is effective.
