COPD is one of the most important and commonly seen diseases in respiratory medicine. Annually, 3 million people die due to COPD. Many patients with COPD are unaware that they have the disease. However, it is a preventable and treatable condition with early diagnosis and treatment. Therefore, I would like to inform our patients about this disease, even briefly.
What is COPD? ‘’COPD stands for "Chronic Obstructive Pulmonary Disease."
- Chronic: Refers to conditions that have been ongoing for a long time.
- Obstructive: Describes the narrowing of the airways. This narrowing can be heard as wheezing by patients. In COPD, airway narrowing is progressive and can become fatal if not intervened in time.
Chronic bronchitis is characterized by a cough and sputum production lasting at least three months for two consecutive years. This cough may be confused with other chronic cough-causing lung diseases such as asthma or tuberculosis, thus requiring investigation.
Emphysema involves damage to the air sacs in the lungs, hindering the regular entry and exit of air during breathing. The abnormal enlargement of these sacs leads to narrowing of the small airways.
Primary Cause of COPD Smoking addiction is the primary cause of COPD. Smoking prevalence has been increasing in our country, and the age at which individuals start smoking is decreasing. Consequently, the frequency of COPD is also rising. How does smoking lead to the disease?
When cigarette smoke reaches the airways, cells gather to clear harmful substances, resulting in inflammation and swelling. The produced mucus increases muscle tension, distorting the structure of bronchial cartilage and air sacs, which narrows the small airways.
Various occupational diseases, such as coal mining, textile, and metalworking, when combined with smoking, can lead to a much faster progression of the disease. Air pollution, use of stoves, and passive smoking are other triggering factors.
How Does a COPD Patient Present to Us? The three most common symptoms are cough, sputum production, and shortness of breath. Patients often attribute these symptoms to smoking, failing to realize their illness. However, over time, symptoms like increased sputum volume, changes in sputum color to yellow-green, and breathlessness during long walks or activities develop. The anterior-posterior chest diameter increases, and as oxygen capacity decreases, cyanosis appears at the fingertips and lips.
How Can We Diagnose COPD?
- Patient history and complaints: Cough, sputum, shortness of breath.
- Pulmonary Function Tests: These are crucial for both diagnosing and monitoring the disease. They also provide information to differentiate between asthma and COPD. We assess lung capacity and the degree of narrowing with these tests.
- **Chest X-ray, and if necessary, CT scans, along with measuring blood oxygen levels, sputum culture in cases of changed sputum quantity and color, guide us in diagnosing and treating the disease.
First Step in COPD Treatment Quitting smoking is the first step. You can seek support from existing smoking cessation clinics.
COPD Treatment Program:
- Smoking cessation: Nicotine replacement medications (which must be taken under medical supervision) and Bupropion (a medication that facilitates quitting smoking).
- Long-term medication: Bronchodilators are used, which, contrary to popular belief, are not addictive. The content and dosage of inhaler therapy are determined based on pulmonary function tests.
- Nutrition: If underweight, focus on protein and fat-rich foods (like meat, chicken, fish, and eggs); if overweight, avoid sugary, starchy, and fatty foods to maintain weight control. If carbon dioxide levels in the blood are elevated, prefer fatty foods and divide meals into six portions.
- Adherence to treatment: Consistent and proper adherence to treatment during exacerbations is crucial for the progression and management of the disease.
