Management of Chronic Obstructive Pulmonary Disease (COPD)



Posted: Monday, August 23, 2010

by Nobel Specialists
Nobel Specialists

Do you have COPD?

Do you have frequent or persistent cough?

Do you cough out phlegm?

Are you short of breath more than other people your age?

Do you smoke?

Are you 40 years old or more?

If you answered "yes" to at least 3 of these questions, it is time to have your lungs checked by a specialist because you may have developed Chronic Obstructive Pulmonary Disease (COPD).

How common is COPD?

> 3 million worldwide died of COPD in 2005

In 2008, COPD is 8th leading cause of death and 7th leading cause for hospital admission in Singapore

What happens in a COPD lung?

COPD is a term used to describe two lung disease processes- emphysema and chronic bronchitis

Emphysema: Like an inflated balloon, air sacs in the lungs in COPD are overstretched and damaged over time. Air is trapped and there is difficulty in bringing air in and out of the lungs.

Chronic bronchitis: the airways are swollen and filled with mucus

What cause COPD?

Long term exposure to lung irritants that destroy the lungs.

Main cause: chronic cigarette smoking

Others: breathing second- hand smoke, smoke from solid fuel cooking, air pollution and cigars

What are the symptoms?

Chronic cough and phlegm production

Shortness of breath on exertion

Chest tightness

Wheeze

Initially, a person with COPD may disregard the symptoms because they can modify the intensity of their daily activities. As the condition progresses, his activities such as walking, doing household chores and grocery shopping can be severely limited by breathlessness.

How is COPD diagnosed?

The loss of lung function in COPD patients is so gradual that many patients do not realize that they have the condition until it is severe. By the time most patients seek medical attention, they may have lost 50% of their pulmonary function.

There is a need for greater awareness of COPD and early diagnosis and treatment can retard progression of disease and improve quality of life.

The Chronic Obstructive Pulmonary Disease Association (Singapore) (www.copdas.com) and other international agencies such as the Global Initiative for Chronic Obstructive Lung Disease (www.goldcopd.com) strongly encourage smokers and ex-smokers, especially those with persistent cough and/or breathlessness to undergo simple lung function test known as spirometry, which is a gold standard for COPD diagnosis.

What is Spirometry?

Spirometry can be performed easily in the clinic

Patient is asked to breath out rapidly into instrument (spirometer) after taking a deep breath

Measures the ratio of the forced expiratory volume in the first second to the forced vital capacity (FEV1/FVC)

Most sensitive and specific test for detecting obstruction of airflow in the lungs

Spirometry has been found to be useful in differentiating COPD from other lung conditions like asthma

How is COPD treated?

Bronchodilator inhalers

Steriod inhalers

Quit Smoking

Vaccination influenza and pneumococcal

Oxygen therapy

Pulmonary rehabilitation/ regular physical exercise

Article By: Dr Jim Teo Yeow Kwan

Respiratory Physician & Intensivist, Nobel Chest & Internal Medicine Centre

www.nobel-chest.com

info@nobelspecialists.com
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