Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) is characterized by the inability of your lungs to ventilate properly. The spectrum of COPD encompasses emphysema, Chronic Bronchitis, and reactive airways disease. Reactive airways disease is similar to asthma and Bronchitis. Most cases of COPD are a mixture of these diseases. Chronic bronchitis is defined as excessive mucous production on at least three months of two consecutive years. Emphysema is caused by destruction of the air sacs (alveoli) in the lungs. These diseases cause inhaled air to remain trapped in the lungs. Therefore, effective air exchange does not take place. COPD is not a contagious disease. It is most often the result of long-time smoking, but some cases of emphysema may be hereditary. Other less common causes include air pollution, childhood infections, and inhalation injury. 

Your doctor can diagnose COPD by evaluating your symptoms, performing a complete physical examination, and ordering pulmonary function tests, a chest x-ray, and arterial blood gases. In emphysema, pulmonary function tests may show large lung volumes and difficulties expiring air. This disease is associated with shortness of breath and little cough or sputum production. Patients with chronic bronchitis may have the same features but also have a chronic, productive cough. This disease may cause disturbances in sleep due to mucous collection in the airways. The chest x-ray allows the doctor to look at changes in the lung because of the disease. Arterial blood gases measure how much oxygen and carbon dioxide is carried in your blood. Abnormal arterial blood gas values are often found in these diseases. These diseases are progressive and can lead to increased strain on your heart. 

Treatment includes smoking cessation and oxygen in people who are found to have a deficiency in oxygen in their blood. It may often include bronchodilation, antibiotics, decongestion and exercise. Vaccinations may decrease the number and type of infection you acquire and your doctor may recommend an influenza vaccine and a pneumococcal pneumonia vaccine. The inherited form of emphysema may require monthly intravenous injection to replace the enzyme which is deficient. Medical treatment and occasional lung transplant may be useful in the treatment of emphysema and bronchitis.

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