Chronic Obstructive Pulmonary Disease (COPD) represents a group of progressive lung conditions that impede airflow, making breathing difficult. It is characterized by long-term respiratory symptoms and gradually develops over many years, often without immediate noticeable symptoms.
Common Symptoms
Individuals with COPD experience a range of symptoms. Shortness of breath is a primary indicator, initially occurring during physical activity and eventually progressing to breathlessness even at rest.
A persistent, chronic cough is another common symptom, which may or may not produce mucus or phlegm. This cough can be intermittent. Wheezing, a whistling or squeaky sound during breathing, and chest tightness are also frequently reported. Less common symptoms include weight loss, fatigue, and swollen ankles due to fluid buildup.
Lung Changes in COPD
COPD encompasses two main conditions: chronic bronchitis and emphysema, which often coexist. Chronic bronchitis involves inflammation and narrowing of the bronchial tubes, the large airways that carry air to and from the lungs. This inflammation leads to increased mucus production, which can clog the airways and make breathing difficult.
Emphysema, on the other hand, involves damage to the tiny air sacs, called alveoli, located at the end of the airways. With emphysema, their walls are destroyed, leading to larger, less efficient air pockets. This damage reduces the surface area available for oxygen absorption into the bloodstream and carbon dioxide removal, leading to trapped old air and reduced oxygen delivery.
Diagnosing COPD
Identifying COPD involves a comprehensive assessment by a healthcare provider. This process begins with a review of the individual’s medical history, including any history of smoking or exposure to lung irritants. A physical examination is also performed, during which the doctor may listen to the lungs for abnormal sounds like wheezing.
The most definitive diagnostic test for COPD is spirometry. This lung function test measures how much air a person can breathe out and how quickly they can do so. During spirometry, the individual breathes into a machine called a spirometer. The test measures the volume of air exhaled in one second (FEV1) and the total amount of air exhaled (FVC); a post-bronchodilator FEV1/FVC ratio below 0.7 is a key criterion for diagnosis. Early diagnosis through spirometry can detect COPD before symptoms are fully recognized, allowing for earlier management.
Disease Progression
COPD is a chronic and progressive condition, meaning its symptoms tend to worsen over time. The gradual decline in lung function can lead to increasing breathing difficulties, significantly impacting daily activities. While the damage to the lungs is permanent, early diagnosis and appropriate management can help slow the disease’s progression.
Individuals with COPD may experience periods when their symptoms suddenly intensify, known as exacerbations or flare-ups. These episodes can last for days or even weeks and often require additional medication or, in severe cases, hospitalization. Exacerbations are commonly triggered by respiratory infections, such as viral or bacterial lung infections, but can also be caused by environmental factors like smoke or air pollution. Each exacerbation can potentially contribute to further, irreversible lung damage and accelerate the decline in lung function.