COPD

What is COPD?

• COPD is an abbreviated disease name consisting of the initials of the name "Chronic Obstructive Pulmonary Disease".

CHRONIC means long-standing and will not go away.

OBSTRUCTIVE means obstructive. It means that the windpipes (bronchi) narrow in this disease.

• With years of exposure to cigarette smoke and other harmful gases and dust, the structures of the windpipes and air sacs (alveoli) are damaged. The disease that occurs due to deterioration and narrowing in the structure of the windpipes is called CHRONIC OBSTACLE BRONCHITIS, and the destruction and disintegration of very small windpipes and air sacs is called EMPHYSEMA. COPD is a term that covers these two diseases, and often these two diseases coexist.

• COPD; It is a disease that narrows the windpipes and slows down the outflow of respiratory air from the lungs. For this reason, the complaint of shortness of breath begins because sufficient breathing is not possible during exertion. COPD; It is a chronic and progressive disease that causes shortness of breath. Shortness of breath is often accompanied by cough and sputum production.

• COPD; It can be prevented if there is no respiratory exposure to all kinds of harmful gases and dust, especially cigarettes, that cause the disease.

• In people who smoke or are exposed to other risk factors, shortness of breath, cough, and phlegm may occur. When complaints of ejaculation begin, it is necessary to immediately consult a health institution. Because with early diagnosis and correct treatment, it is possible to get rid of this progressive and lung-crippling disease.

• It is not possible to treat and repair the disorders that occur in the structures of the windpipes and alveoli. Medications can only reduce the complaint of shortness of breath. Medicines have no effect on eliminating the disease or slowing its progression. After stopping smoking and other exposures in a patient with COPD, the damaged structure of the lungs cannot be repaired, but the progression of the disease slows down.

• Slow down the rate of progression of COPD. The most effective method known to eliminate the disease is to stop using cigarettes and other tobacco products and other exposures that cause the disease. Exposure to all kinds of harmful inhaled gases, dust and particles should be avoided at home, at work or in open environments.

• COPD is a treatable disease. With early diagnosis, termination of risky exposures, regular use of medications, maintenance of physical activity, and compliance with other treatment rules, many COPD patients can live a near-normal life.

For COPD. What are the risk factors?

COPD; It is a disease that occurs as a result of interaction with environmental factors, also called "risk factors", in people with genetic predisposition.

Smoking is the most important cause of COPD. At least 25% of smokers develop COPD. In other words, one in three or four smokers develops COPD. There are varying degrees of sensitivity to cigarette smoke exposure among individuals. It is the genetic characteristics that determine this situation. For this reason, while COPD does not develop in people who have smoked for many years, there may be patients diagnosed with COPD at a young age.

 

COPD occurs after approximately 20 years of smoking a pack of cigarettes a day. If more than one pack of cigarettes is smoked per day, the time to development of COPD may be even shorter. The disease usually begins to show symptoms after the age of 40. The majority of patients diagnosed with COPD are current smokers or have smoked for a long time and quit. The disease progresses insidiously because smokers generally ignore complaints such as shortness of breath, cough and phlegm due to exertion. For this reason, when COPD is diagnosed, patients usually lose a significant part of their lung capacity.

 

Biofuels (coal, wood) used for making bread, making tandoors and cooking in rural areas. Inhalation of smoke (e.g. charcoal, charcoal and dung) is also a very important risk factor, just like smoking. It is estimated that 3 million people in the world are exposed to biofuel smoke. This number is much higher than the number of smokers.

Eat work Long-term exposure to dust, smoke and chemicals is an important risk factor for COPD. Mines, metal industry, wood industry, paper production, cement, grain and textile labor are the leading risky business groups. Irritating gases and fumes that may cause COPD; nitrogen oxide, sulfur dioxide, strong acids, ammonia, chlorine, ozone, phosgene, paint, resin and varnish.

Air pollution in cities can also cause COPD and when added to other exposures. It is estimated that it will facilitate the development of COPD disease. Additionally, air pollution is an important cause of COPD exacerbations.

Asthma is considered a risk factor for COPD. It becomes very easy for asthmatic patients to develop COPD, especially if they do not pay attention to their treatment and are exposed to risk factors for COPD.

Poor lung development due to lower respiratory system infections and malnutrition in childhood is a risk factor for COPD. It is considered a risk.

Alpha-1 antitrypsin (AAT) deficiency, which is a genetic disease, is also an important risk factor for COPD. The AAT enzyme is synthesized in the liver and is responsible for protecting the protein structure of the body. The risk of developing COPD increases due to lung damage that may occur in enzyme deficiency.

What is the prevalence of COPD?

COPD is a very important global public health problem for the whole world. According to World Health Organization (WHO) reports, it is the disease with the fastest increasing mortality rate. However, it is not given enough importance by governments and health authorities. It is estimated that there are approximately 600 million COPD patients in the world. In addition, it is thought that there are millions more COPD patients who are undiagnosed. Because COPD is an insidiously progressive disease and therefore two-thirds of patients are not diagnosed. While the prevalence of COPD is decreasing in developed countries, it is increasing in developing countries. In developing countries, the prevalence of COPD in the population over the age of 40 is approximately 10% on average, although it varies between countries. COPD has a higher rate in the population over the age of 60. With the most optimistic estimate, there are 5 million people with COPD in our country. upcoming The incidence of COPD will increase further in 30 years. COPD is much more common in men than women. However, it is estimated that there will be a significant increase in women in the future. COPD is the third most common cause of death today, and the annual death toll will approach 5 million by 2030. All these figures show that the diagnosis and treatment of COPD causes a significant economic cost.

What is the course of COPD?

In the early stages of the disease, the disease is mild. In the middle or middle stages, the complaint of shortness of breath is either absent or at a level that does not affect daily life or impair the quality of life. In this stage, shortness of breath; It is felt during efforts such as running, walking fast or climbing stairs. Patients reduce their effort levels to reduce shortness of breath, and in this case, the diagnosis of the disease is delayed. Very few of the patients are diagnosed in this period when the disease is just beginning.

Cough and sputum production have different severity in each patient. In the early stages of the disease, there is a lack of sensitivity to the fact that cough and sputum production may be the first signs of a significant disease. Generally, one does not go to the doctor unless complaints such as cough, phlegm production and shortness of breath are very disturbing. Cough and expectoration initially occur only in the morning. Phlegm is usually produced in very small amounts in the first years. Especially smokers do not pay attention to cough and phlegm and accept it as a natural consequence of smoking. An important reason why smokers do not go to the doctor because of their illness is to avoid receiving warnings to quit smoking. In fact, producing a small amount of phlegm along with a non-severe cough can be an early sign of a very important disease, namely COPD. If smoking continues and the disease progresses, coughs become more severe and the amount of sputum gradually increases. Patients begin to expectorate at any time of the day. Sometimes, a cough begins to be severe enough to cause suffocation.

As the disease progresses, patients begin to have difficulty in doing their jobs due to shortness of breath. At least half of the patients are diagnosed at a later stage and their lung capacity is at least half at the time of diagnosis. They lose theirs. As the disease progresses further, patients become unable to perform daily living activities. Patients need the help of others to continue their lives. In the later stages of the disease, blood oxygen levels decrease significantly, so they usually have to use oxygen constantly. Sometimes, using oxygen may not be sufficient, and in this case, it may be necessary to use artificial respiration devices called mechanical ventilators in addition to oxygen therapy.

In the advanced stages of the disease, many discomforts other than shortness of breath, cough and phlegm occur. These are;

• Profuse sweating

• Bruising on the tongue, lips, and fingertips

• Severe headache

• Palpitation

• Drowsiness during the day, insomnia at night

• Decrease in mental activities (forgetfulness, inattention)

• Extreme irritability

• Severe weakness, fatigue

• Weight Loss

• Decrease in sexual potency

• Stomach disorders, abdominal bloating and indigestion

• Constipation

• Numbness, tingling, burning sensation in hands and feet

• Tremors in the hands

• Blister collection (edema) in the feet

 

How is COPD diagnosed? How is it done?

COPD patients usually have one or more complaints of shortness of breath, cough and sputum production. It is important to suspect COPD whether there are risk factors or not. There is usually a history of smoking, biofuel use or asthma for at least 20-25 years. Complaints in patients generally increase during the winter months and the first diagnosis occurs during exacerbations.

The following tests are used in the diagnosis of COPD and evaluation of the disease. The definitive diagnostic method, defined as the "gold standard" in diagnosing COPD, is the test called breath test (spirometry). Spirometry is performed by breathing in and out through a device connected to a computer. Spirometry is a test that measures how much air goes in and out of the lungs and the speed of the air coming out. The windpipes are narrowed in COPD

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