Generality
Chronic obstructive pulmonary disease (known in English as COPD, Chronic obstructive pulmonary disease) is a progressive disease affecting the bronchi and lungs.
COPD is characterized by airflow limitation, which tends to worsen over time, making breathing difficult
Initially, COPD can manifest itself with dyspnoea, even after small efforts, and cough with the presence of phlegm.
Currently, there is no effective cure, but several treatments are available to control symptoms and avoid dangerous complications.
What's this
- Chronic obstructive pulmonary disease, also called chronic obstructive pulmonary disease (COPD), is a pathology of the respiratory system, characterized by an irreversible obstruction of the airways (bronchi and lungs).
- COPD is associated with a state of chronic inflammation, which results in an "excessive production of mucus, a thickening of the bronchial walls and destruction of the lung parenchyma (emphysema).
- In the long term, the consequence of this pathological process is a real remodeling of the bronchi, which causes a consistent reduction in respiratory capacity (chronic obstructive bronchitis).
Causes
Chronic obstructive pulmonary disease is due to the combination of various insults, which add up over the years, damaging the bronchi and lungs.
In the presence of COPD, the air enters and exits with difficulty from the airways, which are narrowed, since their walls tend to be thickened and edematous (swollen) due to the contraction of the small muscle cells that surround them or due to the accumulation of mucous secretions.
The most important cause of chronic obstructive pulmonary disease is tobacco smoke, particularly cigarette smoking (minus cigar and pipe smoking), which accelerates and accentuates the natural decay of respiratory function.
COPD typically begins in adulthood, and those affected have almost always been smokers for many years.
Other factors implicated in the development of COPD are:
- Passive smoke (favors the inhalation of gas and particulates);
- Exposure to irritating particles, fumes and vapors, dust and chemicals, both at home and in the workplace (example: silica or cadmium and products of combustion of cooking or heating fuels).
- Air pollution (smog and environmental fine dust, emissions from motor vehicles, stoves, air conditioning systems, etc.);
- Respiratory disorders (asthma and bronchial hypersensitivity);
- Airway infections (bronchitis, pneumonia and pleurisy).
Among the individual factors, there are some genes that are thought to be associated with the onset of COPD. At the moment, the deficiency of alpha-1 antitrypsin, a liver protein, which has a protective effect on the elastic fibers of the alveoli, has been indicated as significant. pulmonary.
Any factor that adversely affects lung development during pregnancy or childhood can also contribute to the onset of chronic obstructive pulmonary disease.
Symptoms, signs and complications
The development and progression of COPD takes several years. Symptoms usually appear more quickly in people who continue to smoke. In any case, COPD results in a consistent reduction in respiratory capacity.
At onset, chronic obstructive pulmonary disease presents with two typical symptoms:
- Dyspnea;
- Productive cough.
Dyspnea is described as an increased effort to breathe or wheezing during even moderate physical exertion (for example, walking). Generally, this manifestation appears gradually over several years and in the most severe cases it can come to limit normal daily activities.
Often, the cough is most intense in the morning and characterized by chronic mucus production (ie with phlegm for 3 or more months a year, for 2 consecutive years). The sputum can be extremely thick and difficult to clear.
The increased susceptibility to respiratory infections of viral, bacterial or fungal origin contributes to this clinical picture. These infections tend to heal slowly and can cause relapses accompanied by aggravated symptoms. As COPD progresses, these episodes tend to become more and more frequent and can induce an "important inflammatory response.
COPD flare-up is a sudden event, usually caused by an infectious cause that causes respiratory symptoms to worsen rapidly. This condition can represent a "medical emergency."
Over the years, COPD patients may develop:
- Wheezing and chest tightness, especially after exertion;
- Weight loss (also due to reduced appetite);
- Morning headache (sign of nocturnal hypercapnia or hypoxemia);
- Lack of energy;
- Swelling in the ankles, feet or legs.
More advanced forms of the disease can be complicated by:
- Pneumothorax;
- Pulmonary hypertension;
- Frequent episodes of acute systemic decompensation;
- Right heart failure;
- Acute or chronic respiratory failure.
Attention! See your doctor (or emergency room) immediately if your symptoms suddenly worsen or if you feel like you can't breathe.
Diagnosis
In case of breathing difficulties and an increase in the frequency of typical winter diseases (colds, flu and bronchitis), it is good to consult your doctor. Chronic cough and expectoration may also precede bronchial obstruction by many years.
If COPD is suspected, the pulmonologist visits the patient and collects a series of anamnestic information about cigarette smoking or the presence of other risk factors, the quality of breathing and the frequency of bronchitis episodes. of the physical examination, the doctor also evaluates the pathologies possibly associated with COPD, such as cardiovascular disease, osteoporosis, metabolic syndrome and depression.
