Thursday, November 15, 2012

Chronic Obstructive Pulmonary Disease (COPD)

By Sandra Gilley, MD
Pulmonary Associates of the Southeast

COPD refers to two lung diseases, chronic bronchitis and emphysema, that cause airflow obstruction that interferes with normal  breathing. Asthma is not included in COPD, but people with asthma  may develop COPD over time. The incidence of COPD among adults in the US in 2008 was 12.1million people. COPD is the fourth leading cause of death in the US.

Tobacco use is the key factor in the development of COPD in the US. Approximately 80 to 90 percent of COPD deaths are caused by smoking. But air pollution in the home and work place, second-hand smoke, and genetic factors also play a role. In developing countries the use of indoor wood-burning cook stoves is thought to play a much larger role in the development and progression of COPD, especially among women. Thus, COPD is a largely preventable disease and early detection  might change its course.

The diagnosis of COPD should be considered in any patient who has dyspnea, chronic cough or sputum  production and/or a history of exposure to risk factors for the disease. Spirometry is required  to make the diagnosis. The severity of the disease is assessed based on the patient's symptoms, risk of exacerbations, degree of spirometric abnormality, and the identification of comorbidities.

The most important step to preventing COPD and slowing its progression is to stop smoking.  Treatment of COPD is based on the symptoms  and disease severity. Pharmacologic therapy included bronchodilators, steroids,  and other medications. These can reduce COPD symptoms, reduce the frequency  and severity of exacerbations, and improve health status and exercise tolerance. Vaccinations for Influenza and Pneumococcal pneumonia  can reduce serious  illness and death in COPD patients. All patients with COPD appear to benefit from rehabilitiation and maintenance of physical activity. Supplemental oxygen therapy improves  exercise tolerance and reduces  mortality.

World COPD Day is an annual event organized  by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) to improve awareness and care of COPD. This year, the event took place on November 14th, with this year's theme being "It's Not Too Late." As part of World COPD Day, Pulmonary Associates of the Southeast hosted a COPD fair in the 1st floor lobby at 880 Montclair Road.

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