COPD is a generic term for chronic bronchitis and pulmonary emphysema - chronic, chronic airway obstructive pulmonary disease characterized by the fact that exhalation is impeded by a narrowing of the bronchi. In the course then comes a destruction of the lung tissue. As a result, the gas exchange is increasingly impaired and the organism does not get enough oxygen.
Causes of COPD
COPD is the result of cigarette smoking in around 9 out of 10 cases - hence the colloquial term smoker's lung. Other causes, such as infections or air pollution, as well as occupational risk factors (dust, chemicals) may favor COPD. The severity and course of the disease are also dependent on genetic factors.
In rare cases it is based on a congenital disease: the AAT deficiency. It lacks an important enzyme, the alpha-1-antitrypsin (also: alpha-1-proteinase inhibitor), which protects the sensitive alveoli from harmful substances. If this substance is missing or does not function adequately, the alveoli and respiratory tract are constantly attacked by inhaled substances and gradually destroyed. For those affected, however, the symptoms usually appear in younger years (25 to 30 years).
Symptoms of COPD
The main signs of the disease are chronic cough especially in the morning, expectoration and increased shortness of breath, especially under stress - in the advanced stage, even short distances become impossible. In the course of the disease, the airways become increasingly narrow and the respiration is impeded. Especially when exhaling the air flow is limited.
Over the years, in addition to respiratory distress, a feeling of "hyperinflation" of the lungs develops. The affected person then has the depressing feeling of constantly breathing on the last reserves of his lungs.
COPD or asthma?
Unlike asthma, COPD is on the quiet side - the disease develops over years or decades. A typical sign of asthma, however, is a sudden onset of shortness of breath. Although asthma and COPD are both associated with a narrowing of the respiratory tract, there are still two different clinical pictures that are also treated differently.
Diagnosis of chronic obstructive pulmonary disease
Any cough that lasts longer than eight weeks may indicate COPD, especially if the person smokes: Risk groups are long-term smokers over the age of 40 who suffer from shortness of breath due to stress, coughing and expectoration (AHA symptoms).
The presumptive diagnosis COPD is usually made by the doctor already out of the described symptoms and the medical history, it is secured especially with the so-called spirometry. With this study, the function of the lung can be assessed by measuring the respiratory volume that can be exhaled after a maximum of deep inhalation in one second with the greatest effort.
Although therapy can not eliminate the cause, early diagnosis and timely treatment of COPD is important to prevent the disease from progressing. Another argument in favor of early treatment is the fact that COPD sometimes leads to considerable physical and social restrictions for those affected, and not infrequently to an increased mortality rate. The risk of cardiac diseases is also greatly increased.
Treatment of COPD
A causal therapy of COPD does not exist until today. This means that the disease can not be cured, but it can slow down the course and positively influence acute worsening. The goal of any treatment is better lung function, less respiratory distress and increased exercise capacity.
Therapy for COPD is composed as follows:
- The most important measure to stop the creeping decay of lung function is smoking cessation.
- Physical exercise or rehabilitative training are also basic measures.
- It is also essential that those affected learn under guidance how they can positively influence their breathing in daily life. These include breath-relieving techniques (lip brakes, certain body postures, cough techniques) at rest, but also under stress.
- In particular, bronchodilators (expand the airways) and cortisone preparations (for inflammation) are used for inhalation.
Often affected people find the conversion difficult
Many sufferers struggle to implement these measures. The following factors play a role:
- The complaints often seem "banal". The typical symptoms of coughing and expectoration are often downplayed by patients.
- An airway obstruction does not arise overnight, but over a long period of time. An asthma patient changes his lifestyle very quickly after a seizure, whereas COPD patients adapt to the symptoms without giving up the causal evil, smoking.
- Because of the shortness of breath so-called avoidance strategies are developed. Although physical exercise would be important, those affected increasingly restrict their scope and everyday life then mainly takes place while sitting down.
- COPD patients often have many attempts to quit smoking and are sometimes discouraged. Therefore, the insight and a genuine effort to change the lifestyle and quit smoking are missing.
COPD: self-help information
Those affected therefore need information in order to successfully implement the therapeutic measures themselves:
- Knowledge about the illness and effects of air or environmental pollution
- Self-control for example peak flowmetry, keeping a COPD diary (available from the German respiratory league)
- Information in dealing with hazardous situations (for example, stays at high altitude, on air travel, certain sports)
- Sports and training therapy, because suitable physical training leads to an increase in performance
- a structured patient training to improve the self-management ability