COPD: Coughing and shortness of breath, is that a silent killer?
This often misunderstood disease causes severe breathing difficulties and can be fatal. Here’s all you need to know from Dr Philippe Serrier, pulmonologist at Cochin Hospital in Paris.
WHAT IS COPD?
It is the acronym for Chronic Obstructive Pulmonary Disease. This term refers to a disease which occludes the bronchus, causes a decrease in respiratory rate and may be associated with the destruction of lung tissue.
WHAT ARE THE SYMPTOMS ?
Severe respiratory failure that can lead to death when the disease reaches its later stages. The bronchial tubes get clogged very gradually and it is for this reason that COPD is so difficult to diagnose. The patients are not aware of anything and gradually reduce their physical exertion because of shortness of breath. They also come with other general symptoms: a morning cough with bronchial obstruction, fatigue or depression.
At which age does the disease appear?
This is very variable but usually not before forty.
WHAT ARE THE RISK FACTORS?
Mainly tobacco. The risk of developing the disease is higher in people who smoke cigarettes (particularly more than one pack a day for fifteen years). Exposure to industrial toxins (petrochemicals, pharmaceuticals, agriculture, dusty work…) is also problematic. It is likely that air pollution is involved. But in 90% of cases, smokers (or former smokers) are the victims of COPD.
Would the disease go away by not smoking?
Unfortunately no. What is lost is permanent. Especially if COPD is associated with emphysema – that is to say the destruction of lung tissue. But when one stops smoking, respiratory decline slows and becomes substantially identical to that of non-smokers.
HOW COPD DIAGNOSED?
With a measurement of breath, to be performed regularly in all exposed smokers or workers. If your doctor does not think, do not hesitate to remind him. The examination can be performed directly in the cabinet if the practitioner has a spirometer. Blowing into this machine, you’ll be able to measure respiratory flows. It is quick and easy. In case of doubt about the outcome, they will send you to a lung specialist to confirm the diagnosis.
HOW DIFFERENT is it from ASTHMA?
Asthma is also reflected in a decline in respiratory rate. But it is variable in time and reversible thanks to medication while it is not the case in COPD. As for chronic bronchitis, characterized by cough and sputum for several months to several years on, it may not be a decrease in respiratory rate but the breath to be measured.
WHAT ARE THE AVAILABLE TREATMENTS?
The use of bronchodilators saves a little bit of breath even if the respiratory rate are limited and they improve exercise tolerance. Inhaled corticosteroids are reserved for severe forms with exacerbation (that is to say that the increase in symptoms is significant and unusually long). It usually results from infection. There are also therapeutic education programs that combine re-training to stress, psychological and dietary support.
ARE THERE OTHER DISEASES FREQUENTLY ASSOCIATED WITH COPD?
Unfortunately yes. Including cardiovascular disorders, muscle wasting, osteoporosis, sleep apnea, undernutrition, anemia, lung cancer and diabetes may be associated with COPD.
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Maureen Diament
