Chronic obstructive pulmonary disease

March 9, 2021Articles 1

Chronic obstructive pulmonary disease (COPD) is a chronic in- flammatory lung condition in which there is a slow, progressive obstruction of airflow into or out of the lungs. Chronic obstructive pulmonary disease is an airflow limitation that is not fully reversible, usually is progressive and is associated with an abnormal inflammatory response with an abnormal inflammatory response of the lungs to inhaled noxious particles or gases.
Types-

Chronic obstructive pulmonary disease is an umbrella term used when you have one or more of these conditions-
• Emphysema-
This results from damage to your lungs, air sacs (alveoli) that destroys the walls inside them and causes to merge into one giant air sac. It cannot absorb oxygen as well, so you get less oxygen in your blood.Damaged alveoli can make your lungs stretch out and lose their springiness. Air gets trapped in your lungs and you can’t breathe it out,So you feel short of breath.
• Chronic bronchitis –
If you have coughing, shortness of breath and mucus that lingers atleast 3 months for 2 years in a row,you have chronic bronchitis.Hair-like fibers called cilia line your bronchial tubes and help move mucus out. When you have chronic bronchitis, you lose your cilia. This makes it harder to get rid of mucus, which makes you cough more and ultimately creates more mucus.
• Refractory asthma –
This type may also be called nonreversible. It doesn’t respond to normal asthma medications.
Symptoms –

Symptoms of COPD appears in two stages –
• Early symptoms –
At first, symptoms of COPD Can be quite mild. Patient might mistake than for a cold.
Early symptoms include-
▪︎occasional shortness of breathe, especially after exercise
▪︎ mild but recurrent cough
▪︎ needing to clear your throat often, especially first thing in the morning
Patient might start making subtle changes, such as avoiding stairs and skipping physical activities.
• Worsening symptoms –
Symptoms can get progressively worse and harder to ignore. As the lungs become more damaged, you may experience –
▪︎ shortness of breath, after even mild forms of exercise like walking up a flight of stairs
▪︎ wheezing, which is a type of higher pitched noisy breathing, especially during exhalations
▪︎ Chest tightness
▪︎ need to clear mucus from lungs everyday
▪︎ frequent colds, flu or other respiratory infections
▪︎ chronic cough, with or without mucus
▪︎ lack of energy
In later stages of COPD, symptoms may also include-
▪︎ fatigue
▪︎ swelling of the feet, ankles or legs
▪︎ weight loss
Causes-
• Cigarette smoke- This is by far the most common reason of COPD. One can also get it from tobacco products, such as cigar and pipe smoke, especially if you breathe in the smoke.
• Secondhand smoke- Even if you aren’t a smoker, you can get COPD from living with one.
• Pollution and fumes- COPD can be caused by air pollution also. Breathing in chemical fumes, dust, or toxic substances at work can also cause it.
• Genetic defect- In rare cases, people with COPD have a defect in their DNA, the code that tells your body how to work properly. This defect is called, ” alpha-1 antitrypsin deficiency”, or AAT deficiency. If you or a family member had serious lung problems- especially at a young age – you should go for AAT deficiency testing
• Asthma – If you don’t treat your asthma, lung damages over time can lead to COPD.
How your lungs are affected –

Air travels down your windpipe (trachea) and into your lungs through two large tubes (bronchi).Inside your lungs, these tubes divide many times- like the branches of a tree – into many smaller tubes (bronchioles) that end in clusters of tiny air sacs (alveoli).
The air sacs have very thin walls full of tiny blood vessels (capillaries). The oxygen in the air you inhale passes into these bloved vessels and enters your bloodstream. At the same time, carbon dioxide – a gas that is a waste product of metabolism – is exhaled.
Your lungs rely on the natural elasticity of the bronchial tubes and air sacs to force air out of your body. COPD causes them to lose their elasticity and over – expand, which leaves some air trapped in your lungs when you exhale.
Complications-
• Respiratory infections
• Heart problems
• Lung cancer
• High blood pressure in lung arteries
• Depression
Diagnosis-
During the physical examination, the doctor will use a stethoscope to listen to patients lungs as he/she breathe. Based on all this information, doctor may order some of following tests to get a more clean picture of disease-
• Spirometry
• Imaging tests like a chest X-ray or CT-scan.
• An arterial blood gas test.
These tests can help determine if you have COPD or a different condition, such as asthma, a restrictive lung disease or heart failure.
Treatment-
Many people with COPD have mild forms of the disease for which little therapy is neededother than smoking cessation. Even for more advanced stages of disease, effective therapy is available which is as follows-
• Medications –
▪︎Bronchodilators are medications that usually come in inhalers- they relax the muscles around your airways. This can help relieve coughing and shortness of breath and make breathing easier. Depending on the severity of your disease. you may need a short-acting bronchodilator before activities,a long acting bronchodilator that you use everyday or both.For example short acting bronchodilators are-
° Albuterol
° Ipratropium
Examples of long acting bronchodilators are –
° Formoterol
° Arformoterol
° Salmeterol
▪︎Inhaled steroids can reduce airway inflammation and help prevent exacerbations. These medications are useful for people with frequent exacerbations of COPD. Examples of inhaled steroids include-
° Fluticasone
° Budesonide
▪︎Combination Inhalers add on both bronchodilators and inhaled steroids. Examples are –
° Fluticasone and vilanterol
° Formoterol and budesonide
° Salmeterol and fluticasone
▪︎Oral steroids are for those people who experience periods when their COPD becomes more severe, called moderate or severe acute exacerbation, short courses ( e.g. 5 days) of oral corticosteroids may prevent further worsening of COPD.
▪︎Theophylline is used when other treatment has been ineffective or if cost is a factor, a less expensive medication, may help improve breathing and prevent episodes of worsening COPD.
▪︎Antibiotics help treat episodes of worsening COPD, but they are not generally recommended for prevention. For example Azithromycin.
• Lung Therapies-
Doctors often use these additional therapies for people with moderate or severe COPD.
▪︎Oxygen therapy – when there is not enough oxygen in your blood, you may need supplemental oxygen.
▪︎Pulmonary rehabilitation program – These programs generally combine education, exercise training, nutrition advice and counselling.
Ayurvedic Perspective-
From Ayurvedic point of view, COPD can be termed as, disorder of Pranavaha srotas.Pranavaha Srotodushti are nearly similar with those of COPD and occurs usually in the prolonged conditions of Kasa or Tamaka Swasa.
Beneficial Herbs-
• Ardraka –

• Ela –

• Haridra –

• Pippli –

• Guduchi –

Effective Medications-
• Chitraka Haritaki
• Vyoshadi Churna
• Shringyadi Churna
• Talishadi Churna
• Vasarhishta
• Mahalaxmivilas Ras
• Pippalyadi Gutika
• Agastya Haritaki
• Vyaghri Haritaki
Yoga and Pranayam –
• Kapalbhati –