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Symptoms, diagnosis and causes of bronchitis and copd (chronic)

Symptoms, diagnosis and causes of bronchitis and copd (chronic)

Symptoms, diagnosis and causes of bronchitis and copd (chronic)

Symptoms, diagnosis and causes of bronchitis and copd (chronic)

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Chronic obstructive pulmonary disease is the collective term for lung disease caused by a long-term combination of emphysema and bronchitis. Breathing becomes more difficult over time because the airways become narrowed, the surface area of the lungs is reduced and breathing in and out becomes more of an effort.

Bronchitis is inflammation of the bronchi, which are the tubes that carry air deep into the lungs. As the lining of the bronchi becomes inflamed, the airways narrow. The inflammation also tends to produce a lot of mucus, which results in a persistent cough as the lungs try to clear it.

Emphysema is long-term damage to the alveoli (the tiny air sacs in the lungs). The delicate membranes become damaged and replaced with scar tissue. This has two key effects: gas exchange is less efficient and the lung tissue loses its natural elasticity, so that breathing out takes more of an effort than normal.

COPD has several other names:

  • Chronic obstructive respiratory disease (CORD)

  • Chronic obstructive lung disease (COLD)

  • Chronic airflow limitation (CAL)

  • Chronic obstructive airway disease (COAD).

Causes and Prevention

In the UK, close to one million people have been diagnosed with chronic obstructive pulmonary disease. It is the fourth most common cause of death after heart disease, cancer and stroke. It is thought that another two million have a mild form of COPD but have yet to seek medical help.

Mild COPD may produce few symptoms beyond occasional breathlessness and coughing in the morning (‘smoker's cough’), after exercise or following an infection. More severe COPD can result in a persistent, productive cough (one that produces phlegm) and breathlessness/wheezing even following mild activity. At its most serious, chronic obstructive pulmonary disease is disabling, with those affected not able to walk more than a few steps without gasping for breath. Some people with COPD eventually need to breathe extra oxygen most of the time.

It is common for people with chronic obstructive pulmonary disease to experience an exacerbation (a flare-up) of symptoms due to bacterial and viral infections in the lungs, which are more common in the winter months.

Asthma may also make the situation worse. Allergens and various other environmental factors can trigger a reaction that causes airways to become narrower. Fortunately, the same medications can be used to relieve both asthma and COPD.

Symptoms and Causes

Smoking/tobacco exposure: this is by far the most common cause of COPD. People who have never smoked rarely develop chronic obstructive pulmonary disease

  • Air pollutants and industrial irritants. Working conditions in the UK have improved dramatically over the last few decades, but dust particles inhaled by miners or textile workers can cause COPD, or make it worse if the individual is also a smoker. Exposure to smoke during a fire and breathing in hazardous gases as a result of war can also result in chronic obstructive pulmonary disease

  • Genetic factors. It is known that some people have a genetic predisposition to develop COPD, but the exact link is not known. It has been observed that about 2% of COPD cases are linked to an alpha 1-antitrypsin (AAT) deficiency.

AAT is a helpful enzyme that prevents lung damage caused by damaging enzymes such as elastase and trypsin. These are produced in the lungs as a result of the inflammatory response to cigarette smoke.

Diagnosis

Spirometry is usually used to diagnose COPD and assess how severe it is. This involves breathing out as hard as you can into a spirometer, which measures the air pressure you create.

However, unlike asthma, chronic obstructive pulmonary disease cannot be completely relieved by medication because there is permanent damage to lung tissue.

Two measurements commonly taken when assessing COPD are:

  • FEV1: forced expiratory volume. This is the amount of air exhaled in one second

  • FVC:  forced vital capacity. This is the total amount that can be exhaled in one breath. Results are compared to the average value for someone of the same age, height, weight and sex who does not have chronic obstructive pulmonary disease.

These two values are used to calculate the FEV1/FVC ratio. This gives a measure of how easily the air in the lungs can be expelled. The lower the value, the more severe is the narrowing of the airways

People with chronic obstructive pulmonary disease are given a diagnosis based on the difference in their exhalation capability compared to someone with healthy lungs:

Mild COPD: an FEV1/FVC ratio at least 80% of predicted value

Moderate COPD: an FEV1/FVC ratio between 50% and 79% of predicted value

Severe COPD: an FEV1/FVC ratio between 30% and 49% of predicted value

Very severe COPD: an FEV1/FVC ratio less than 30% of predicted value.

 

Submit a request for further information, a quotation or indicative cost. Your enquiry will be forwarded to up to 3 private healthcare providers. They will respond directly with further information.

Get a quote for bronchitis and COPD (chronic) treatment >

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