COPD Signs And Symptoms: Understanding The Importance Of Early Detection And Timely Intervention

Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease which is characterised by airflow obstruction leading to breathing difficulty. In India, COPD is a significant health concern. According to National Center for Biotechnology Information (NCBI), with 37.8 million cases, COPD in India is the 2nd leading cause of death and disability. Yet, despite being a major cause of health impairment and death, COPD frequently remains undiagnosed. This stems from a lack of awareness around the causes, symptoms and treatment of the condition and results in its inadequate management.

Understanding COPD

COPD is a common lung condition, on the rise and understood by the term emphysema or chronic bronchitis. Emphysema involves permanent damage to the small air sacs at the end of the airways in the lungs. Chronic Bronchitis is because of damaged airways leading to persistent coughing with mucus, related to long standing airway inflammation. The most incriminating risk factor for COPD is cigarette smoking. COPD can also be caused by various other factors ranging from exposure to indoor pollution (like long standing smoke from cooking stoves), outdoor air pollution, and workplace exposure to harmful substances, especially in jobs like farming. The most common symptoms of COPD are difficulty in breathing and a long-lasting cough with phlegm. This can be disabling and affect the whole body.

The critical role of early detection

Given the gradual but progressive nature of the condition, symptoms tend to emerge slowly and worsen over time, impacting both lung function as well as overall quality of life. This can restrict an individual's capacity to perform everyday tasks and might hinder a person from engaging in even the most fundamental activities like walking, climbing steps or preparing meals. In more severe cases, the rapid worsening of symptoms can even lead to a COPD flare-up (or lung attack), with doctor visits or hospitalization, and can take patients days or weeks to recover.

Furthermore, complications from COPD can become life threatening beyond shortness of breath and limitations of activities if left undetected. Individuals run the risk of developing respiratory complications that include lung infections such as pneumonia, and risk of lung cancer in the long run. Additionally, COPD causes a lack of oxygen supply to the tissues of the body and result in cardiac complications hypertension, coronary artery disease (heart attacks), and heart failure.

Diagnosing COPD

A complete health history including smoking details and other exposures (coal, wood, kerosene cooking, occupational exposure), and a meticulous physical examination, must be followed by a lung function test called spirometry, which is crucial for the diagnosis and staging of COPD. Spirometry is the gold-standard diagnostic test for COPD. It involves measuring the amount of air one can breathe in and out in a fixed amount of time thus quantifying the lung function, and staging disease.

The important message is that patient history and clinical examination are not enough to diagnose COPD, and a lung function with spirometry is necessary to catch the disease early.

Managing and living with COPD

While you can't fully reverse COPD-related lung damage, you can manage the symptoms and slow the progression of the disease with lifestyle changes and appropriate treatment strategies, under the supervision of a Respiratory specialist or Physician.

An essential part of this treatment involves using inhaled medications, especially bronchodilator inhalers that help relax obstructed airways, making breathing easier. Inhalers can be used regularly or when experiencing acute symptoms, as decided by the doctor. Using the inhaler correctly is vital, and a spacer device may be recommended for effective medication delivery.

For specific patient groups who may struggle with inhalation therapy, nebulized treatments can be highly effective, particularly during acute COPD flare-ups. Furthermore, programs like Pulmonary Rehabilitation can significantly enhance the quality of life. They help patients learn breathing techniques and exercises that can assist in managing symptoms such as breathlessness, improving oxygen intake, and improving overall lung health, and can be a game changer for COPD patients.

Raising awareness

For patients to actively seek a diagnosis, participate in self-care programs, and use action plans effectively, it's crucial for them to recognize what can trigger their symptoms and spot early warning signs of the condition.

The gap in patient knowledge needs to be addressed through educational initiatives. Awareness is the preliminary step which will allow for better, more well-informed conversation around the disease, its prevention, diagnosis and treatment. Patient awareness initiatives, patient support programs need to be driven on a national scale to educate patients about the condition and the benefits of early detection. Awareness combined with action can impact COPD outcomes across the country. A 'stitch in time saves nine' has never been more true, as in the approach to this disease.

(Dr. Ravindra Mehta, Chief of Pulmonary, Critical Care and Interventional Pulmonology, Apollo Hospitals, Bangalore)

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