What is Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)?

Obstruction of the flow of air into the lungs is caused by chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD), and it is a chronic inflammatory disease. Wheezing, sputum production, cough and breathing difficulty are the primary symptoms. Particular matter or irritant gases exposure for a long time can cause chronic obstructive lung disease or chronic obstructive airway disease (COAD). Lung cancer, heart disease and various other conditions can develop with this infection.

Chronic Obstructive Lung Disease

The vulnerability of the condition can be reduced and the patient can achieve improved quality of life and full control over the symptoms of chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) through proper treatment management.

Pathophysiology of Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

Repeated bronchitis or inflammation of airway causes microscopic damage to the air sacs and the airways in the lungs. The persistent inflammation of bronchial mucosa brings about the physical changes such as swelling (odema) an scarring of mucosal layer resulting in chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD). The partial obstruction of airway passage is caused by swelling of mucosal epithelial cell and thick secretion of mucus lying within the airway passage. The obstruction to air movement causes symptoms of difficult breathing. Later the layer of smooth muscle fibers within airway passage increases in size and seldom relaxes resulting in worstening of narrowing of air passage.

The damage that will accrue due to chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) will never be undone, unfortunately. Lowering the risk of getting chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) can be attained through some preventive measures.

Several lung diseases that are chronic are named chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD). Emphysema and chronic bronchitis are the two main conditions for chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) infection. Different parts in the lungs are affected by these diseases but the reality is that both lead to breathing difficulty and complications.

The structure of the lung must be known well in order to understand the pathophysiology of chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD). Two pipes below the trachea called the bronchi leads air into right and left lungs. Bronchioles are other smaller tubes that branches from the bronchi. Alveoli are little sacs at the bronchioles' ends. The web of tiny blood vessels called capillaries are spread within the alveolar sac. Capillaries are the microscopic blood vessels connects arteries to veins. The red blood cells floating within capillaries in alveoli releases carbon di oxide into alvoli and same time picks up oxygen. The oxygenated blood circulates through entire body.

The alveolus is the part of the lungs that are affected by emphysema. Damage occurs to fibers making up the alveoli. Chronic disease makes these fibers less elastic and thus unable to function after you exhale. More mucus is produced if the inflammation occurs in the bronchioles. Bronchitis is the condition. Chronic bronchitis can result following the persistence of bronchitis. Bits of acute bronchitis that are temporary can occur but these effects are not regarded as chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD).

Causes of Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

Smoking of tobacco is one of the main cause of chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) in developed countries. Heating in homes that are poorly ventilated retains fume containing carbon di-oxide and carbon monoxide. The regular inhalation of these fumes causes chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) in developing countries.

Causes of Chronic Obstructive Lung Disease

Clinically apparent chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) is developed by about 25% of chronic smokers even though half have got evidence that are subtle regarding chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD). There are several less common conditions of the lungs that are linked to smokers. Only until further examination is conducted the diagnosis of COLD caused by chronic smoking can be concluded cautiously.

How the Lungs are Affected by Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)?

Trachea (windpipe) directs air down the lungs via two tubes that are large called bronchi. The tube further divides many times inside the lungs like tree branches- forming tubes that are smaller called bronchioles encoding in air sacs that are tiny called alveoli. The walls of the air sacs are thin and are full of capillaries (blood vessels). The oxygen passes into the bloodstream via the blood vessels after you inhale from the air. Carbon dioxide is a metabolic waste production form of gas, is exhaled.

In order to force the air outside, the air sacs after the inhalation to optimum reduction of size alveoli, the bronchiole tubes must be elastic in its natural state. The chronic obstructive lung disease traps the air in alveoli because of narrowing of air passge. The continuous overexpansion of alveoli results in loss of elasticity and ability to natural contraction of alveoli to exhale air in patient suffering with chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD).

What Causes the Airway Blockage in Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)?

Chronic bronchitis causes chronic inflammation of mucosa and deeper tissue, which affects elastic and smooth muscles fibers of bronchiole. The retention of water within alveolar wall and excessive secretion of mucus causes narrowing of the bronchial tubes. Mucus is produced by mucosal cells lining breating tubes or bronchioles. The retention of mucus within the lumen of air passage and swelling of the wall of air passage causes moderate to severe narrowing of the air passage or breathing tubes. Chronic cough develops owing to the urge to clear the airways.

Emphysema. The elastic fibers and the fragile walls of alveoli are destroyed by this disease of the lungs. The airflow during exhaling will be impaired because of the collapsing small airways. The air remains trapped in alveoli resulting in increased size of overall lung and decreased capacity to exchanged oxygen in to blood and carbon di oxide into alveolar lumen or space.

Other Irritants and Cigarette Smoke Leading to Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

Long term smoking of cigarette causes damage to the lungs which leads to chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD). 25% of cigarette smokers develop chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD), which brings in other factors like susceptibility of the genes as another factor that might be contributing.

Smoke, fumes, dust exposure and air pollution in workplace, pipe smoke secondhand smoke and cigar smoke are other irritants that might cause this disease.

Signs and Symptoms of Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

It is only until when significant damage has taken place in your lung, is the time that chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) symptoms will appear. If you continue smoking and exposed airway and alveoli to smoke related irritants then the condition will worsen. Daily cough in the morning while producing sputum is the main symptom of chronic bronchitis. The symtoms of continuous smoking is not seasonal but daily through out the year lasting for a period of several years consecutively in many cases.

Chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) other symptoms include:

  • Shortness of breathing also known as dyspnea particularly while doing physical work.
  • Chest tightness
  • Wheezing
  • Excess mucus which makes it a mandatory to clear the throat first in the morning.
  • Greenish, white, yellow or clear sputum is produced by a chronic cough.
  • The beds of the finger nails (cyanosis) and the lips will be blue.
  • Infection of the respiratory system will be regular.
  • Fatigue.

Exacerbation is an episode likely to accrue when a person has chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD). The symptoms worsen than the normal day-to-day routine and are usually persistent for a couple of days.

Risk Factors for Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

The risk factors of chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) include:

  • Asthmatic People Who Smoke- Chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) risks are increased even more when one smokes and he/she has asthma which is a chronic disease of the airway.
  • Age- Symptoms often begin when an individual is at least 35-40 years due to the slow development of chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD).
  • Genes- COPD is caused by alpha-1-antitrypsin deficiency which is a disorder of the genes as noted above. The susceptibility of the disease is increased owing to genetic factors of some smokers.
  • Tobacco Smoke Exposure- Long-term smoking of cigarette accounts for a significant risk factors for getting chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD). Risks are increased with the more packs you smoke and the duration that you smoke. Marijuana smokers, pipe smokers and cigar smokers are at risk and also those who are exposed to second hand smoke in high quantity.
  • Chemical and Dust Exposure- Chemical and dust exposure in the workplace. Your lungs can be inflamed and irritated when you are exposed to chemical vapors, fumes and dust, for a long time in your occupation.

Complications in Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

Chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) complications include:

  • Respiratory Infections- Chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) are susceptible to diseases like flu, cold and pneumonia. The tissues of the lung and airway passage can be further damaged due to infection resulting persistent inflammation and tissue suppuration. Some viral and bacterial infections can be prevented through regular vaccination to combat pneumococcal pneumonia and an annual flu.
  • Heart Problems- Symptoms of heart diseases become worst when individual suffers with chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD). Severe compromised oxygen exchanges and continuous low blood oxygen resulting in cyanosis or blue mucosa causes fatal heart attack.
  • Lung Cancer- Smokers who do not have chronic bronchitis have lower risk of developing lung cancer than those with chronic bronchitis. The risk is reduced remarkably when one quits smoking.
  • High Blood Pressure- Pulmonary hypertension (high blood pressure on arteries bringing blood to the lungs) may be caused by chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD).
  • Depression- You may be hindered from participating in activities that you like due to difficulty to breathe. Depression can develop owing to the contribution of a serious illness you are dealing with. If you have the notion that you are developing depression, or you fell sand or helpless, talk to your doctor.

Tests to Diagnose Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

Misdiagnosis of chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) occurs commonly. Smokers are told often that the symptoms are caused by chronic smoking and may stopped following discontinuation of smoking. In most cases smoker do not discontinue smoking and chronic obstructive lung disease (COLD) or chronic obstructive airway disease continues to become severe and irreversible. In the same note those having chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) fails to be diagnosed until the advancement of the disease renders intervention less effective.

The below tests might be recommended by your doctor if you are suffering with symptoms of COLD or COAD.

  • Pulmonary function test. The lung function test is commonly spirometry. A large tube that is linked with a spirometer is blown into during this test. The amount of air that can be held by your lungs and the rate of blowing out of the lungs are measured by this machine. Chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) can be detected by spirometry even before the symptoms of this disease are detected. The progress of treatment and extent, and progress of the disease can be tracked using this machine. The effect of the bronchodilator administration is often measured by spirometry. The lung volume is measured, the capacity of diffusion, and the pulse oximetry are other test conducted to ascertain lung function.
  • Chest x-ray. Emphysema which is one of the causing factors of chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) can be shown through an x-ray scan. Heart failure and other lung problems can be ruled out via an X-ray.
  • CT scan. The determination whether a chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) surgery is beneficial to your condition and emphysema detection can achieve through a CT scan. Lung cancer screening can use CT scans since people with chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) are more vulnerable than those who smoked and did not develop the disease.
  • Analysis of arterial blood gas. The efficiency of the lung to bring in oxygen while expelling carbon dioxide is measured in this blood test.

Treatment for Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

Medications for Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

Chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) signs and symptoms are treated by doctors using medication of different types. Medication intake ranges from those taken when needed and those taken regularly.

  1. Bronchodilators for Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

    Bronchodilator helps to relax smooth muscles, which is hypertrophied and less often relaxes. The bronchodilator is inhaled following use of spray and acts directly on smooth muscles resulting in muscle relaxation and improvement in diameter of airway passage. Breathing will be easier that reduces symptoms of shortness of breath and coughing. The severity of your chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) will determine whether you will need short-acting bronchodilator prior to any activity or a long-acting bronchodilator used on a daily basis, or both.

  2. Inhaled Steroids for Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

    Exacerbation can be prevented and inflammation of the airway is reduced, through the use of inhaled corticosteroid medications. Hoarseness, oral infections and bruising are some of the likely side effects. Exacerbations of chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) in a frequent basis will prove useful when these medications are administered. Budesonide (pulmicort and fluticasone (flovent) are two examples of inhaled steroids.

  3. Combination Inhalers for Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

    Inhaled steroids and bronchodilators are combined sometimes in medication for chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD). Fluticasone (advir) and salmeterol and budesonide (symbicort) and formoterol are an elaborate illustration of combination inhalers.

  4. Oral Steroids for Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

    Worsening of chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) can be prevented with (5 days administration for example) oral corticosteroids in patients having severe acute or moderate exacerbation. Serious side effects can accrue due to long term use of this medication for example-

    • Diabetes
    • Obesity
    • Osteoporosis
    • Cataracts
    • Elevated risk of infections.
  5. Phosphodiesterase-4 Inhibitors to Treat Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

    This medicine is new and has been approved for people with chronic bronchitis severe chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD). It is called roflumilast (Daliresp) which is a phosphodisterase-4 inhibitor. The airways are relaxed and inflammation reduced by this drug. Weight loss and diarrhea are the common side effects.

  6. Theophylline for Treating Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

    This medication prevents exacerbations in chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) and improves breathing and it is very cheap. Tremor, fast heartbeat, headache, nausea are some of the side effects. Low doses are recommended because side effects depend on the dose.

  7. Antibiotics for Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

    Chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) symptoms can be aggravated by respiratory infections like influenza, pneumonia and acute bronchitis. Despite the fact that antiviral and antibiotics are preferred for treating acute exacerbations, they are not recommended for prevention generally. Despite recent research showing that azithromycin as antibiotic, prevents exacerbation it is unclear if this is due to its anti-inflammatory properties or its antibiotic effects.

Lung Therapies for Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

People with severe or moderate chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) might be helped by doctors through using the following additional therapies:

  • Pulmonary Rehabilitation Program- Counseling, nutrition advice and exercise training, are the typical combination involved in this program. Your needs can be met after tabling it out with various specialist who will iron it out.
  • Oxygen Therapy- Supplemental oxygen might be recommended if you blood lacks sufficient oxygen. Oxygen can be delivered to your lungs through several devices. These are units that are light in weight and can be carried easily around town as you run your errands. People with chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) might be using this oxygen when sleeping or during activities whereas other use it all the time. Life extension has been confirmed to be through oxygen therapy and the quality of life is also improved. You should let your doctor know your need and preferences.

Exacerbations Management for Treating Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

Symptoms can worsen for weeks or days despite the fact that you may be going on with treatment in chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD). Lung failure can result if immediate treatment is not administered immediately, a condition called acute exacerbation.

Treatment in the hospital, supplemental oxygen, additional medications (like steroids and antibiotics or both) when exacerbation occur. Prevention of future exacerbations can be discussed by your doctor and you, like stopping smoking habits, taking long-term bronchodilators or steroids or other medications. Avoiding polluted air when possible and being vaccinated against flu annually.

Surgery to Treat Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

Severe emphysema prompts for surgery for chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) when medication is insufficient.

  • Surgery to reduce lung volume. Tissues that are damaged will be removed by the surgeon from the upper lung. Diaphragm will work efficiently and more space created for the healthy lung. Survival and quality of life is improved because of this.
  • Lung transplant. Specific criteria must be met by those transplanting lungs but breathing ability. Risks like organ rejection might render you to immune suppression medications for life in chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD).

Prevention of Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

The path for preventing chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) is clear and its cause is clear too, unlike in some diseases. Cigarette smoking is directly linked to the massive cases that are reported. Do not smoke at all so as to prevent chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) or quit smoking now.

If you have tried to stop smoking once, twice or a couple of times then this statement is not easy for you and may not seem simple if you have smoked for a long time. Don't give up. Tobacco cessation program can help you and thus you should find one to solve this problem for good. Damage to your lung can be prevented through the chance.

Chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) other risk factor is the exposure of chemical dust and fumes in your workplace. Address this issue with your supervisor if you are working with any lung irritant. You will be able to protect yourself using protective equipments of the respiratory system.

Life Expectancy of Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

GOLD System for Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

The measurements of the life expectancy of chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) patient have been developed by researchers. ''staging'' of the disease is one method. The severity of the disease is measured when conducting staging. GOLD System is one of the measurement systems designed by The Global Initiative for COPD. FEV1 (forced expiratory volume) is used, and it is a test determining the quantity of air that can be exhaled in one second by an individual, in categorizing COPD's severity:

  • Stage 1: Disease is mild having FEV1 of 80% or more of the normal.
  • Stage 2: The disease is moderate having FEV1 OF 50-80% of the normal
  • Stage 3: Emphysema is severe having FEV1 of between 30- 50% 0f the normal condition
  • Stage 4: Chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) is very severe having FEV1 of less than the third stage or of those falling under stage 3 low oxygen levels in blood and FEV1.

Generally, with increased stage of chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD), the prognosis also worsens.

BODE Index System for Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD)

Other scientist perceives that FEV1 is inadequate measure of ascertaining the severity of chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD). BODE Index is another development of this experts that is use to determine the life expectancy. BODE signifies: Body mass, Airflow Obstruction, Dyspnea and Exercise capacity.

The picture of chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD) effects on your life must be taken into account.

  • Body Mass: BMI (body mass index) or adjustment of weight to height is used in determination of obesity or overweight. If you are too thin you can confirm through the use of BMI. Prognosis is worse for people who are too thin (the disease prediction of the outcome).
  • Airflow Obstruction: This implies FEV1 that is the GOLD system.
  • Dyspenea: Difficulty to breath is dyspenea. The chance of survival is lower in those who have difficulty to breath as compared to those who are able to breathe better. This is according to the suggestion of some studies.
  • Exercise Capacity: The ability to tolerate exercise is determined. ''six minute walk'' is the test measure used often.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: October 27, 2015

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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