Chronic obstructive pulmonary disease (COPD), is an umbrella term for a group of respiratory ailments including bronchiectasis, chronic bronchitis and emphysema. This spectrum of diseases involves airway obstruction that interferes with the ability to breathe normally. The symptoms are non-reversible but some treatments may slow down disease progression. The World Health Organization (WHO), describes COPD as a life threatening condition that is potentially being under diagnosed given increasing numbers afflicted with this condition and the prevalence of risk factors.
The Case for COPD
The American Lung Association reports that close to 13 million Americans older than 18 were diagnosed with COPD in 2011. However, in the same period, closer to 24 million patients exhibited symptoms of impaired lung function. The condition is most common in the 65 and older age group although COPD can manifest at any age. Data from the Centers for Disease Control and Prevention indicate that COPD affects 64 out of every 1,000 persons 65 and older with women more likely than men to be diagnosed with the condition.
Smoking remains the highest risk factor with 80 percent of COPD deaths attributed to smoking according to studies by the Department of Health and Human Services. While other environmental irritants increase COPD risks, socioeconomic status appears to be a contributing factor.
Stages of COPD
According to WHO reports, patients who present with dyspnea accompanied by abnormal sputum production, a chronic cough and risk factors for the condition should undergo COPD testing. Spirometry measures the presence of and the extent of airflow obstruction. The results, referred to as PFT or pulmonary function tests, are indicated as FEV1, forced expiratory volume in one second, and FVC, or forced vital capacity. Factors such as height, weight, age, gender and race may affect FVC and FEV numbers.
The Mayo Clinic also recommends alternative tests including a chest X-ray, a CT scan of the lungs or arterial blood gas analysis for a definitive diagnosis.
The Global Initiative for Chronic Obstructive Lung Disease provides guidelines for determining the severity of the condition so that patients can receive appropriate treatment.
Stage I
At its mildest stage, patients are almost asymptomatic except for FEV values below 80 percent. Shortness of breath may not be felt at this stage although some coughing and mucus production may be evident.
Early intervention is important in COPD. At this stage, mild airway obstruction can be managed using short-acting or quick relief bronchodilators.
Stage II
In Stage II, coughing and sputum production become difficult to ignore. Patients experience shortness of breath with moderate exertion such as walking briskly or going up an incline. FEV numbers will range from a low of 50 to a high of 79.
This is often the stage when COPD patients seek medical help. Symptoms can be managed with a combination of short-acting bronchodilators and longer-acting medications. Patients are encouraged to improve lung function through pulmonary therapies.
Stage III
In Stage III COPD, symptoms become more pronounced with the FEV number ranging from 30 to 49 percent of normal values. Shortness of breath, coughing and mucus may limit the person’s ability to function normally.
At this stage, the treatment plan includes bronchodilators, pulmonary rehabilitation and inhaled corticosteroids to manage severe symptoms. Pneumonia and influenza vaccinations are recommended to minimize complications from these diseases.
Stage IV
Patients with very severe COPD will show an FEV lower than 30 percent of normal values. Coughing and mucus production may be so severe that normal routine such as eating become difficult.
In addition to bronchodilators and corticosteroid inhalants, oxygen therapy may help. Surgical removal of diseased lung tissues may be recommended, and immunizations from common respiratory ailments are highly recommended at this stage.
