Definition

The two sister conditions of chronic bronchitis and chronic obstructive pulmonary disease (COPD) are characterised by the production of cough, sputum and / or shortness of breath that is not easily reversed by treatment as asthma can be. In addition the chronic lung damage caused by smoking, emphysema, is also included in the term COPD.

Incidence/Age/Sex

About 15-20 % of middle aged men and 10% of middle aged women have chronic cough and COPD.

Causes/Preventions

The overwhelming cause of COPD is cigarette smoking, Approximately a third of smokers will develop respiratory disease. The most effective intervention in dealing with this disease is to STOP Smoking. Rarely may be associated with an inherited enzyme defect Alpha -1 antitrypsin deficiency.

Signs & Symptoms

Patients with chronic bronchitis have cough, usually first thing in the morning and the bringing up of regular small amounts of sputum which can be coloured. COPD is characterised by increasing shortness of breath on exertion usually not associated with wheeze.

Complications

If untreated by firstly stopping smoking and then by inhaled medication there will be increasing shortness of breath progressing to respiratory failure can develop over many years.

Investigations

Measurement of lung capacity usually by “spirometry” is mandatory in the diagnosis of COPD. This can be performed at local doctors surgeries, or at specialist chest clinics. Routine chest x-rays are useful to exclude other conditions.

Treatment

STOP smoking. Inhaled treatment to open the airways (bronchodilators) and in some cases inhaled steroids can help. In more severe cases oral steroids can be useful. In severe end stage cases, oxygen therapy is required, and specific exercise training in multi-disciplinary teams , pulmonary rehabilitation, can be very helpful.


Source: www.privatehealth.co.uk
Last Editorial Review: 15/1/2010