Chronic Obstructive Pulmonary Disease (COPD)

Hi,

I am Dr. Manav Manchanda, Pulmonologist. Today I will talk about COPD. This problem is very common in India nowadays especially in ruler as well as in the urban population. 15-20% Indian population is affected by this disease. And it is the fourth most common cause of death in India as well as western hemisphere. The major risk factors for COPD is cigarette smoking, environmental pollution, industrial areas pollution, crop burning pollution, and indoor pollution. We can also find this disease in patients who are having second-hand exposure to smoke. Now the symptoms will be cough, breathlessness, wheezing, chest tightness and sputum production.

The diagnosis of this disease mainly rests with a certain investigation like pulmonary function test which is the most important test. In this, the patient blows into a machine which majors the lung capacity of the patient. Certain other tests like a blood test, x-ray, oxygen & carbon dioxide measurement, sputum test, CT scan maybe require in some group of patients. But pulmonary function test remains the mainstay of the diagnosis. It also tells us the severity of the disease. Now, this disease is basically characterized by irreversible destruction of the airways so until and unless you stop the offending agents the disease goes on progressively. Sometimes, the disease so worsens that patient is bedridden and requires oxygen.

So, the initial treatment starts with avoiding the risk factors. So, any patient who comes to us and having a history of smoking, we ask them to avoid smoking so that the disease progression can be stopped. If he is working in an industry where there is a lot of dust, we ask them to change their job. Next comes the role of medications for these patients. We grade the patients into severity. The commonly used medicines are in the form of inhalers which is the most effective treatment for the patient. A certain group of patients who are having more severe disease, they require some oral tables also. Also, these patients will be vaccinated for common virus and bacteria.

Then comes the role of exercises of the patients. These patients should be taught about respiratory exercises. So that their lung capacity can be improved and the disease progression can be stopped. Next, we give them a self-care management plan. So, when should a patient contact a Dr. Most of the patients have the problem of worsening the symptoms. And this occurs in the pollen season or in the winter season. The treatment has to be increased in consultation with Dr. Somtime ventilator is also required for the patient. The patient should go to the clinic regularly so that the patient should take the precaution prior to the disease is going to happen and to stop the disease from happening. We can also modify the treatment only on that basis.

Thank You!