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Published by Nader Smadi
Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease

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Published by: Nader Smadi on Feb 07, 2009
Copyright:Attribution Non-commercial


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Chronic obstructive pulmonary disease (COPD) is the overall term for a group of chronic lung conditions that obstruct the airways in your lungs. COPD usually refersto obstruction caused by chronic bronchitis and emphysema, but it can also refer todamage caused by asthmatic bronchitis. In all forms of COPD, there's a blockagewithin the tubes and air sacs that make up your lungs, which hinders your ability toexhale. And, when you can't properly exhale, air gets trapped in your lungs and makesit difficult for you to breathe in normally.COPD is very common. It's a major cause of death and illness worldwide, and it's thefourth-leading cause of death in the United States. In the majority of cases, COPD iscaused by long-term smoking and could be prevented by not smoking or quittingsmoking. However, once symptoms begin, the damage to your lungs can't bereversed, and there's no cure. Treatments for COPD focus primarily on controllingsymptoms and preventing further damage.
Initially, COPD is often silent. Signs and symptoms may not appear until there'ssignificant lung damage, but once symptoms begin, they typically worsen over time.COPD symptoms may include:
Persistent cough
Increased mucus production
Shortness of breath, especially during physical activities
Chest tightness
Frequent respiratory infections
To understand COPD, it helps to understand how your lungs work and how they can become obstructed.
How your lungs work 
 When you inhale, air travels down your windpipe (trachea) and into your lungsthrough two large tubes (bronchi). Inside your lungs, these tubes divide many times — like the branches of a tree — into many smaller tubes (bronchioles) that end inclusters of tiny air sacs (alveoli). The air sacs have very thin walls full of tiny bloodvessels (capillaries). The oxygen in the air you inhale passes into these blood vesselsand enters your bloodstream, where it will be distributed throughout your body. At thesame time, carbon dioxide — a waste product of metabolism — is removed andexhaled.When you breathe in, most of the work is done by the muscles in your diaphragm andrib cage. These muscles contract as you inhale, which expands your chest cavity anddraws air into your lungs. However, these muscles don't expel the air back out again.To force air out of your body, your lungs rely on the natural elasticity of the bronchialtubes and air sacs. When your tubes or air sacs are damaged, they lose their elasticity.This can slow down air movement when you exhale and trap stale air in your lungs,leaving you to work harder to get adequate oxygen in and carbon dioxide out.
Causes of airway obstruction
 COPD primarily refers to obstruction in the lungs from two chronic lung conditions.Many people with COPD have both:
This lung disease causes inflammation within the fragile walls of the alveoli.This can destroy some of the walls and some of the elastic fibers, which allows small airways to collapse when you breathe out. This impairs airflow out of your lungs.
Chronic bronchitis.
This condition, which is characterized by an ongoing cough, causesinflammation and narrowing of the major and smaller bronchial tubes. Chronic bronchitisalso causes increased mucus production, which can block the narrowed tubes.
Asthmatic bronchitis also is sometimes classified as COPD, because it obstructsairways and makes it difficult to inhale. Asthmatic bronchitis — also known as bronchial asthma — is a term used to describe chronic bronchitis accompanied bycontractions of the muscle fibers in the lining of the airways (bronchospasm).
Cigarette smoke and other irritants
 In the vast majority of cases, the damage in the lungs that leads to COPD is caused bylong-term cigarette smoking. But other irritants can cause COPD, including cigar smoke, secondhand smoke, pipe smoke, air pollution and certain occupational fumes.In rare cases, COPD results from low levels of a protein called alpha-1-antitrypsin.This is a rare genetic disorder known as alpha-1-antitrypsin deficiency.
Risk factors
Risk factors for COPD include:
Exposure to tobacco smoke.
The most significant risk factor for COPD islong-term cigarette smoking. The more years you smoke and the more packsyou smoke, the greater your risk. Pipe smokers, cigar smokers and peopleexposed to large amounts of secondhand smoke also are at risk.
Occupational exposure to dusts and chemicals.
Long-term exposure tochemical fumes, vapors and dusts can irritate and inflame your lungs.
COPD develops slowly over years, so most people are at least 40 yearsold when symptoms begin.
A rare genetic disorder known as alpha-1-antitrypsin deficiency isthe source of a few cases of COPD. Researchers suspect that some geneticfactors may also make certain smokers more susceptible to the disease.
When to seek medical advice
If you're a smoker with signs and symptoms of COPD — such as cough, mucus production or shortness of breath — talk to your doctor. If you've been told that youhave chronic bronchitis, emphysema or asthmatic bronchitis and you startexperiencing symptoms of COPD, talk to your doctor. It's important to act quickly to preserve your lungs.
Tests and diagnosis

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