Obstructive-lung-disease (COLD or COPD) is a chronic, progressive respiratory disease. It is a pulmonary airflow obstruction that is not fully reversible. Like most chronic diseases it is easier to prevent than it is to reverse. COPD is a common diagnosis in skilled nursing homes. The only therapeutic intervention shown to alter the course of COPD is removal of the noxious trigger.
This disease is the result of abnormal inflammation caused by irritants in the air that we breathe. It is the fourth leading cause of death in the United States and is projected to be the third leading cause of death by 2020. Each year about 119,000 people in the United States die from COPD and another 30,000 people in the United Kingdom.
Obstructive-lung-disease is a common disease. The cumulative effect of years of “smoking” is the leading cause of COPD. Sources of irritants that can cause COPD include tobacco smoke, air pollution, and the burning of certain fuels in poorly ventilated areas. Like cancer and other chronic diseases there is no early warning that the victim may be at risk.
As we breathe air enters through our nose (and mouth) and enters the lungs through the windpipe (trachea) and bronchial tubes. Oxygen is made available to our blood by the air sacs (alveoli) and carbon dioxide is removed. Any obstruction in the windpipe and/or the bronchial tubes will restrict the availability of life-sustaining oxygen and removal of carbon dioxide.
Our bodies were designed with a system to protect our airways and lungs from irritants. First several ounces of mucus are produced per day to keep the air passages moist and protected from irritants. This mucus that lines the breathing tubes is in constant motion with the help of cilia. Cilia are tiny hairs that move back and forth to move mucus up the throat to an elastic cartilage flap (epiglottis). Secondly, irritation of the bronchial tubes causes us to cough an action that can quickly remove mucus.
If airways are regularly attacked by environmental irritants such as cigarette smoke, more mucus is produced to trap particles. Eventually, mucus glands are two or three times their normal size and cilia in air passages are also damaged. To make matters worse, any undamaged cilia are paralyzed for at least 20 minutes after the smoker has had a cigarette. In COPD, the lungs lose elasticity and bronchioles (small secondary air tubes) can collapse.
The presence of obstructive-lung-disease is associated with bronchitis and emphysema. Bronchitis is an inflammation of the bronchioles with dilation of the mucus glands and their ducts. In emphysema, air ducts enlarge and lose the ability to perform the gas exchange function of the lungs. The result is fewer air sacs with a sharp decline in their ability to perform the oxygen and carbon dioxide exchange.
A large number of COPD patients also have asthma. Asthma is defined as an inflammatory disease of the airways, in which obstruction is often completely reversible. When a patient has asthma, the muscle bands that surround the airways in the lungs tighten. This allows less air to pass through. Mucus production increases, narrowing the airways even further.
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