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The truth about dyspnea: Do you know how COPD affects your daily life?
Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by long-term respiratory symptoms and difficulty breathing caused by airflow limitation. According to the 2024 GOLD report, COPD is a heterogeneous lung condition that is often accompanied by difficulty breathing, coughing, sputum production, and other complications. These symptoms occur primarily due to abnormalities in the airways (bronchitis, bronchiolitis) and/or alveoli (emphysema), resulting in persistent and often progressive airflow obstruction.
The main symptoms of COPD include difficulty breathing and coughing, which may become more severe as the disease progresses and make daily activities such as walking or dressing difficult.
Although there is currently no treatment for COPD, it can be prevented and treated. The two most common types of COPD are emphysema and chronic bronchitis, which have become the classic phenotypes of COPD. However, this basic view has been challenged because varying degrees of emphysema, chronic bronchitis, and potentially important vascular disease coexist in many COPD patients, which has introduced the classification of other phenotypes or subtypes.
Emphysema is characterized by the enlargement of the alveoli and the destruction of their walls, which results in permanent damage to the lung tissue. Chronic bronchitis refers to productive cough that occurs for at least three months per year and lasts for two years. While it is true that these conditions may not cause immediate airflow restriction, young smokers are at a significantly higher risk of developing COPD.
The main cause of COPD is smoking, but other risk factors include indoor and outdoor air pollution, occupational-related irritants, and certain genetic factors.
In developing countries, common sources of household air pollution include coal and biomass (wood and dried manure) commonly used for cooking and heating. COPD is diagnosed primarily through lung function tests that measure difficulty with airflow. Most cases of COPD can be prevented by reducing exposure to risk factors, such as smoking and other sources of air pollution. Although treatment can slow the progression of the disease, there is no conclusive evidence that any drug can change the long-term decline in lung function.
COPD symptoms and daily challenges
Difficulty breathing
Dyspnea is the main symptom of COPD. This chronic shortness of breath is one of the most troublesome symptoms for patients, often leading to accompanying anxiety and a decrease in living ability. Symptoms may change over time and appear differently from day to day. For more severe COPD patients, they often use mouth breathing to relieve breathing difficulties.
Cough
Chronic cough is often the first symptom of COPD, can be phlegm-free or phlegm-free, and is often more noticeable in the morning. When a cough lasts for more than three months and is accompanied by phlegm, it is diagnosed as chronic bronchitis. Some COPD patients incorrectly attribute symptoms to the consequences of smoking, which may delay medical intervention for them.
Deterioration
An acute exacerbation is a sudden worsening of symptoms and signs, often accompanied by increased dyspnea and an increase in coughing, wheezing, and thick sputum. The most common causes of exacerbations include viral infections, and hospitalization rates for COPD exacerbations have dropped significantly during the COVID-19 pandemic, perhaps due to reduced air pollution.
Other diseases coexisting with COPD
COPD often coexists with multiple other conditions (comorbidities), in part due to shared risk factors. Common comorbidities include cardiovascular disease, skeletal muscle dysfunction, metabolic syndrome, etc. Depression and anxiety are also common complications among COPD patients, which reduce their quality of life. Many COPD patients ultimately die from other comorbidities rather than directly from breathing problems.
In fact, the existence of COPD is not only a physical burden, but also affects the patient's mental health and overall quality of life.
Treatment and Management
Although there is currently no cure for COPD, there are a variety of treatments that can improve patients' quality of life, including smoking cessation, vaccinations, pulmonary rehabilitation, inhaled bronchodilators, and steroids. Some patients may benefit from long-term oxygen therapy, lung volume reduction surgery, or even lung transplantation. Increased use of medications, antibiotics, or steroids is often required during acute exacerbations.
Future challenges of COPD
As life expectancy increases globally, the number of COPD cases is expected to rise. According to 2021 statistics, COPD has become the fourth leading cause of death, responsible for approximately 5% of total mortality. Faced with this situation, society needs to strengthen its understanding of COPD and preventive measures to reduce its impact on human health.
Imagine what a significant change it would be if we could effectively deal with COPD and improve the quality of life and survival rates of these patients.
