COPD: Permanent changes in the lungs

21 October 2017

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Cough, shortness of breath and phlegm? Behind it can put a COPD: This disease progresses untreated continues almost always on. In time, they may increasingly cause problems in normal everyday loads such as climbing stairs or getting dressed. However, in many cases, COPD can be avoided - as their main cause is smoking.

COPD is the acronym for the English term chronic obstructive pulmonary disease (translated: Chronic obstructive pulmonary disease).

Thus, COPD is a permanent (= chronic) lung disease. It is characterized by an increasing disturbance of the airflow in the lungs (so-called. obstruction).

are responsible primarily the following changes in the lungs, which can be used individually or in COPD occur in combination:

The picture shows the schematic structure of the bronchi.

COPD: The chronic obstructive pulmonary disease, the bronchial tubes become narrowed, in pulmonary emphysema, the lung is overinflated morbid. Both will restrict air flow in the lungs.

How often COPD is exactly is hard to say because of the high number of undiagnosed cases. It is anticipated that about 13 percent of over 40 year olds in Germany are affected by the.

Although COPD still affects more men than women, but no longer are the numbers nearly as far apart as ever. Overall, the lung disease is now regarded as the Widespread disease with the highest growth rate.

Worldwide, COPD is currently the fourth leading cause of death. Outstripped it is only by the coronary heart disease (CHD), stroke and - narrowly - infections of the lower respiratory tract.

Facts About COPD

What is COPD? The acronym COPD stands for the English term chronic Obstructive pulmonary disease, which translates "chronic obstructive pulmonary disease" means.

Cause of COPD (chronic obstructive pulmonary disease) is usually a long-lasting pollution the lungs - about by years of inhaling harmful substances:

The main risk factor for COPD: smoking! © Jupiter Images / iStockphoto

The main risk factor for COPD: smoking!

In rare cases, COPD can also hereditary causes have: A certain inherited damage to genetic material (genetic defect), the so-called Alpha-1 antitrypsin deficiency, can lead to disturbances in the lungs and cause pulmonary emphysema, from a chronic obstructive pulmonary disease may develop.

Furthermore, frequent respiratory infections in childhood favor or even a for some time existing asthma COPD.

Most of COPD is preceded by a simple chronic bronchitis with cough and phlegm: In this, the airway is not narrowed permanently. Unlike the COPD, the lungs from a simple chronic bronchitis can recover. Who does not remedy its causes, however, risking that the bronchial tubes in the course of disease and narrowing results in a chronic obstructive bronchitis.

The costs associated with COPD lung changes then can not be reversed (that is, they are irreversible). The permanent inflammation result,

Video: COPD - how is the disease?

Typical of COPD (Chronic Obstructive Pulmonary Disease), the so-called AHA symptoms:

This COPD symptoms can suddenly and significantly worse: GP call that exacerbation. Then there is usually shortness of breath seizures and increased productive cough. Such exacerbation of COPD may have different trigger have, such as:

Frequently, the COPD is also associated with increasing inefficiency and a generally reduced strength.

The cough typically lasts for some time to because of COPD often preceded by chronic bronchitis. The symptoms depend on the time of day: Especially in the morning after getting the victims cough often very strong, often associated with sputum. Are additional respiratory infections before, there are often violent bouts of breathlessness.

Note: A seemingly harmless smoker's cough may be the first signs of COPD!

More often irritating cough, which usually without Mucus production and occurs especially in the morning and at night, has a COPD asthmatic component out. Sufferers often cough paroxysmal or have attacks of breathlessness - trigger this are often external stimuli such as:

These seizures are caused by the squeamish bronchial system. Often sufferers awake at night on with coughing. In the course of COPD symptoms in frequency and severity are increasing.

In addition to coughing and heavy sputum in chronic bronchitis occurs. Still before the COPD developed both symptoms can thus already exist. For chronic obstructive pulmonary disease, especially morning sputum is typical, the normally white, is discolored yellow-green in bacterial infections.

Unlike cough and sputum shortness of breath is almost never before with simple chronic bronchitis. Only when a COPD has developed all three symptoms together. The reason is that the shortness of breath is due to the narrowed bronchi.

each COPD is characterized by increasing symptoms of shortness of breath characterized. First, the chronic obstructive pulmonary disease causes problems in breathing only during exercise; advanced stage occurs even at rest to shortness of breath.

Without proper treatment, the shortness of breath, getting too little air (dyspnea) increased until those affected almost constantly feel. Depending on how COPD is pronounced, the symptoms can extend so that sufferers feel even the slightest effort than hard work.

COPD (chronic obstructive pulmonary disease) usually remains undetected until an advanced stage. The reason for the late diagnosis: Who suffers morgendlichem cough and occasional difficulty in breathing, suspected not equal a disease and possibly also goes late to the doctor.

Because COPD often go undetected long have the World Health Organization (WHO) and the National Institute of Health (NIH), the so-called Global Initiative for chronic obstructive Lung Disease (GOLD) founded. The GOLD has set itself the goal

In order to distinguish COPD from other diseases (such as asthma or tuberculosis) and determine the appropriate therapy is a accurate diagnosis important. Therefore, many family physicians refer the patient to a pulmonologist - fachsprachlich called pulmonologist. It can detect COPD using a lung function test (spirometry).

Suspicion of COPD, the first step in the diagnosis usually is to record the medical history carefully (so-called. Anamnesis). Then, the following tests are used:

this is not sufficient to determine the COPD sure further investigation may follow. These include:

share medical COPD according to the criteria of Global Initiative for chronic obstructive Lung Disease (GOLD) in four classes and four patient groups on. Of the severity COPD is then determined in two steps. It is aimed to be

The first step to determine the COPD severity consists in a Lung function test. Depending on how strong the lung function is already compromised, dividing the patients into four classes - GOLD 1 (stage with least damage) to 4 GOLD (stage with maximum impairment). Important for this division are two distinct values:

Usually the ratio of FEV1 to FVC is greater than 0.75 (75%), in the elderly, the limit is a ratio of 0.7 (70%) - in people with COPD, this value is lower.

The second step for determining the severity of COPD GOLD to is the number of symptom exacerbations (So-called. exacerbations) and the symptom severity to detect and the patients, accordingly, in groups of A divide (low) to D (high). Crucial for the classification into the four patient groups:

The pulmonary function value and the ABCD grade thus flow separately in the COPD severity one: If someone, for example, relatively good FEV1 has (= COPD GOLD-class 2), but at the same time two or more exacerbations in the year (= patient group D) corresponding to the COPD severity GOLD D2.

This separate consideration of the pulmonary function value and the ABCD grade allows clinicians to better respond to the individual COPD patients and to make the treatment more individualized.

If signs of COPD is first a physical examination to: This includes the inspection of the lungs, the blood pressure measurement as well as an examination of heart, abdomen and legs.

In the COPD diagnosis plays Assessment of lung a central role. Here, the doctor examines the airway and checked for abnormal breath sounds by knocks the chest and listening. By the slapping sound of doctor can determine whether the lung during breathing may shift enough - or whether, for example, there is water in the lungs, which causes a loss of the knocking sound.

When listening to the lungs, the doctor pays attention to damp rales, caused by mucus and occur mainly in the forms of bronchitis COPD. He also checked dry wheezing, such as humming or whistling, which are typical of narrowed airways that occur in COPD or asthma.

In a COPD with emphysema, the chest is barrel-shaped changed and the respiratory movements are considerably restricted. The breathing is heard weaker than in healthy people and percussion sounds hollow.

Often result in suspicion of COPD called spirometry for use - a measuring and recording the respiration, a extensive pulmonary function testing allows. Using spirometry, the physician may, for example, enter the following values:

The existing frequently before the start of COPD simple Chronic bronchitis is usually in spirometry no significant changes. is a chronic obstructive bronchitis before, the doctor may, however clear signs of a narrowing of the bronchi determine.

In order to distinguish COPD from asthma, is also a so-called Bronchospasmolysis test helpful: This inhaling a drug that expands the bronchi. If the airway is not narrowed with a renewed lung function test after about ten minutes, this indicates an asthmatic disease. The reason: Only with an asthmatic disease the bronchial tubes are fully extended. Is the narrowing of the test are made, there is a chronic obstructive pulmonary disease.

In COPD, plays laboratory diagnosis a subordinate role: Special blood tests for the diagnosis of lung diseases that would be comparable, for example, with values ​​for liver or kidney function, there is not.

Nevertheless, in the context of diagnosis Basic laboratory tests needed, to recognize alongside the existing COPD inflammation and possible comorbidities. Also, you can exclude the laboratory diagnostics is a very rare inherited cause of COPD: the antitrypsin deficiency syndrome.

To determine the syndrome, the physician must determine the alpha-1 antitrypsin. This study is useful, for example in people under 45 years of age who have symptoms of COPD. For the non-hereditary chronic obstructive pulmonary disease is more a disease of the elderly.

In addition, the Blood gas analysis This study helps to assess a possible respiratory insufficiency, and also contributes to the follow-up of lung disease: in COPD part of laboratory diagnostics. The blood gas analysis provides evidence as to whether the gas exchange, ie the absorption of oxygen (O2) and the release of carbon dioxide (CO2), in the lungs is impaired.

In COPD patients with emphysema classic signs of hyperinflation are seen (such as the low-lying diaphragm) on the radiograph. The image of the lung as a whole is translucent (transparent) than that in normal lung because more air in the lungs is present.

Even with COPD without emphysema, it is useful to x-ray if necessary - for example, to eliminate inflammation and tumors.

while the basic diagnosis with a COPD usually by the family doctor takes place is for the Further Testing usually a Lungenfacharzt (Pneumologist) responsible.

Using whole body plethysmography can during normal tidal breathing the measure breathing resistance when breathing in and out. The patient sits in a small airtight space which is approximately a cubic meter size. The body plethysmography provides more accurate and more informative results than spirometry.

In the COPD diagnosis of respiratory physician uses the bronchoscopy to into the trachea and its major branches (bronchi) to see and the to look more closely mucous membranes. For this purpose, the doctor pushes an approximately pencil thick, flexible hose at the end of a small camera, through the mouth into the respiratory tract. In examining the pulmonologist can directly take tissue samples and then fine tissue be examined (histologically) (so-called. biopsy).

In COPD (chronic obstructive pulmonary disease) therapy aims primarily,

to basic treatment COPD include in any case drugs. Particularly important for the therapy agents to expand the bronchi, making it easier to breathe. In addition, anti-inflammatory agents can be used. How the treatment concrete shape, depends on the particular severity of lung disease from.

supportive a non-drug therapy can be useful for COPD - here, for example, physical training, breathing training, a change in diet or oxygen inhalation offer. The latter are often necessary, especially when the COPD is very advanced.

A advanced COPD usually makes a lifelong therapy necessary because: Completely the existing damage to bronchi and lungs can not be reversed. By long-term measures is no complete cure is possible. However, an appropriate treatment can simplify the lives of those affected by alleviates the symptoms and the progression of COPD is staying - which also increases the life expectancy.

In COPD patients can for therapy different drugs are used. The aim of treatment is to relieve symptoms and prevent acute respiratory problems.

Which drugs are most appropriate, aimed primarily to the COPD stages. Thus, the drug therapy in the early stages is often only in assuming a suitable agent in acute respiratory distress. More frequent and severe symptoms, however, require a permanent treatment - in advanced stages often with a combination of several drugs.

main goal COPD of drug therapy is that to provide bronchodilators and thereby to improve breathing. This is achieved by using so-called bronchodilators: These drugs increase the narrowed bronchi by relaxing the bronchial muscles. The bronchodilators are available in different dosage forms are available:

If bronchodilators with advanced COPD do not work sufficiently, cortisone drugs are useful for therapy: The cortisone to inhale (That collect in the lungs), usually helps well against the chronic inflammation of the bronchial mucosa. However, the cortisone treatment usually applies only temporarily as recommended.

On the course of COPD therapy by mucolytic agents such as acetylcysteine ​​or ivy extract has no direct effect. Therefore, doctors recommend not generally these agents to treat chronic obstructive pulmonary disease. However useful expectorants may be circumstances for the treatment of acute infections and massive mucus.

Mucolytic drugs freely airways. How this works, illustrates to you our video.

Causes COPD dry, annoying cough (cough), however, can help a cough suppressants with codeine or noscapine. However, it is always advisable to these drugs only in exceptional cases and in the short term apply, because: cough suppressants suppress the urge to cough, so you can cough up the mucus is no longer in a natural way - the mucus can then settle in the bronchi and ultimately favor pneumonia.

Occur in COPD complications, such as bacterial lung infections, are useful for treating some antibiotic drugs. Antibiotics are recommended in any case if

Such changes are signs of infection, are responsible in most cases for the bacteria - rare viruses. Those who develop bacterial respiratory infections as part of COPD should be treated consistently with antibiotics, because the state of health may otherwise deteriorate permanently. Before therapy, a saliva collection is recommended to the bacteria and their resistance (so-called. Resistance) to the various antibiotic drugs to determine.

In addition to medication and non-drug therapy plays an important role in COPD. Among the treatment options include, for example:

In advanced stages of COPD is a long-term therapy has with oxygen proven: The Life expectancy increases by the long-term oxygen therapy (LTOT) clear. Prevails in your blood, a significant chronic lack of oxygen can be obtained from the LTOT via a nasogastric tube at least 16 to 24 hours a day oxygen.

Useful the long-term oxygen therapy especially in COPD and simultaneous chronic right heart failure is (right heart failure). Regular monitoring by the specialist is necessary.

In COPD (chronic obstructive pulmonary disease), the course will depend on how much the disease is pronounced, and especially of how those affected behave. Accordingly, the forecast very differently. In any case, appropriate therapy and not smoking have a positive effect on disease progression.

While the simple chronic bronchitis, which usually precedes a COPD, can heal in a short time, COPD is chronic obstructive pulmonary disease usually not completely curable. However, a life without tobacco in many cases, the progressive course helps stop and relieve the symptoms significantly.

COPD with emphysema is a poorer prognosis connected: Then the chronic obstructive pulmonary disease is not irreversible because the lung tissue is too badly damaged. In the long term emphysema can damage the heart.

To the common complications of COPD include bronchial infections and the lung infection. This illnesses as well as cigarette smoke or noxious fumes, dust or fumes can cause the condition of the affected worsened acute.

Additionally occurring serious diseases of the heart and lungs worsen COPD usually acute. Makes itself felt such exacerbation of COPD by the following symptoms:

A late complication COPD is the so-called pulmonary heart disease - a weakening and enlargement of the right ventricle due to the increased resistance in the pulmonary artery. heavy, life-threatening complications are these Failure of the respiratory muscles and the heart failure.

COPD (chronic obstructive pulmonary disease), you can effectively prevent by the Avoid risk factors. The main risk factor for COPD is Smoke: 90 percent of people with COPD are smokers!

Non smoking have a significantly lower risk of COPD. Only in very exceptional cases, they develop chronic bronchitis, such as an occupational disease, or (hereditary) emphysema at an alpha 1-Antitrypsinmangelsyndrom.

If you are suffering from COPD, you can possible complications in part by the following vaccinations prevent:

In COPD, the flu vaccine is every year recommendable, because the flu pathogens change annually. Vaccination protects but only before the real flu (influenza) - simple colds caused by other viruses, the vaccine does not prevent. It is useful when the partners of the persons concerned to be vaccinated against flu.

Especially for people with COPD who are over 60 years old, pneumococcal vaccination is important. Pneumococci are common bacteria that can cause pneumonia. A pneumococcal vaccine can prevent them frequently.

Pneumococcal vaccination is strictly recommended for the prevention of complications for asthmatics and people with COPD.

COPD - Germany e.V.
The association COPD - e.V. Germany wants to help people to help themselves. On the site you will find the dates for information events of the association.

German Atemwegsliga e.V.
With her considered by experts recommendations it sets standards. offer versatile information, including training, a discussion forum addresses to specialist clinics, etc.
That of emphysema and COPD hotline site at the clinic in Bad Reichenhall offers comprehensive information on the disease, timely information and FAQs.

German Emphysemgruppe e.V.
Discussion and information service for all emphysema and alpha-1 antitrypsin deficiency patients.

Patient organization emphysema COPD Germany
Information about meeting places, addresses, event data, contacts and programs of various regional active COPD support groups.
With their cessation program "smokeless" the Federal Center for Health Education (BZgA) wants to ease the way to a life without tobacco.


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