What is COPD?
COPD, or chronic obstructive pulmonary disease, is a serious disease of the lungs, characterized by the progressive and unstoppable obstruction of the airways of the bronchial tree (ie bronchi and bronchioles); a severe limitation of the air flow passing through the aforementioned airways follows, especially during the expiratory phase.
COPD is dramatic in its consequences, as it seriously and definitively (without the possibility of a return to normality) compromises the normal anatomy of the lungs and their functionality.
Fortunately, in recent years, the medical-scientific community has provided for the improvement of symptomatic treatments capable of curbing the distinctive progression of COPD, delaying or even avoiding the appearance of some respiratory disabilities.
Why is it called Chronic Obstructive Pulmonary Disease?
- Bronchopneumopathy, because the suffering is borne by the bronchi and lungs;
- Chronic, because COPD has a course that, although slow, is progressive and unstoppable;
- Obstructive, because the cause of breathing difficulties is an abnormal narrowing of the airways.
Early diagnosis
An early diagnosis of COPD is very important from a therapeutic point of view, as symptomatic treatments are decidedly more effective when the disease is in its early stages. Moreover, when COPD is in its infancy, structural changes affecting the bronchial tree and the lungs are still minimal and the impairment of respiratory function is still largely treatable with good results.
The difficulties of early diagnosis
Unfortunately, there is a great impediment to the early diagnosis of COPD, given by the subtle nature of this pathology, which is almost asymptomatic (and therefore difficult to recognize) at the onset stage and only becomes manifest in the more advanced phases, when the function of the respiratory system in general is seriously compromised.
How to cope with the subtle nature of COPD? Periodic checks
To cope with the subtle nature of COPD (asymptomatic as long as the patient's condition is not seriously compromised), doctors strongly recommend those at risk (eg: smokers over the age of 40, subjects who practice work at risk, subjects suffering from alpha-1-antitrypsin deficiency, etc.) to perform some simple diagnostic tests regularly, first of all spirometry .
SPIROMETRY
Fast, practical and painless, spirometry records the inspiratory and expiratory capacity of the lungs, and the patency (ie opening) of the pulmonary airways.
From an executive point of view, spirometry requires the patient to vigorously blow into a tube connected to a machine, specifically designed to record lung capacity and lung emptying speed, during the blowing action.
Who are the subjects at risk?
Factors such as:
- Smoking;
- Daily exposure to passive smoking;
- Prolonged exposure to environmental pollutants;
- Prolonged exposure to dust and chemicals (vapors, irritants, fumes, etc.) in a professional environment;
- Genetic predisposition, linked to a mutation of the alpha-1-antitrypsin gene.
How do you know if you have COPD at an early stage?
To identify who among those at risk has a high probability of suffering from COPD at an early stage, doctors have developed a special test. This test consists of a simple questionnaire, which includes a total of 5 questions to which the patient is asked to respond with sincerity.
If the answer to at least 3 of these questions is affirmative, the person has a good chance of being a carrier of COPD and it is important that he contact his treating doctor as soon as possible, in order to book a follow-up visit.
Entering the details of the 5 questions of the questionnaire, these consist of:
- Does the patient have cough and phlegm frequently?
- Does the patient have difficulty breathing compared to his peers?
- Has the patient limited physical activity due to the difficulty in breathing?
- Is the patient over 40?
- Is the patient a smoker or an ex-smoker?
If there is someone among the readers who thinks they can be at risk of COPD, they can answer these questions and see what they are. Please note that the affirmative answer to at least 3 questions out of 5 must be an alarm bell, to be immediately exposed to a doctor.
Why prevent?
COPD draws the attention of many people, between doctors and ordinary people, as it is a disease with a large socio-medical impact. Consider, in fact, that:
- COPD is the fourth leading cause of death in the United States, after heart disease, cancer and cerebrovascular disease.
- In Europe, 4-10% of the adult population suffers from COPD.
- In 2000, global deaths from COPD were 2.8 million; in 2012, they rose to almost 3 million; in 2015, they reached 3.2 million.
- In the last 20-25 years, the number of deaths from COPD has increased by almost 50%.
- In Italy, where diseases of the respiratory system are the third cause of death, COPD accounts for 50-55% of deaths due to diseases of the respiratory system and the 7th cause of hospitalization.
- Still in Italy, about 5 million people suffer from COPD (just under 10% of the population) and about 17, 000 deaths per year from COPD.
- If neglected, COPD can cause respiratory failure and become highly debilitating.
- The mortality rate of COPD at 5 years from its diagnosis fluctuates, depending on the severity of the condition, between 40% and 70%.
- COPD is widespread throughout the world, but especially in the most industrialized countries, where it is constantly increasing mainly due to environmental pollution (a problem that is less relevant in developing countries).
- For the next few years, an overall increase in COPD morbidity is expected, so that the latter will move from the current 12th place to the 6th.
- Over the next 10 years, due to air pollution and tobacco smoke, the prevalence of COPD will increase by 50% in men and even 130% in women.
At least 75% of individuals with COPD smoke or have smoked for years.
According to the WHO, there are over a billion heavy smokers in the world, thus over a billion people at risk of COPD.
