What is COPD?

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. It’s caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions.

Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. Chronic bronchitis is inflammation of the lining of the bronchial tubes, which carry air to and from the air sacs (alveoli) of the lungs. It’s characterized by daily cough and mucus (sputum) production.

Emphysema is a condition in which the alveoli at the end of the smallest air passages (bronchioles) of the lungs are destroyed as a result of damaging exposure to cigarette smoke and other irritating gases and particulate matter.

With proper management, most people with COPD can achieve good symptom control and quality of life, as well as reduced risk of other associated conditions.

What are the symptoms of COPD?

COPD symptoms often don’t appear until significant lung damage has occurred, and they usually worsen over time, particularly if smoking exposure continues. For chronic bronchitis, the main symptom is a daily cough and mucus (sputum) production at least three months a year for two consecutive years.

Other signs and symptoms of COPD may include:

  • Shortness of breath, especially during physical activities
  • Wheezing
  • Chest tightness
  • Having to clear your throat first thing in the morning, due to excess mucus in your lungs
  • A chronic cough that may produce mucus (sputum) that may be clear, white, yellow or greenish
  • Blueness of the lips or fingernail beds (cyanosis)
  • Frequent respiratory infections
  • Lack of energy
  • Unintended weight loss (in later stages)
  • Swelling in ankles, feet or legs

What causes COPD?

Smoking

Most cases of COPD are caused by inhaling pollutants; that includes tobacco smoking (cigarettes, pipes, cigars, etc.), and second-hand smoke.

COPD most often occurs in people 40 years of age and older who have a history of smoking. These may be individuals who are current or former smokers. While not everybody who smokes gets COPD, most of the individuals who have COPD (about 90% of them) have smoked.

Environmental Factors

Fumes, chemicals and dust found in many work environments are contributing factors for many individuals who develop COPD.

COPD can also occur in those who have had long term exposure and contact with harmful pollutants in the workplace. Some of these harmful lung irritants include certain chemicals, dust, or fumes. Heavy or long-term contact with second-hand smoke or other lung irritants in the home, such as organic cooking fuel, may also cause COPD. Individuals who have worked for many years around these irritants are at risk for developing mild COPD.

Genetics

Genetics can also play a role in an individual’s development of COPD—even if the person has never smoked or has ever been exposed to strong lung irritants in the workplace.

How is COPD diagnosed?

A mild case of COPD can be difficult to confirm and will require your doctor to carry out a series of tests to rule out other conditions. Typically a diagnosis of COPD is confirmed using a combination of tests which may include:

  • Lung (pulmonary) function tests.Pulmonary function tests measure the amount of air you can inhale and exhale, and if your lungs are delivering enough oxygen to your blood.

Spirometry is the most common lung function test. During this test, you’ll be asked to blow into a large tube connected to a small machine called a spirometer. This machine measures how much air your lungs can hold and how fast you can blow the air out of your lungs.

Spirometry can detect COPD even before you have symptoms of the disease. It can also be used to track the progression of disease and to monitor how well treatment is working. Spirometry often includes measurement of the effect of bronchodilator administration. Other lung function tests include measurement of lung volumes, diffusing capacity and pulse oximetry.

  • Chest X-ray. A chest X-ray can show emphysema, one of the main causes of COPD. An X-ray can also rule out other lung problems or heart failure.
  • CT scan. A CT scan of your lungs can help detect emphysema and help determine if you might benefit from surgery for COPD. CT scans can also be used to screen for lung cancer.
  • Arterial blood gas analysis. This blood test measures how well your lungs are bringing oxygen into your blood and removing carbon dioxide.
  • Laboratory tests. Laboratory tests aren’t used to diagnose COPD, but they may be used to determine the cause of your symptoms or rule out other conditions. For example, laboratory tests may be used to determine if you have the genetic disorder alpha-1-antitrypsin (AAt) deficiency, which may be the cause of some cases of COPD. This test may be done if you have a family history of COPD and develop COPD at a young age, such as under age 45. 

Managing COPD

COPD is a progressive and (currently) incurable disease, but with the right diagnosis and treatment, there are many things you can do to manage your COPD and breathe better. People can live for many years with COPD and enjoy life.

Smoking Cessation

Unlike some diseases, COPD has a clear cause and a clear path of prevention. The majority of cases are directly related to cigarette smoking, and the best way to prevent COPD is to never smoke — or to stop smoking now. It’s also a good idea to avoid second-hand smoke exposure whenever possible.

Medication

Doctors use several kinds of medications to treat the symptoms and complications of COPD. You may take some medications on a regular basis and others as needed. 

Therapy

Here at Respiratory Physiotherapy Ireland, we can apply a range of therapy techniques and advice to manage your symptoms and maintain the best possible level of lung function and comfort. We can also advise on activity modification to make daily living easier. Along with advice for you and your family on appropriate self-management techniques to maximise your functional ability between therapy sessions.

What would physiotherapy treatment for COPD involve?

At Respiratory Physiotherapy Ireland, Our physiotherapists will ensure you receive specialised treatment for your COPD. Giving up smoking has one of the biggest global health benefits to the improvement of this condition. Depending on the severity and duration of your COPD, your treatment may involve:

  • Secretion clearance:
    • Active Cycle of Breathing
    • Autogenic Drainage
    • Positive Expiratory Pressure (PEP)
    • Oscillating positive expiratory pressure
    • Effective / productive coughing techniques.
    • Postural drainage in sitting and lying.
    • Manual techniques, including percussion and vibrations
  • Breathing techniques:
    • Controlling respiratory rate
    • Diaphragmatic breathing
    • Relaxation breathing exercises
    • Deep breathing exercises and incentive spirometry
    • Positions of ease to decrease breathlessness
    • Paced breathing as a strategy to maintain control of breathing during exercise
  • Education and Advice:
    • Illness cause and progression.
    • Effects of environmental and allergen factors, including smoking.
    • Medication management
  • Exercise Assessment and Prescription
    • Those experiencing dyspnoea on exertion (even mild dyspnoea) may benefit from a formal exercise program. A formal exercise program generally includes aerobic and resistance training. Exercise training includes intensity, frequency, duration, type, mode and progression based on the severity and type of COPD.

It will be important to note that the respiratory physiotherapy we apply should be closely incorporated with other health care professional’s management of the client’s needs.

Summary

Although there is no ‘cure’ for chronic obstructive pulmonary disease (COPD), it is usually possible to improve your health and quality of life with the support of health professionals. Respiratory physiotherapists are an essential part of the team that can help you.

For more information on how physiotherapy can help treat COPD, or to book yourself an assessment, please contact us here at Respiratory Physiotherapy Ireland.

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+353 86 105 5791

+353 86 105 5791

Have any questions?
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