Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow limitation that is not fully reversible and an abnormal inflammatory response in the lungs. The latter represent the innate and adaptive immune responses to a lifetime of exposure to noxious particles, fumes and gases, particularly cigarette smoke. All cigarette smokers have inflammatory changes within their lungs, but those who develop COPD exhibit an enhanced or abnormal inflammatory response may result in mucous hyper-secretion (chronic bronchitis), tissue destruction (emphysema), disruption of normal repair and defense mechanism causing small airway inflammation (bronchiolitis) and fibrosis.
These pathological changes result in increased resistance to airflow in the small conducting airways and increased compliance and reduced elastic recoil of the lungs. This causes progressive airflow limitation and air trapping, which are the hallmark features of COPD. There is increasing understanding of the cell and the molecular mechanism that result in the pathological changes found and how these lead to physiological abnormalities and subsequent development of symptoms.
What are the causes of a COPD exacerbation?
These are two very common causes of COPD exacerbation:
- Lung infections, such as bronchitis and pneumonia. Infections are the most common cause of COPD exacerbations and are usually caused by a virus, but they can also be caused by bacteria.
- Lung irritation from dust, fumes, and other sources of air pollution.
When you experience a COPD exacerbation, there is a dramatic increase in mucus production in your lungs as well as narrowing of the airways of the lungs a (bronchial tubes). The increased mucus production and airway narrowing decrease the air flow in the lungs, worsening the symptoms of cough and shortness of breath.
Other cases of COPD exacerbations include heart failure, allergic reactions, accidental inhalation of food or stomach contents into the lungs, and exposure to temperature changes or chemicals. In about one third of COPD exacerbations, doctors cannot find a cause.
Symptoms of COPD
The most common symptoms seen in COPD are breathlessness, cough and fatigue. There is no good correlation between lung function and symptoms of COPD, not even the standardized scoring of breathlessness correlates well with FEV; the important message being that a simple physiological measure can never substitute a symptom history.
Breathlessness is the most significant symptom in COPD and it is associated with significant disability, poor quality of life and poor prognosis.
Cough and Sputum Production
Cough is respiratory defense mechanism protecting the airways and cough is the major method of clearing excess mucus production. In COPD patients, cough as a symptom is almost as common as breathlessness and may actually precede the onset of breathlessness. Cough is usually worse in the morning but seldom disturbs the patient’s sleep; it can, nevertheless, be disabling because of the embarrassment felt by many patients when they have bursts of productive cough on social occasions and may contribute to the isolation often imposed on patients due to breathlessness.
Wheezing is generally seen as an asthma symptom but frequently occurs in COPD as well. However, nocturnal wheeze is uncommon in COPD and Suggests the presence of asthma and/or heart failure.
Fatigue is frequently reported by COPD patients.
Chest pain is a common complaint in COPD, mostly secondary to muscle pain. However, it should be noted that ischemic heart disease is frequent in any population of heavy smokers and COPD patients may be at particular risk. Acid reflux occurrence is also frequent in COPD.
Ankle swelling may result from immobility secondary to breathlessness or as result of right heart failure. Anorexia and weight loss often occurs as the disease advances and should be mirrored by measurements of body mass index (BMI) and body composition. Psychiatric morbidity is high in COPD, reflecting the social isolation, the neurological effects of hypoxemia and possibly the effects of systemic inflammation. Sleep quality is impaired in advanced disease and this may contribute to neuropsychiatric comorbidity.
How is COPD diagnosed?
The diagnosis is largely made on the clinical grounds in patients who have smoked. It is confirmed by demonstrating airflow obstruction that shows little day to day or diurnal variation and minimal response to bronchodilators. Airflow obstruction can only be accurately showed by spirometry rather than by measuring peak flow rates.
- Many patients will only present at the time of an exacerbation and will be unaware that they have a chronic illness. Some will have had a cough or been breathless for some time but will not have recognized that these were symptoms of a lung condition. It is often only in retrospect that patients realize that they have been breathless on exertion or have had a productive cough for several years. Many smokers have a morning cough that they regard as normal for them and become breathless on exertion, which they regard as a part of normal ageing.
- Age is risk factor for COPD and the presence of symptoms suggestive of a diagnosis of COPD in patients under the age of 40 should raise the possibility of an alternative diagnosis or an unusual etiology such as a-1 antitrypsin deficiency.
Homeopathic treatment of COPD symptoms
Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat COPD symptoms but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several medicines are available for COPD symptoms treatment that can be selected on the basis of cause, sensation, modalities of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are some specific homeopathic remedies which are quite helpful in the treatment of COPD symptoms:
Kali Carb, Kali Iod, Anacardium, Cina, Carbo Veg, Lachesis, Naja, Cuprum Ars, Hepar Sulph, Lycopodium, Opium, Phosphorous, Sulphur, Spongia, Selenium, Stannum Met, Rumex, Silicea, Nux Vom, kali bi, and many other medicines..
- Graema P. Currie- ABC of COPD ;2011;6
- Campion Quinn- 100 questions & answers about chronic obstructive pulmonary disease (COPD); 2005; 45-46
- Nicola Hanania- COPD: A Guide to Diagnosis and Clinical Management; 2010; 24
- David M. G. Halpin- Copd : Your Question Answered; 2004; 25