COPD-Chronic Obstructive Pulmonary Disease (COPD) is a common respiratory condition involving the airways and characterized by airflow limitation. It affects more than 5 percent of the population and is associated with a high level of chronic illness and mortality.
It is the third-ranked leading cause of death in the United States, killing more than 120,000 individuals each year. Due to its high prevalence and chronicity, COPD causes high resource utilization with frequent clinician office visits, hospitalizations due to acute exacerbations, and the need for chronic therapy (eg, supplemental oxygen therapy, medications)
There are two different large sub-types Chronic Bronchitis and Emphysema with multiple variations or combinations in between.
Chronic bronchitis is defined as a chronic productive cough for three months in each of two successive years in a patient in whom other causes of chronic cough (eg, bronchiectasis) have been excluded. It may precede or follow the development of airflow limitation. This definition has been used in many studies, despite the arbitrarily selected symptom duration.
Emphysema is defined by abnormal and permanent enlargement of the airspaces distal to the terminal bronchioles that are accompanied by destruction of the airspace walls, without obvious fibrosis (ie, there is no fibrosis visible to the naked eye). Exclusion of obvious fibrosis was intended to distinguish the alveolar destruction due to emphysema from that due to the interstitial cases of pneumonia. However, many studies have found increased collagen in the lungs of patients with mild COPD, indicating that fibrosis can indeed be a component of emphysema. While Emphysema can exist in individuals who do not have airflow obstruction, it is more common among patients who have moderate or severe airflow obstruction.
Although no cure for COPD is available as of yet, with the combination of the cessation of smoking and treatments the progression of the disease can be slowed, and lifestyles improved.
The Global Initiative for Asthma gives the following definition of asthma. “Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. The chronic inflammation is associated with airway responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing, particularly at night or in the early morning. These episodes are usually associated with widespread, but variable, airflow obstruction within the lung that is often reversible either spontaneously or with treatment.”
Asthma is a very treatable condition. With modern therapies, many patients are able to live a very active and symptom-free lifestyle while reducing the need for health care utilization. The treatment is multi-pronged involving education, prevention, and medical therapy. Early and appropriate intervention for this chronic condition can lead to a significant reduction in disease burden and optimizing health.
Idiopathic pulmonary fibrosis (IPF)
IPF is a chronic, relentlessly progressive fibrotic (scarring) disorder of the lower respiratory tract that typically affects adults over the age of 40. There are many illnesses under the category of Interstitial Lung Disease.
Symptoms are often progressive shortness of breath and cough and often can be subtle.
This requires a thorough and systematic evaluation to ascertain the cause of the lung condition and to determine properly directed treatment.