COPD (chronic obstructive pulmonary disease) is a respiratory disease steadily increasing in society, but it is also very undervalued both by patients who suffer from it by the medical establishment. He speaks Dr.. Simone Bianconi, specialist in Pneumology in Rome
1) What causes COPD?
COPD is a disease that mainly affects smokers, but also the environmental and occupational pollution play a very important role, as well as family history.
2) What are the symptoms of COPD?
The COPD symptoms come on gradually and slowly over time and patients often turn to a specialist in very late stages. That's why it is critical to recognize the warning signs such as air hunger for progressive efforts, cough and sputum (phlegm expulsion) especially in the morning.
3) How do you have COPD?
To make a definite diagnosis is necessary to perform a spirometry, a very simple test in which we measure the patient's breathing capacity making blow through a mouthpiece. The diagnostic test is the relationship between two parameters, the FEV1 and FVC, that if less than 70% makes it possible to make a diagnosis of bronchial obstruction.
This examination is important both in diagnosis and in patient monitoring over time and, therefore, to see if the disease is under control, is improving or getting worse.
4) How is COPD?
Medications that treat COPD are bronchodilators. They are inhaled medications that are taken through innovative and effective devices, they do get the medication in the form of microparticles in the smallest bronchi, site of obstruction.
There are two categories of bronchodilators, beta 2 stimulants and antimuscarinic, which can be administered individually or in combination. There are medications that can be taken safely with restrictions lower than those of many other commonly used drugs. The positive thing about these drugs is that, being inhalers, have a very poor absorption into the circulation compared to the tablet; the bad thing is that patients do not actually consider them so important and, after an initial period, they tend not to hire more. The biggest challenge for us Pulmonologist is just to make it clear to our patients that these drugs should be consumed every day throughout the year, like the drugs for high blood pressure or diabetes.
In advanced stages of the disease the main drug becomes, unfortunately, oxygen therapy for at least 18 hours a day and that's what we must absolutely avoid.
Thanks to the constant intake of bronchodilators not only the patient can improve his ability to exercise and quality of life, but also drastically reduce what we call exacerbations of the disease. Exacerbations are events where there was a worsening of symptoms, particularly of air hunger, cough and sputum production. In these phases we must resort to the use of antibiotics and corticosteroids, both at home and in hospitalization regime.
The advice that we give to patients suffering from this disease is to never leave the bronchodilator drug and perform every 4-6 months of outpatient spirometry controls.
Editor Karin Moscow