Early Diagnosis Of COPD Can Avert Lung Attack

For a patient of chronic obstructive pulmonary disease (COPD), symptoms of more than usual coughing, wheezing or shortness of breath, leading to excessive exhaustion, with changes in the color, thickness or amount of mucus can mean it’s a 'lung attack'. 

In COPD, the airways of the lungs are inflamed and narrowed. A viral or bacterial lung infection or even smoking or exposure to smoke or air pollution can further injure the airway and lung tissue leading to a lung attack. An attack can last for days or even weeks. Often patients are treated with antibiotics and corticosteroids. If the attack is severe, the patient may need to be hospitalized. Most importantly, each lung attack, results in permanent, irreversible damage to the lungs, making the person, more and more vulnerable to more such attacks. Repeated attacks lead to a significant loss of lung function, making breathing difficult, even while performing simple day to day tasks, significantly affecting the quality of life of the patient. The attacks may eventually significantly compromise the lungs and turn fatal for the patient. 

Symptoms of a Lung Attack

A patient with COPD, may not be able to do all the activities that a person without COPD can do and any physical exertion may typically lead to shortness of breath. During a lung attack, the symptoms can get much worse than usual.

The most common signs and symptoms of a lung attack are:

•More coughing, wheezing, or shortness of breath than usual

•Changes in the color, thickness, or amount of mucus

•Feeling tired for more than one day

•Swelling of the legs or ankles

•More trouble sleeping than usual

•Feeling the need to increase oxygen flow if the patient is on oxygen. 

The following symptoms indicate an emergency: 

•Severe shortness of breath or chest pain

•Blue color in lips or fingers

•Confusion, disorientation, or difficulty speaking in full sentences

COPD – The numbers 

An estimated 328 million people have COPD worldwide. According to the Global Burden of Disease (GBD), COPD is already the third leading cause of death worldwide, something that World Health Organization (WHO) had not predicted to occur until 2030. In 15 years, COPD is expected to become the leading cause of death worldwide, but up to 90 per cent of the deaths occur in low- and middle-income countries (LMICs) including India. These numbers call out for an urgent need to improve screening and early diagnosis of COPD for better management. 

COPD is common, preventable and treatable - yet it is often underdiagnosed. 

An important aspect of COPD is that it is a progressively worsening lung condition, which means that while the disease may be mild at first with only occasional symptoms, such as shortness of breath, wheezing, and coughing, as time goes by, symptoms may occur more often and interfere with daily activities. When COPD becomes severe, the symptoms may be present most of the time. Unfortunately, despite such a high number of patients with COPD, many go undiagnosed until late in their disease course when significant loss of lung function has already set in. 

Early recognition of the condition may offer multiple benefits to the patient. Appropriate treatment initiated early in the course of the disease, and avoiding the triggers which cause the lung attacks, such as cigarette smoke, or even air pollutants, offers the patient the best chance at mitigating the substantial complications associated with COPD. Primarily, early recognition may allow practitioners to appropriately recognize a lung attack whereas without this defined diagnosis, the attacks may just be labeled as multiple episodes of a lower respiratory tract condition such as acute bronchitis. Furthermore, medical treatment initiated early in the course of COPD (in addition to smoking cessation) may alter the rate of progression of the disease, allowing the patient to have a healthier, fuller life. For these reasons, establishing and acting on an early diagnosis of COPD is a critical step. 

Dr Jaideep Gogtay

Guest Author The author is Global Chief Medical Officer, Cipla