COPD [Chronic (Chronic) Obstructive Pulmonary Disease] is a progressive lung disease that is not caused by microbes in the airways, but due to an inflammation.

General Information

Disease features occur as a result of non-microbial inflammation of the airways due to cigarette smoke and other harmful gases and particles. This inflammation occurs over the age of 40 and above, with the narrowing of the airways as a result of the destruction of the small air chambers in the lungs (emphysema). The narrowing of the airways and the destruction of the air sacs (alveoli), the smallest unit of the lung, gradually increase. Airways that are normally flexible like balloons that can expand and contract lose this feature. The air entering the enlarged air sacs becomes harder to get out and starts to swell even more. These changes in the air sacs are abnormal and permanent. These findings are called “Emphysema”.

In COPD, small airways also swell due to non-microbial inflammation, and the amount of sputum increases as a result of overworking of the sputum-producing glands. Air passage through narrowed airways becomes more difficult. These findings were defined as “chronic bronchitis”.

In the definition of COPD, “Chronic bronchitis” and “Emphysema” are included together.
As a result, it causes complaints such as shortness of breath and/or chronic cough and sputum production. Although the cough complaint that occurs in the early stages of the disease is actually the first symptom of the disease, this complaint is usually attributed to “smoking” and the patient consults the doctor later. If the disease can be detected at this initial stage, the progression of the disease can be stopped.

The incidence of COPD is 15-20% in adults over the age of 40. In other words, one out of every 5 people over the age of 40 in our society has COPD. According to data from the Global Burden of Disease Study, COPD causes 2.9 million deaths annually. Today, COPD, which has become the 3rd cause of death all over the world, is responsible for 5.5% of all deaths. Respiratory system diseases are the third most common cause of death in Turkey and 61.5% of these deaths are due to COPD.

What are the factors that cause the disease?
Although active smoking is a mandatory risk factor for the development of COPD, it shows that some other environmental and genetic factors are also effective in the development of the disease.

Smoking: It is the most important cause of the disease. About half of the adults in our country smoke. The age of starting smoking, the intensity of the smoke, the daily and total smoking amount affect the development of the disease. Respiratory system diseases and chronic bronchitis are more common in children whose parents smoke. After the age of 30, this decrease in lung capacity slows down. It has been reported that smoking is responsible for the development of COPD at a rate of 80-90%, the risk of developing COPD is 9.7-30 times higher than non-smokers, and smoking is responsible for 85% of deaths due to COPD in men and 69% in women. There is a strong relationship between the amount of cigarettes smoked and the loss of lung function.

SMOKING IS THE MOST IMPORTANT RISK FACTOR!

Passive Smoking: When non-smokers, especially children, are exposed to smoke in a smoking environment, respiratory system diseases, especially asthma and COPD, are seen in these people in older ages.
It is known that exposure to cigarette smoke for more than +0 hours per week and for more than 5 years increases the risk of developing COPD by 50%.

Inhalation of Dust, Smoke and Various Gases Due to Occupation: Those working in mining and metalworking, wood and paper manufacturing; COPD is seen more frequently as a result of exposure to organic-inorganic dust, smoke and gases in the workplace environment in cement, grain and textile workmanship. If people working in these lines of business also smoke, the risk of developing the disease increases even more.

Indoor Air Pollution: In our country, in women who generally do not smoke; Burning bushes, twigs or dung for heating or cooking and exposure to their fumes causes the development of COPD.

Air Pollution: Urban air pollution causes both COPD and an exacerbation of this disease.

Gender: The disease was more common in men due to the frequency of smoking and their occupational exposure to various dusts, fumes and gases. With the prevalence of smoking in women in recent years, COPD has been increasing rapidly in women.

Deficiency of a body protein called alpha-1 antitrypsin: Less than 1% of patients develop COPD as a result of genetic deficiency of this protein. Smoking accelerates the development of the disease in these people, and the disease occurs at the age of 30-40. Inherited, this deficiency is the only genetic disorder known to cause the development of COPD.

Socioeconomic Status: Since lung functions are lower in people living in low socioeconomic conditions, COPD development is rapid.

Dietary Factors: Vitamin A, C, E deficiency and alcohol use may play a role in the development of COPD.

The most common complaints in COPD are shortness of breath, cough and sputum production. Smokers cough and cough up sputum and therefore do not consult a doctor. A decrease in physical activity occurs due to shortness of breath. The person who suffers from shortness of breath during exertion does not want to walk, reduces his daily work, hesitates to go to the market and prefers not to leave the house over time. In this way, the gradually increasing decrease in physical activity deteriorates the quality of life of the patient, causes the progression of the disease, leads to disability and death. 75% of patients with COPD show insufficient physical activity. This rate increases as the disease progresses. In patients with COPD who were followed up for 20 years, a 30-40% decrease was found both in patients who walked for two hours a week or more, and in patients who were admitted to the hospital due to COPD and in the death rates due to this disease. Therefore, it is necessary to ‘increase physical activity’ both to prevent this disease and to prevent its progression.

Do you have COPD? Test it!
1. Do you cough frequently most days of the week?
2. Do you produce phlegm most days of the week?
3. Is your breath more easily constricted than your peers?
4. Are you over 40?
5. Do you currently smoke or have you used to smoke?

IF YOU ANSWERED YES TO AT LEAST THREE OF THE ABOVE QUESTIONS, CONSULT A CHEST DISEASES SPECIALIST AND HAVE A RESPIRATORY FUNCTION TEST FOR DIAGNOSIS OF COPD.

The diagnosis of COPD can be made easily with the “breath measurement test”, which is a simple and painless test. Early diagnosis of COPD will reduce the rates of disability and death due to the disease. For this reason, if at least one of the complaints of chronic cough, sputum and shortness of breath are present in people over 40 years of age, who smoke or have been drinking and/or are in a dusty environment due to occupational or environmental conditions, the person should be seen by a chest diseases physician and “breathing”. measurement test should be done.

Although COPD is a progressive disease, it is preventable and treatable. The first thing that a patient with COPD should do is to apply to a physician in order to quit smoking. Smoking addiction is a treatable disease. Apart from this, avoiding other harmful dust and fumes, making flu and pneumonia vaccines and providing inhalation drug therapy as well as recommending and applying physical activity; It is an important step in both the development of the disease, the progression of the disease and the prevention of its bad consequences. Heavy exercises are not necessary for adequate physical activity, moderate-intensity physical activity most days of the week is sufficient. Walking, which is an activity that everyone can do, can provide almost all the benefits of regular physical activity.

There may be some differences in the development of COPD among smokers. After the age of 35, lung functions begin to be lost at a certain rate every year. However, this loss is much higher in smokers than in nonsmokers. According to this, the restriction in lung functions in a non-smoker only occurs when people reach the age of 120, whereas in smokers, since the loss in the lungs is 2-3 times higher, the occurrence of disease and the emergence of complaints reach the age of 50. If smokers quit smoking at the age of 40-50, the loss of lung functions partially recovers. The development of severe deterioration with breath measurement in COPD occurs as a result of accelerated decline in lung functions over many years. If you have been diagnosed with COPD, If treatment is not started, over time, the person will become unable to perform daily life activities due to shortness of breath. In this case, the patient’s mobility is greatly reduced. They need the help of their relatives or others to continue their lives. Since the blood oxygen level decreases in severe and very severe COPD patients, these patients need to take oxygen for at least 15-18 hours, especially at night, during sleep and during exertion.

• Since smoking is the most important risk factor for the disease, you should stop smoking. It is possible to prevent the disease by preventing smoking.
• Since smoking of people working in occupations exposed to dust and smoke will increase the probability of contracting COPD, it becomes much more important for these people to stay away from smoking. In addition, in these workplaces, measures such as the use of masks that will reduce the degree of exposure to substances such as dust and smoke, and the provision of a suitable workplace environment will be beneficial.
• It is recommended to use other sources instead of animal or vegetable sourced fuels, which are mostly used for cooking or heating at homes in rural areas.

The patient with the diagnosis of COPD is followed according to the stage of the disease. In COPD, it is necessary to regularly monitor exposure to risk factors, the patient’s current disease status, the effects of the disease on daily life, prognostic factors, disease progression, complications, daily physical activity level, vaccination applications, treatment effectiveness, and treatment side effects.

Exposure to smoking and other risk factors should be questioned, and necessary suggestions and interventions should be made to prevent exposure to risk factors.

Complaints of current treatment, level of control, drug side effects, patient’s compliance with treatment and technique are evaluated at each control. In addition to these, the patient’s perception and beliefs about the disease, family and social support, and problems in accessing qualified health services should be monitored. As for the frequency of follow-up, no definite recommendation is made, and it is stated that the frequency should be determined individually according to the conditions of the patient and the severity of the disease.

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