Most cases of COPD preventable with smoking cessation

special to the herald-leaderNovember 15, 2013 

COPD, or chronic obstructive pulmonary disease, is a disease that makes it difficult to breathe. It's the fourth leading cause of death in the U.S. By 2020, it will move up to the no. 3 spot. Women are now more likely to be diagnosed with COPD than men.

Cigarette smoking is the no. 1 cause of COPD, accounting for 90 percent of the 12.7 million cases in the U.S. The remaining 10 percent of cases are caused by exposure to environmental factors (chemical fumes, air pollution, particle dust), or a genetic deficiency.

More than 29 percent of Kentuckians smoke, significantly higher than the national average of around 20 percent. In turn, Kentucky has the highest occurrence of COPD, affecting nine percent of the state's population.

In 2011, the most recent data available, COPD cost the nation more than $32 billion. Emergency room visits alone accounted for $1.5 billion.

COPD causes chronic inflammation of the airway, making breathing difficult. Over time, the disease progresses and symptoms worsen. The culprits of COPD are the particles present in cigarette smoke, so while this disease is incurable, continuing to smoke after a diagnosis will decrease the effectiveness of treatment efforts and worsen the disease.

The disease can cause coughing that produces large amounts of mucus, wheezing, shortness of breath, tightness in the chest and other symptoms. These symptoms are often long term, when taken into consideration with a patient's smoking history, may point a physician to diagnose COPD.

To diagnose COPD, physicians use spirometry, or a painless test where a technician will have a patient take a deep breath, and blow as hard as possible into a tube that's connected to a small machine. The machine, a spirometer, measures how much air you breathe out and how fast you can blow it — an indicator of lung function. Based on the grade of COPD found, that will help the physician determine how to treat the case.

The most common treatment is the use of bronchodilators, or a medication that helps to relax the muscles around your airways. This makes breathing easier by helping to open a patient's airway. For more severe cases, a physician may use the combination of a bronchodilator along with an inhaled glucocorticosteroid. Steroids help reduce inflammation of the airways, but are not recommended as a singular treatment for COPD.

The damage from COPD cannot be reversed, and there is no cure. Doctors can use a combination of medications and treatments to help limit the symptoms, which can be debilitating and even deadly. Quitting smoking can help lessen the symptoms by stopping the cycle of chronic inflammation.

Current treatments are designed to help manage and improve lung function. The goal of treatment is to also reduce the rate of decline of lung function. While aging causes a natural decline in lung function, with cigarette smoking, the rate of decline is much more rapid, making individuals more susceptible to chronic bronchitis and emphysema, two of the major causes of CPOD.

As physicians, our goal is to intervene with medication to improve lung function and reduce inflammation, and use smoking cessation techniques to help patients quit smoking, and reduce the overall rate of decline of lung function.

The most important thing that a patient can do to reduce the risk of diminishing his or her lung function or developing COPD, is to not smoke. Quitting smoking now can greatly improve your lung function and help prevent COPD and other diseases of the lungs. For those already diagnosed with COPD, stopping smoking is the best treatment to limit debilitating symptoms.

Eli Colón. M.D., Saint Joseph Pulmonary Critical Care Associates, Saint Joseph Hospital, part of KentuckyOne HealthEli Colón. M.D., Saint Joseph Pulmonary Critical Care Associates, Saint Joseph Hospital, part of KentuckyOne Health

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