Obstructive pulmonary disease is a category of respiratory illness characterized by airway obstruction. Many obstructive diseases of the lung are due to narrowing of the smaller bronchus and larger bronchioles, often because of the excessive contraction of the smooth muscle itself. It is generally characterized by inflamed and easily folded airways, obstruction to airflow, respiratory problems and frequent visits to medical and inpatient clinics. Types of obstructive pulmonary disease include; asthma, bronchiectasis, bronchitis and chronic obstructive pulmonary disease (COPD). Although COPD has similar characteristics to all other obstructive pulmonary diseases, such as signs of coughing and wheezing, they are different conditions in terms of disease onset, frequency of symptoms and reversibility of airway obstruction. Cystic fibrosis is also sometimes included in obstructive pulmonary disease.
Video Obstructive lung disease
Diagnosis
The diagnosis of obstructive disease requires several factors depending on the exact disease being diagnosed. But one similarity between them is the FEV1/FVC ratio of less than 0.7, ie the inability to breathe 70% of their breath in one second.
The following is an overview of the major obstructive pulmonary disease. Chronic obstructive pulmonary disease is primarily a combination of chronic bronchitis and emphysema, but may be more or less overlap with all conditions.
Maps Obstructive lung disease
Type
Asthma
Asthma is an obstructive pulmonary disease in which the bronchial tubes (airways) are extra sensitive (hyperresponsive). The airways become inflamed and produce excessive mucus and the muscles around the airways tighten making the airways narrow. Asthma is usually triggered by breathing in objects in the air such as dust or pollen that produce allergic reactions. This can be triggered by other things such as upper respiratory tract infections, cold air, exercise or smoke. Asthma is a common condition and affects over 300 million people worldwide. Asthma causes recurrence of wheezing episodes, shortness of breath, chest tightness, and cough, especially at night or in the morning.
- Exercise-triggered Asthma - is common in people with asthma, especially after participating in outdoor activities in cold weather.
- Occupational Asthma - It is estimated that 2% to 5% of all episodes of asthma may be caused by exposure of a specific sensitization agent at work.
- Nocturnal Asthma - is a characteristic problem in less controlled asthma and is reported by more than two-thirds of patients treated below optimal.
The peak flow meter can record the variation of asthma severity over time. Spirometry, measurement of lung function, can provide an assessment of the severity, reversibility, and variability of air flow restrictions, and help confirm the diagnosis of asthma.
Bronchiectasis
Bronchiectasis refers to abnormal and irreversible dilatation of the bronchus caused by destructive and inflammatory changes in the airway wall. Bronchiectasis has three major anatomic patterns: cylindrical bronchiectasis, varicose bronchiectasis, and cystic bronchiectasis.
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive airway disease (COAD) or chronic airflow restriction (CAL), is a group of diseases characterized by inadequately reversible airflow restraints. Airflow in and out of the lungs is disrupted. It can be measured with breathing apparatus such as peak flow meter or with spirometry. The term COPD includes conditions of emphysema and chronic bronchitis although most patients with COPD have both characteristics of these conditions to varying degrees. Asthma which is a reversible airway obstruction is often considered separate, but many COPD patients also have some degree of reversibility in their airways.
In COPD, there is an increase in airway resistance, indicated by the decrease in forced expiratory volume in 1 second (FEV1) measured by spirometry. COPD is defined as a forced expiratory volume in 1 sec for a forced vital capacity ratio (FEV1/FVC) of less than 0.7. The residual volume, the volume of air remaining in the lungs after full expiration, often increases in COPD, such as total lung capacity, while vital capacity remains relatively normal. Increased total lung capacity (hyperinflation) can produce a clinical feature of "barrel chest" - a chest with large front-to-back diameter that occurs in some individuals with COPD. Hyperinflation can also be seen on the chest x-rays as diaphragmatic flattening.
The most common cause of COPD is smoking. COPD is a gradual progressive condition and usually only develops after about 20 pack-years of smoking. COPD can also be caused by respiration in particles and other gases.
Diagnosis COPD is established through spirometry although other lung function tests may be helpful. Chest x-rays are often instructed to look for hyperinflation and exclude other lung conditions but COPD lung damage is not always seen in chest x-ray. Emphysema, for example, can only be seen on a CT scan.
The main form of long-term management involves the use of inhaled bronchodilators (especially beta and anticholinergic agonists) and inhaled corticosteroids. Many patients end up needing oxygen supplementation at home. In severe cases that are difficult to control, chronic treatment with oral corticosteroids may be necessary, although this is full of significant side effects.
COPD is generally irreversible although lung function can be partially recovered if the patient stops smoking. Smoking cessation is an important aspect of treatment. The pulmonary rehabilitation program involves intensive exercise training combined with education and is effective in improving shortness of breath. Severe emphysema has been treated with pulmonary volume reduction surgery, with some success in carefully selected cases. Lung transplantation is also performed for severe COPD in carefully selected cases.
The lack of alpha 1-antitrypsin is a rare genetic condition that causes COPD (especially emphysema) because of the lack of antitrypsin protein that protects the fragile alveolar walls of protease enzymes released by the inflammatory process.
See also
Restrictive lung disease
References
Source of the article : Wikipedia
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