A Magazine of People and
Possibilities
Chronic Obstructive Pulmonary
Disorder
by Dr. Raj Rakhra
Chronic obstructive pulmonary disease (COPD),
also known as chronic obstructive airway disease (COAD), is in
a group of diseases characterized by the pathological limitation
of airflow in the airway that is not fully reversible. COPD is
the umbrella term for chronic bronchitis, emphysema, chronic asthma
and a range of other lung disorders. It is most often due to tobacco
smoking, but can be due to other airborne irritants such as coal
dust, asbestos or solvents, as well as from congenital conditions.
COPD and Bronchitis
Acute bronchitis is an inflammation or obstruction in the bronchial
tubes which results in a buildup of mucous, along with coughing,
fever, pain in the chest, fatigue, sore throat and difficulty
breathing. Bronchial spasm, a contraction of the smooth muscle
in the walls of the bronchi may also occur. Swelling of the mucous
membrane and hyper secretion of bronchial glands frequently accompany
Bronchitis that can either be acute or chronic. Acute bronchitis
is usually caused by an infection that can be bacterial, viral,
chlamydial, mycoplasmal or a combination of agents may be the
cause.
Chronic bronchitis results from frequent irritations of the lungs
such as exposure to cigarette smoke, air pollutants or other noxious
and irritant fumes rather than infection. Allergies may also cause
chronic bronchitis that reduce the exchange of oxygen and carbon
dioxide in the lungs. As a result, the heart has to work harder
in an attempt to compensate. Over time this can lead to pulmonary
hyper tension, an enlargement of the heart. Climate factors, viral
infections, unhealthy environments, exposure to dust, cold and
dampness also increase the risk of chronic bronchitis.
Asthma and COPD
Asthma is a condition in which the bronchial tubes in the lungs
react to different stimuli by becoming inflamed. These asthma
triggers vary and may include exercise, cold air, allergens (such
as dust, ragweed, mold, or cat dander), infections, and emotional
reactions. Inflammation of the bronchial airways causes them to
become constricted and narrowed. This narrowing of the airways,
called bronchoconstriction, produces the symptoms of shortness
of breath, tightness in the chest, coughing, and wheezing. Some
people suffer asthma symptoms continuously; others experience
them only if exposed to triggers. Regardless of the cause, severe
asthma is a serious health concern.
Exposure to environmental allergens can trigger asthma symptoms.
Among the most common allergens are microscopic droppings of dust
mites and cockroaches, airborne pollens and molds, plants and
plant proteins, enzymes, and pet dander (minute scales of hair,
feathers, or skin). Exposure to a variety of occupational irritants
(e.g., vapors, dust, gases, fumes, tobacco smoke, air pollution)
also can worsen or cause asthma.
Certain medications may trigger asthma symptoms. Some people
with asthma have attacks triggered by sensitivities or allergies
to some medications such as aspirin, ibuprofen, indomethacin,
naproxen etc. Others react to sulfites (chemicals commonly used
to preserve foods such as tuna, salads, dried apples and raisins,
and beverages such as lemon juice, grape juice, and wine). Other
factors that may contribute to asthma or worsen symptoms include
sinus infections, gastro esophageal reflux disease (GERD), pregnancy,
menstruation, and even the time of day. Asthma also can be induced
by exercise or cold air.
Signs and Symptoms
Inflammation of the bronchial airways causes them to become constricted
and narrowed. Narrowing of the airways, called bronchial constriction,
produces shortness of breath, tightness in the chest, coughing,
and wheezing.
Diagnosis
The diagnosis of asthma usually is based on the patient's symptoms,
medical history, a physical examination, and laboratory tests
that measure pulmonary (lung) function. Doctors typically look
for signs that the patient's airflow is obstructed and that the
obstruction is at least partially reversible.
Emphysema Related COPD
Emphysema is a degenerative lung disease that usually develops
after many years of exposure to cigarette smoke or other toxins
that pollute the air.
This debilitating, often fatal disease is characterized by the
enlargement and destruction of alveoli. The lungs lose elasticity.
As a result, exhaling becomes difficult and air stays trapped
in the lungs. This obstructs the exchange of oxygen and carbon
dioxide with the blood, leading to coughing, breathing difficulties,
wheezing, rapid heartbeat. Most people who are diagnosed with
emphysema are long time smokers. Symptoms may not occur until
middle age, when the person's ability to exercise or physical
activity begins to decline. The patient may start with a productive
cough which becomes worse with time. Regular smoking causes low
level inflammation of the lungs that increases the chance of developing
this disease. This damage becomes worse over time. Persons with
this disease have air sacs in the lungs that are unable to fill
with fresh air.
Symptoms
Shortness of breath, chronic cough, with or without sputum production,
wheezing, decreased ability to exercise, anxiety, unintentional
weight loss, ankle, feet, and leg swelling, fatigue. Physical
examination may show wheezing, decreased breath sounds, or prolonged
exhalation (exhalation takes more than twice as long as inhalation).
The chest may be barrel-shaped. There may be signs of chronically
insufficient oxygen levels in the blood, arterial blood gases
showing low levels of oxygen in the blood (hypoxemia), and high
levels of carbon dioxide (respiratory acidosis)
Smoking cessation
is the most important and effective treatment. Only quitting smoking
can stop the progression of lung damage once it has started. Medications
used to improve breathing, broncho dilators and infections should
be treated when required.
Low-flow oxygen can
be used during exertion, continuously, or at night. Pulmonary
rehabilitation can improve exercise tolerance and quality of life
in the short-term. Oxygenation therapies are very helpful in emphysema
and any other viral respiratory infections.
Ayurvedic Medicine
suggest Vata and Kapha dosha aggravation. Avoiding icy cold
drinks or food, cold windy and humid climate is required to reduce
the aggravation. Expectorants: sitopal powder, honey, curcumin,
boswellia, chavan prasha, ginger and lobelia will help the breathing.
Avoid dairy milk products and fried oily foods.
Astragulus, Ephedra and licorice improve the oxygen function.
Vitami A, C, Pycnoginol or grape seed extract, garlic, Dymethylglycine
will improve the oxygen supply and increase endurance for emphysema
patients.
Acute asthma attack is a serious problem and should always be attended
to by a professional health care provider. Chronic and mild cases
of asthma and bronchitis may find the following products to be
helpful: Quercitin with vitamin C, and bromelain has an anthistamine
effect and can help stop inflammation. Vitamin A is needed for
tissue repair and has an antioxidant effect. Higher doses of vitamin
C protects the lungs and reduces infection. Magnesium may help
to stop acute asthma attacks and have a dilating effect on the
bronchial muscles. Grape seed extract, curcumin and bromelain,
ginger, and boswellia combination will be very helpful. Lobelia,
mahuang may provide quick relief. It should be noted that many
of these herbs should be used with care, especially when used
with other medications or if there are other or multiple diagnosis.
Dr. Rakhra is a Naturopathic Physician, serving Calgary
for more than twenty years and practicing Complementary Medicine since 1964. He is a
Member of Alberta Association of Naturopathic Doctors. Dr. Rakhra's clinic is located at 121 - 14 Street North West in Calgary, Alberta. You
can reach his office at 403-270-7033. Visit his website at: www.aynh.com.
Read more articles by Dr. Rakhra Here.