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Chronic Obstructive Pulmonary Disease

Introduction

It is a condition characterized by obstruction of the airways (the tubes that carry air in and out of the lungs) which is not fully reversible. It includes chronic bronchitis and emphysema. There is underlying inflammation of the airways, most commonly due to tobacco smoking leading to damage to the lung tissue. It was estimated that the prevalence of COPD in Malaysian men was around 4.7%.

Symptoms

Signs and symptoms of COPD include shortness of breath, chronic cough, excessive phlegm production, wheeze (whistling noise), and chest tightness and reduced exercise tolerance. The patients may also experience tiredness, sleep disturbance and weight loss.

Complications

Physical

  • Frequent lung infections requiring recurrent hospital admissions
  • Respiratory failure
  • Right heart failure
  • Weight loss

Psychological

  • Depression and anxiety
  • Stress to carers

Social

  • Social isolation – due to shortness of breath and reduced exercise tolerance.
  • Financial burden – due to frequent hospital admissions and treatments

Treatment

Non drug treatment

  • Stop smoking – can get help from quit smoking clinics available in some government clinics.
  • Pulmonary rehabilitation – (described below in rehabilitation section)

Drug treatment

  • Medications in the form of tablets, inhalers (pump device delivering medicines into the airways) and/or nebulizers (machine delivering medicine in gaseous form) may improve symptoms.
  • Oxygen treatment may be required in some cases.
  • Antibiotic treatment is usually required in treatment of infection.

Surgery

  • In selected cases, lung surgery may be required.

Prevention

Stop smoking- nicotine replacement therapy may help administration of vaccines (to prevent recurrence of lung infections) ie. Flu and pneumococcal vaccines.

Rehabilitation

Multidisciplinary pulmonary rehabilitation (by doctors, nurses, physiotherapist, and dietitian) involves exercise, disease management training and nutritional advice to help patients stay active and carry out day to day activities. Assessment by clinical psychologist and medical social worker may be helpful in some cases.

 

Last Review : 26 April 2012
Writer : Dr. Joseph Ngeh
  : Dr. Mohd Daud Che Yusof
  : Dr. R. Sukumar a/l Rajaretnam
Reviewed : Dr. George Taye