Chronic obstructive pulmonary disease (COPD) is a long-term lung condition that causes difficulty breathing and affects millions of people worldwide. Despite its significant health burden, COPD remains underdiagnosed in many parts of the world, leading to delays in treatment and poor health outcomes. This article aims to explore the high burden of COPD, its impact on daily life, and how it can be effectively managed with early diagnosis, proper treatment, and lifestyle adjustments.
The high burden of underdiagnosis and limited access to treatment
COPD is often described as a "silent disease" because its symptoms can develop gradually and may be mistaken for other conditions, such as asthma or simply the normal effects of ageing. As a result, many people with COPD are not diagnosed until the disease has progressed significantly. In fact, studies have shown that nearly half of people with COPD remain undiagnosed, particularly in the early stages of the disease.
1,2,3
The burden of underdiagnosis is compounded by limited access to effective treatments. In many low-income and rural areas, healthcare systems may lack the resources for early screening and diagnostic testing, and treatments may not be readily available. This can lead to poor disease management and higher rates of hospitalisation due to exacerbations (sudden worsening of symptoms).
However, when COPD is diagnosed early and managed properly, it is possible to slow the progression of the disease and improve quality of life. The key to effective management is a combination of pharmacological treatments, lifestyle changes, and self-care strategies, such as pulmonary rehabilitation and symptom management techniques.
The impact of COPD
COPD is not just a physical condition but also has profound emotional and social impacts.
The most common symptoms of COPD include:
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Shortness of breath (dyspnoea), especially during physical activity
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Chronic cough and mucus production
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Wheezing and chest tightness
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As the disease progresses, the lungs become less efficient at oxygen exchange, leading to an increasing feeling of breathlessness. This can significantly reduce a person's ability to carry out everyday activities, such as climbing stairs, walking, or even talking. For many people with COPD, simply breathing becomes an exhausting task, and they may feel as though they are constantly fighting for every breath.
The emotional toll of COPD is also considerable. Patients may experience anxiety and depression as they struggle to manage their symptoms and deal with the limitations the disease places on their lives. Social isolation and a sense of loss of independence are common among people living with COPD.
Managing COPD day-to-day: Key strategies for symptom control
Effective management of COPD requires a holistic approach that involves both medical treatments and lifestyle modifications. Below are some of the key strategies for managing the condition on a day-to-day basis:
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Medications
The cornerstone of COPD treatment is medication, which helps control symptoms and prevent exacerbations. Common medications include:
- Bronchodilators: These drugs help relax the muscles around the airways, making it easier to breathe. They can be short-acting (for immediate relief) or long-acting (for daily control).
- Steroids: Inhaled corticosteroids may help reduce inflammation in the airways, especially during flare-ups.
- Phosphodiesterase-4 inhibitors: These help reduce inflammation and relax the airways.
It’s important for people with COPD to follow their doctor's instructions and adhere to their medication regimen to manage symptoms effectively.
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Breathing exercises
Breathing exercises can play a crucial role in easing shortness of breath and reducing the feeling of air hunger. Two common types of breathing techniques that are beneficial for people with COPD are:
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Pursed-lip breathing: This technique helps control breathing and prevents airway collapse. To practice pursed-lip breathing:
- Inhale slowly through your nose.
- Purse your lips as though you are about to whistle.
- Exhale slowly through pursed lips, taking longer to exhale than to inhale.
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Diaphragmatic breathing: This exercise helps strengthen the diaphragm and improve breathing efficiency.
- Sit or lie down in a comfortable position.
- Place one hand on your chest and the other on your abdomen.
- Breathe in slowly through your nose, allowing your abdomen to rise (while keeping your chest still).
- Exhale slowly through your mouth, feeling your abdomen fall.
These exercises help slow down breathing, reduce feelings of panic, and improve lung function. Over time, they can also reduce the frequency and severity of breathlessness.
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Diet and nutrition
Good nutrition is essential for managing COPD. COPD patients are at risk of malnutrition due to several factors, such as decreased appetite, difficulty eating while breathing, and increased energy expenditure due to the effort required for breathing. A balanced diet can help maintain energy levels, improve lung function, and reduce the risk of infections.
Key nutritional tips for people with COPD include:
- Adequate protein intake: Protein is essential for muscle strength, including the muscles used for breathing. Good sources of protein include tilapia, mackerel or tuna, and plant-based options like tofu or tempeh.
- Eat small, frequent meals: Large meals can increase feelings of fullness and make it harder to breathe. Eating smaller, more frequent meals helps to maintain energy levels.
- Stay hydrated: Drinking enough fluids helps to thin mucus, making it easier to cough up and clear from the lungs.
- Focus on anti-inflammatory foods: Turmeric contains curcumin, a potent anti-inflammatory compound, while mackerel and sardines are both rich in omega-3 fatty acids which help reduce inflammation.
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Physical activity
Regular physical activity is one of the most important things you can do to manage COPD. Exercise helps improve lung function, build strength, and reduce breathlessness. However, it is important to choose activities that are appropriate for your fitness level and to avoid overexertion.
Pulmonary rehabilitation programs are highly recommended for people with COPD. These programs provide a structured approach to exercise, education, and emotional support. Exercise training can help increase stamina, improve overall fitness, and reduce symptoms.
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How to support someone with COPD
If you have a loved one with COPD, providing support can be crucial in helping them manage their condition and improve their quality of life. Here are some ways to offer help:
Encourage adherence to treatment
Help remind them to take their medications, attend medical appointments, and follow their doctor’s advice.
Create a comfortable environment
Ensure that their living space is free from dust, smoke, or other irritants that could worsen symptoms.
Offer emotional support
Living with COPD can be isolating. Be there to listen, offer encouragement, and help them stay positive.
Help with physical tasks
COPD can make it difficult to perform daily activities. Offering to help with tasks like shopping, cooking, or cleaning can reduce stress.
DID YOU KNOW?
Spirometry is a simple test where one blows through a tube and is used to confirm a diagnosis of COPD.
However, up to 95% of people with COPD are underdiagnosed around the world, due to the unavailability of spirometry in low- and middle-income countries.4
References
- Chronic obstructive pulmonary disease (COPD). World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)#:~:text=Chronic%20obstructive%20pulmonary%20disease%20(COPD)%20is%20a%20common%20lung%20disease,damaged%20or%20clogged%20with%20phlegm.
- Chronic Obstructive Pulmonary Disease (COPD). Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/8709-chronic-obstructive-pulmonary-disease-copd.
- COPD Prevention. National Heart, Lung, and Blood Institute. Available at: https://www.nhlbi.nih.gov/health/copd/prevention#:~:text=The%20best%20way%20to%20prevent,the%20leading%20cause%20of%20COPD.
- Ho T, Cusack RP, Chaudhary N, Satia I, Kurmi OP. Under- and over-diagnosis of COPD: a global perspective. Breathe (Sheff). 2019;15(1):24-35.
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