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Useful facts on COPD (kols)

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Chronic obstructive pulmonary disease (COPD)

Estimates indicate that around 370 000 persons in Norway suffer from COPD. Of these, it is assumed that as many as 280 000 do not know that they are sick. COPD is the fastest developing disease in the world, and before 2020, COPD will be the third biggest cause of death internationally.

What is COPD?

COPD is characterised by the airways becoming permanently constricted, such that it becomes difficult to breathe. This leads to increased effort in breathing and feelings of breathlessness. Typical symptoms include laboured breathing, coughing and bringing up mucus. Physical activity exacerbates the symptoms. In serious cases of COPD it will be difficult to breathe even when resting.

Who gets COPD?

Tobacco smoking is the most significant individual reason for COPD and is estimated to be responsible for two out of three cases in Norway. Six to eight percent of those that suffer from the disease have never smoked and at least 15 percent of cases would never have occurred if it had not been for exposure at work. Hereditary factors also play a role.

On a global basis, it is estimated that approximately 95 percent of persons with COPD are smokers and these have often smoked daily for more than 20 years.

However, recent research shows that there is a three times greater chance of developing COPD if a person has had asthma as a child, than if they have smoked daily and not had asthma.

Read more about the studies here

Diagnosis of COPD

COPD develops gradually, and it can take as long as 30-40 years before the first symptoms appear. Inflammation of the airways leads to constriction and scarring which cannot be detected via a normal X-ray examination. COPD can be diagnosed by a doctor, by measuring lung function (spirometry). The symptoms of COPD are similar to those of asthma, and distinguishing between the two conditions can be difficult.

The intensity of symptoms in COPD can vary. Some individuals have a mild form of the disease – without being particularly restricted in terms of their ability to carry out daily activities, whilst others are invalided and require a continuous supply of oxygen. In some cases, individuals have both COPD and asthma.

 

Incidence

It is estimated that 370 000 Norwegians over the age of 18 years have developed COPD and that 20 000 new cases develop each year. Less than half of these have been diagnosed. The proportion that becomes unwell increases significantly with age. COPD is the disease that is increasing most rapidly, and the World Health Organisation ranks the condition as the world’s 4th leading cause of death. Calculations show that before 2020, COPD will be the world's 3rd most significant cause of death internationally.

What happens in the airways with COPD?

  • Inflammatory changes (inflammation) of the mucosa.
  • Increased quantity of mucus in the bronchi.
  • Spasm (constriction) of the musculature surrounding the bronchi.
    • Destruction of support tissue for small and large airways. In COPD, damage - and eventual destruction - of the support tissue surrounding the bronchi can be observed. This results in a tendency for the bronchi to collapse when the individual breathes out.

Above is an illustration of the lungs. The topmost image shows a normal lung. Below this, the windpipe has thickened connective tissue, making it more constricted, which is typical in cases of COPD. In addition, flimmer hairs, designed to keep the airways open, become weaker and have a tendency to collapse when breathing out.

Above is an illustration with a normal windpipe at the top right. Below this is a windpipe as it appears with COPD, with a thickened connective tissue that makes it more constricted, with weakened flimmer hairs, which is typical for COPD. In addition there is a lot of mucus, something many experience. The mucus makes the passage further constricted and leads to coughing, which in turn makes it even more difficult to breathe.

The difference between asthma and COPD

In asthma, symptoms will occur in the form of separate attacks, often with fluctuations in lung function on a daily basis. With COPD, the symptoms develop gradually, with less variation than with asthma. With asthma, lung function is normal between attacks. With COPD, lung function is gradually reduced over a period of years.

Education

Education is important in order to increase the level of knowledge about COPD, so that it is easier to manage the disease. This knowledge can be acquired from COPD centres or during a stay at a rehabilitation clinic. Some Learning and Managing Centres (LMS) around the country hold various COPD courses. Some of them also have courses designed particularly for carers of persons with COPD. The centres are often linked to hospitals. There is no overview of all the LMS in Norway- contact your local hospital to find out more about these.